Abstract:
Despite the prevalence of dysautonomia in people with Long COVID, it is currently unknown whether Long COVID dysautonomia is routinely accompanied by structural or functional cardiac alterations. In this retrospective observational study, the presence of echocardiographic abnormalities was assessed. Left ventricular (LV) chamber sizes were correlated to diagnostic categories and symptoms via standardized patient-reported outcome (PRO) questionnaires. A total of 203 individuals with Long COVID without pre-existing cardiac disease and with available echocardiograms were included (mean age, 45 years; 67% female). Overall, symptoms and PRO scores for fatigue, breathlessness, quality of life, disability, anxiety and depression were not different between those classified with post-COVID dysautonomia (PCD, 22%) and those unclassified (78%). An LV internal diameter at an end-diastole z score < -2 was observed in 33 (16.5%) individuals, and stroke volume (SV) was lower in the PCD vs. unclassified subgroup (51.6 vs. 59.2 mL, 95% C.I. 47.1-56.1 vs. 56.2-62.3). LV end-diastolic volume (mean diff. (95% CI) -13 [-1--26] mL, p = 0.04) and SV (-10 [-1--20] mL, p = 0.03) were smaller in those individuals reporting a reduction in physical activity post-COVID-19 infection, and smaller LVMI was weakly correlated with worse fatigue (r = 0.23, p = 0.02). The majority of individuals with Long COVID report shared symptoms and did not demonstrate cardiac dysfunction on echocardiography.
摘要:
尽管长型COVID患者普遍存在自主神经障碍,目前尚不清楚长期COVID自主神经失调是否经常伴有结构或功能心脏改变。在这项回顾性观察研究中,评估了超声心动图异常的存在.通过标准化的患者报告结果(PRO)问卷,将左心室(LV)室大小与诊断类别和症状相关。共纳入203例长COVID患者,没有预先存在的心脏病,并且有可用的超声心动图(平均年龄,45岁;67%为女性)。总的来说,疲劳的症状和PRO评分,呼吸困难,生活质量,残疾,焦虑和抑郁在COVID后自主神经障碍分类中没有差异(PCD,22%)和未分类的(78%)。在33例(16.5%)个体中观察到左心室内径在舒张末期z评分<-2时,PCD中的每搏输出量(SV)较低。未分类亚组(51.6vs.59.2mL,95%C.I.47.1-56.1vs.56.2-62.3)。左心室舒张末期容积(平均差异。(95%CI)-13[-1--26]mL,p=0.04)和SV(-10[-1--20]mL,p=0.03)在报告COVID-19感染后身体活动减少的个体中更小,LVMI越小,疲劳越差(r=0.23,p=0.02)。大多数患有长型COVID的个体报告有共同的症状,并且在超声心动图上没有表现出心功能障碍。