ABSTRACT
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic carried cardiac complications and unfavorable lifestyle changes that may increase cardiovascular risk. OBJECTIVES: The study objectives entailed establishing the cardiac status of convalescents several months after COVID-19, and the 10-year risk of fatal and non-fatal atherosclerotic cardiovascular disease (ASCVD) events, according to Systemic Coronary Risk Estimation-2 (SCORE2) and SCORE2-Older Persons algorithm. PATIENTS AND METHODS: The study included 553 convalescents aged 63.50 (SD 10.26), 316 (57.1%) women, hospitalized at the Cardiac Rehabilitation Department, Ustron Health Resort, Poland. The history of cardiac complications, exercise capacity, blood pressure control, echocardiography, 24-hour electrocardiogram Holter recording, and laboratory tests were assessed. RESULTS: 20.7% of men and 17.7% of women (p=0.38) had cardiac complications during acute COVID-19, most often heart failure (10.7%), pulmonary embolism (3.7%), and supraventricular arrhythmias (6.3%). On average, four months after diagnosis, echocardiographic abnormalities were found in 16.7% of men and 9.7% of women (p=0.10), and benign arrhythmias in 45.3% and 44.0% (p=0.84). Preexisting ASCVD was reported in 21.8% of men and 6.1% of women (p<0.001). The median risk in SCORE2/SCORE2-Older Persons in apparently healthy people was high for participants aged 40-49 (3.0%, interquartile range 2.0-4.0) and 50-69 (8.0%, 5.3-10.0), and very high (20.0%, 15.5-37.0) for participants aged ≥70. SCORE2 rating in men aged <70 was higher than in women (p<0.001). CONCLUSIONS: Data collected in convalescents indicates a relatively small number of cardiac problems that could be associated with a history of COVID-19 in both sexes, whereas the high risk of ASCVD, especially in men.
ABSTRACT
Symptoms of long COVID-19 syndrome (long COVID-19) are reported by 80% of convalescents up to several months after contracting the coronavirus-19 disease (COVID-19). The study aimed to assess the frequency and correlations of long COVID symptoms with sex, disease severity, time since the onset of the disease, and exercise capacity in a population of Polish convalescents hospitalized as a part of a rehabilitation program after COVID-19. The retrospective analysis was carried out based on medical records concerning reported symptoms, comorbidities, exercise capacity, fatigue and dyspnea on Borg's scale, arterial oxygen saturation (SpO2), spirometric parameters, chest X-rays/computed tomography scans, systolic pulmonary artery pressure, and left ventricular ejection fraction. The study involved 471 patients aged 63.83 ± 9.93 years who had been hospitalized 191.32 ± 75.69 days from the onset of COVID-19, of which 269 (57.1%) were women. The most common symptoms were fatigue (99.57%), dyspnea (99.36%), and myalgia (97.03%). Women reported more symptoms than men (p < 0.001) and rated their fatigue as more severe (p = 0.021). Patients with depressed moods reported more physical symptoms than others (p < 0.001). Most long COVID symptoms, including dyspnea, fatigue, and depressive symptoms, were found with the same frequency in patients 12-24 weeks and >24 weeks after recovery (p = 0.874, p = 0.400, and p = 0.320, respectively), regardless of acute COVID-19 severity (p = 0.240, p = 0.826, and p = 0.108, respectively). Dyspnea severity correlated with forced vital capacity (FVC) (r = -0.153, p = 0.005), and forced expiratory volume in one second (FEV1) (r = -0.142, p = 0.008). Fatigue severity correlated with impaired FVC and FEV1 (both r = -0.162, p = 0.003). Fatigue and dyspnea inversely correlated with the distance in a six-minute walk test (r = -0.497, p < 0.001, and r = -0.327, p < 0.001). In conclusion, in our cohort, long COVID symptoms are more common in women. Dyspnea/fatigue and depressive symptoms do not tend to subside after an average six-month recovery period. The intensity of perceived fatigue may be exaggerated by the coexistence of neuropsychiatric disorders. Increased fatigue and dyspnea correlate with impaired spirometric parameters and significantly affects convalescents' exercise capacity.
ABSTRACT
INTRODUCTION: A history of COVID-19 causes the deterioration of the cardiorespiratory fitness (CRF). The study's objectives entailed evaluating the effectiveness of cardiopulmonary rehabilitation (CR) after COVID-19 carried out under the National Health Fund program. PATIENTS AND METHODS: 553 convalescents were included, mean age 63.50, SD (10.26) years, 316 (57.1%) women, 23.10 (IQR 16.25-29.00) weeks after COVID-19, hospitalized at the Cardiac Rehabilitation Department of the Ustron Health Resort, Poland. The mean duration of the CR was 21.0 (IQR 21.0-28.0) days. RESULTS: The baseline CRF as assessed by the six-minute walk test (6MWT) was reduced to 76.32% of predicted values (15.87) in men and 85.83% (15.60) in women, while the mean values of spirometric parameters were normal. During the CR, there was an improvement in median 6MWT distance of 42.50m (95%CI 37.50, 45.00, P <0.001) and in median exercise tolerance assessed on the Borg's scale (fatigue of -1.0 points, 95%CI -1.0, -1.0, P <0.001; dyspnea of -1.5 points, 95%CI -1.5, -1.0, P <0.001). The decrease in mean resting blood pressure by 8.57mmHg (95%CI -11.30, -5.84, P <0.001) for systolic and by 3.38mmHg (95%CI -4.53, -2.23, P <0.001) for diastolic values was observed. The most significant improvement was seen in the group with low CRF at baseline, which qualified for rehabilitation models C/D. The CR effectiveness was not depended on the severity of COVID-19 and the time to the commencement of rehabilitation. CONCLUSIONS: CR is a safe and effective intervention that can accelerate recovery from COVID-19, including increasing exercise capacity and exercise tolerance.
ABSTRACT
The coronavirus disease 2019 (COVID-19) is associated with an increase in the incidence of cardiovascular diseases (CVD) that persists even several months after the onset of infection. COVID-19 may also have an impact on arterial stiffness, which is a risk factor for CVD. We aimed to analyze if and to what extent arterial stiffness measured by photoplethysmography differed among COVID-19 convalescents depending on the acute phase severity and time elapsed since disease onset. A total of 225 patients (mean age 58.98 ± 8.57 years, 54.7% women) were analyzed after COVID-19 hospitalization at the Cardiac Rehabilitation Department of the Ustron Health Resort (Poland). In the entire study population, no differences were found in the mean values of stiffness index (SI) and reflection index (RI) depending on the severity of the acute COVID-19 and the time since the onset of the disease. There were no differences in the heart rate (HR) according to the severity of acute COVID-19; the mean HR was higher in patients who had COVID-19 less than 12 weeks before the study than in convalescents more than 24 weeks after the acute disease (p = 0.002). The mean values of SI and RI were higher in men than in women (p < 0.001), while the heart rate (HR) was similar in both sexes (p = 0.286). However, multiple linear regression analyses after adjusting for factors influencing arterial stiffness, i.e., sex, age, body mass index, smoking status, hypertension, diabetes, the severity of the acute COVID-19, and the time from the disease onset, confirmed that age, sex, time from disease onset, and diabetes are the most important determinants that could influence arterial stiffness.