TDNet Discover

Background: When COVID-19 was first identified in December of 2019, it was unclear if there were any lasting effects. Research has shown that those who recovered from COVID-19 can develop long-COVID or post-COVID conditions. Cardiovascular injury has been observed in numerous adult patients throughout post-recovery from acute COVID-19 illness. However, there is a lack of evidence regarding the prevalence of these cardiovascular effects. Purpose: This research sought to determine the prevalence of adult patients who develop cardiovascular injury after recovering from COVID-19 and which patient population is at a greater risk of these complications. Methods: An evidence-based clinical review was performed by three researchers using the databases PubMed, CINAHL Complete, and Medline Complete. Three articles were selected based on the following inclusion criteria: adults, cardiovascular symptoms, recovered from COVID-19, symptoms within 12 months of recovery, and assessed as good quality. Studies with pregnant women or prior cardiovascular disease were excluded from this research. An Excel tool was utilized to systematically extract key data from each included study and reviewed by an additional researcher for accuracy. Results: CMR results from patients recovered from COVID-19 showed an increased number of TI and T2 abnormalities, pericardial effusion, and increased LGE. Cardiac manifestations seen after recovery from COVID-19 were most commonly heart palpitations and tachycardia. Echocardiogram abnormalities seen after recovery from COVID-19 were diastolic dysfunction, left ventricular ejection fraction, pericardial effusion, pulmonary hypertension, reduced global longitudinal strain, global hypokinesis, and left ventricular hypertrophy. However, these findings were only seen in 17% of patients. There was an increased prevalence of abnormal CMR v findings in patients with undetermined cardiac enzymes versus normal cardiac enzymes. However, elevated cardiac enzyme results were inconclusive. Elevated troponin and NT-proBNP results ranged from about 3.5% to 10%, respectively. ECG after recovery from COVID also presented inconclusive results. T wave changes, right bundle branch block, ST segment changes, and sinus tachycardia were all observed. However, it was more common to find no ECG abnormalities post-COVID recovery. Finally, patients who recovered from COVID-19 may be at an increased risk of experiencing major cardiovascular adverse events, such as myocardial infarction, heart failure, arrhythmia, and stroke. In 47,780 patients who recovered from COVID19, 4.8% of patients experienced at least one of these major cardiovascular events. CMR abnormalities were found to be less common in athletes compared to non-athletes, which was an unexpected finding.