Mid-term subclinical myocardial injury detection in patients who recovered from COVID-19 according to pulmonary lesion severity

  1. Ikram Chamtouri
  2. Rania Kaddoussi
  3. Hela Abroug
  4. Mabrouk Abdelaaly
  5. Taha Lassoued
  6. Nesrine Fahem
  7. Saoussen Cheikh'Hmad
  8. Asma Ben Abdallah
  9. Walid Jomaa
  10. Khaldoun Ben Hamda
  11. Faouzi Maatouk

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Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2) may cause damage to the cardiovascular system during the acute phase of the infection. However, recent studies reported mid- to long-term subtle cardiac injuries after recovering from acute coronavirus disease 2019 (COVID-19). This study aimed to determine the relationship between the severity of chest computed tomography (CT) lesions and the persistence of subtle myocardial injuries at mid-term follow-up of patients who recovered from COVID-19 infection.

Methods

All patients with COVID-19 were enrolled prospectively in this study. Sensitive troponin T (hsTnT) and chest CT scans were performed on all patients during the acute phase of COVID-19 infection. At the mid-term follow-up, conventional transthoracic echocardiograph and global longitudinal strain (GLS) of the left and right ventricles (LV and RV) were determined and compared between patients with chest CT scan lesions of < 50% (Group 1) and those with severe chest CT scan lesions of greater or equal to 50% (Group 2).

Results

The mean age was 55 ± 14 years. Both LV GLS and RV GLS values were significantly decreased in group 2 ( p = 0.013 and p = 0.011, respectively). LV GLS value of more than −18 was noted in 43% of all the patients, and an RV GLS value of more than −20 was observed in 48% of them. The group with severe chest CT scan lesions included more patients with reduced LV GLS and reduced RV GLS than the group with mild chest CT scan lesions [(G1:29 vs. G2:57%, p = 0.002) and (G1:36 vs. G2:60 %, p = 0.009), respectively].

Conclusion

Patients with severe chest CT scan lesions are more likely to develop subclinical myocardial damage. Transthoracic echocardiography (TTE) could be recommended in patients recovering from COVID-19 to detect subtle LV and RV lesions.

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  1. Version published to 10.3389/fcvm.2022.950334
  2. ScreenIT

    SciScore for 10.1101/2022.03.14.22272130: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: All participants had signed an informed consent.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    RV GLS more than -20% was considered as pathological [6] Statistical analysis: Statistical analyses were performed using SPSS (Statistical Program for Social Sciences) version 20.0.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)
    Statistical Program
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Study limitations: Our study has some limitations. First, three dimension echocardiography as well as circonferencial and radial strain were not performed. Second, echocardiography was not performed during acute phase of COVID-19 infection. Moreover, cardiac magnetic resonance imaging and cardiac computed tomography imaging were not performed.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2022.03.14.22272130v1 on medRxiv