Niebauer Julia Hanne, Binder-Rodriguez Christina, Iscel Ahmet, Schedl Sarah, Capelle Christophe, Kahr Michael, Cadjo Simona, Schamilow Simon, Badr-Eslam Roza, Lichtenauer Michael, Toma Aurel, Zoufaly Alexander, Valenta Rosmarie, Hoffmann Sabine, Charwat-Resl Silvia, Krestan Christian, Hitzl Wolfgang, Wenisch Christoph, Bonderman Diana
Department of Cardiology, Favoriten Clinic, 1100 Vienna, Austria.
Department of Cardiology, Medical University of Vienna, 1090 Vienna, Austria.
J Clin Med. 2023 Feb 15;12(4):1536. doi: 10.3390/jcm12041536.
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], = 0.026), reduced GLS (OR 5.2 [95% CI: 1.6-16.7], = 0.003) and/or left ventricular diastolic dysfunction (OR 4.2 [95% CI: 1.03-17], = 0.04). Predictors of Long-COVID included length of in-hospital stay (OR: 1.15 [95% CI: 1.05-1.26], = 0.004), admission to intensive care unit (OR cannot be computed, = 0.001) and higher NT-proBNP (OR: 1.5 [95% CI: 1.05-2.14], = 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.
我们旨在通过一项前瞻性登记研究，确定重症新型冠状病毒肺炎（COVID-19）疾病后的心肺长期影响以及长期新冠（Long-COVID）的预测因素。共纳入了150例连续住院患者（2020年2月至2021年4月），出院6个月后进行临床随访。其中，49%的患者出现疲劳，38%的患者出现运动性呼吸困难，75%的患者符合长期新冠的标准。超声心动图检查发现1处全球纵向应变（GLS）降低，4%的患者出现舒张功能障碍。磁共振成像显示18%的患者有微量心包积液，4%的患者有既往心包炎或心肌炎的迹象。11%的患者肺功能受损。胸部计算机断层扫描发现22%的患者有感染后残留。虽然疲劳与心肺异常无关，但运动性呼吸困难与肺功能受损（比值比[OR]3.6[95%置信区间：1.2 - 11]，P = 0.026）、GLS降低（OR 5.2[95%置信区间：1.6 - 16.7]，P = 0.003）和/或左心室舒张功能障碍（OR 4.2[95%置信区间：1.03 - 17]，P = 0.04）相关。长期新冠的预测因素包括住院时间（OR：1.15[95%置信区间：1.05 - 1.26]，P = 0.004）、入住重症监护病房（OR无法计算，P = 0.001）和较高的N末端脑钠肽前体（NT-proBNP）（OR：1.5[95%置信区间：1.05 - 2.14]，P = 0.026）。即使在出院6个月后，大多数患者仍符合长期新冠的标准。虽然未发现疲劳与心肺异常之间存在关联，但运动性呼吸困难与肺功能受损、GLS降低和/或舒张功能障碍相关。
