Contribution of transthoracic echocardiography in post Covid-19 patients

INTRODUCTION: The coronavirus is a major emerging public health problem. This virus induces a respiratory disease as well as extra-respiratory diseases, mainly of the heart. The evolution of the cardiac damage caused by Covid-19 is still unknown and poorly studied. OBJECTIVE: Our objective is to study the cardiac repercussions of the Covid-19 virus by transthoracic echocardiography (TTE) in post-infection patients. METHOD: We conducted a prospective study of patients diagnosed with Covid-19 pneumopathy, who were hospitalized at Fattouma Bourguiba Hospital in Monastir during the period from January 2021 to June 2021.TTE was performed after discharge from the hospital, in the echocardiography laboratory of the Cardiology Department B of the Fattouma Bourguiba University Hospital of Monastir. Demographic characteristics, scanographic and biological data, intra-hospital evolution were collected from the patients’ medical records. RESULTS: In our study, we included 61 patients. TTE was performed in a mean of 61.3 days after Covid infection. For left ventricular (LV) study, the mean LV ejection fraction (LVEF) was 63.2 ± 6.7%. The LV was dilated in 03 (4.9%) cases. LV end-diastolic diameter averaged 44.5 ± 5.7 mm. Global longitudinal LV Strain averaged −17 ± 3.6% and was impaired in 27 (44.3%) patients. For the right ventricular (RV) study, RV systolic dysfunction was observed in 03 (4.9%) cases. The RV was dilated in 04 (6.6%) cases. Pulmonary hypertension (PAH) was found in 21 (34.4%) cases. The longitudinal Strain of the free wall of the VD was on average −19.4 ± 5.2% and impaired in 32 (52%) patients. For the analytical study, the alteration of the LV Strain was correlated with male gender (P = 0.007), ventral decubitus (VD) positioning (P = 0.019) and hospitalization in an intensive care unit (P = 0.045) (protective effect in the latter two cases). The presence of PAH was correlated with the antecedent of arterial hypertension (P = 0.014) and the VD positioning (P = 0.008). Impaired RV Strain was correlated with male gender (P < 0.001). CONCLUSION: In post-Covid-19 patients, LV and DV Strain functions are altered on average, despite normal LVEF and RV systolic function in the majority of patients.