Prognostic Value of Left Ventricular Global Longitudinal Strain in COVID-19

The novel severe acute respiratory syndrome coronavirus 2019 (COVID-19) was declared a global pandemic by the World Health Organization on March 11, 2020.1 Reports have noted right ventricular longitudinal strain to be a strong predictor of mortality in patients with COVID-19.2 Although left ventricular global longitudinal strain (GLS) has been well validated as a prognostic cardiovascular marker,3 the utility of left ventricular GLS in risk stratification of COVID-19 remains unknown. After adjusting for age and LV ejection fraction, the association between GLS and mortality was unchanged (HR 1.39; 95% CI: 1.11 to 1.76, p = 0.005 from COVID19; HR 1.54; 95% CI: 1.10 to 2.15, p = 0.011 from echocardiogram). [...]we observed significantly increased mortality with decrease (less negative) in left ventricular GLS in patients with COVID-19. Cytokine storm and cardiomyocyte oxidative stress has been linked to impaired global longitudinal strain on echocardiography.5 Although limited by the small sample size, observational nature, unobserved confounding variables, and lack of metrics to further classify illness severity, our findings suggest that left ventricular GLS may be associated with mortality in patients with COVID-19.