Differential impacts of COVID-19 variants on human microvascular function

Nishijima, Yoshinori; Hader, Shelby N.; Beyer, Andreas

doi:10.1093/cvr/cvad006

Cited by 5 publications

(4 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This number is in accordance with other reports stating that patients with COVID-19 exhibited abnormal CMR findings at rates of 18% to 78% [3][4][5][6], depending on the included patient cohort, the severity of the acute infection, hospitalization, and time after the viral infection. Our time analysis revealed a decrease in the prevalence of abnormal CMR findings after 3 to 5 months, probably due to repeated vaccination or to the less cardio-invasive SARS-CoV-2 variants (e.g., Omicron); these findings are in line with other reports [5,25]. However, the role of spontaneous improvement in cardiac abnormalities and the role of an arbitrary intake of diverse anti-inflammatory or antioxidant dietary supplements during the long COVID-19 period cannot be excluded.…”

Section: Discussionsupporting

confidence: 92%

Improvement of Symptoms and Cardiac Magnetic Resonance Abnormalities in Patients with Post-Acute Sequelae of SARS-CoV-2 Cardiovascular Syndrome (PASC-CVS) after Guideline-Oriented Therapy

Gyöngyösi,

Hasimbegovic,

Han

et al. 2023

Biomedicines

View full text Add to dashboard Cite

Cardiac magnetic resonance (CMR) studies reported CMR abnormalities in patients with mild–moderate SARS-CoV-2 infection, suggesting ongoing myocardial inflammation. Patients (n = 278, 43 ± 13 years, 70.5% female) with post-acute sequelae of SARS-CoV-2 cardiovascular syndrome (PASC-CVS) were included prospectively into the Vienna POSTCOV Registry between March 2021 and March 2023 (clinicaltrials.gov NCT05398952). Clinical, laboratory, and CMR findings were recorded. Patients with abnormal CMR results were classified into isolated chronic pericardial (with/without pleural) effusion, isolated cardiac function impairment, or both (myopericarditis) groups. Medical treatment included a nonsteroidal anti-inflammatory agent (NSAID) for pericardial effusion and a condition-adapted maximal dose of heart failure (HF) treatment. Three months after medical therapy, clinical assessment and CMR were repeated in 82 patients. Laboratory analyses revealed normal hematological, inflammatory, coagulation, and cardiac biomarkers. CMR abnormalities were found in 155 patients (55.8%). Condition-adapted HF treatment led to a significant increase in the left ventricular ejection fraction (LVEF) in patients with initially reduced LVEF (from 49 ± 5% to 56 ± 4%, p = 0.009, n = 25). Low–moderate doses of NSAIDs for 3 months significantly reduced pericardial effusion (from 4/3;5.75/mm to 2/0;3/mm, median/interquartile ranges/p < 0.001, n = 51). Clinical symptoms improved markedly with a decrease in CMR abnormalities, which might be attributed to the maintenance of NSAID and HF medical treatment for PASC-CVS.

show abstract

Section: Discussionsupporting

confidence: 92%

Improvement of Symptoms and Cardiac Magnetic Resonance Abnormalities in Patients with Post-Acute Sequelae of SARS-CoV-2 Cardiovascular Syndrome (PASC-CVS) after Guideline-Oriented Therapy

Gyöngyösi,

Hasimbegovic,

Han

et al. 2023

Biomedicines

View full text Add to dashboard Cite

show abstract

“…Our time-analysis revealed a slight decrease in the prevalence of abnormal CMR ndings after 3 months, probably due to repeated vaccination or to the less cardio-invasive SARS-CoV-2 variants (e.g. Omicron) (11). However, the role of spontaneous improvement of cardiac abnormalities or the role of arbitrary intake of diverse anti-in ammatory or antioxidant dietary supplements during the long COVID period cannot be excluded.…”

Section: Discussionmentioning

confidence: 69%

Improvement of clinical symptoms and cardiac abnormalities detected by cardiac magnetic resonance imaging in patients with long COVID syndrome after guideline-oriented therapy

Gyöngyösi¹,

Hašimbegović²,

Lukovic³

et al. 2023

Preprint

View full text Add to dashboard Cite

Patients with cardiovascular long COVID syndrome and cardiac magnetic resonance (CMR) scans were included prospectively into the Vienna PostCoV Registry between March 2021 and March 2023 (EC: 1008/2021, clinicaltrials.gov NCT05398952; n=240). Clinical symptoms, age and sex, time between COVID-positivity and vaccination and CMR, as well as CMR findings were recorded. After medical treatment, clinical assessment and CMR was repeated in 67 patients with pathological CMR findings showing myopericarditis, pericardial effusion or cardiac functional abnormalities. Blood pressure and condition-adapted heart failure treatment led to a significant increase in left ventricular ejection fraction. Low-moderate doses of NSAIDs for 3 months significantly reduced pericardial effusion. Clinical symptoms improved markedly with a decrease in CMR abnormalities. In conclusion, medical treatment of cardiac/cardiovascular long COVID syndrome related to CMR abnormalities led to significant improvement in ejection fraction and decreased pericardial effusion, and were associated with improvements in the cardiovascular long COVID complaints.

show abstract

“…This study concluded that COVID-19 patients had infection-triggered mechanisms, which ultimately resulted in the development of CMD. Although this finding has been confirmed in several studies, especially in hospitalized patients with COVID-19, the severity of CMD among COVID-19 patients appears to vary partly because of the virus variant that caused the disease [34–39]. Importantly, a very recent study in the United Kingdom identified microangiopathic thrombosis as a common cause of myocardial injury in hospitalized COVID-19 patients with troponin elevation [40].…”

Section: Coronary Microcirculationmentioning

confidence: 85%

Familial hypercholesterolemia: The nexus of endothelial dysfunction and lipoprotein metabolism in COVID-19

Vuorio

Raal

Kovanen

2023

Current Opinion in Lipidology

View full text Add to dashboard Cite

Purpose of reviewPatients with heterozygous familial hypercholesterolemia (HeFH) are at increased risk for COVID-19 cardiovascular complications in the acute phase of the infection. Elevated levels of LDL-C and often lipoprotein(a) are present from birth and lead to endothelial dysfunction, which is aggravated by a direct viral attack of the endothelial cells and their exposure to the toxic levels of circulating proinflammatory and prothrombotic mediators during the hyperinflammatory reaction typical of COVID-19. Recent findingsEvidence to date shows the benefit of lipid-lowering therapy in patients with COVID-19. In HeFH patients who are at much higher cardiovascular risk, the focus should, therefore, be on the effective lowering of LDL-C levels, the root cause of the greater cardiovascular vulnerability to COVID-19 infection in these patients. The ongoing use of statins and other lipid-lowering therapies should be encouraged during the ongoing COVID pandemic to mitigate the risk of cardiovascular complications from COVID-19, particularly in HeFH patients. SummaryEpidemiologic registry data show that the incidence of myocardial infarction is increased in SARS-CoV-2infected HeFH patients. There is a need to study whether the risk for acute cardiovascular events is increased in the long-term and if there are changes in lipid metabolism after SARS-CoV infection(s) in patients with HeFH.

show abstract

Differential impacts of COVID-19 variants on human microvascular function

Cited by 5 publications

References 4 publications

Improvement of Symptoms and Cardiac Magnetic Resonance Abnormalities in Patients with Post-Acute Sequelae of SARS-CoV-2 Cardiovascular Syndrome (PASC-CVS) after Guideline-Oriented Therapy

Improvement of Symptoms and Cardiac Magnetic Resonance Abnormalities in Patients with Post-Acute Sequelae of SARS-CoV-2 Cardiovascular Syndrome (PASC-CVS) after Guideline-Oriented Therapy

Improvement of clinical symptoms and cardiac abnormalities detected by cardiac magnetic resonance imaging in patients with long COVID syndrome after guideline-oriented therapy

Familial hypercholesterolemia: The nexus of endothelial dysfunction and lipoprotein metabolism in COVID-19

Contact Info

Product

Resources

About