Cardiovascular status and echocardiographic changes in survivors of COVID-19 pneumonia three months after hospital discharge

Krinochkin, D. V.; Ярославская, Е. И.; Shirokov, N. E.; Gultyaeva, E. P.; Криночкина, И. Р.; Korovina, I. O.; Mamarina, A. V.; Osokina, N; Мельников, Н. Н.; Трифанова, Т. А.; Горбатенко, Е. А.; Petelina, T.

doi:10.15829/1560-4071-2021-4656

Cited by 3 publications

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“…Пациенты с сопутствующими заболеваниями, в т.ч. пожилые, обычно демонстрируют дисфункциональный иммунный ответ, вследствие чего может возникнуть цитокиновый шторм, позволяющий развиться системному воспалению [5,6].…”

Section: материал и методыunclassified

“…Известно, что уровень СРБ коррелирует с тяжестью течения, распространенностью воспалительной инфильтрации и прогнозом при COVID-19 [1,[5][6][7][8][9][10]. В нашем исследовании концентрация СРБ увеличивалась у большинства пациентов и коррелировала с TNF-α (рис.…”

Section: результаты и обсуждениеunclassified

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Cytokine profile in hospitalized patients with COVID-19 of different severity

Grigoryeva¹,

Sinichkina

Petrova

et al. 2022

Russ J Cardiol

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Analysis of cytokine profile markers in conjunction with the clinical manifestations of coronavirus disease 2019 (COVID-19) can provide valuable information about the pathogenetic manifestations of the disease, and therefore, in the future, determine drugs that affect the cytokine storm and have an anti-inflammatory effect.Aim. To identify correlations between the parameters of the developed cytokine profile and the clinical course in hospitalized patients with COVID-19 of different severity.Material and methods. The study included 70 hospitalized patients with a confirmed diagnosis of COVID-19, with a mean age of 58 [50;69] years, including 40 men (57%) and 30 women (43%). The average lung involvement according to computed tomography (CT) at admission was CT-2 [1;3]. Peripheral venous blood was taken at admission, which averaged 7 [6; 8] days from the symptom onset. Standard biochemical parameters were studied, as well as 47 cytokines and chemokines using the Multiplex system (Merck KGaA, Darmstadt, Germany).Results. Correlations was found between the lung involvement degree and the level of IL-8 (r=0,31, p<0,05), IL-15 (r=0,35, p<0,05), IL-18 (r=0,31, p<0,05), MCP-1 (r=0,36, p<0,05), MIG (r=0,50, p<0,05), TNF-α (r=0,41, p<0,05). An inverse correlation was also found in the level of blood oxygen saturation with the same indicators as follows: IL-8 (r=-0,27, p<0,05), IL-15 (r=-0,34, p<0,05), IL-18 (r=-0,31, p<0,05), MCP-1 (r=-0,40, p<0,05), MIG (r=-0,56, p<0,05), TNF-α (r=-0,45, p<0,05). IL-6 levels were significantly elevated in patients with severe COVID-19 (CT3, CT4), while no increase in IL-6 was observed in patients with moderate disease (CT1, CT2). It is noteworthy that in patients with diabetes, the highest values of IL-12, IL-9 were recorded.Conclusion. Hyperinflammatory syndrome in severe COVID-19 is manifested by high levels of IL-6, MIG, MDC, MCP-1, M-CSF, TNF-α, β, IL-8, IL-18, IL-15. With the CT-1 and CT-2, an increase in only the level of IL-18, IL-8 is noted. The identified patterns prove and make it possible to explain a number of systemic inflammatory changes that occur with COVID-19.

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Section: результаты и обсуждениеunclassified

Cytokine profile in hospitalized patients with COVID-19 of different severity

Grigoryeva¹,

Sinichkina

Petrova

et al. 2022

Russ J Cardiol

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Comparison of clinical and echocardiographic parameters of patients with COVID-19 pneumonia three months and one year after discharge

et al. 2022

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Aim To study changes in clinical and echocardiographic parameters in patients after documented COVID-19 pneumonia at 3 months and one year following discharge from the hospital. Material and methods The study included 116 patients who have had documented COVID-19 pneumonia. Patients underwent a comprehensive clinical evaluation at 3 months ± 2 weeks (visit 1) and at one year ± 3 weeks after discharge from the hospital (visit 2). Mean age of the patients was 49.0±14.4 years (from 19 to 84 years); 49.6 % were women. Parameters of global and segmentary longitudinal left ventricular (LV) myocardial strain were studied with the optimal quality of visualization during visit 1 in 99 patients and during visit 2 in 80 patients.Results During the follow-up period, the incidence rate of cardiovascular diseases (CVD) increased primarily due to development of arterial hypertension (AH) (58.6 vs. 64.7 %, р=0.039) and chronic heart failure (CHF) (35.3% vs. 40.5 %, р=0.031). Echocardiography (EchoCG) showed decreases in values of end-diastolic dimension and volume, LV end-systolic and stroke volumes (25.1±2.6 vs. 24.5±2.2 mm /m2, p<0.001; 49.3±11.3 vs. 46.9±9.9 ml /m2, p=0.008; 16.0±5.6 vs. 14.4±4.1 ml /m2, p=0.001; 36.7±12.8 vs. 30.8±8.1 ml /m2, p<0.001, respectively). LV external short-axis area (37.1 [36.6–42.0] vs. 38.7 [35.2–43.1] cm2, р=0.001) and LV myocardial mass index calculated with the area-length formula (70.0 [60.8–84.0] vs. 75.4 [68.2–84.9] g /m², р=0.024) increased. LV early diastolic filling velocity (76.7±17.9 vs. 72.3±16.0 cm /sec, р=0.001) and lateral and septal early diastolic mitral annular velocities decreased (12,10±3,9 vs. 11.5±4.1 cm /sec, р=0.004 and 9.9±3.3 vs. 8.6±3.0 cm /sec, р<0.001, respectively). The following parameters of LV global longitudinal (–20.3±2.2 vs. –19.4±2.7 %, р=0.001) and segmental strain were impaired: apical segments (anterior, from –22.3±5.0 to –20.8±5.2 %, р=0.006; inferior, from –24.6±4.9 to –22.7±4.6, р=0.003; lateral, from –22.7±4.5 to –20.4±4.8 %, р<0.001; septal, from –25.3±4.2 to –23.1±4.4 %, р<0.001; apical, from –23.7±4.1 to –21.8±4.1 %, р<0.001), mid-cavity (anteroseptal, from –21.1±3.3 to –20.4±4.1 %, р=0.039; inferior, from –21.0±2.7 to –20.0±2.9 %, р=0.039; lateral, from –18.4±3.7 to –17.6±4.4 %, р=0.021). RV basal and mid-cavity sphericity indexes increased (0.44±0.07 vs. 0.49±0.07 and 0.37±0.07 vs. 0.41±0.07, respectively, р<0.001 for both). A tendency for increased calculated pulmonary arterial systolic pressure (22.5±7.1 and 23.3±6.3 mm Hg, р=0.076) was observed. Right ventricular outflow tract velocity integral decreased (18.1±4.0 vs. 16.4±3.7 cm, р<0.001).Conclusion Patients after COVID-19 pneumonia one year after discharge from the hospital, compared to the follow-up data 3 months after the discharge, had an increased incidence of CVD, primarily due to the development of AH and CHF. EchoCG revealed changes in ventricular geometry associated with impairment of LV diastolic and systolic function evident as decreases in LV global longitudinal strain and LV myocardial apical and partially mid-cavity strain.

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Prevalence of cardiovascular pathology and relationship of left ventricular global longitudinal strain three months after COVID-19

Krinochkin

Yaroslavskaya

Shirokov

et al. 2023

jour

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Purpose: To study the prevalence of cardiovascular diseases and the correlations of left ventricle global longitudinal strain (LV GLS) in patients 3 months after proven COVID-19 pneumonia.Material and methods. 369 patients with proven COVID-19 pneumonia underwent a comprehensive clinical examination and echocardiography (EchoCG) after 3 months ± 3 weeks after their discharge from the hospital. Mean age of the patients was 54 [46; 61]; 50.9% of them were women. LV GLS was studied in 284 (77%) of patients with optimal visualization quality during echocardiography. LV GLS was considered reduced in the limit of > –18%. Study Registration: ClinicalTrials.gov ID: NCT04501822.Results. 3 months after discharge, obesity was noted in 46.5% of patients, cardiovascular diseases were diagnosed in 73.4%, including de novo in 8.4%. Arterial hypertension occurred in 71.5% of patients, coronary artery disease — in 22.5%. The average left ventricle (LV) ejection fraction was 67.8 ± 5.0%, the average LV GLS was –19.5 ± 2.3%. LV GLS was reduced in 24.4% of the patients. LV GLS showed no correlation with the patient age, NYHA functional class and LV ejection fraction. Reduced LV GLS was independently associated with male sex (OR 1.399; 95% CI 1.239–1.580; p < 0.001), obesity (OR 1.268; 95% CI 1.132–1.421; p < 0.0001), diabetes mellitus (OR 1.204; 95 % CI 1.017–1.425; p = 0.031) and hypertension (OR 1.120; 95% CI 1.002–1.252; p = 0.046). LV GLS showed moderate positive correlations with echocardiographic parameters of right ventricle (RV): the length (r = 0.346), diastolic (r = 0.333) and systolic area (r = 0.326), width at the basal (r = 0.358) and midlevel (r = 0.321), as well as with the dimension of the proximal RV outfl ow tract (r = 0.302, all p < 0.001). LV GLS showed a weak correlation with the severity of lung lesions during hospitalization (r = 0.184; p = 0.002).Conclusions. 3 months after COVID-19 pneumonia, cardiovascular diseases were diagnosed in 73.4%. Reduced LV GLS was observed in 24.4% of survivors and was associated with male sex, obesity, diabetes mellitus, arterial hypertension and linear and planimetric RV dimensions.

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Cardiovascular status and echocardiographic changes in survivors of COVID-19 pneumonia three months after hospital discharge

Cited by 3 publications

References 10 publications

Cytokine profile in hospitalized patients with COVID-19 of different severity

Cytokine profile in hospitalized patients with COVID-19 of different severity

Comparison of clinical and echocardiographic parameters of patients with COVID-19 pneumonia three months and one year after discharge

Prevalence of cardiovascular pathology and relationship of left ventricular global longitudinal strain three months after COVID-19

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