A Multidisciplinary Approach to Evaluate the Presence of Hepatic and Cardiac Abnormalities in Patients with Post-Acute COVID-19 Syndrome—A Pilot Study

Bende, Felix; Tudoran, Cristina; Sporea, Ioan; Fofiu, Renata; Bâldea, Victor; Cotrău, Radu; Popescu, Alina; Şirli, Roxana; Ungureanu, Bogdan Silviu; Tudoran, Mariana

doi:10.3390/jcm10112507

Cited by 25 publications

(26 citation statements)

References 37 publications

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“…Likewise, other complications have been reported, such as postural orthostatic tachycardia syndrome [81,82] and orthostatic intolerance without hemodynamic effects [83]. Lastly, right ventricular dysfunction in response to fibrotic lung injury, pulmonary hypertension and/or clot burden in patients recovering from severe disease have also been described with an incidence of diastolic dysfunction of 32-55%, and an occurrence of pulmonary hypertension of 10-35% up to 12 weeks following the acute phase [84][85][86].…”

Section: Cardiovascular Involvementmentioning

confidence: 98%

Post-COVID-19 Syndrome: Involvement and Interactions between Respiratory, Cardiovascular and Nervous Systems

Visco

Vitale

Rispoli

et al. 2022

JCM

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Though the acute effects of SARS-CoV-2 infection have been extensively reported, the long-term effects are less well described. Specifically, while clinicians endure to battle COVID-19, we also need to develop broad strategies to manage post-COVID-19 symptoms and encourage those affected to seek suitable care. This review addresses the possible involvement of the lung, heart and brain in post-viral syndromes and describes suggested management of post-COVID-19 syndrome. Post-COVID-19 respiratory manifestations comprise coughing and shortness of breath. Furthermore, arrhythmias, palpitations, hypotension, increased heart rate, venous thromboembolic diseases, myocarditis and acute heart failure are usual cardiovascular events. Among neurological manifestations, headache, peripheral neuropathy symptoms, memory issues, lack of concentration and sleep disorders are most commonly observed with varying frequencies. Finally, mental health issues affecting mental abilities and mood fluctuations, namely anxiety and depression, are frequently seen. Finally, long COVID is a complex syndrome with protracted heterogeneous symptoms, and patients who experience post-COVID-19 sequelae require personalized treatment as well as ongoing support.

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Section: Cardiovascular Involvementmentioning

confidence: 98%

Post-COVID-19 Syndrome: Involvement and Interactions between Respiratory, Cardiovascular and Nervous Systems

Visco

Vitale

Rispoli

et al. 2022

JCM

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“…However, in contrast with Deffieux’s study, viscosity was found to be useful for predicting the degree of necroinflammation [ 16 , 31 ]. Moreover, a recently published study found higher Vi PLUS liver values in COVID-19 patients with pulmonary injury compared to COVID-19 patients without pulmonary injury [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

The Non-Invasive Ultrasound-Based Assessment of Liver Viscosity in a Healthy Cohort

et al. 2022

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Liver fibrosis is the most significant prognostic factor in chronic liver disease (CLD). Clinical practice guidelines recommend the use of non-invasive techniques, such as two-dimensional shear-wave elastography (2D-SWE), to assess liver stiffness as a marker of fibrosis. Several other factors influence liver stiffness in addition to liver fibrosis. It is presumed that changes due to necro-inflammation modify the propagation of shear waves (dispersion). Therefore, new imaging techniques that investigate the dispersion properties of shear waves have been developed, which can serve as an indirect method of measuring liver viscosity (Vi PLUS). Defining the reference values in healthy subjects among different age groups and genders and analyzing the factors that influence these values is essential. However, published data on liver viscosity are still limited. This is the first study that aimed to assess the normal range of liver viscosity values in subjects with healthy livers and analyze the factors that influence them. One hundred and thirty-one consecutive subjects with healthy livers were enrolled in this prospective study. The results showed that Vi PLUS is a highly feasible method. Liver stiffness, age and BMI influenced the liver viscosity values. The mean liver viscosity by Vi PLUS in subjects with healthy livers was 1.59 Pa·s.

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“…Nevertheless, elevated baseline AST especially in patients aged > 65 years was a strong predictor of adverse clinical outcomes. Recently, LSM and CAP were also investigated among patients with persisting post-acute COVID-19 syndrome and no history of liver disease [35]. LSM but not CAP was higher (but still within the normal range) in patients who suffered from a more severe form of COVID-19 during acute illness (5.08 kPa vs. 4.39 kPa, p = 0.017 for LSM, and 291.64 dB/m vs. 266.06 dB/m, p = 0.062 for CAP).…”

Section: Discussionmentioning

confidence: 99%

FibroScan-AST Score Predicts 30-Day Mortality or Need for Mechanical Ventilation among Patients Hospitalized with COVID-19

Zelenika

Lucijanić

Bokun

et al. 2021

JCM

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Background: Liver involvement in Coronavirus disease 2019 (COVID-19) has been recognised. We aimed to investigate the correlation of non-invasive surrogates of liver steatosis, fibrosis and inflammation using transient elastography (TE) and FibroScan-AST (FAST) score with (a) clinical severity and (b) 30-day composite outcome of mechanical ventilation (MV) or death among patients hospitalized due to COVID-19. Method: Patients with non-critical COVID-19 at admission were included. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed by TE. Clinical severity of COVID-19 was assessed by 4C Mortality Score (4CMS) and need for high-flow nasal cannula (HFNC) oxygen supplementation. Results: 217 patients were included (66.5% males, median age 65 years, 4.6% with history of chronic liver disease). Twenty-four (11.1%) patients met the 30-day composite outcome. Median LSM, CAP and FAST score were 5.2 kPa, 274 dB/m and 0.31, respectively, and neither was associated with clinical severity of COVID-19 at admission. In multivariate analysis FAST > 0.36 (OR 3.19, p = 0.036), 4CMS (OR 1.68, p = 0.002) and HFNC (OR 7.03, p = 0.001) were independent predictors of adverse composite outcome. Conclusion: Whereas LSM and CAP failed to show correlation with COVID-19 severity and outcomes, FAST score was an independent risk factor for 30-day mortality or need for MV.

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A Multidisciplinary Approach to Evaluate the Presence of Hepatic and Cardiac Abnormalities in Patients with Post-Acute COVID-19 Syndrome—A Pilot Study

Cited by 25 publications

References 37 publications

Post-COVID-19 Syndrome: Involvement and Interactions between Respiratory, Cardiovascular and Nervous Systems

Post-COVID-19 Syndrome: Involvement and Interactions between Respiratory, Cardiovascular and Nervous Systems

The Non-Invasive Ultrasound-Based Assessment of Liver Viscosity in a Healthy Cohort

FibroScan-AST Score Predicts 30-Day Mortality or Need for Mechanical Ventilation among Patients Hospitalized with COVID-19

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