Higher Incidence of Chemotherapy-Related Cardiac Dysfunction after Third Wave COVID-19 Pandemic: A Single Cardioncology Centre Experience

Aims: COVID 19 pandemic has revolutionized the practice of cardiology. New surveillance protocols have been proposed in the field of cardioncology reducing outpatient visits and performing focus echocardiography. The aim of our study was to assess the impact of the COVID-19 pandemic on the development of chemotherapy-related cardiac dysfunction (CTRCD), showing the experience of a single italian cardioncology centre.Methods and results: A single center retrospective study was carried out evaluating 96 patients with hematological or solid tumors treated with anthracyclines and admitted to our cardioncology unit from June to August 2019 and 60 patients referred to our unit after third wave COVID-19 pandemic (from June to August 2021) for baseline or follow-up cardiological check. The incidence of CTRCD was assessed in all patients performing echocardiogram at the time of the enrollment. We found a significantly higher incidence of CTRCD in the second period compared to first period (13% vs 2%, p value 0,0058). Especially two cases of late onset cardiotoxicity in high risk patients were observed before pandemic; after third wave pandemic, 7 cases of early cardiotoxicity were observed also in patients without high risk and 1 case of late onset cardiotoxicity in a patient at high risk. 5 patients with CTRCD had COVID 19 infection.Conclusion: COVID 19 pandemic seems to influence and favor the onset of CTRCD in patients treated with anthracyclines, indirectly reducing hospital access of cancer patients and cardiological checks. A direct myocardial damage induced by COVID 19 could be assumed.