Long COVID-19 Syndrome Severity According to Sex, Time from the Onset of the Disease, and Exercise Capacity-The Results of a Cross-Sectional Study.

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.

Effectiveness of cardiopulmonary rehabilitation after COVID-19 in Poland.

INTRODUCTION: Patients with a history of COVID­19 are characterized by a deteriorated level of cardiorespiratory fitness (CRF). The COVID­19 rehabilitation program of the National Health Fund (NHF) was developed and financed by the public insurer in Poland to help convalescents return to full health. OBJECTIVES: We aimed to evaluate the effectiveness of cardiopulmonary rehabilitation (CR) after COVID­19, carried out under the NHF program. PATIENTS AND METHODS: The study included 553 convalescents at a mean age of 63.5 years (SD, 10.26; 316 women [57.1%]), hospitalized at the Cardiac Rehabilitation Department of the Ustron Health Resort, Poland, after a median of 23.10 weeks (interquartile range [IQR], 16.25-29.00) following COVID­19. The mean duration of CR was 21 days (IQR, 21-28). The effectiveness of CR was assessed based on the improvement in spirometry and clinical parameters, as well as indicators of CRF and exercise tolerance. RESULTS: The mean baseline CRF level, as assessed by the 6­minute walk test (6MWT), was reduced to 76.32% of the predicted value (SD, 15.87) in men and 85.83% of the predicted value (SD, 15.60) in women, while the mean values of the spirometry parameters were normal. During CR, there was an improvement in the median 6MWT distance by 42.5 m (95% CI, 37.50-45.00; P <0.001), and in the median exercise tolerance assessed on the Borg scale (fatigue, by -1 point; 95% CI, -1.0 to -1.0; P <0.001; dyspnea, by -1.5 points; 95% CI, -1.5 to -1.0; P <0.001). We observed a decrease in the mean resting blood pressure by 8.57 mm Hg (95% CI, -11.30 to -5.84; P <0.001) for systolic and by 3.38 mm Hg (95% CI, -4.53 to -2.23; P <0.001) for diastolic values. The most pronounced improvement was seen in the patients with low CRF level at baseline, who were eligible for lower­intensity rehabilitation models. The CR effectiveness was not dependent on the severity of COVID­19 or the time from the disease onset to the commencement of rehabilitation. CONCLUSIONS: CR is a safe and effective intervention that can accelerate recovery from COVID­19, including an increase in exercise capacity and exercise tolerance.

Cardiac status and atherosclerotic cardiovascular risk of convalescents after COVID-19 in Poland.

INTRODUCTION: The COVID­19 pandemic brought about cardiac complications and unfavorable lifestyle changes that may increase cardiovascular risk. OBJECTIVES: Our aim was to establish the cardiac status of convalescents several months after COVID­19, and the 10­year risk of fatal and nonfatal atherosclerotic cardiovascular disease (ASCVD) events, according to the Systemic Coronary Risk Estimation­2 (SCORE2) and SCORE2­Older Persons (OP) algorithms. PATIENTS AND METHODS: The study included 553 convalescents (mean [SD] age, 63.5 [10.26] years; 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, 24­hour Holter electrocardiogram recording, and laboratory workup were assessed. RESULTS: A total of 20.7% of men and 17.7% of women (P = 0.38) had cardiac complications during acute COVID­19, most often heart failure (10.7%), pulmonary embolism (3.7%), and supraventricular arrhythmias (6.3%). On average, 4 months after COVID­19 diagnosis, echocardiographic abnormalities were found in 16.7% of men and 9.7% of women (P = 0.1), and benign arrhythmias in 45.3% of men and 44% of women (P = 0.84). Preexisting ASCVD was reported in 21.8% of men and 6.1% of women (P <0.001). The median risk assessed by SCORE2/SCORE2­OP algorithms in apparently healthy people was high for the participants aged 40-49 years (3%; interquartile range [IQR], 2%-4%) and 50-69 years (8%; IQR, 5.3%-10%), and very high (20%; IQR, 15.5%-37%) for the participants aged 70 years and above. The SCORE2 risk in men aged over 70 years was higher than in women (P <0.001). CONCLUSIONS: Data collected in the convalescents indicate a relatively small number of cardiac problems that could be associated with a history of COVID­19 in either sex, and a high risk of ASCVD, especially in men.

Coagulation Factor XIII Val34Leu Polymorphism in the Prediction of Premature Cardiovascular Events-The Results of Two Meta-Analyses.

BACKGROUND: Polymorphisms within the gene that encodes for coagulation factor XIII (FXIII) have been suggested to be involved in the pathogeneses of ischemic stroke (IS) and myocardial infarction (MI). The Val34Leu polymorphism is one of the most commonly analysed FXIII polymorphisms. However, studies on the role of the Val34Leu polymorphism in the aetiology of vascular diseases often show contradictory results. In the present meta-analysis, we aimed to pool data from available articles to assess the relationship between the FXIII Val34Leu polymorphism and the susceptibilities to IS of undetermined source and premature MI in patients aged below 55 years. METHODS: We searched databases (PubMed, Embase, Google Scholar, SciELO, and Medline) using specific keywords (the last search was in January 2022). Eventually, 18 studies (627 cases and 1639 controls for IS; 2595 cases and 4255 controls for MI) met the inclusion criteria. Data were analysed using RevMan 5.4 and StatsDirect 3 link software. The relation between Val34Leu polymorphism and disease was analysed in five genetic models, i.e., dominant, recessive, additive, heterozygous, and allelic. RESULTS: No relation between Val34Leu polymorphism and IS in young adults was observed in all analysed genetic models. For premature MI, significant pooled OR was found between the carrier state of the Leu allele (Val/Leu + Leu/Leu vs. Val/Val) and a lack of MI, suggesting its protective role (OR = 0.80 95%CI 0.64-0.99, p = 0.04). A similar finding was observed for the heterozygous model in MI (Val/Leu vs. Val/Val) (OR = 0.77 95%CI 0.61-0.98, p = 0.03). No relation was found for the recessive, additive, and allelic models in MI. CONCLUSIONS: In the population of young adults, no positive correlation was found between the FXIII Val34Leu polymorphism and IS of undetermined source in any of the analysed genetic models. In turn, the carrier state of the 34Leu allele as well as FXIII heterozygotes themselves were found to play a protective role in relation to premature MI.

Photoplethysmographic Measurement of Arterial Stiffness in Polish Patients with Long-COVID-19 Syndrome-The Results of a Cross-Sectional Study.

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.