The journal of personalized medicine recently published a study (14/11/23) which assessed echocardiographic abnormalities and symptom burden in 203 individuals with long COVID without pre-existing cardiac disease. Overall, long COVID symptoms and quality of life scores were not different between those with post-COVID dysautonomia (PCD) and those unclassified.
16.5% had reduced left ventricular (LV) size. Stroke volume was lower in the PCD subgroup compared to unclassified. LV size measures did not differ between groups. Diastolic dysfunction, LV hypertrophy, and other abnormalities were uncommon.
Of 200 included, 44 (22%) had PCD based on symptoms/testing. The remaining 156 (78%) were unclassified long COVID. Patient-reported outcomes for fatigue, breathlessness, quality of life, disability, anxiety and depression were similar between PCD and unclassified groups.
Most reported reduced moderate/vigorous physical activity after COVID-19. Those reporting reduced activity had smaller LV volumes and stroke volumes. Smaller LV mass index correlated with worse fatigue.
Despite overlap in symptoms and cardiac features, only 22% of individuals were diagnosed with PCD. This suggests under-recognition of dysautonomia in long COVID. Cardiac atrophy correlates with reduced activity and fatigue but is not a sole biomarker for PCD.
In conclusion, most individuals with long COVID did not have cardiac abnormalities on echocardiography. Improved recognition and care of PCD in long COVID will require better biomarkers than echocardiography alone.
You can read the full report here.