ABSTRACT
Background: Some patients present persistent ground glass opacities (GGO) and/or consolidations after an acute episode of SARS-CoV-2 pneumonia (COVID19). Risk factors for persistent pneumonitis (PPN) and potential response to corticosteroids remain unclear. Objective(s): To evaluate the clinical characteristics of patients with PPN, as well as to detect possible risk factors and the role of corticosteroids. Method(s): We conducted a prospective, controlled, multicenter analysis of patients hospitalized because of COVID19 with (n=152) or without (n=140) PPN. PPN was defined by the persistence of pulmonary opacities in a chest CT scan >14 days after admission. Characteristics of participants were obtained from their medical records. A CT score was used to quantify parenchymal abnormalities when PPN was suspected. Result(s): Compared to controls, patients with PPN were older and suffered more comorbidities, also D-dimer and Creactive protein levels were higher. The most frequent features observed in CT scans were GGO (97%), consolidation (95%), bronchial dilatation (93%) and reticular pattern (92%) with a CT score of 16.12+/-4.26. Multivariate logistic regression identified age and C-reactive protein levels on admission as independent risk factors for PPN. No significant differences were observed in thoracic CT scan one-month after discharge in patients treated with higher corticosteroids doses (>50 mg/day after discharge) compared to lower doses. Conclusion(s): Age and raised C-reactive protein levels on admission are significant risk factors of PPN after COVID19. Treatment with high doses of corticosteroids does not seem to add benefit.
ABSTRACT
Background Cardiac muscle injury has been described as a known consequence of coronavirus-2019 (COVID-19) with poor clinical outcome. We aim to study the correlation between myocardial muscle injury and specific echocardiographic findings and, hence the association with mortality. Methods We conducted a retrospective cohort at the University Medical Center in Lubbock, Texas, under IRB of L20-172. We included COVID-19 patients from March 2020 until July 2020 who had transthoracic echocardiography (TTE) during their hospital admission. Myocardial muscle injury was defined by elevated troponin. Results A total of 101 patients were included. The mean age was 60 years, and 69.3 % were males. A total of 66 patients had a myocardial injury. Patients with myocardial injury had higher mortality than those without myocardial injury with a P-value of < 0.05, and this value remained significant after running a multiple regression analysis model. Only 4 patients had an ejection fraction of less than 40%. 11 patients had pericardial effusion. Only 4 patients had tricuspid annular plane systolic excursion (TAPSE)<1.5 cm. The mortality rate was 29.7%, and only 6 patients developed acute myocardial infarction. No difference was found between the two groups regarding the different echocardiographic findings. Conclusion Patients with COVID-19 and myocardial injury had higher mortality than those without myocardial injury with no difference regarding the different echocardiographic findings. [Formula presented]