Echocardiographic Assessment of Recovered Patients with Mild COVID-19 Infection: A Case-Control Study

Context: Coronavirus disease 2019 (COVID-19) has been revealed as a severe illness with a wide-ranging cardiac manifestation and has a worldwide burden on the health-care system.

Aims: Our aim in this study is to assess the impact of mild COVID-19 infection on cardiac function in patients without previous structural heart disease.

Settings and design: We evaluated 100 outpatients with a history of mild COVID-19 infection without needing hospitalization within 3 weeks to 3 months after recovery from the acute phase of the illness between August 2020 and July 2021.

Subjects and methods: The patients were compared with 105 healthy participants without a history of COVID-19 as the control group. All participants underwent comprehensive transthoracic echocardiography.

Statistical analysis used: Data were analyzed using IBM SPSS statistics 23. For all tests, P < 0.05 was defined as statistically significant.

Results: COVID-19 patients had higher global longitudinal strain (P = 0.001), systolic pulmonary artery pressure (P = 0.008), RV E' (P = 0.049), and RV A' (P = 0.003), while had lower septal tissue velocities (P = 0.01) and left ventricular ejection fraction (EF) (LVEF) (P = 0.03). Abnormal EF (LVEF <55%) was noted in 19% of the COVID-19 patients and 8.6% of the control group (P = 0.03). Moderate or more diastolic dysfunction was noted in 10 COVID-19 patients but only in one participant in the control group (P = 0.005).

Conclusions: Mild COVID-19 infection can result in cardiac functional and structural changes, even in patients without known previous structural heart disease. Echocardiography can be a useful modality for risk assessment and follow-up in patients with COVID-19.