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Poyatos P, Luque N, Sabater G, Eizaguirre S, Bonnin M, Orriols R, Tura-Ceide O. Endothelial dysfunction and cardiovascular risk in post-COVID-19 patients after 6- and 12-months SARS-CoV-2 infection. Infection 2024:10.1007/s15010-024-02173-5. [PMID: 38324145 DOI: 10.1007/s15010-024-02173-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/01/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION SARS-CoV-2 infection causes severe endothelial damage, an essential step for cardiovascular complications. Endothelial-colony forming cells (ECFCs) act as a biomarker of vascular damage but their role in SARS-CoV-2 remain unclear. The aim of this study was to assess whether the number of ECFCs and angiogenic biomarkers remained altered after 6 and 12-months post-infection and whether this imbalance correlated with the presence of long-COVID syndrome and other biological parameters measured. METHODS Seventy-two patients were recruited at different time-points after overcoming COVID-19 and thirty-one healthy controls. All subjects were matched for age, gender, BMI, and comorbidities. ECFCs were obtained from peripheral blood and cultured with specific conditions. RESULTS The results confirm the presence of a long-term sequela in post-COVID-19 patients, with an abnormal increase in ECFC production compared to controls (82.8% vs. 48.4%, P < 0.01) that is maintained up to 6-months (87.0% vs. 48.4%, P < 0.01) and 12-months post-infection (85.0% vs. 48.4%, P < 0.01). Interestingly, post-COVID-19 patients showed a significant downregulation of angiogenesis-related proteins compared to controls indicating a clear endothelial injury. Troponin, NT-proBNP and ferritin levels, markers of cardiovascular risk and inflammation, remained elevated up to 12-months post-infection. Patients with lower numbers of ECFC exhibited higher levels of inflammatory markers, such as ferritin, suggesting that ECFCs may play a protective role. Additionally, long-COVID syndrome was associated with higher ferritin levels and with female gender. CONCLUSIONS These findings highlight the presence of vascular sequela that last up to 6- and 12-months post-infection and point out the need for preventive measures and patient follow-up.
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Affiliation(s)
- Paula Poyatos
- Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI), 17190, Girona, Spain
- Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain
| | - Neus Luque
- Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI), 17190, Girona, Spain
| | - Gladis Sabater
- Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI), 17190, Girona, Spain
- Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain
| | - Saioa Eizaguirre
- Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI), 17190, Girona, Spain
- Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain
| | - Marc Bonnin
- Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI), 17190, Girona, Spain
- Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain
| | - Ramon Orriols
- Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI), 17190, Girona, Spain.
- Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain.
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Madrid, Spain.
| | - Olga Tura-Ceide
- Department of Pulmonary Medicine, Dr. Josep Trueta University Hospital de Girona, Santa Caterina Hospital de Salt and the Girona Biomedical Research Institute (IDIBGI), 17190, Girona, Spain.
- Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain.
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Madrid, Spain.
- Department of Pulmonary Medicine, Servei de Pneumologia, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Villarroel, 170, 08036, Barcelona, Spain.
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Eizaguirre S, Sabater G, Belda S, Calderón JC, Pineda V, Comas-Cufí M, Bonnin M, Orriols R. Long-term respiratory consequences of COVID-19 related pneumonia: a cohort study. BMC Pulm Med 2023; 23:439. [PMID: 37951891 PMCID: PMC10638724 DOI: 10.1186/s12890-023-02627-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/31/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Our aims were to describe respiratory sequelae up to 12 months after discharge in COVID-19 patients with severe pneumonia requiring non-invasive respiratory support therapies. METHODS This study was undertaken at University Hospital Doctor Josep Trueta (Girona, Spain) between March 2020 and June 2020. Three months after discharge, we evaluated their dyspnoea and performed Saint George's respiratory questionnaire, pulmonary function tests, blood test, 6-min walking test, and a high-resolution CT (HRCT). At the six and 12-month follow-up, we repeated all tests except for pulmonary function, 6-min walking test, and HRCT, which were performed only if abnormal findings had been previously detected. RESULTS Out of the 94 patients recruited, 73% were male, the median age was 62.9 years old, and most were non-smokers (58%). When comparing data three and 12 months after discharge, the percentage of patients presenting dyspnoea ≥ 2 decreased (19% vs 7%), the quality-of-life total score improved (22.8% vs 18.9%; p = 0.019), there were less abnormal results in the pulmonary function tests (47% vs 23%), the 6-min walking test distance was enhanced (368.3 m vs 390.7 m, p = 0.020), ground glass opacities findings waned (51.6% vs 11.5%), and traction bronchiectasis increased (5.6% vs 15.9%). Only age showed significant differences between patients with and without pulmonary fibrotic-like changes. CONCLUSION Most patients improved their clinical condition, pulmonary function, exercise capacity and quality of life one year after discharge. Nonetheless, pulmonary fibrotic-like changes were observed during the follow-ups.
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Affiliation(s)
- Saioa Eizaguirre
- Department of Respiratory, Dr. Josep, Trueta University Hospital of Girona, and Santa Caterina Hospital of Salt, Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain
| | - Gladis Sabater
- Department of Respiratory, Dr. Josep, Trueta University Hospital of Girona, and Santa Caterina Hospital of Salt, Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain
| | - Sònia Belda
- Department of Respiratory, Dr. Josep, Trueta University Hospital of Girona, and Santa Caterina Hospital of Salt, Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain
| | - Juan Carlos Calderón
- Department of Respiratory, Dr. Josep, Trueta University Hospital of Girona, and Santa Caterina Hospital of Salt, Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain
| | - Victor Pineda
- Department of Radiology, Dr. Josep, Trueta University Hospital of Girona, and Santa Caterina Hospital of Salt, Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain
- Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Catalonia, Spain
| | - Marc Comas-Cufí
- Department of Computer Science, Mathematics and Statistics, University of Girona, Girona, Catalonia, Spain
| | - Marc Bonnin
- Department of Respiratory, Dr. Josep, Trueta University Hospital of Girona, and Santa Caterina Hospital of Salt, Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain
| | - Ramon Orriols
- Department of Respiratory, Dr. Josep, Trueta University Hospital of Girona, and Santa Caterina Hospital of Salt, Girona Biomedical Research Institute (IDIBGI), Girona, Catalonia, Spain.
- Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Catalonia, Spain.
- Biomedical Research Networking Centre On Respiratory Diseases (CIBERES), Madrid, Spain.
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Roso-Llorach A, Serra-Picamal X, Cos FX, Pallejà-Millán M, Mateu L, Rosell A, Almirante B, Ferrer J, Gasa M, Gudiol C, Moreno AM, Morales-Rull JL, Rexach M, Sabater G, Auguet T, Vidal F, Lerida A, Rebull J, Khunti K, Argimon JM, Paredes R. Evolving mortality and clinical outcomes of hospitalized subjects during successive COVID-19 waves in Catalonia, Spain. Glob Epidemiol 2022; 4:100071. [PMID: 35018339 PMCID: PMC8739818 DOI: 10.1016/j.gloepi.2022.100071] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 02/07/2023] Open
Abstract
Background The changes in shield strategies, treatments, emergence variants, and healthcare pathways might shift the profile and outcome of patients hospitalized with COVID-19 in successive waves of the outbreak. Methods We retrospectively analysed the characteristics and in-hospital outcomes of all patients admitted with COVID-19 in eight university hospitals of Catalonia (North-East Spain) between Feb 28, 2020 and Feb 28, 2021. Using a 7-joinpoint regression analysis, we split admissions into four waves. The main hospital outcomes included 30-day mortality and admission to intensive care unit (ICU). Findings The analysis included 17,027 subjects admitted during the first wave (6800; 39.9%), summer wave (1807; 10.6%), second wave (3804; 22.3%), and third wave (4616; 27.1%). The highest 30-day mortality rate was reported during the first wave (17%) and decreased afterwards, remaining stable at 13% in the second and third waves (overall 30% reduction); the lowest mortality was reported during the summer wave (8%, 50% reduction). ICU admission became progressively more frequent during successive waves. In Cox regression analysis, the main factors contributing to differences in 30-day mortality were the epidemic wave, followed by gender, age, diabetes, chronic kidney disease, and neoplasms. Interpretation Although in-hospital COVID-19 mortality remains high, it decreased substantially after the first wave and is highly dependent of patient's characteristics and ICU availability. Highest mortality reductions occurred during a wave characterized by younger individuals, an increasingly frequent scenario as vaccination campaigns progress. Funding This work did not receive specific funding.
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Affiliation(s)
- Albert Roso-Llorach
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gorina (IDIAPJGol), Barcelona, Catalonia, Spain.,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalonia, Spain
| | | | - Francesc X Cos
- Institut Català de la Salut (ICS), Barcelona, Catalonia, Spain
| | - Meritxell Pallejà-Millán
- Unitat de Suport a la Recerca Tarragona-Reus, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Reus, Catalonia, Spain
| | - Lourdes Mateu
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalonia, Spain.,Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.,Universitat de Vic-UCC, Vic, Catalonia, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Antoni Rosell
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalonia, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.,Department of Respiratory Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.,Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Catalonia, Spain
| | - Benito Almirante
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalonia, Spain.,Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Spanish Network for Research in Infectious Disease (REIPI), Instituto de Salud Carlos III, Madrid, Spain
| | - Jaume Ferrer
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalonia, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.,Department of Respiratory Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Mercè Gasa
- Department of Respiratory Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Catalonia, Spain.,Institut d'investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Catalonia, Spain.,University of Barcelona, Barcelona, Catalonia, Spain
| | - Carlota Gudiol
- Institut d'investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Catalonia, Spain.,University of Barcelona, Barcelona, Catalonia, Spain.,Infectious Diseases Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Catalonia, Spain
| | - Anna Maria Moreno
- Hospital Universitari Arnau de Vilanova, IRBL, Lleida, Catalonia, Spain
| | | | - Maria Rexach
- Department of Internal Medicine, Hospital Universitari Doctor Josep Trueta, Girona, Catalonia, Spain.,Internal Medicine Research Group, Institut d'investigació Biomèdica de Girona - IDIBGI, Girona, Catalonia, Spain
| | - Gladis Sabater
- Department of Internal Medicine, Hospital Universitari Doctor Josep Trueta, Girona, Catalonia, Spain
| | - Teresa Auguet
- Hospital Universitari de Tarragona Joan XXIII, Tarragona, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Catalonia, Spain.,Universitat Rovira i Virgili, Tarragona, Catalonia, Spain
| | - Francesc Vidal
- Hospital Universitari de Tarragona Joan XXIII, Tarragona, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Catalonia, Spain.,Universitat Rovira i Virgili, Tarragona, Catalonia, Spain
| | - Ana Lerida
- Hospital de Viladecans, Viladecans, Catalonia, Spain
| | - Josep Rebull
- Hospital Universitari Verge de la Cinta, Tortosa, Catalonia, Spain
| | - Kamlesh Khunti
- Diabetes Research Center, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Josep M Argimon
- Institut Català de la Salut (ICS), Barcelona, Catalonia, Spain
| | - Roger Paredes
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalonia, Spain.,Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.,Universitat de Vic-UCC, Vic, Catalonia, Spain.,IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.,Center for Global Health & Diseases, Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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