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Subclinical left ventricular dysfunction in COVID-19 recovered patients using speckle tracking echocardiography
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  • Sudhanshu Mahajan,
  • Shekhar Kunal,
  • Bhushan Shah,
  • Shobhit Garg,
  • Girish MP,
  • Ankit Bansal,
  • Vishal Batra,
  • Jamal Yusuf,
  • Saibal Mukhopadhyay,
  • Suresh Kumar,
  • Sanjay Tyagi,
  • Anubha Gupta,
  • Mohit Gupta
Sudhanshu Mahajan
GB Pant Hospital
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Shekhar Kunal
GB Pant Hospital
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Bhushan Shah
GB Pant Hospital
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Shobhit Garg
Maulana Azad Medical College
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Girish MP
GB Pant Hospital
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Ankit Bansal
GB Pant Hospital
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Vishal Batra
GB Pant Hospital
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Jamal Yusuf
GB Pant Hospital
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Saibal Mukhopadhyay
GB Pant Hospital
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Suresh Kumar
Maulana Azad Medical College
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Sanjay Tyagi
GB Pant Hospital
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Anubha Gupta
Indraprastha Institute of Information Technology Delhi
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Mohit Gupta
GB Pant Hospital
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Abstract

Objectives: Myocardial injury during active coronavirus disease-2019 (COVID-19) infection is well described however, its persistence during recovery is unclear. We assessed left ventricle (LV) global longitudinal strain (GLS) using speckle tracking echocardiography (STE) in COVID-19 recovered patients and studied its correlation with various parameters.Methods: A total of 134 subjects within 30-45 days post recovery from COVID-19 infection and normal LV ejection fraction were enrolled. Routine blood investigations, inflammatory markers (on admission) and comprehensive echocardiography including STE were done for all. Results: Of the 134 subjects, 121 (90.3%) were symptomatic during COVID-19 illness and were categorized as mild: 61 (45.5%), moderate: 50 (37.3%) and severe: 10 (7.5%) COVID-19 illness. Asymptomatic COVID-19 infection was reported in 13 (9.7%) patients. Subclinical LV and right ventricle (RV) dysfunction were seen in 40 (29.9%) and 14 (10.5%) patients respectively. Impaired LVGLS was reported in 1 (7.7%), 8 (13.1%), 22 (44%) and 9 (90%) subjects with asymptomatic, mild, moderate and severe disease respectively. LVGLS was significantly lower in patients recovered from severe illness (mild: -21 ± 3.4%; moderate: -18.1 ± 6.9%; severe: -15.5 ± 3.1%; P < 0.0001). Subjects with reduced LVGLS had significantly higher interleukin-6 (P < 0.0001), C-reactive protein (P = 0.001), lactate dehydrogenase (P = 0.009) and serum ferritin (P = 0.03) levels during index admission. Conclusions: Subclinical LV dysfunction was seen in nearly a third of recovered COVID-19 patients while 10.5% had RV dysfunction. Our study suggests a need for closer follow-up among COVID-19 recovered subjects to elucidate long-term cardiovascular outcomes.

Peer review status:IN REVISION

25 May 2021Submitted to Echocardiography
26 May 2021Assigned to Editor
26 May 2021Submission Checks Completed
01 Jun 2021Reviewer(s) Assigned
14 Jun 2021Review(s) Completed, Editorial Evaluation Pending
18 Jun 2021Editorial Decision: Revise Major