No Link Between Long COVID and Worsening Cardiac Dysfunction - EMJ

No Link Between Long COVID and Worsening Cardiac Dysfunction

RESEARCHERS from the Norwegian University of Science and Technology, Trondheim, Norway, have found that those affected by long COVID did not present with worsened cardiac dysfunction. The cohort study of 182 patients from six major hospitals in Norway did not reveal any evidence of changes to the cardiac structure or function that could be leading to continual symptoms experienced by patients. 

The 182 participants were monitored throughout their hospitalisation due to COVID-19 from February–June 2020. At the 3-month mark, over 50% of patients reported dyspnoea, which endured throughout until the 12-month mark. Study lead Charlotte Ingul, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, explained the results obtained from the echocardiography, with the main pathologies being a low left ventricular (LV) global longitudinal strain (19% of patients at 3 months, and 15% at 12 months), a low LV ejection fraction (16% and 14%), and diastolic dysfunction (13% and 17%). The study authors also noted no correlation between cardiac structure and function and the observed shortness of breath, nor any marked changes to cardiac arrhythmia. 

Previous studies have shown cardiac dysfunction during acute COVID-19 infection, and although the long-term effects of this finding are unclear, the National COVID Cohort Collaborative (N3C) observed a 45% increase in heart failure following severe acute respiratory syndrome coronavirus 2 infection. This result is thought to be attributed to deterioration of the pulmonary and cardiovascular systems that manifest over longer periods of time. 

Highlighting potential limitations of the Norwegian study, Ingul explained: “Although we did not have pre‐COVID echocardiographic data on the participants, these findings suggest that there is limited long‐term cardiac remodelling and progressive dysfunction after hospitalisation for COVID‐19, and that cardiac recovery from the acute disease predominantly occurs within the first 3 months.” Participants were also only eligible for 24-hour echocardiogram monitoring at the 12-month mark if they had presented with an arrhythmia at the 3-month mark. The authors also recognised that the severe acute respiratory syndrome coronavirus 2 variants circulating at the time of the study would not align with those being transmitted today. 

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