The Dark Side of Long COVID-19: Impaired Cardiac Function, Quality of Life and Functional Capacity in Egyptian Long COVID-19 Patients

The Dark Side of Long COVID-19: Impaired Cardiac Function, Quality of Life and Functional Capacity in Egyptian Long COVID-19 Patients

Ghadeer Abdelhafez Abdellatef Assal , Lamyaa Said El Bagoury , Prithwish Banerje , Yasser Alaaeldin Mahmoud Abdellatif , Mona Mostafa Rayan , Mohamed Farouk Allam

 

QJM: An International Journal of Medicine, Volume 118, Issue Supplement_1, November 2025, hcaf224.078, https://doi.org/10.1093/qjmed/hcaf224.078

 

Abstract

Introduction. Long COVID-19 remains a complex health issue, with dyspnea being one of the most prevalent symptoms. While most studies have focused on its respiratory effects, its impact on cardiac function has received less attention. This study aimed to assess how Long COVID-19 affects functional capacity, cardiac function, and quality of life, providing a more comprehensive understanding of its long-term consequences.

Methodology. The present study included 34 patients with Long COVID- 19 who presented to Ain Shams University Hospitals (Cairo, Egypt) between February 2022 and December 2022, at least four weeks after acute COVID-19 infection. Patients exhibited varying degrees of initial disease severity and reported symptoms such as dyspnea, chest pain, or palpitations. Each participant underwent assessment using the Euro Quality of Life (EuroQol) questionnaire, the 6- Minute Walk Test (6MWT), and echocardiography, including two-dimensional left ventricular global longitudinal strain (GLS).

Results. Dyspnea was the most frequently reported cardiovascular symptom, affecting 94.1% of patients, followed by chest pain (67.6%) and palpitations (64.7%). The study population ranged in age from 18 to 67 years, with a predominance of females (85.3%). Only 2.9% were smokers, while 76.5% had pre-existing chronic conditions, most commonly atopy and vitamin D deficiency. All patients reported a significantly decreased quality of life compared to their pre-COVID-19 state (P < 0.001). Notably, 25% of participants exhibited oxygen desaturation during the 6MWT, and 20.6% had impaired GLS (defined as GLS above -16%). Patients with abnormal GLS were more likely to have diabetes mellitus, a history of oxygen therapy during acute infection, and less colchicine use compared to those with normal GLS (GLS below -18%). Furthermore, abnormal GLS correlated with reduced walking distance in the 6MWT, diastolic dysfunction, and impaired right ventricular (RV) systolic function, as indicated by decreased tricuspid annular plane systolic excursion (TAPSE) measurements.

Conclusion. Long COVID-19 significantly affects functional capacity and quality of life. A subset of patients demonstrates subtle left ventricular systolic dysfunction, as evidenced by impaired GLS despite a preserved ejection fraction. These findings highlight the need for long-term cardiac follow-up and potential management strategies to address lingering cardiovascular impairments in Long COVID-19 patients.

 

Keywords. Long COVID-19, Dyspnea, Quality of life, 6-Minute Walk Test, Echocardiography, Global longitudinal strain, EuroQOL questionnaire, Post-COVID syndrome

https://academic.oup.com/qjmed/article-abstract/118/Supplement_1/hcaf224.078/8341257?redirectedFrom=fulltext&login=false