Article ; Online: Cardiac sequelae after coronavirus disease 2019 recovery: a systematic review.
2021 Volume 27, Issue 9, Page(s) 1250–1261
Abstract: Background: Coronavirus disease 2019 (COVID-19) has been implicated in a wide spectrum of cardiac ... manifestations after COVID-19 recovery.: Exposure: Severe acute respiratory syndrome coronavirus 2 infection ... manifestations following the acute phase of the disease.: Objectives: To assess the range of cardiac sequelae ...
| Abstract | Background: Coronavirus disease 2019 (COVID-19) has been implicated in a wide spectrum of cardiac manifestations following the acute phase of the disease. Objectives: To assess the range of cardiac sequelae after COVID-19 recovery. Data sources: PubMed, Embase, Scopus (inception through 17 February 2021) and Google scholar (2019 through 17 February 2021). Study eligibility criteria: Prospective and retrospective studies, case reports and case series. Participants: Adult patients assessed for cardiac manifestations after COVID-19 recovery. Exposure: Severe acute respiratory syndrome coronavirus 2 infection diagnosed by PCR. Methods: Systematic review. Results: Thirty-five studies (fifteen prospective cohort, seven case reports, five cross-sectional, four case series, three retrospective cohort and one ambidirectional cohort) evaluating cardiac sequelae in 52 609 patients were included. Twenty-nine studies used objective cardiac assessments, mostly cardiac magnetic resonance imaging (CMR) in 16 studies, echocardiography in 15, electrocardiography (ECG) in 16 and cardiac biomarkers in 18. Most studies had a fair risk of bias. The median time from diagnosis/recovery to cardiac assessment was 48 days (1-180 days). Common short-term cardiac abnormalities (<3 months) included increased T1 (proportion: 30%), T2 (16%), pericardial effusion (15%) and late gadolinium enhancement (11%) on CMR, with symptoms such as chest pain (25%) and dyspnoea (36%). In the medium term (3-6 months), common changes included reduced left ventricular global longitudinal strain (30%) and late gadolinium enhancement (10%) on CMR, diastolic dysfunction (40%) on echocardiography and elevated N-terminal proB-type natriuretic peptide (18%). In addition, COVID-19 survivors had higher risk (risk ratio 3; 95% CI 2.7-3.2) of developing heart failure, arrythmias and myocardial infarction. Conclusions: COVID-19 appears to be associated with persistent/de novo cardiac injury after recovery, particularly subclinical myocardial injury in the earlier phase and diastolic dysfunction later. Larger well-designed and controlled studies with baseline assessments are needed to better measure the extent of cardiac injury and its clinical impact. |
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| MeSH term(s) | Adult ; COVID-19/complications ; COVID-19/diagnosis ; COVID-19 Nucleic Acid Testing ; Echocardiography ; Electrocardiography ; Heart Diseases/epidemiology ; Heart Diseases/etiology ; Humans ; Magnetic Resonance Imaging, Cine ; SARS-CoV-2/genetics ; SARS-CoV-2/isolation & purification | ||||||||||
| Language | English | ||||||||||
| Publishing date | 2021-06-23 | ||||||||||
| Publishing country | England | ||||||||||
| Document type | Journal Article ; Systematic Review | ||||||||||
| ZDB-ID | 1328418-6 | ||||||||||
| ISSN | 1469-0691 ; 1470-9465 ; 1198-743X | ||||||||||
| ISSN (online) | 1469-0691 | ||||||||||
| ISSN | 1470-9465 ; 1198-743X | ||||||||||
| DOI | 10.1016/j.cmi.2021.06.015 | ||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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