Impaired Cardiovascular Hemodynamics in Patients Hospitalized with COVID-19 Pneumonia.

Background

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection may be associated with impaired cardiac function, especially in severe cases requiring hospitalization. Impedance cardiography (ICG) is a noninvasive method for assessing cardiac function. It could be useful for the early detection of hemodynamic dysfunction, particularly in patients with a severe course of COVID-19. Aim: This study aimed to analyze and compare the hemodynamic profiles of patients hospitalized with SARS-CoV-2-induced pneumonia to those of a control group.

Methods

This prospective, observational, clinical study included 30 hospitalized patients (both men and women, mean age: 48 years) diagnosed with COVID-19 pneumonia (COVID group). Their data were compared to those of a retrospective control group (CG). The study participants were propensity score-matched based on clinical characteristics, including age, blood pressure (BP), and body mass index (BMI). ICG measurements of hemodynamic profiles were performed using a Niccomo device and included heart rate (HR), stroke volume index (SI), cardiac index (CI), velocity index (VI), acceleration index (ACI), Heather index (HI), systemic vascular resistance index (SVRI), and thoracic fluid content (TFC).

Results

Patients with COVID-19 showed significantly higher HR (p < 0.0001) and SVRI (p = 0.0003) and lower values for several cardiac function parameters, including SI (p < 0.0001), VI (p < 0.0001), ACI (p = 0.004), and HI (p < 0.0001). Additionally, 11 patients (37%) in the COVID group had a low SI (<35 mL/m2), compared to only 1 patient (3%) in the control group (p < 0.0001). A statistically significant difference in left ventricular ejection fraction (LVEF) was also observed (p < 0.0001), although absolute values remained within the normal range.

Conclusions

SARS-CoV-2 infection negatively affects the cardiovascular system, leading to impaired heart function even in low-risk patients. Impedance cardiography may serve as a simple, noninvasive tool for identifying individuals with cardiac dysfunction following COVID-19 pneumonia.