Mid-term subclinical myocardial injury detection in patients recovered from COVID-19 according pulmonary lesion severity.

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV 2) may cause damage of the cardiovascular system during the acute phase of infection. However, Recent studies described a mid and long-term subtle cardiac injuries after recovery from acute Coronavirus disease 19 (COVID-19).The aim of this study was to determine the relationship between the severity of chest computed tomography (CT) lesions and the persistence of subtle myocardial injuries at mid-term follow-up of patients recovered from COVID-19 infection. MethodsAll COVID-19 patients were enrolled prospectively in this study. Sensitive troponin T (hsTnT) and chest CT scan was performed in all patients at the acute phase of Covid-19 infection. At the mid-term follow up, conventional transthoracic echocardiograph and global longitudinal strain (GLS) of left and right ventricles (LV and RV) were determined and compared between patients with chest CT scan lesions less than 50% (Group 1) and those with severe chest CT scan greater or equal to 50% (Group 2). ResultsThe mean age was 55 more or less than 14 years. Both LV GLS and RV GLS were significantly decreased in the group 2 (p=0.013 and p=0.011, respectively). LV GLS value more than -18% was noted in 43% of all the patients and RV GLS value more than -20% was observed in 48% of them. The group with severe chest CT scan lesions included more patients with reduced LV GLS and reduced RV GLS than the group with mild chest CT scan lesions (G1:29% vs. G2:57%, p=0.002) and (G1:36% vs. G2:60 %, p=0.009) respectively). ConclusionPatients with severe chest CT scan lesions are more likely to develop subclinical myocardial damage. TTE could be recommended in patients recovering from COVID-19 to detect subtle LV and RV lesions. Trial registrationThe cohort of patients is a part of the research protocol (IORG 00093738 N{degrees}102/OMB 0990-0279) approved by the Hospital Ethics Committee.

Spontaneous pneumomediastinum: Experience in 13 patients.

Spontaneous pneumomediastinum (SPM) is a rare clinical entity that concerns mainly young adults. We report 13 cases (11 males/2 females) of SPM. The average age was 31 ±â€¯0.85 years. The most common precipitating factor was asthma attack. The onset symptoms were mainly chest pain (11 cases). Synchronous pneumothorax was found in 5 cases and it was bilateral in 2 patients. The evolution was marked by the spontaneous resorption. SMP is an underrecognized cause of chest pain in young adults. Chest radiography is usually sufficient for the diagnosis, and further diagnostic procedures are generally not necessary. The prognosis is often favorable.