JCI Insight (May 2022)

Role of antibodies, inflammatory markers, and echocardiographic findings in postacute cardiopulmonary symptoms after SARS-CoV-2 infection

  • Matthew S. Durstenfeld,
  • Michael J. Peluso,
  • J. Daniel Kelly,
  • Sithu Win,
  • Shreya Swaminathan,
  • Danny Li,
  • Victor M. Arechiga,
  • Victor Zepeda,
  • Kaiwen Sun,
  • Shirley Shao,
  • Christopher Hill,
  • Mireya I. Arreguin,
  • Scott Lu,
  • Rebecca Hoh,
  • Viva Tai,
  • Ahmed Chenna,
  • Brandon C. Yee,
  • John W. Winslow,
  • Christos J. Petropoulos,
  • John Kornak,
  • Timothy J. Henrich,
  • Jeffrey N. Martin,
  • Steven G. Deeks,
  • Priscilla Y. Hsue

Journal volume & issue
Vol. 7, no. 10

Abstract

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Shortness of breath, chest pain, and palpitations occur as postacute sequelae of COVID-19, but whether symptoms are associated with echocardiographic abnormalities, cardiac biomarkers, or markers of systemic inflammation remains unknown. In a cross-sectional analysis, we assessed symptoms, performed echocardiograms, and measured biomarkers among adults more than 8 weeks after confirmed SARS-CoV-2 infection. We modeled associations between symptoms and baseline characteristics, echocardiographic findings, and biomarkers using logistic regression. We enrolled 102 participants at a median of 7.2 months following COVID-19 onset; 47 individuals reported dyspnea, chest pain, or palpitations. Median age was 52 years, and 41% of participants were women. Female sex, hospitalization, IgG antibody against SARS-CoV-2 receptor binding domain, and C-reactive protein were associated with symptoms. Regarding echocardiographic findings, 4 of 47 participants (9%) with symptoms had pericardial effusions compared with 0 of 55 participants without symptoms; those with effusions had a median of 4 symptoms compared with a median of 1 symptom in those without effusions. There was no strong evidence for a relationship between symptoms and echocardiographic functional parameters or other biomarkers. Among adults more than 8 weeks after SARS-CoV-2 infection, SARS-CoV-2 RBD antibodies, markers of inflammation, and, possibly, pericardial effusions are associated with cardiopulmonary symptoms. Investigation into inflammation as a mechanism underlying postacute sequelae of COVID-19 is warranted.

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