Cardiac Manifestations of Coronavirus Disease 2019 (COVID-19): a Multicenter Cohort Study

Background: This study aimed to investigate the cardiac manifestations of coronavirus disease 2019 (COVID-19). Methods: From February to March 2020, we prospectively and retrospectively enrolled consecutive patients diagnosed with COVID-19. Patient's data such as the demographic characteristics, symptoms, vital signs, laboratory and radiologic findings, electrocardiographic, and echocardiographic data, including the global longitudinal strain (GLS) of both ventricles, were obtained. Results: Forty patients (median age, 58 years; 50% men) were enrolled in the initial analysis. Patients were classified into severe and nonsevere groups based on the current guidelines. The 13 patients in the severe group were significantly older, had a greater prevalence of bilateral pneumonia and leukocytosis, and higher aspartate transaminase levels than patients in the nonsevere group. Patients in the severe group had a slightly lower left ventricular ejection fraction (LVEF) than those in the nonsevere group (median [interquartile range], 61.0% [58.5%, 62.3%] vs. 66.7% [60.6%, 69.8%], P= 0.015). In a subgroup of 34 patients in whom GLS could be analyzed, patients in the severe group had a significantly impaired left ventricular GLS (LVGLS) than those in the nonsevere group (18.1% (-18.8%, -17.1%] vs. -21.7% (-22.9%, -19.9%], P= 0.001). There were no significant differences in total wall (RVGLS(total), -19.3% [-23.9%, -18.4%] vs. -24.3% (-26.0%, -22.6%], P= 0.060) and free wall (RVGLS(fw), -22.7% [-27.2%, 18.6%] vs. -28.8% [-30.4%, -24.1%], P= 0.066) right ventricle GLS (RVGLS). Conclusion: Patients with severe COVID-19 had lower LVEF and LVGLS. RVGLS was not different between patients with severe and nonsevere COVID-19.