Opportunistic Screening for Asymptomatic Left Ventricular Dysfunction in Coronavirus Disease 2019 (COVID19) Survivors

Coronavirus Disease 2019 (COVID-19) emerged in December 2019, and in mere few months has
resulted in a pandemic of viral pneumonia. As of April 2020, over 2 million populations were
infected and more than 150,000 deaths globally. In the initial report from Wuhan, China, up
to 27.8% COVID19 patients had an elevated troponin level indicating myocardial damage during
the index hospitalization for COVID. This is nearly 10-folded higher than that of other
common viral illnesses such as influenza (2.9%). Possible mechanisms including acute coronary
events, cytokine storm, and COVID-19 related myocarditis, have been postulated for the
cardiac involvement in COVID-19. Nonetheless, it is unknown whether COVID-19 survivors are at
risk cardiac dysfunction including cardiac arrhythmia and heart failure.

The prospective screening study aims to evaluate the possible latent effects from COVID-19 in
COVID-19 survivors. COVID-19 survivors 4-6 weeks after hospital discharge will be recruited
from the Infectious Disease clinic, Queen Mary Hospital. Standard 12-lead electrocardiogram,
serum troponin, NT-proBNP, and standard transthoracic echocardiogram will be performed for
COVID-19 survivors.

The outcome measures include (1) new onset cardiac arrhythmia, (2) NT-proBNP elevation above
the diagnostic range of heart failure, and (3) newly detected left ventricular dysfunction.