Hidden Danger of COVID-19 Outbreak: Evaluation of Subclinical Myocardial
Dysfunction in Patients with Mild Symptoms
Abstract
Background: The COVID 19 infection, which is caused by the novel
coronavirus SARS-CoV-2, has rapidly emerged as a global public health
issue. This study aimed to evaluate whether subclinical myocardial
dysfunction using left ventricular global longitudinal strain (LVGLS) in
non-hospitalized mildly symptomatic COVID-19 patients. Methods: Fifty
(26 male, 24 female) non-hospitalized COVID-19 patients and 50 age- and
sex-matched healthy volunteers have included in the study. Apical four-,
three-, and two-chamber images were analyzed longitudinally by
conventional methods and speckle tracking echocardiography (STE) for
left ventricle functions. Results: The mean age of the COVID-19 patients
was 39.55±8.96, 52% of them were male. The most prevalent presenting
symptoms were fever (in 34 (68%)), asthenia (in 30 (60%)), loss of
appetite (in 21 (42%)), myalgia (in 20 (40%)), and cough (in 13
(26%)). Plasma levels of C-reactive protein (CRP) were significantly
higher in the COVID-19 patients than in the controls (10.84±12.44 vs.
4.50±2.81, p < 0.001). There was no significant difference
between the groups in terms of standard echocardiography and Doppler
parameters (p>0.05). Left ventricular longitudinal strain
and strain velocity parameters were significantly decreased in COVID-19
patients compared to healthy individuals. LV-GLS values (-21,72 ± 3,85%
vs. -23,11 ± 4,16%; P =0,003) were significantly lower in COVID-19
patients when compared with the healthy controls. Conclusion: Mildly
symptomatic COVID-19 patients also have subclinical myocardial
dysfunction similar to hospitalized patients. STE has the potential for
detecting subclinical LV systolic dysfunction and can provide useful
information on the risk stratification in the mildly symptomatic
COVID-19 population.