Echocardiographic changes after COVID-19 infection with lung damage and their association with manifestations of post-COVID syndrome (prospective 6-month follow-up)

Background. Current and past COVID-19 infection can provoke and aggravate the course of cardiovascular diseases, initiating the processes of thrombosis, inflammation and fibrinogen synthesis, affecting the pleuropericardial space, increasing the load on the right heart. The staging of the infectious process requires prospective studies to verify the nature of heart damage and its relationship with clinical manifestations and prognosis in each phase.
The aim. To identify the features of heart damage after past COVID-19 infection with lung damage in practically healthy people, their condition dynamics during a 6-month prospective observation, and compare them with the clinical manifestations of post-COVID syndrome.
Materials and methods. A closed cohort prospective (6-month) clinical and echocardiographic study of 100 patients was conducted. The echocardiographic study data were compared with the clinical manifestations of post-COVID syndrome.
Results. In the first month of observation, the main clinical manifestations in patients after the COVID-19 infection were general weakness, shortness of breath during physical exertion, swelling of the lower extremities, palpitations, arterial hypertension, thoracic pain, dilation of the left atrium and right ventricle on echocardiography, increased pressure in the pulmonary artery, signs of impaired relaxation of the left ventricle, valvular regurgitation, the presence of fluid in the pericardial cavity, with positive dynamics by the 6th month of observation. Echocardiography indicators are reliably associated with shortness of breath, general weakness, palpitations, increased blood pressure, and swelling of the legs.
Conclusion. The first month after the COVID-19 infection, in the studied group of patients, echocardiography is characterized by dilation of the heart chambers, increased systolic pressure in the pulmonary artery and valvular regurgitation, impaired diastolic function of the left ventricle and the presence of fluid in the pericardial cavity with stabilization of the indicators by the sixth month. A relationship was found between echocardiography parameters and clinical manifestations.

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