Cardiac Manifestations of Coronavirus Disease 2019 (COVID-19): a Multicenter Cohort Study

• Published in: Journal of Korean medical science 2020, 35(40), , pp.1-13
• Main Authors: Kim, Minkwan, Nam, Jong Ho, Son, Jang Won, Kim, Sun Oh, Son, Nak Hoon, Ahn, Chul Min, Shim, Chi Young, Hong, Geu Ru, Kim, In Cheol, Choi, Jinwoo, Kang, Seung Mo, Choi, Yeoung Ho, Yoon, Hae Kyoung, Uhm, Jae Sun, Jung, In Hyun
• Format: Article
• Language: English
• Subjects: Adult; Aged; Betacoronavirus; Clinical Laboratory Techniques; Coronavirus Infections - complications; Coronavirus Infections - diagnosis; COVID-19; COVID-19 Testing; Echocardiography; Electrocardiography; Female; Heart - physiopathology; Heart Diseases - diagnosis; Heart Diseases - virology; Heart Ventricles; Hospitalization; Humans; Male; Middle Aged; Observer Variation; Original; Pandemics; Pneumonia, Viral - complications; Pneumonia, Viral - diagnosis; Prospective Studies; Reproducibility of Results; Retrospective Studies; SARS-CoV-2; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - virology; Ventricular Function, Left; 의학일반
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2020.35.e366

This study aimed to investigate the cardiac manifestations of coronavirus disease 2019 (COVID-19). From February to March 2020, we prospectively and retrospectively enrolled consecutive patients diagnosed with COVID-19. Patient's data such as the demographic characteristics, symptoms, vital signs, laboratory and radiologic findings, electrocardiographic, and echocardiographic data, including the global longitudinal strain (GLS) of both ventricles, were obtained. Forty patients (median age, 58 years; 50% men) were enrolled in the initial analysis. Patients were classified into severe and nonsevere groups based on the current guidelines. The 13 patients in the severe group were significantly older, had a greater prevalence of bilateral pneumonia and leukocytosis, and higher aspartate transaminase levels than patients in the nonsevere group. Patients in the severe group had a slightly lower left ventricular ejection fraction (LVEF) than those in the nonsevere group (median [interquartile range], 61.0% [58.5%, 62.3%] vs. 66.7% [60.6%, 69.8%], = 0.015). In a subgroup of 34 patients in whom GLS could be analyzed, patients in the severe group had a significantly impaired left ventricular GLS (LVGLS) than those in the nonsevere group (-18.1% [-18.8%, -17.1%] vs. -21.7% [-22.9%, -19.9%], = 0.001). There were no significant differences in total wall (RVGLStotal, -19.3% [-23.9%, -18.4%] vs. -24.3% [-26.0%, -22.6%], = 0.060) and free wall (RVGLSfw, -22.7% [-27.2%, -18.6%] vs. -28.8% [-30.4%, -24.1%], = 0.066) right ventricle GLS (RVGLS). Patients with severe COVID-19 had lower LVEF and LVGLS. RVGLS was not different between patients with severe and nonsevere COVID-19.