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[This article belongs to Volume - 70, Issue - 12]
Published on : 2025-12-16 21:36:41
Article Code: AMJ-16-12-2025-12357
Title : Long-term Cardiovascular Recovery Patterns in Women Post-COVID-19. A Multi-center Prospective Analysis from Middle Eastern Cohorts
Author(s) : Layla Al-Mansouri, MD, PhD, Khalid M. Al-Shehri, MBBS, FACC, Sarah Mitchell, PhD, Fatima H. Al-Rashi PhD
Abstract :
Background: Long COVID syndrome affects approximately 10-30% of survivors, with women demonstrating
consistently higher rates of persistent cardiac symptoms. Yet longitudinal data on cardiovascular recovery trajectories
in female patients from the Middle East remain notably sparse.
Objectives: To characterize cardiac function recovery patterns in women at 12 and 24 months following COVID-19
infection, utilizing cardiovascular magnetic resonance (CMR) imaging and established biomarker panels.
Methods: We conducted a prospective cohort study encompassing 4,892 women (mean age 42.3±8.7 years) across
12 academic and tertiary centers in six Gulf Cooperation Council states. Participants underwent CMR and biomarker
assessment (troponin I, NT-proBNP, CRP) at 3, 12, and 24 months post-infection. Mixed-effects models and survival
analysis were employed to identify predictors of delayed recovery.
Results: Persistent myocarditis was evident in 1,895 participants (38.7%) at 12 months, decreasing modestly to 34.2%
by 24 months (p<0.001 for trend). NT-proBNP levels remained 45% higher in symptomatic versus recovered women
(median 168 vs 116 pg/mL, p<0.001). Hospitalization during acute infection (OR=1.89, 95% CI: 1.52-2.34) and
metabolic syndrome (OR=2.11, 95% CI: 1.78-2.49) emerged as the most significant predictors of impaired recovery.
Conclusions: This study demonstrates that women in the Middle East experience protracted and heterogeneous
cardiac recovery following COVID-19. Our findings advocate for extended 24-month surveillance protocols tailored
to regional risk profiles.