Cardiologic Manifestations in Omicron-Type Versus Wild-Type COVID-19: A Systematic Echocardiographic Study. 1/25/2023. Ghantous E. J Am Heart Assoc.

Study designed to compare echocardiographic findings in patients hospitalized with COVID-19 between early Wild-Type disease (03/21-09/16/20) and the later Omicron variant 01/03-05/22. 162 consecutive patients hospitalized with Omicron COVID-19 were compared with propensity-matched patients (148 total pairs) with the wild-type variant (COVID-19 Wuhan_hu_1) previously studied used as control. Both patient cohorts evaluated within 48 hours by trained echocardiographers following defined and comprehensive protocol followed by off line speckle tracking evaluation and supplemented by routine biochemical and radiographic investigations. Patients with the wild-type variant had larger RV, poorer RV function, and higher pulmonary vascular resistance compared with patients in the Omicron-variant matched cohort irrespective of grade of disease. In the matched cohort, in hospital death, requirement for invasive ventilation, and combined events was higher in the wild type disease. Patients with acute wild-type infection and no cardiac disease or cardiovascular risk factors had echocardiographic LV and RV parameters, suggesting that acute wild-type infection causes acute elevation of RV afterload, resulting in lower left-filling pressure and stroke volume. However, in a similar group of patients with acute Omicron-type infection, these changes were not recorded. In the majority of patients with abnormal LV systolic function, or elevated filling, and a previous echocardiographic exam, similar abnormalities were recorded in the exam before the current admission, suggesting that in most patients with Omicron, LV dysfunction is related to background cardiac disease and that acute infection does not cause significant additive LV injury.

https://www.ahajournals.org/doi/10.1161/JAHA.122.027188