People who have had even mild COVID-19 can experience lingering breathlessness, or dyspnea, where it is difficult to catch their breath. In research presented at EuroEcho 2021, a meeting of the European Society of Cardiology, Belgian investigators have discovered heart abnormalities in a small number of people with long COVID who continued having breathlessness during physical exertion a year after being hospitalized for COVID-19.

What The Researchers Did

There is mounting research illustrating patient experiences of long-lasting symptoms following recovery from COVID-19 infection, called long COVID, as well as cardiovascular complications. In this study at University Hospital Brussels, a research team led by Maria-Luiza Luchian, M.D., (a Ph.D. candidate at the hospital), investigated whether long- COVID patients with heart issues were more likely to have breathlessness, which could be extending their breathing difficulties.

• Sixty-six patients who had been hospitalized with COVID-19 and had no previous heart or lung issues were studied.
• Patients had a mean age of 50 years and were mostly men.
• At one year post-hospitalization, patients were assessed for lung function and long- COVID symptoms using chest CT (computed tomography) scanning and spirometry.
• A combination of heart ultrasound and a new imaging method called myocardial work was used to more accurately examine heart function.
• The researchers then looked at the association between heart function and breathlessness.

What They Found

The team discovered that 35% or 23 of 66 patients experienced breathlessness upon exertion after one year from their hospital release.

At one year post-hospitalization and after factoring in age and sex:

• A strong link between abnormal heart function and persistent breathlessness was found.
• Imaging showed that patients with prolonged breathlessness were more likely to have heart issues than those without breathlessness.

What It Means

Luchian says a decline in cardiac output from “subtle” heart abnormalities could explain why long-COVID patients still have breathlessness a year after their hospital release. Myocardial work could be a useful early-detection tool for more timely care of heart issues in long COVID.

She concluded, “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.”

*Welsh, E.T. (2021, December 13). Patients with long COVID-19 may have cardiac complications due to dyspnea after one year. Healio. https://www.healio.com/news/cardiology/20211213/patients-with-long-covid19-may-have-cardiac-complications-due-to-dyspnea-after-1-year