Persistent Dyspnea in Patients with Long COVID-19 May Indicate Heart Issues

Patients who were hospitalized with COVID-19 continued presenting with dyspnea 1 year after recovering from infection, according to a small study presented at EuroEcho 2021, a scientific congress of the European Society of Cardiology (ESC).

“The findings could help to explain why some patients with long COVID still experience breathlessness one year later and indicate that it might be linked to a decrease in heart performance,” said co-author Maria-Luiza Luchian, MD, PhD student, University Hospital Brussels, Belgium, in an ESC press release.

Luchian and colleagues enrolled 66 patients (mean age, 50 years, 67% men) without a history of cardiovascular or pulmonary disease who were hospitalized with COVID-19 between March and April 2020 at the University Hospital Brussels.

Researchers used spirometry and chest computed tomography (CT) to assess participants’ lung function and possible COVID-19 sequelae 1 year after hospital discharge. Investigators performed transthoracic echocardiography (TTE) and used a new echocardiography-based imaging technique called myocardial work to noninvasively determine total active myocardial performance, providing more precise information on cardiac function than previous methods.

At 1 year after hospital discharge, 23 patients (34.8%) had dyspnea during physical activity, according to the study abstract.

Researchers found that abnormal heart function was independently and significantly associated with persistent exertional dyspnea at 1-year post-discharge, after the team adjusted for age and gender. Furthermore, cardiac imaging showed poorer cardiac performance in participants with dyspnea than without dyspnea at 1 year after hospitalization.

“Myocardial work could be a new echocardiographic tool for early identification of heart function abnormalities in patients with long COVID-19, who might need more frequent and long-term cardiac surveillance,” concluded Luchian in the release. “Future studies including different COVID-19 variants and the impact of vaccination are needed to confirm our results on the long-term evolution and possible cardiac consequences of this disease.”

Reference: Luchian ML, Lochy S, Belsack D, et al. Persistent dyspnea 1 year after COVID - 19 infection in apparently healthy subjects: a potential indicator of subclinical cardiac dysfunction. Abstract presented at EuroEcho 2021, held virtually December 9-11, 2021.