Cardiac sequelae after COVID-19: results of a one-year follow-up study with ECG monitoring

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Authors

MAREKOVÁ Gabriela RADVAN Martin BARTEČKOVÁ Elis BULKOVÁ Veronika KAMENÍK Martin KOC Lumír HOŘÍNKOVÁ Jana ŠTĚPÁNOVÁ Radka KALA Petr

Year of publication 2025
Type Article in Periodical
Magazine / Source Cor et Vasa
MU Faculty or unit

Faculty of Medicine

Citation
web https://e-coretvasa.cz/artkey/cor-202505-0008_cardiac-sequelae-after-covid-19-results-of-a-one-year-follow-up-study-with-ecg-monitoring.php
Doi https://doi.org/10.33678/cor.2025.019
Keywords COVID-19; ECG monitoring; Follow-up; Heart rate variability; SARS-CoV-2
Attached files
Description Objective: To evaluate the need for ECG monitoring of unselected patients recovered from COVID-19 and to estimate the risk of development of arrhythmias and heart rate variability change after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: Between March 2020 and January 2021 patients who had recovered from PCR-proven SARS-CoV-2 symptomatic infection (alfa and beta variants) were enrolled in a prospective observational cohort study CoSuBr (COvid SUrvivals in BRno) and those with two 7-day ECG monitoring have been analysed. Demographic parameters, patient history, clinical evaluation, and 7-day ECG monitoring were recorded within two times intervals: the first at least six weeks after infection and a follow-up visit one year later to establish any changes in heart rate variability (HRV). Results: The study group consisted of 74 individuals, 42 of which were females (56.8%), with 7-day ECG monitoring performed in both time intervals. The mean age was 48 years (range 21-77 years). The mean time interval between the onset of the infection and the follow-up visit was 105 days. At the time of enrolment, 61% of the patients were experiencing ongoing symptoms, while more than half of the whole group (51.3%) mentioned at least one symptom of possible cardiac origin (breathing problems, palpitations, exercise intolerance, fatigue). There was no change in the average heart rate between visits (72.7 +/- 8 vs. 72.5 +/- 8/min; p = 0.756), and no difference in the incidence of supraventricular or ventricular ectopy. There was no difference in parameters between symptomatic/asymptomatic groups. At the one-year follow-up visit after COVID-19 infection, there was no change in heart rate variability evaluated by SDNN (V1 vs. V2 156.6 +/- 40.6 vs. 156.0 +/- 38.0; p = 0.855), rMSSD (V1: 33 +/- 13.95 to 30.6 +/- 12.89; p = 0.175) and triangle (V1: 28.5 +/- 7.8 to 29.5 +/- 8.8; p = 0.488). We evaluated the presence of supraventricular and ventricular arrhythmias, and the ECG monitoring showed no significant pathology. Conclusion: Despite a lot of information regarding cardiac impairment caused by SARS-CoV-2, our study does not suggest an increased risk in developing arrhythmias after COVID-19 in the one-year follow-up. Based on our results, routine ECG monitoring is currently not recommended after recovery from COVID-19.
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