Contents
Even a mild to moderate course of COVID-19 can lead to complications. According to the findings of doctors from Hamburg, long covid appears in non-hospitalized patients about 6-9 months after the infection. The changes are visible in several body systems, and the organs where they are most extensive are the heart, blood vessels, lungs and kidneys.
- A few months ago, a group of German medics analyzed the results of studies of 443 people who had been infected with coronavirus at home (mild and moderate course of COVID-19)
- Patients were subjected to comprehensive tests after an average of nine months from obtaining a positive test for the presence of SARS-CoV-2
- After comparing their results with those of the control group, it turned out that there are changes in the heart, blood vessels, lungs, kidneys and brain.
- On the basis of the conducted research, doctors developed a scheme for dealing with patients with long covid. In the medical community, it is called the “Hamburg algorithm”
- Prof. Filipiak: «This is the first, very sensible proposal of a systemic approach to long covid patients. (…) Personally, this algorithm suits me very well »
- More information can be found on the TvoiLokony home page
Long covid under the magnifying glass again
The starting point for the study was the fact that the previous analyzes of patients with long covid concerned mostly those who were hospitalized due to SARS-CoV-2 infection. Meanwhile, people who have had COVID-19 at home and have had mild or moderate infection rates are also at risk of long covid, as the study conducted showed very well. German medics presented its results in an article published in the “European Heart Journal”.
The assessment of the work of individual systems and organs after COVID-19 concerned 443 patients aged 45-74 years, who were examined on average after nine months after receiving a positive PCR test result. The results of these studies were compared with the parameters obtained in the tests of 1328 people from the control group.
The condition of the lungs, heart, blood vessels, kidneys and brain was assessed. Doctors subjected patients to tests such as: spirometry, echocardiography, ECG, magnetic resonance imaging, Doppler ultrasound, as well as those using neuroimaging methods. Basic laboratory tests were also performed to check the level of, among others, leukocytes, sodium, potassium, glucose, hemoglobin or CRP. The level of anti-SARS-CoV-2 antibodies was also checked.
Four organs with changes
The conclusions of the study were unequivocal: in convalescents who have undergone COVID-19 light to moderate changes in lung, heart, kidney and blood vessel function (there were no signs of structural brain damage or neurocognitive impairment).
The image of the lungs showed, inter alia, due to their lower total capacity and higher respiratory resistance. «(…) we found a much lower TLC ( total lung capacity – total amount of air in the lungs – ed.) In people with mild or moderate infection compared to the control group. (…) Assessment of lung function should be considered after recovery from COVID-19 at the slightest suspicion, even in seemingly healthy people »- urge German doctors.
Further part below the video.
Within the circulatory system, a tendency towards more focal myocardial fibrosis was observed, but no swelling was found. More significant changes were noticed in the ventricles of the heart. In the left, it was a slightly reduced ejection fraction (the percentage of blood ejected during a contraction of the heart muscle – ed.) higher levels of cardiac biomarkers, reflecting little myocardial involvement. On the other hand, in the right, the contraction fraction, which the authors of the publication assessed as “significantly reduced”.
«In the long run, even a slight decrease in left ventricular function and a slight increase in NT-proBNP concentration translate into an increased risk of death in the general population. Therefore, after recovery from COVID-19, NT-proBNP testing may be recommended, followed by echocardiographic monitoring in the event of elevated levels to avoid untreated cardiac dysfunction, »the authors of the study indicate.
In the case of blood vessels, doctors noted that there were ‘incompressible’ veins in the thigh, which could suggest future problems with blood clots. «Our data suggest a significantly higher incidence thrombosis deep veins in study participants after SARS-CoV-2 infection«, The medics said, adding that the finding is further evidence of the link between COVID-19 and venous thromboembolism.
Changes were also observed in the kidneys, as evidenced by, inter alia, increased creatinine and cystatin C and decreased sodium and potassium levels. Abnormalities in the composition of the eyes and the picture of the kidneys may suggest an initial form of chronic kidney diseasewhich increases the risk of cardiovascular disease and death.
- Check it out: “The silent and insidious killer” who destroys our health. How is kidney failure diagnosed? [WE EXPLAIN]
Have you been infected with COVID-19 and are worried about the side effects? Check your health by completing a comprehensive research package for convalescents.
Doctors are keenly interested in the “Hamburg algorithm”
The procedure followed during the observation of the study participants met with great interest in the medical community. As Prof. dr hab. n. med. Krzysztof J. Filipiak, cardiologist, internist, hypertensiologist and clinical pharmacologist, rector of the Medical University of Maria Skłodowskiej-Curie in Warsaw, doctors even talk about the “Hamburg algorithm”.
«This is the first, very sensible proposal of a systemic approach to long covid patients. (…) Personally, this algorithm suits me very well »- assessed the expert, paying attention to the next stages of diagnosis of patients after mild or moderate course of COVID-19.
The doctor noted that each phase of the diagnosis resulted from a different one. When cardiac function is tested, the recommended test is BNP (type B natriuretic peptide), and only when this is elevated should echocardiography be considered.
If you are assessing kidney function, biochemical tests will suffice, where you check kidney function by comparing the patient’s historical glomerular filtration data to the current values. If you are assessing lung function, you are looking for any characteristics that the patient has respiratory problems 6-9 months after COVID-19. You reach for echocardiography and then perform more advanced pulmonary examinations
said prof. Filipiak, addressing his colleagues in the profession.
Biochemical tests play a very important role in this diagnosis. An example is the diagnosis of changes in the venous system, where even with the slightest suspicion of deep vein thrombosis, basic tests, such as the level of D-dimers, should be performed. Only after receiving the results, you can consider ultrasound of the veins. “Depending on what comes out in these studies, you plan on drug therapy,” he added.
We encourage you to listen to the latest episode of the RESET podcast. This time Joanna Kozłowska, author of the book High Sensitivity. A Guide for Those Who Feel Too Much »says that high sensitivity is not a disease or dysfunction – it’s just a set of characteristics that affect the way you perceive and perceive the world. What are the genetics of WWO? What are the perks of being highly sensitive? How to act with your high sensitivity? You will find out by listening to the latest episode of our podcast.