Cardiopulmonary Long-Term Sequelae in Patients after Severe COVID-19 Disease

Niebauer, Julia Hanne; Binder-Rodriguez, C.; Iscel, Ahmet; Schedl, Sarah; Capelle, C; Kahr, Michael; Cadjo, Simona; Schamilow, Simon; Badr-Eslam, Roza; Lichtenauer, Michael; Toma, Aurel; Zoufaly, Alexander; Valenta, Rudolf; Hoffmann, Sabine; Charwat-Resl, Silvia; Krestan, Christian; Hitzl, Wolfgang; Wenisch, Christoph; Bonderman, Diana

doi:10.3390/jcm12041536

Cited by 4 publications

(4 citation statements)

References 34 publications

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“…A detailed methodology of study-related clinical examinations has been described in our previous publication reporting the results of the first 150 patients at their 6 months follow-up visit ( 11 ).…”

Section: Methodsmentioning

confidence: 99%

“…As previously described in greater detail ( 11 ), patients had either been hospitalized on a regular ward (91%, n = 182) or an intensive care unit (ICU; 9%, n = 18) of our dedicated COVID-19 unit. After hospital discharge, patients were contacted in a consecutive manner.…”

Section: Methodsmentioning

confidence: 99%

“…Information is scarce how long symptoms persist (5)(6)(7)(8). As symptoms are in general very heterogenous in general and include more than 200 different ones, with fatigue being most common (9,10), it continues to be difficult to substantiate symptoms with respective underlying pathologies (11).…”

Section: Introductionmentioning

confidence: 99%

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Severe COVID-19 and its cardiopulmonary effects 6 and 18 months after hospital discharge

Niebauer,

Iscel,

Schedl

et al. 2024

Front. Cardiovasc. Med.

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IntroductionSARS-CoV-2 infection affects the cardiopulmonary system in the acute as well as long-term phase. The aim of the present study was to comprehensively assess symptoms and possible long-term impairments 6 and 18 months after hospitalization for severe COVID-19 infection.MethodsThis prospective registry included patients with PCR-confirmed COVID-19 infection requiring hospitalization. Follow-up approximately 6 months post discharge comprised a detailed patient history, clinical examination, transthoracic echocardiography, electrocardiogram, cardiac magnetic resonance imaging (cMRI), chest computed tomography (CT) scan, pulmonary function test (PFT), six-minute walk test (6MWT) and a laboratory panel. At the time of the second follow-up visit at 18 months, patients without pathologic findings during the first study visit were contacted by phone to inquire about the course of their symptoms. In all other patients all initial examinations were repeated.ResultsTwo hundred Patients, who were hospitalized for COVID-19, were contacted by phone and were recruited for the study. Due to dropouts the second study visit was performed in 170 patients. A comparison between the two study visits at 6 and 18 months post discharge showed the following results: Six months after discharge, 73% and 18 months after discharge 52% fulfilled the criteria for Long COVID with fatigue being the most common symptom (49%). Echocardiography at 6 months post discharge showed an impaired left ventricular function in 8% of which 80% returned to normal. Six months post discharge, cMRI revealed pericardial effusion in 17% which resolved in 47% of the 15 patients who underwent a control cMRI. Signs of peri- or myocarditis were present in 5% of the patients and were resolved in all 4 patients who attended control studies. At 6 months, chest CT scans identified post-infectious residues in 24%. In the 25 repeated chest CT scans 20% showed full recovery. Length of in-hospital stay was identified as a significant predictor for persisting Long COVID (95% CI: 1.005–1.12, p = 0.03).ConclusionComparing 6 to 18 months, the prevalence of Long COVID decreased over time, but a high symptom burden remained. Structural and functional abnormalities were less frequent than the portrayed symptoms, and it thus remains a challenge to substantiate the symptoms.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Severe COVID-19 and its cardiopulmonary effects 6 and 18 months after hospital discharge

Niebauer,

Iscel,

Schedl

et al. 2024

Front. Cardiovasc. Med.

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“…Symptoms are often nonspecific, such as fatigue and dyspnea, and difficult to assess objectively. In cases of comorbidity with preexisting cardiopulmonary diseases, there is also an overlap with symptoms [ 5 ]. There has been growing evidence of residual lung changes in convalescent COVID-19 patients in the long term [ 6 , 7 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

What Remains up to 7 Months after Severe and Moderate Pneumonia in Non-Vaccinated Patients with Long COVID? Results of a CT Study

Kurys-Denis,

Grzywa-Celińska,

Podgórska

et al. 2023

JCM

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Background: There is a growing evidence of long-lasting lung changes after COVID-19. Our aim was to assess the degree of lung injury and evaluate the recovery process of 4–7-month-non-vaccinated convalescent patients discharged from hospital after moderate and severe COVID-19 pneumonia, who presented with symptoms of long-COVID. Methods: On control lung CT after mean 5-month recovery period, we classified and determined the prevalence of residual radiological abnormalities in 39 symptomatic patients. To assess the advancement of the persisting changes we used the total severity score (TSS) and the chest CT score and then correlated the results with clinical data. Results and conclusions: On follow-up CT images, 94.9% of patients showed persistent radiological abnormalities. The most frequent changes were ground-glass opacities (74.4%), reticular pattern (64.1%), fibrotic changes (53.8%), nodules (33.3%), bronchiectasis (15.4%), vascular enlargement (10.3%), and cavitation (5.1%). The median TSS score was 4.1 points (interquartile range 3), whereas the median of the chest CT score 5.4 points (interquartile range of 4.5). No significant differences were observed between sex subgroups and between the severe and moderate course groups. There were no association between both CT scores and the severity of the initial disease, indicating that, mean 5 months after the disease, pulmonary abnormalities reduced to a similar stage in both subgroups of severity.

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Cardiovascular disease as part of Long COVID: a systematic review

Tsampasian,

Bäck,

Bernardi

et al. 2024

European Journal of Preventive Cardiology

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Background Long COVID syndrome has had a major impact on million patients’ lives worldwide. The cardiovascular system is an important aspect of this multifaceted disease that may manifest in many ways. We have hereby performed a narrative review in order to identify the extent of the cardiovascular manifestations of the Long COVID syndrome. Methods and Results An in-depth systematic search of the literature has been conducted for this narrative review. The systematic search of PubMed and Cochrane databases yielded 3,993, of which 629 underwent full text screening. A total of 78 studies were included in the final qualitative synthesis and data evaluation. The pathophysiology of the cardiovascular sequelae of Long COVID syndrome and the cardiac manifestations and complications of Long COVID syndrome are critically evaluated. In addition, potential cardiovascular risk factors are assessed, and preventive methods and treatment options are examined in this review. Conclusions This systematic review poignantly summarises the evidence from the available literature regarding the cardiovascular manifestations of Long COVID syndrome and reviews potential mechanistic pathways, diagnostic approaches, preventive measures and treatment options.

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Cardiopulmonary Long-Term Sequelae in Patients after Severe COVID-19 Disease

Cited by 4 publications

References 34 publications

Severe COVID-19 and its cardiopulmonary effects 6 and 18 months after hospital discharge

Severe COVID-19 and its cardiopulmonary effects 6 and 18 months after hospital discharge

What Remains up to 7 Months after Severe and Moderate Pneumonia in Non-Vaccinated Patients with Long COVID? Results of a CT Study

Cardiovascular disease as part of Long COVID: a systematic review

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