Impact of COVID-19 vaccination in post-COVID cardiac complications.

BACKGROUND: After the acute infection, COVID-19 can produce cardiac complications as well as long-COVID persistent symptoms. Although vaccination against COVID-19 represented a clear reduction in both mortality and ICU admissions, there is very little information on whether this was accompanied by a decrease in the prevalence of post-COVID cardiac complications. The aim of this study was to analyze the relationship between COVID-19 vaccination and the prevalence of post-COVID cardiac injury assessed by echocardiogram, and long-COVID persistent cardiac symptoms. METHODS: All patients who consulted for post-COVID evaluation 14 days after discharge from acute illness were included. Patients with heart disease were excluded. The relationship between complete vaccination scheme (at least two doses applied with 14 days or more since the last dose) and pathological echocardiographic findings, as well as the relationship of vaccination with persistent long-COVID symptoms, were evaluated by multivariate analysis, adjusting for age, sex and clinical variables that would have shown significant differences in univariate analysis. RESULTS: From 1883 patients, 1070 patients (56.8%) suffered acute COVID-19 without a complete vaccination scheme. Vaccination was associated with lower prevalence of cardiac injury (1.35% versus 4.11%, adjusted OR 0.33; 95% CI 0.17-0.65, p=0.01). In addition, vaccinated group had a lower prevalence of persistent long-COVID symptoms compared to unvaccinated patients (10.7% versus 18.3%, adjusted OR 0.52; 95% CI 0.40-0.69, p<0.001). CONCLUSION: Vaccination against COVID-19 was associated with lower post-COVID cardiac complications and symptoms, reinforcing the importance of fully vaccinating the population.

Compromiso cardíaco y su relación con la gravedad del cuadro agudo y los síntomas persistentes en la convalecencia de infección por COVID-19 / Cardiovascular Involvement and its Relationship with the Severity of the Acute Phase and Persistent Symptoms during Recovery from COVID-19 Infection

RESUMEN Introducción: La infección por COVID-19 se asocia a compromiso cardiovascular en su etapa aguda. La información sobre el compromiso cardíaco en la etapa de convalecencia de la enfermedad tanto en pacientes con y sin síntomas persistentes es limitada. Objetivos: 1. Analizar el compromiso cardíaco mediante ecocardiograma en la etapa de convalecencia de la enfermedad por COVID-19; 2. Explorar su asociación con: a) gravedad del cuadro agudo y b) persistencia de síntomas. Métodos: Estudio analítico, observacional, prospectivo y unicéntrico. Se incluyeron pacientes consecutivos que consultaron al centro para realizar evaluación post-COVID. Se realizó ecocardiograma Doppler color transtorácico en busca de hallazgos patológicos. Resultados: Se incluyeron 600 pacientes desde el 01/09/2020 al 01/05/2021. Veintinueve (4,8%) presentaron hallazgos patológicos en el ecocardiograma. Los pacientes con cuadros iniciales moderados o graves presentaron mayor prevalencia de trastornos de motilidad parietal (4,3% versus 0,5%, p = 0,02) y derrame pericárdico (4,3% versus 0,24%, p = 0,01) en comparación con aquellos con cuadros asintomáticos o leves. En el ajuste multivariado esta asociación no alcanzó significación estadística. El 28,6% de los pacientes referían síntomas persistentes, no observándose una asociación entre la presencia de los mismos y los hallazgos ecocardiográficos patológicos. Conclusión: La prevalencia de compromiso cardíaco evaluado mediante ecocardiograma en la etapa de convalecencia de la enfermedad por COVID-19 fue de 4,8%. Los pacientes con cuadros iniciales más graves presentaron más hallazgos patológicos. La significancia no se sostuvo en el análisis multivariado. Los síntomas persistentes no se asociaron a mayor compromiso cardíaco.

ABSTRACT Background: The acute phase of COVID-19 infection is associated with cardiovascular involvement, but there is limited information regarding this relationship in the recovery phase from this disease both in patients with or without persistent symptoms. Objectives: The aims of this study were: 1. To analyze cardiovascular involvement by echocardiography in the recovery phase from COVID-19 disease, and 2. To explore its association with: a) the severity of the acute phase and b) the presence of persistent symptoms. Methods: An analytical, observational, prospective and single-center study was carried out, including consecutive patients attending the center for post-COVID-19 evaluation who underwent a transthoracic color Doppler echocardiogram looking for pathological outcomes. Results: A total of 600 patients were included from September 1, 2020 to May 1, 2021, and 29 of these patients (4.8%) presented pathological findings in the echocardiogram. Patients with moderate or severe acute phase COVID-19 infection had a higher prevalence of wall motion disorders (4.3% vs. 0.5%, p=0.02) and pericardial effusion (4.3% vs. 0.24%, p=0.01) compared with those with asymptomatic or mild symptoms; however, after multivariate adjustment, this association did not reach statistical significance. In 28.6% of cases, patients reported persistent symptoms, with no evident association between their presence and pathological echocardiographic results. Conclusion: The prevalence of cardiovascular involvement evaluated by echocardiography was 4.8% in the recovery phase from COVID-19 disease. Patients with more severe initial clinical presentation exhibited more pathological findings, but the significance was not sustained in the multivariate analysis. Persistent symptoms were not associated with greater cardiovascular involvement.

Impacto psicosocial de la pandemia por COVID-19 en adultos de Buenos Aires / Psychosocial Impact of the COVID-19 Pandemic on the Adult Population of Buenos Aires

RESUMEN Introducción: En marzo de 2020, la Organización Mundial de la Salud (OMS) declaró a la enfermedad SARS-CoV-2, coronavirus, una pandemia. Desde ese momento, se lleva a cabo un experimento psicológico notablemente grande en el mundo: el aislamiento social. Objetivos: Analizar la repercusión del aislamiento social sobre los hábitos saludables y algunos aspectos psicosociales y conductuales durante el confinamiento y las restricciones impuestas por la pandemia en el área metropolitana de Buenos Aires (AMBA). Material y métodos: Se confeccionó una encuesta y se convocó por redes sociales (WhatsApp, Instagram, Facebook, e-mail) a que la respondieran en forma anónima todos excepto el personal médico. Resultados: Tras 7 días de enviado el correspondiente enlace, habían contestado la encuesta 2912 personas; el 48,2% de ellas tenía entre 40 y 60 años y en su mayoría eran mujeres. El 43,53% percibieron modificaciones en sus hábitos de vida, como el aumento en las horas frente a dispositivos electrónicos, que se duplicó en la cuarentena. Esto se acompañó de mayor sedentarismo: el 83,5% hacía ejercicio antes de la pandemia, pero solo el 6,4% mantuvo la cantidad de horas semanales de ejercicio que hacía antes del aislamiento. El 43,52% presentó alteración en sus hábitos alimenticios y el 41% refirió síntomas compatibles con depresión, ansiedad, tristeza, falta de voluntad o desesperanza. Conclusiones: Nuestro estudio sugiere que el bienestar psicológico y los hábitos saludables son amenazados por el confinamiento establecido para contener la transmisión de COVID-19, por lo que es preciso implementar medidas para prevenir consecuencias en nuestra población.

ABSTRACT Background: In March 2020 the World Health Organization (WHO) declared the SARS-CoV-2 coronavirus a pandemic, and since then a remarkably large psychological experiment has been carried out in the world: social isolation. Objectives: The aim of this study was to analyze the impact of social isolation on healthy habits and psychosocial and behavioral aspects during the confinement and restrictions imposed by the pandemic in the metropolitan area of Buenos Aires (AMBA). Methods: An anonymous survey, excluding medical personnel, was carried out through social networks (WhatsApp, Instagram, Facebook and e-mail). Results: Within 7 days of sending the link 2,912 people answered the survey. Age was between 40 and 60 years in 48.2% of participants, with a predominance of women. In 43.53% of cases, respondents perceived changes in their lifestyle, such as a twofold increase of hours in front of electronic devices during quarantine. This was accompanied by a more sedentary lifestyle, since 83.5% exercised before the pandemic but only 6.4% maintained the prior hours of weekly physical activity. Altered eating habits was reported by 43.52% of participants and 41% referred symptoms compatible with depression, anxiety, sadness, unwillingness or hopelessness. Conclusions: Our study suggests that psychological wellbeing and healthy habits are threatened by confinement in the face of the COVID-19 pandemic, so it is necessary to implement measures to prevent consequences in our population.