Participants completed symptom questionnaires every 3 months.Īmong 5,963 baseline participants (4,504 COVID survivors and 1,459 controls), 4,056 had 3-month and 2,856 had 6-month data at analysis. In a prospective study published last week in Open Forum Infectious Diseases, a team led by Rush University researchers used statistical modeling to identify symptomatically similar groups among adult COVID-19 survivors infected 3 and 6 months earlier and uninfected controls with COVID-like symptoms from December 2020 to September 2022. The latest data from the ongoing, multisite INSPIRE study suggest that long COVID is dynamic and can be grouped into four clinically distinct symptom profiles, or phenotypes. The authors called for future prospective studies to assess the small blood vessels of COVID-19 survivors and to identify the implications for long-COVID management. "Patients with lingering symptoms such as chest pain or shortness of breath following a severe infection may want to have a PET scan with blood flow assessment to check for microvascular dysfunction," senior author Mouaz Al-Mallah, MD, said in a Houston Methodist news release. The study authors noted that COVID-related cardiac damage could be caused by the rupture of inflammatory plaques (vessel blockages), blood clots, low blood-oxygen levels, cardiac output-related stress, or systemic inflammation of the lining of blood vessels. Patients with lingering symptoms such as chest pain or shortness of breath following a severe infection may want to have a PET scan with blood flow assessment to check for microvascular dysfunction. After a median follow-up of 285 days, 41 patients died of any cause, and 46 were hospitalized for heart failure exacerbation, 10 for heart attack, 21 for a percutaneous coronary intervention, and 6 for coronary artery bypass grafting (CABG) 90 days after PET.Įvent rates were higher, and event-free survival was lower, in long-COVID patients than controls and in those with a MFR lower than 2 in all analyses and subgroups. The odds of impaired MFR rose with increasing COVID-19 severity (no symptoms aOR, 2.6 hospitalized aOR, 3.8 and ICU aOR, 8.5). Impaired MFR rates were similar across variants. The percentage of patients with this MFR peaked 6 to 9 months after imaging, decreasing thereafter.
Long-COVID patients had a significantly higher likelihood of having an MFR of less than 2 (adjusted odds ratio, 3.1). Average length of stay was 7.6 days for hospitalization and 24.4 for ICU stay.Ī higher proportion of long-COVID patients than controls had an impaired MFR (50% vs 27%), mainly because of significant difference in MFR of less than 2 under stress (58% vs 49%) and a slight difference in a myocardial blood flow of less than 1 at rest (66% vs 72% in cases vs controls). Most long-COVID patients (165 of 271 61%) had mild symptoms, while 92 (34%) were hospitalized, and 14 (5%) were admitted to an intensive care unit (ICU). The median number of days from COVID-19 infection to PET imaging was 174 days. Average patient age was 65 years, and 52% were men. The most common reasons for PET were chest pain (73% vs 67% in cases vs controls) and shortness of breath (42% vs 36%).
MFR is a prognostic indicator that shows how much the heart can increase blood flow under an increased need for oxygen.
The research was published last week in European Heart Journal Cardiovascular Imaging. Researchers from Houston Methodist in Texas used positron emission tomography (PET) to compare myocardial flow reserve (MFR) between 271 symptomatic patients who tested positive for COVID-19 less than 3 months or more than 9 months earlier and 815 uninfected matched control patients during the Beta, Delta, and Omicron variant waves. Proportion with impaired blood flow fell over time Networkġ0% for new customer auto-ship purchase, 8% for new customer one-time purchase, 6% for existing customer auto-ship purchase, 4% for existing customer one-time purchaseĦ% for new existing auto-ship purchase, 10% for new customer auto-ship purchase, 4% for existing customer one-time purchase, 8% for new customer one-time purchaseģ.2% for existing customers one-time purchase, 6.4% for existing customer auto-ship purchases, 6.A pair of US studies has better characterized persistent COVID-19 symptoms, with one suggesting a higher likelihood of small blood-vessel heart dysfunction among hospitalized patients, and the other concluding that long COVID is a range of conditions rather than a single one.
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