Long-Term Echocardiographic Findings in COVID-19 Patients: Insights from a Two-Year Follow-up Study

Background: Myocardial involvement is a significant early manifestation of coronavirus pandemic (COVID-19), with studies indicating that up to 30% of patients may experience irreversible myocardial damage. Objectives: This study aimed to evaluate the echocardiographic parameters of COVID-19 patients over a two-year follow-up period. Methods: Hospitalized COVID-19 patients at Modarres Hospital, Tehran, Iran, were selected through retrospective medical record analysis. Various echocardiographic parameters were assessed at baseline and during the two-year follow-up, including left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), left Atrial Volume Index (LAVi), and right ventricular end-diastolic dimension (RVEDD). A paired sample t-test was used to compare primary and secondary echocardiographic variables. Results: Echocardiographic analysis revealed significant improvements in various parameters over the two-year follow-up. The E/A ratio increased from 1.09 ± 0.27 to 1.15 ± 0.23 (P = 0.01), and left ventricular global longitudinal strain (LVGLS) improved from -19.24 ± 5.18% to -20.38 ± 3.59% (P = 0.005). Additionally, RVEDD decreased from 28.07 ± 4.31 mm to 27.32 ± 4.73 mm (P = 0.003), while the fractional area change (FAC) increased from 46.6 ± 9.16% to 47.54 ± 7.9% (P = 0.02). S-velocity increased from 12.16 ± 2.32 cm/s to 13.02 ± 2.2 cm/s (P = 0.001), systolic pulmonary artery pressure (SPAP) decreased from 28.48 ± 7.56 mmHg to 26 ± 6.7 mmHg (P = 0.001), and right ventricular global longitudinal strain (RVGLS) showed a significant change from -22.47 ± 7.22% to -23.04 ± 3.23% (P = 0.001). Conclusions: While most echocardiographic parameters remained normal, the study found notable recovery in several measures two years post-hospitalization. These findings underscore the importance of long-term cardiovascular monitoring for COVID-19 survivors, highlighting the potential reversibility of myocardial involvement associated with the infection. This study provides valuable insights into long-term echocardiographic changes in COVID-19 patients, indicating potential reversibility of myocardial involvement.