hemodinâmica cardíaca e capacidade funcional no pós Covid-19: série de casos

Abstract

Introduction: Cardiovascular disease and cardiac complications are currently the most common comorbidities among patients with COVID-19. Although there are some hypotheses that may justify it, the mechanisms of cardiac injury by the coronavirus are not clear. The objective was to evaluate the impact of COVID-19 on cardiac function, through cardiographic impedance, in post-COVID-19 patients during the 1-minute sit-to-stand functional test (1-STS), to understand how the disease affects the functional capacity of these patients from the hemodynamic point of view. Methods: This is a cross-sectional study developed by the Pneumocardiovascular Laboratory of the Onofre Lopes University Hospital (HUOL). The analyzed data refer to collections from July 2020 to March 2022. The 1-STS was performed with concomitant analysis of cardiographic impedance by PhysioFlow (Manatec, Paris, France) . Results: Thirty-six individuals affected by COVID-19 were recruited, 13 of whom were women, and all met the inclusion criteria. Thus, 36 post-COVID-19 individuals were evaluated and compared to 11 healthy individuals, 8 of them women, matched by sex and age. There was a statistical difference between the subjects of the COVID-19 group in relation to the control group, both in the number of repetitions performed and in the percentage value (%) of predicted repetitions. We observed a statistically significant intergroup difference in the post-COVID-19 group in systolic volume (p moment=0.0014), systolic volume index (p moment=0.0002; p group=0.01), heart rate (p moment<0.0001; p group =0.01), cardiac output (p<0.0001), cardiac index (p moment<0.0001; p group=0.0004), contractility index (p moment and group<0.0001), ventricular ejection time (p moment <0.0001), systemic vascular resistance index (p moment<0.0001; p group =0.001), systemic vascular resistance (p moment<0.0001), end diastolic volume (p group<0.0001) and ejection fraction (p moment=0.0002; p group <0.0001). Conclusion: Thus, we can conclude in this series of cases that, compared to healthy individuals, the post-COVID-19 group presents (I) reduced functional capacity, identified through 1-STS, (II) changes in cardiac hemodynamic responses, and (III) increased systemic vascular resistance. More studies are needed to reinforce the functional and cardiovascular changes found and better understand them, in order to measure the impact of COVID-19 on different degrees of disease severity.