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Del Vecchio L, Balafa O, Dounousi E, Ekart R, Fernandez BF, Mark PB, Sarafidis P, Valdivielso JM, Ferro CJ, Mallamaci F. COVID-19 and cardiovascular disease in patients with chronic kidney disease. Nephrol Dial Transplant 2024; 39:177-189. [PMID: 37771078 PMCID: PMC10828215 DOI: 10.1093/ndt/gfad170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Indexed: 09/30/2023] Open
Abstract
Millions of people worldwide have chronic kidney disease (CKD). Affected patients are at high risk for cardiovascular (CV) disease for several reasons. Among various comorbidities, CKD is associated with the more severe forms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This is particularly true for patients receiving dialysis or for kidney recipients. From the start of the SARS-CoV-2 pandemic, several CV complications have been observed in affected subjects, spanning acute inflammatory manifestations, CV events, thrombotic episodes and arrythmias. Several pathogenetic mechanisms have been hypothesized, including direct cytopathic viral effects on the myocardium, endothelial damage and hypercoagulability. This spectrum of disease can occur during the acute phase of the infection, but also months after recovery. This review is focussed on the CV complications of coronavirus disease 2019 (COVID-19) with particular interest in their implications for the CKD population.
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Affiliation(s)
- Lucia Del Vecchio
- Department of Nephrology and Dialysis, Sant'Anna Hospital, ASST Lariana, Como, Italy
| | - Olga Balafa
- Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece
| | - Evangelia Dounousi
- Department of Nephrology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Robert Ekart
- Department of Dialysis, Clinic for Internal Medicine, University Medical Center Maribor, Maribor, Slovenia
| | | | - Patrick B Mark
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Pantelis Sarafidis
- 1st Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Jose M Valdivielso
- Vascular and Renal Translational Research Group, Institute for Biomedical Research on Lleida (IRBLleida), Lleida, Spain
| | - Charles J Ferro
- Department of Renal Medicine, University Hospitals Birmingham and Institute of Cardiovascular Sciences, University of Birmingham, Birmingham,UK
| | - Francesca Mallamaci
- Francesca Mallamaci Department of Nephrology, Dialysis, and Transplantation Azienda Ospedaliera “Bianchi-Melacrino-Morelli” & CNR-IFC, Reggio Calabria, Italy
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Di Pentima C, Cecchini S, Spannella F, Giulietti F, Allevi M, Schiavi P, Carnevali F, Zoppi L, Ciociola MC, Ventura F, Dragano G, Giordano P, Paci E, Sarzani R. Radiological lung sequelae, functional status and symptoms in older patients 3 and 6 months after hospitalization for COVID-19 pneumonia. Intern Emerg Med 2023; 18:1075-1085. [PMID: 37022640 PMCID: PMC10078021 DOI: 10.1007/s11739-023-03259-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 03/24/2023] [Indexed: 04/07/2023]
Abstract
The aim of our study was to assess the lung sequelae and clinical consequences 3 and 6 months after hospitalization for COVID-19 pneumonia in older patients. An observational study was conducted on 55 patients aged 65 years and older. Activities of daily living (ADL) and clinical frailty scale (CFS) were assessed at baseline and after 3 months. Both quantitative assessment at chest high-resolution computed tomography (CT) and semi-quantitative severity score (CTSS) were performed at baseline and after 3 and 6 months. Mean age: 82.3 ± 7.1 years. Male prevalence: 56.4%. After 6 months, ground-glass opacities (GGO) were still detectable in 22% of subjects, while consolidations were no longer appreciable. During follow-up, CTSS reached an overall median score of zero after 6 months. Fibrotic-like changes were found in 40% of subjects with an overall median score of 0 (0-5) points, being more prevalent in males. Patients reporting worsening ADL and CFS were 10.9% and 45.5%, respectively. They were associated with the burden of comorbidities, especially history of heart failure and chronic obstructive pulmonary disease at baseline. Amnesic disorders, exertional dyspnea, and fatigue were the most relevant symptoms reported. No association emerged between persistent or new-onset symptoms and evidence of fibrotic-like changes. The typical chest CT abnormalities of the COVID-19 pneumonia acute phase resolved in most of our older patients. Mild fibrotic-like changes persisted in less than half of the patients, especially males, without significantly affecting the functional status and frailty condition, which instead were more likely associated with pre-existing comorbidities.
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Affiliation(s)
- Chiara Di Pentima
- Internal Medicine and Geriatrics, IRCCS INRCA, via Della Montagnola n. 81, 60127, Ancona, Italy
- Department of Clinical and Molecular Sciences, University "Politecnica Delle Marche", via Tronto 10/a, Ancona, Italy
| | - Sara Cecchini
- Department of Radiology, IRCCS INRCA, via Della Montagnola 81, Ancona, Italy
| | - Francesco Spannella
- Internal Medicine and Geriatrics, IRCCS INRCA, via Della Montagnola n. 81, 60127, Ancona, Italy.
- Department of Clinical and Molecular Sciences, University "Politecnica Delle Marche", via Tronto 10/a, Ancona, Italy.
| | - Federico Giulietti
- Internal Medicine and Geriatrics, IRCCS INRCA, via Della Montagnola n. 81, 60127, Ancona, Italy
- Department of Clinical and Molecular Sciences, University "Politecnica Delle Marche", via Tronto 10/a, Ancona, Italy
| | - Massimiliano Allevi
- Internal Medicine and Geriatrics, IRCCS INRCA, via Della Montagnola n. 81, 60127, Ancona, Italy
- Department of Clinical and Molecular Sciences, University "Politecnica Delle Marche", via Tronto 10/a, Ancona, Italy
| | - Paola Schiavi
- Internal Medicine and Geriatrics, IRCCS INRCA, via Della Montagnola n. 81, 60127, Ancona, Italy
- Department of Clinical and Molecular Sciences, University "Politecnica Delle Marche", via Tronto 10/a, Ancona, Italy
| | - Francesca Carnevali
- Department of Radiology, IRCCS INRCA, via Della Montagnola 81, Ancona, Italy
| | - Lorenzo Zoppi
- Department of Radiology, IRCCS INRCA, via Della Montagnola 81, Ancona, Italy
| | | | - Fiammetta Ventura
- Department of Radiology, IRCCS INRCA, via Della Montagnola 81, Ancona, Italy
| | - Gina Dragano
- Internal Medicine and Geriatrics, IRCCS INRCA, via Della Montagnola n. 81, 60127, Ancona, Italy
| | - Piero Giordano
- Internal Medicine and Geriatrics, IRCCS INRCA, via Della Montagnola n. 81, 60127, Ancona, Italy
| | - Enrico Paci
- Department of Radiology, IRCCS INRCA, via Della Montagnola 81, Ancona, Italy
| | - Riccardo Sarzani
- Internal Medicine and Geriatrics, IRCCS INRCA, via Della Montagnola n. 81, 60127, Ancona, Italy
- Department of Clinical and Molecular Sciences, University "Politecnica Delle Marche", via Tronto 10/a, Ancona, Italy
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Rothlin RP, Pelorosso FG, Duarte M, Nicolosi L, Ignacio FC, Salgado MV, Vetulli H. Telmisartan and losartan: The marked differences between their chemical and pharmacological properties may explain the difference in therapeutic efficacy in hospitalized patients with COVID-19. Pharmacol Res Perspect 2023; 11:e01083. [PMID: 37038324 PMCID: PMC10086312 DOI: 10.1002/prp2.1083] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 03/17/2023] [Accepted: 03/25/2023] [Indexed: 04/12/2023] Open
Affiliation(s)
- Rodolfo Pedro Rothlin
- Sociedad Argentina de Farmacología Clínica, Asociación Médica Argentina, Buenos Aires, Argentina
| | - Facundo Germán Pelorosso
- Servicio de Anatomía Patológica, Hospital de Alta Complejidad El Calafate SAMIC, Santa Cruz, Argentina
| | - Mariano Duarte
- Laboratorio de Hipertensión, División de Cardiología, Hospital de Clínicas "José de San Martín", Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
- Segunda Cátedra de Fisiología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Liliana Nicolosi
- División de Cardiología, Hospital Español de Buenos Aires, Buenos Aires, Argentina
| | - Fernandez Criado Ignacio
- Sección de Tecnología Educativa e Informática Médica, Hospital de Clínicas "José de San Martín", Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - María Victoria Salgado
- Centro de Estudios de Estado y Sociedad, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Servicio de Medicina Familiar, Hospital de Alta Complejidad El Calafate SAMIC, Santa Cruz, Argentina
| | - Héctor Vetulli
- Servicio de Electrofisiología Cardíaca, Arritmias y Marcapasos, Sanatorio Otamendi y Miroli, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
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