Skonieczny Grzegorz, Skowrońska Marta, Dolacińska Agnieszka, Ratajczak Beata, Sulik Patrycja, Doroba Oliwia, Kotula Alicja, Błażejowska Ewelina, Staniszewska Izabela, Domaszk Olaf, Pruszczyk Piotr
Cardiology Department and Intensive Cardiac Unit, Provincial Polyclinical Hospital, Torun, Poland.
Department of Internal Medicine & Cardiology, Medical University of Warsaw, Warsaw, Poland.
Cardiol J. 2025;32(1):1-8. doi: 10.5603/cj.99538. Epub 2024 Nov 7.
SARS-CoV-2 infection may lead to myocardial and endothelial damage. The present study sought to characterize the cardiovascular sequel in a large group of consecutive patients admitted for out-patient cardiovascular follow-up after a symptomatic COVID-19 infection.
The aims of this study were as follows: to evaluate the presence of post-covid cardiovascular symptoms in an unselected population of outpatients referred to a post-COVID outpatient cardiology clinic and to characterize the long-term abnormalities associated with a more severe COVID-19 infection clinical course. A total of 914 patients were included in this single-center, observational, cross-sectional study, of which 163 were hospitalized and 149 required mechanical ventilation for COVID-19 pneumonia. Patients were analyzed at follow-up according to the care setting during the initial presentation.
The median time to follow-up was 126 days. At that time, only 3.5% of patients reported no persistent dyspnea, chest pain, or fatigue on exertion. In a follow-up echocardiographic assessment, patients who required hospitalization showed slight alterations in the pulmonary acceleration time and the tricuspid regurgitation pressure gradient, as well as reduced exercise tolerance during treadmill exercise testing when compared to patients with a benign clinical course. 24-hour Holter EKG monitoring or 24-hour blood pressure monitoring did not identify significant differences between the analyzed subgroups.
The current study reports on an association between COVID-19 severity and the presence of cardiovascular alterations at follow-up. A simple diagnostic protocol, comprising an exercise treadmill test and transthoracic echocardiography is useful in identifying patients who may benefit from regular, structured cardiovascular medical care.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染可能导致心肌和内皮损伤。本研究旨在对一大组有症状的新型冠状病毒肺炎（COVID-19）感染后因门诊心血管随访而入院的连续患者的心血管后遗症进行特征描述。
本研究的目的如下：评估转诊至COVID-19门诊心脏病诊所的未选择门诊患者群体中COVID-19后心血管症状的存在情况，并对与更严重的COVID-19感染临床病程相关的长期异常进行特征描述。本单中心、观察性横断面研究共纳入914例患者，其中163例曾住院治疗，149例因COVID-19肺炎需要机械通气。根据初次就诊时的护理情况对患者进行随访分析。
随访的中位时间为126天。那时，只有3.5%的患者报告在运动时没有持续的呼吸困难、胸痛或疲劳。在随访超声心动图评估中，与临床病程较轻的患者相比，需要住院治疗的患者在肺动脉加速时间和三尖瓣反流压力梯度方面有轻微改变，并且在平板运动试验中的运动耐量降低。24小时动态心电图监测或24小时血压监测未发现分析的亚组之间存在显著差异。
本研究报告了COVID-19严重程度与随访时心血管改变之间的关联。一个简单的诊断方案，包括平板运动试验和经胸超声心动图，有助于识别可能从定期、结构化心血管医疗护理中获益的患者。
