J Clin Med . A Multidisciplinary Approach to Evaluate the Presence of Hepatic and Cardiac Abnormalities in Patients with Post-Acute COVID-19 Syndrome-A Pilot Study

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J Clin Med


. 2021 Jun 6;10(11):2507.
doi: 10.3390/jcm10112507.
A Multidisciplinary Approach to Evaluate the Presence of Hepatic and Cardiac Abnormalities in Patients with Post-Acute COVID-19 Syndrome-A Pilot Study


Felix Bende ^{1 2 3} , Cristina Tudoran ^{3 4 5} , Ioan Sporea ^{1 2 3} , Renata Fofiu ^{1 2} , Victor Bâldea ^{1 2} , Radu Cotrău ^{1 2} , Alina Popescu ^{1 2 3} , Roxana Sirli ^{1 2 3} , Bogdan Silviu Ungureanu ⁶ , Mariana Tudoran ^{3 4 5}



Affiliations

• PMID: 34204032
• DOI: 10.3390/jcm10112507

Abstract

(1) Background: Patients suffering from the novel coronavirus 2019 (COVID-19) disease could experience several extra-pulmonary involvements, including cardiovascular complications and liver injury. This study aims to evaluate the presence of cardiac and liver alterations in patients with post-acute COVID-19 syndrome using transthoracic echocardiography (TTE) and liver elastography (LE). (2) Methods: A total of 97 subjects recovering from COVID-19, attending the hospital's specialized outpatient clinic for persisting symptoms at 3 to 11 weeks after the acute illness, were included in this study. They all had a basal COVID-19 assessment, and subsequently, a clinical evaluation, laboratory tests, TTE, and LE. (3) Results: considering the presence of pulmonary injury during COVID-19, patients were divided into two groups. Although none of them had altered systolic function, we evidenced pulmonary hypertension, diastolic dysfunction, increased liver stiffness, viscosity, and steatosis in around one-third of the patients, with significantly higher values in subjects with pulmonary injury compared to those without. (4) Conclusion: persisting symptoms characterizing the post-acute COVID-19 syndrome could be explained by residual cardiac and hepatic lesions, which were worse in more severe COVID-19 forms. These patients may be at risk of developing liver fibrosis and cardiac alterations and should be investigated in the first 12 weeks after the onset of the infection.

Keywords: COVID-19; cardiovascular alterations; cytokine storm; inflammation; liver elastography; liver injury; transthoracic echocardiography.