Prevalence of Cardiac Abnormalities in Post Covid-19 Adult Survivors Seen At Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Background: Cardiovascular complications significantly contributed to the burden of Covid-19 morbidity and mortality during the 3-year pandemic that started in late 2019. Emerging evidence at the time showed that infection led to diverse cardiovascular complications associated with severe disease and increased morbidity and mortality. Covid-19 infection also resulted in the deterioration of pre-existing Cardiovascular Disease (CVD). Data from High-Income Countries (HIC) demonstrated that myocarditis, pulmonary thrombo-embolism with attendant right heart dysfunction, and acute coronary events were largely responsible for the complications but the long-term CV sequel remains unknown in populations residing in sub-Saharan Africa.

Objective: To describe the acquired cardiac, non valvular, and rhythm abnormalities amongst patients and staff at Moi Teaching and Referral Hospital (MTRH) as well as students of Moi University School of Medicine (MUSOM) who had recovered from Covid-19 infection.

Methods: This was a cross-sectional study at MTRH with participants drawn from the in-patient wards, outpatient clinics, and staff and students of MTRH and MUSOM respectively. Participants aged 18 years and above who had previously been diagnosed with Covid-19 were consecutively recruited into the study. We excluded those with known cardiac disease prior to Covid-19 infection and those with severe chest deformities in whom imaging was technically difficult. Socio-demographic and clinical data were collected using a structured questionnaire. A standard 2-dimensional, Doppler (color and spectral)echocardiogram and 12 lead electrocardiogram were done. Blood samples were drawn for evaluation of LDL, glycated haemoglobin (HBA1c) and cardiac troponin.

Results: One hundred and seven participants were consecutively recruited between July 2022 and January 2023. Females comprised 53% of the population. Staff and students made up 45% of the study population. One hundred and four (97.2%) participants had normal Left Ventricular (LV) systolic function. There were no Regional Wall Motion Abnormalities (RWMA) reported. ECG changes which included T-wave inversions and Left Bundle Branch Block (LBBB) were reported in 3(2.8%) participants. Elevated (low density lipoprotein) LDL and overweight/obesity were the most prominent cardiovascular risk factors reported in 27% and 70% respectively.

Conclusion: Patients who recovered from Covid-19 infection at MTRH had a very low prevalence of cardiac disease but a high burden of cardiovascular risk factors.