Early Cardiopulmonary Disease Indicators in Young Adults With Long COVID: A Scoping Review of the Clinical Use of Ultrasonography

Objective: This scoping review aimed to summarize the cardiopulmonary implications of long COVID in young adults (ages 18-25) utilizing lung and cardiac sonography to identify subclinical abnormalities. Materials and Methods: A comprehensive literature search was conducted across six databases (PubMed, MEDLINE, Embase, CINAHL, Scopus, and Web of Science) from 2020 to August 2024, following Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Review (PRISMA-ScR) guidelines. The search strategy included terms related to “echocardiography,” “ultrasonography,” and “post-acute COVID-19 syndrome.” Studies were screened using Covidence software, focusing on young adults with confirmed COVID-19 who underwent sonographic evaluation in the post-acute phase. Of 583 articles identified, six met the inclusion criteria. Results: Included studies varied in design, comprising case series and prospective observational studies. Pulmonary findings include ventilatory inefficiency in athletes despite preserved exercise capacity, and pleural thickening and fragmentation were present. Echocardiographic evaluations showed constriction-like features, impaired left atrial strain, and reduced global longitudinal strain, in individuals with mild infections. Conclusion: Sonography can play a crucial role in identifying subclinical abnormalities in young individuals with long COVID. These findings underscore the need for routine imaging assessments to guide clinical management and inform rehabilitation strategies. Longitudinal studies are warranted to establish standardized imaging protocols and to better understand the long-term implications of COVID-19.