Cardiac symptoms persist in 10% of patients with long-term COVID-1

In a recent study posted on medrex sib*Preprint server, researchers described long-term cardiac symptoms associated with coronavirus disease 2019 (COVID-19).

Recent studies have shown that long-term cardiac symptoms associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can persist for months or years. Symptoms such as chest discomfort, inflammatory heart disease, and arrhythmias are frequent. Myocardial inflammation, or myocarditis, which can be caused directly by viral infection, can progress to asymptomatic or frank myocardial dysfunction with or without electrophysiological abnormalities with long-term consequences. I have. The intensity and duration of these cardiac symptoms vary from patient to patient. Detecting its risk factors is an important and active area of ​​research that can inform the monitoring and treatment of such conditions and reduce the burden of eventual illness and death in COVID-19 survivors.

study: Long-term cardiac symptoms after COVID-19: a systematic review and meta-analysis.Image Credit: Kateryna Kon / Shutterstock

About research

In this study, researchers assessed and synthesized relevant information from studies describing long-term cardiac symptoms observed after COVID-19.

The team performed a systematic review according to the priority reporting items of the Systematic Reviewers and Meta-Analysis (PRISMA) criteria. Long-term COVID-19 was described as symptoms lasting more than 4 weeks from the date of follow-up index, including symptom onset, hospitalization, and discharge. Additionally, the team conducted initial searches on two preprint servers and his seven electronic databases between 1 January 2020 and 10 May 2021. screening procedure.

A modified version of the Newcastle-Ottawa Scale (NOS) assesses the quality of seven components of each study, including sample size, sample representativeness, exposure assessment, covariate assessment, outcome assessment, statistical analysis, and follow-up was designed to The quality of each item was evaluated as “good”, “average”, and “bad”, and a score was given. The team adopted R (version 4.2.2) for all analyses. The percentage of commonly observed cardiac symptoms was calculated as the proportion of her COVID-19 survivors reporting a specific cardiac symptom per total percentage of COVID-19 survivors.

result

The current systematic review examined 101 studies related to long-term cardiac conditions after COVID-19, 92 of which provided sufficient data for meta-analysis. These studies evaluated 49 distinct long-term cardiac symptoms observed after COVID-19, with chest discomfort and arrhythmias being the best studied symptoms. More than two-thirds of all studies included prospective cohorts, 14 were retrospective and 15 were cross-sectional. Most studies included online surveys, community studies, and multi- or single-hospital studies.

About 60% of the studies had sample sizes between 100 and 999 participants, and 28% included at least 1,000 participants. The majority of studies clinically confirmed SARS-CoV-2 infection. Long-term cardiac symptoms were clinically examined or reported by patients. The index days of the follow-up period differed between studies. In addition, inpatients were recruited in 45 studies, outpatients in 15 studies, and inpatients and outpatients in 35 studies. Although the majority of studies included his COVID-19 patients regardless of severity, the tools used to measure severity varied considerably.

More than 5 studies have reported 10 cardiac conditions, including chest discomfort, arrhythmia, cardiac abnormalities, hypertension, myocardial injury, stroke, thromboembolism, heart failure, myocarditis, and coronary artery disease. Both random-effects and fixed-effects meta-analyses were also performed for these symptoms. All symptoms showed significant variation between studies. A random-effects model accounted for pooled proportions of cardiac symptoms, including chest pain, hypertension, arrhythmia, cardiac abnormalities, thromboembolism, myocardial injury, stroke, coronary artery disease, myocarditis, and heart failure.

After stratification, heterogeneity remained significantly higher in most symptoms from strata. Studies with the lowest quality score, weakest sampling strategy, weakest cross-sectional approach, and smallest sample size showed the highest prevalence of both conditions. For example, the percentage of his COVID-19 survivors who experienced chest discomfort varied from 21.32% for low quality, 9.26% for medium quality, and 4.04% for high quality score analyses. Similar trends were observed for other symptoms. However, the low proportion of studies in some strata hampered formal analysis.

Conclusion

The findings of the study highlight a range of cardiac symptoms observed after COVID-19, many of which can last for months or even a year. There is considerable variability in study design, and there is wide variability in the proportions of symptoms reported by study characteristics. The researchers believe limitations of existing research have prevented him from furthering his knowledge of COVID-19 at this time. The current study demonstrated the need for quality research on his COVID-19 over time and long-term cardiac monitoring for COVID-19 survivors.

*Important Notices

medrex sib We publish a non-peer-reviewed, preliminary scientific report and should not be taken as conclusive, to guide clinical practice/health-related actions, or to be treated as established information.