Cardiopulmonary Long-Term Sequelae in Patients after Severe COVID-19 Disease.
Julia Hanne NiebauerChristina Binder-RodriguezAhmet IscelSarah SchedlChristophe CapelleMichael KahrSimona CadjoSimon SchamilowRoza Badr-EslamMichael LichtenauerAurel TomaAlexander ZoufalyRosmarie ValentaSabine HoffmannSilvia Charwat-ReslChristian KrestanWolfgang HitzlChristoph WenischDiana BondermanPublished in: Journal of clinical medicine (2023)
We aimed to identify cardiopulmonary long-term effects after severe COVID-19 disease as well as predictors of Long-COVID in a prospective registry. A total of 150 consecutive, hospitalized patients (February 2020 and April 2021) were included six months post hospital discharge for a clinical follow-up. Among them, 49% experienced fatigue, 38% exertional dyspnea and 75% fulfilled criteria for Long-COVID. Echocardiography detected reduced global longitudinal strain (GLS) in 11% and diastolic dysfunction in 4%. Magnetic resonance imaging revealed traces of pericardial effusion in 18% and signs of former pericarditis or myocarditis in 4%. Pulmonary function was impaired in 11%. Chest computed tomography identified post-infectious residues in 22%. Whereas fatigue did not correlate with cardiopulmonary abnormalities, exertional dyspnea was associated with impaired pulmonary function (OR 3.6 [95% CI: 1.2-11], p = 0.026), reduced GLS (OR 5.2 [95% CI: 1.6-16.7], p = 0.003) and/or left ventricular diastolic dysfunction (OR 4.2 [95% CI: 1.03-17], p = 0.04). Predictors of Long-COVID included length of in-hospital stay (OR: 1.15 [95% CI: 1.05-1.26], p = 0.004), admission to intensive care unit (OR cannot be computed, p = 0.001) and higher NT-proBNP (OR: 1.5 [95% CI: 1.05-2.14], p = 0.026). Even 6 months after discharge, a majority fulfilled criteria for Long-COVID. While no associations between fatigue and cardiopulmonary abnormalities were found, exertional dyspnea correlated with impaired pulmonary function, reduced GLS and/or diastolic dysfunction.
Keyphrases
- coronavirus disease
- sars cov
- left ventricular
- computed tomography
- magnetic resonance imaging
- intensive care unit
- ejection fraction
- blood pressure
- end stage renal disease
- oxidative stress
- respiratory syndrome coronavirus
- emergency department
- heart failure
- chronic kidney disease
- sleep quality
- heat stress
- hypertrophic cardiomyopathy
- acute myocardial infarction
- early onset
- positron emission tomography
- coronary artery disease
- cross sectional
- palliative care
- left atrial
- depressive symptoms
- acute coronary syndrome
- advanced cancer
- atrial fibrillation
- acute respiratory distress syndrome
- drug induced
- dual energy