Bende Felix, Tudoran Cristina, Sporea Ioan, Fofiu Renata, Bâldea Victor, Cotrău Radu, Popescu Alina, Sirli Roxana, Ungureanu Bogdan Silviu, Tudoran Mariana
Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy "Victor Babes" Timisoara, 300041 Timisoara, Romania.
Center of Advanced Research in Gastroenterology and Hepatology, Faculty of Medicine, University of Medicine and Pharmacy "Victor Babes" Timisoara, 300041 Timisoara, Romania.
J Clin Med. 2021 Jun 6;10(11):2507. doi: 10.3390/jcm10112507.
(1) Background: Patients suffering from the novel coronavirus 2019 (COVID-19) disease could experience several extra-pulmonary involvements, including cardiovascular complications and liver injury. This study aims to evaluate the presence of cardiac and liver alterations in patients with post-acute COVID-19 syndrome using transthoracic echocardiography (TTE) and liver elastography (LE). (2) Methods: A total of 97 subjects recovering from COVID-19, attending the hospital's specialized outpatient clinic for persisting symptoms at 3 to 11 weeks after the acute illness, were included in this study. They all had a basal COVID-19 assessment, and subsequently, a clinical evaluation, laboratory tests, TTE, and LE. (3) Results: considering the presence of pulmonary injury during COVID-19, patients were divided into two groups. Although none of them had altered systolic function, we evidenced pulmonary hypertension, diastolic dysfunction, increased liver stiffness, viscosity, and steatosis in around one-third of the patients, with significantly higher values in subjects with pulmonary injury compared to those without. (4) Conclusion: persisting symptoms characterizing the post-acute COVID-19 syndrome could be explained by residual cardiac and hepatic lesions, which were worse in more severe COVID-19 forms. These patients may be at risk of developing liver fibrosis and cardiac alterations and should be investigated in the first 12 weeks after the onset of the infection.
(1) 背景:2019年新型冠状病毒病(COVID-19)患者可能会出现多种肺外表现,包括心血管并发症和肝损伤。本研究旨在使用经胸超声心动图(TTE)和肝脏弹性成像(LE)评估急性COVID-19综合征后患者的心脏和肝脏改变情况。(2) 方法:本研究纳入了97例从COVID-19中康复的受试者,他们在急性疾病后3至11周因持续症状前往医院的专科门诊就诊。他们均进行了基础COVID-19评估,随后进行了临床评估、实验室检查、TTE和LE。(3) 结果:根据COVID-19期间是否存在肺损伤,将患者分为两组。虽然他们均未出现收缩功能改变,但我们发现约三分之一的患者存在肺动脉高压、舒张功能障碍、肝脏硬度增加、黏度增加和脂肪变性,与无肺损伤的患者相比,有肺损伤的患者上述指标值明显更高。(4) 结论:急性COVID-19综合征持续存在的症状可能由残留的心脏和肝脏病变所解释,在更严重的COVID-19类型中情况更糟。这些患者可能有发生肝纤维化和心脏改变的风险,应在感染发病后的前12周进行检查。