Breathlessness in patients with long COVID may signal heart problems

Breathlessness in patients with long COVID may signal heart problems
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A small study suggests that COVID-19 patients who continue to be short of breath during physical activity one year after recovering may have heart problems or damage.

With the increasing evidence of heart problems following a COVID-19 infection and long-lasting symptoms such as dyspnoea (shortness of breath), known as long COVID, there is a growing need to investigate the cause.

The new research was presented at the EuroEcho 2021, the scientific congress of the European Society of Cardiology (ESC).

Are heart problems more common with long COVID?

The study investigated whether subclinical heart abnormalities were more common in long COVID patients with dyspnoea – potentially explaining the reason for their symptoms.

The study included 66 patients without previous heart problems or lung disease who were hospitalised with COVID-19 between March and April 2020 at the University Hospital Brussels. Participants, on average, were 50 years old and 67% were men.

At one-year after hospital discharge, spirometry together with chest computed tomography was used to assess lung function and possible sequela of COVID-19. Cardiac ultrasounds were performed to examine heart function and included a new imaging technique called myocardial work, which provides more precise information on heart function than previous methods.

At one year, the researchers found that 23 patients (35%) had shortness of breath during effort.

“The findings could help to explain why some patients with long COVID still experience breathlessness one year later and indicate that it might be linked to a decrease in heart performance,” said study author Dr Maria-Luiza Luchian of University Hospital Brussels, Belgium.

Heart function and shortness of breath

The researchers examined the association between imaging measures of heart function and shortness of breath one year after adjusting for age and gender. The analysis showed that heart problems were independently and significantly associated with persistent dyspnoea. Cardiac imaging revealed poorer heart performance in patients with versus without dyspnoea; at one year after hospitalisation due to COVID-19.

Dr Luchian said: “Our study shows that more than a third of COVID-19 patients with no history of heart or lung disease had persistent dyspnoea on effort a year after discharge from hospital. When looking in detail at heart function by cardiac ultrasound, we observed subtle abnormalities that might explain the continued breathlessness.”

She concluded: “Myocardial work could be a new echocardiographic tool for early identification of heart function abnormalities in patients with long COVID-19, who might need more frequent and long-term cardiac surveillance. Future studies including different COVID-19 variants and the impact of vaccination are needed to confirm our results on the long-term evolution and possible cardiac consequences of this disease.”



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