Work

Elevated Risk of Long‐Term Decline in Left Ventricular Ejection Fraction After COVID‐19

Year: 2025

Type: article

Abstract: BACKGROUND: COVID-19 has been linked to cardiovascular complications, but its long-term impact on left ventricular (LV) function is unclear. We investigated whether SARS-CoV-2 infection is associated with increased risk of LV ejection fraction (LVEF) decline and whether vaccination mitigates this risk. METHODS: In this retrospective study, we included patients with COVID-19, normal baseline LVEF (≥50%), and at least one follow-up echocardiogram from 2016 to 2024. Outcomes were LVEF dropping <50%, 40%, and 30%. Multivariable Cox models adjusted for demographics, comorbidities, vaccination status, and baseline LVEF. Associations with acute-phase blood biomarkers were examined. RESULTS: <0.005) and higher rates of LVEF decline <50%, 40%, and 30%. Both hospitalized (adjusted hazard ratio [aHR], 1.57 [1.30-1.91]) and non-hospitalized (aHR, 1.48 [1.18-1.85]) patients with COVID-19 had greater risk of LVEF <50% versus controls; only hospitalized patients had significantly increased risk of LVEF<40% (aHR, 1.81 [1.35-2.43]) and <30% (aHR, 2.79 [1.72-4.54]). Vaccination was not significantly associated with LVEF decline. Baseline LVEF, older age, male sex, history of heart failure, myocardial infarction, and chronic kidney disease were associated with greater risk. Elevated troponin, B-type natriuretic peptide, D-dimer, and thrombocytopenia predicted greater risk in hospitalized patients with COVID-19. CONCLUSIONS: SARS-CoV-2 infection is associated with long-term LVEF declines, especially in hospitalized patients. Vigilant cardiac surveillance may be needed in survivors of COVID-19 to mitigate progressive dysfunction.

Source: Journal of the American Heart Association

DOI: 10.1161/jaha.125.043976

Authors: Roham Hadidchi, Ekram Ali, Hannah Piskun, Sonya Henry, Lili Zhang, Tim Q Duong

Institutions: Albert Einstein College of Medicine, Montefiore Health System

Language: English

Topic: COVID-19 Clinical Research Studies

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,810