RESULTS OF ASSESSING CENTRAL HEMODYNAMICS AND EXTERNAL RESPIRATION IN PATIENTS AFTER COMMUNITY-ACQUIRED CORONAVIRUS PNEUMONIA
Keywords:
Community-acquired pneumonia, central hemodynamics, pulmonary respiration, COVID-19, SARS-CoV-2, cell damage, cell membrane rupture, ischemia, inflammatory cytokines, scarring and pericarditisAbstract
Along with the growing number of patients with coronavirus pneumonia, an increasing number of them continue to describe symptoms such as fatigue, palpitations, decreased physical activity, shortness of breath, chest pain, neurocognitive difficulties, muscle pain and weakness, depression, anxiety and other mental health problems. These symptoms persist for several weeks after the acute phase of the viral infection has passed. Greenhalgh et al classified the condition as post-acute COVID-19 if symptoms persisted 3 to 12 weeks after illness onset, and as long-term COVID-19 if symptoms persisted for more than 3 months. These definitions were derived from the research they conducted. Data on the incidence of this disease vary widely from study to study, from ten percent to fifty percent of all cases. Protracted COVID-19 syndrome is unique compared to post-acute syndromes following other severe infections in that it has been described even in patients who had mild to moderate infections and did not require intensive care unit admission. This contrasts with other post-acute syndromes that develop after other severe infections. We do not have a complete understanding of the processes that are responsible for development after acute COVID-19. Some authors have hypothesized that chronic viremia may be caused by an inadequate or absent antibody response, inflammation and immunological reactions, deconditioning caused by post-traumatic stress, or even relapse and/or reinfection with the SARS-CoV-2 virus. These conditions can increase the risk of myocardial damage and inflammation, which can subsequently lead to left ventricular dysfunction of the heart.
Treatment of acute COVID-19 is associated with numerous complications, since clear recommendations do not exist. To our knowledge, there are currently only a small number of studies that have comprehensively assessed patients with acute COVID-19, particularly concomitant cardiovascular (CV) disorders assessed by transthoracic echocardiography (TTE), to determine the extent to which persistent changes may be responsible for the continuation of symptoms. In addition, several attempts have been made to develop scales to assess the functional status of patients recovering from acute COVID-19; however, the follow-up care of these patients is still a matter of debate.
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