Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Tor Biering-Sørensen, University of Copenhagen, Denmark
- Second opponent: Professor Orly Vardeny, University of Minnesota Medical School, US
- Third member and chair of the evaluation committee: Professor William Edward Louch, University of Oslo
Chair of the Defence
Professor Thor Edvardsen, University of Oslo
Principal Supervisor
Professor Peder Langeland Myhre, University of Oslo
Summary
Cardiovascular disease remains the leading cause of death worldwide, and since the 1930s there has been recognition of a link between cardiac disease and infectious diseases. The COVID-19 pandemic raised concerns about long-term cardiac complications, as many hospitalized patients had elevated cardiac biomarkers and cardiac abnormalities on imaging. Additionally, many patients experienced persistent symptoms such as dyspnea, raising questions about whether cardiac dysfunction could explain "long COVID" syndrome.
The aims of this thesis were to investigate long-term cardiac outcomes in patients hospitalized with COVID-19, examining cardiac function, injury markers, and cardiovascular events in the first year after discharge, by conducting prospective observational studies and a retrospective registry study.
In the prospective studies, patients underwent echocardiography, cardiopulmonary exercise testing, electrocardiograms, blood tests, and questionnaires at 3 and 12 months post-discharge. A subset underwent cardiac MRI at 6 months. In the registry study, we compared the incidence of cardiac disease among COVID-19 patients to those hospitalized with viral and bacterial pneumonia.
Echocardiography showed no progression of cardiac dysfunction from 3 to 12 months. Cardiac troponin levels normalized within three months, and very low troponin levels at 3 months largely ruled out cardiac dysfunction. These findings were not associated with persistent dyspnea. Minor myocardial scars on MRI were found in approximately 20% of patients but were not associated with symptoms or impaired cardiovascular function one year post-COVID-19. The registry study showed no elevated risk of cardiac disease or need for cardiologic examinations after COVID-19 compared to other pneumonias.
Overall, these findings suggest stable cardiac function after COVID-19 hospitalization, with cardiac disease unlikely as the primary cause of long COVID symptoms. The results indicate that most patients do not require long-term cardiologic follow-up.
Additional information
Contact the research support staff.