Myocardial Dysfunction and Risk of Long COVID in Patients Recovered From Mild and Moderate COVID‐19, 2025, Zhou et al

Myocardial Dysfunction and Risk of Long COVID in Patients Recovered From Mild and Moderate COVID‐19

Binyu Zhou, Yiran Zhang, Shuang Han, Jiqing Zhang, Lin Song, Haiyan Wang

Purpose
Numerous recovered COVID‐19 patients exhibit persistent cardiovascular symptoms. However, the degree of myocardial dysfunction and its associated risk factors remain unclear. This study aims to evaluate myocardial dysfunction in recovered patients and pinpoint predictors of persistent cardiovascular symptoms.

Methods
We reviewed the echocardiograms of patients who recovered from mild or moderate COVID‐19 and presented with cardiovascular symptoms during the Omicron surge. Myocardial strain was analyzed in 546 patients before and after infection, and in 351 prepandemic healthy controls. Clinical follow‐up at 12 months post‐infection was used to evaluated symptom persistence, and multivariable logistic regression was used to identify independent predictors.

Results
Baseline characteristics showed no significant differences between patients and controls (all p > 0.05). Although the left ventricle global longitudinal strain (LVGLS) remained stable post‐infection, significant reductions emerged in regional left ventricle longitudinal strains (LVLS) and all left atrial strains (LAS) (all p < 0.05). Persistent cardiovascular symptoms affected 16.5% (90/546) of patients at 1‐year follow‐up. Multivariate analysis showed that only LA conduit strain (OR = 0.919, 95% CI: 0.857, 0.985, p = 0.017) and basal inferoseptal LVLS (OR = 0.883, 95% CI: 0.792, 0.986, p = 0.026) correlated with persisting cardiovascular symptoms.

Conclusion
Our findings demonstrate that subclinical but persistent COVID‐19‐associated myocardial dysfunction is characterized by regional LVLS impairment and LAS reduction. The identified strain parameters (LAScd and basal inferoseptal LVLS) serve as novel imaging markers for stratifying patients at risk of persistent cardiovascular symptoms. These results advocate for targeted echocardiographic surveillance and early intervention strategies in post‐COVID care pathways.

ClinicalTrials.gov identifier: NCT06170307

Link | PDF (Echocardiography) [Open Access]

 

Describing the patients as recovered is very misleading. It should be either ‘survivor’ or LC/PACS/etc.