Assessment of Adult Patients with Long COVID Manifestations Suspected as Cardiovascular: A Single-Center Experience
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Participants
2.2. Assessment and Follow-Up
2.3. Outcomes and Exposures
2.4. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Long-COVID Manifestations and Findings
3.3. Cardiovascular Morbidity
3.4. Symptomatic Course
3.5. Predictors of Presumably COVID-Related New CV Diagnoses and Symptom Non-Improvement
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total Cohort (n = 96) | |
---|---|
Demographic Details | |
Age, years | 54 (44–64) |
Male | 44 (46) |
Cardiovascular Background | |
Prior CV Disease | 15 (16) |
CV Risk Factors | |
Any | 69 (72) |
Pre-diabetes/Diabetes Mellitus | 34 (35) |
Hypertension | 22 (23) |
Dyslipidemia | 56 (58) |
Obesity | 30 (31) |
Present Smoking | 10 (10) |
Acute Covid Data | |
Symptoms During Acute COVID | 95 (99) |
Acute COVID Severity, per NIH Criteria | |
Mild | 40 (42) |
Moderate | 30 (31) |
Severe | 26 (27) |
Hospitalization | |
Frequency | 28 (29) |
Length, days | 8 (5–18) |
Invasive Ventilation | 1 (3.4) |
Abnormal Tests Results | |
ECG | 10 (45) |
TTE | 2 (25) |
Serum Biomarkers (hs-cTn ± NT-proBNP) | 3 (13) |
Time from COVID Diagnosis to Examination, days | 142 (111–197) |
COVID Vaccination Doses | |
0 | 8 (10) |
1 | 27 (35) |
2 | 42 (55) |
Total Cohort (n = 96) | |
---|---|
Symptoms | |
Any | 96 (100) |
Fatigue | 48 (50) |
Dyspnea | 54 (56) |
Chest Pain | 40 (42) |
Palpitations | 36 (38) |
Dizziness/Vertigo | 4 (4) |
Pre-syncope/Syncope | 2 (2) |
NYHA Class Functional Status | |
I | 43 (45) |
II | 41 (43) |
III | 12 (12) |
IV | 0 (0) |
ECG Findings | |
Any | 32 (34) |
Rhythm Disorders | 3 (3) |
Rate Disorders | 0 (0) |
Conduction Disorders | 12 (13) |
ST-T changes | 20 (21) |
TTE Findings | |
Any | 31 (32) |
LV Systolic Dysfunction | 4 (4) |
RV Systolic Dysfunction | 1 (1) |
Grade2 and up Diastolic Dysfunction | 2 (2) |
LA Dilatation | 6 (6) |
Moderate and up Valvular Dysfunction | 1 (1) |
Systolic Pulmonary Hypertension | 1 (1) |
Pericardial Effusion | 18 (19) |
Cardiac Provocation Test Findings | |
Any | 6 (13) |
Ischemic Findings | 2 (4) |
Atrial Fibrillation | 1 (2) |
Chronotropic Incompetence | 3 (6) |
Age-Adjusted CV Fitness | |
Good | 15 (39) |
Average | 14 (36) |
Low | 10 (26) |
Holter ECG findings | |
Any | 5 (14) |
Inappropriate Sinus Tachycardia | 1 (3) |
Atrial Tachycardia | 1 (3) |
Non-Sustained Ventricular Tachycardia | 1 (3) |
Couplet Ventricular Premature Beats | 1 (3) |
1st degree AV block | 1 (3) |
CCT findings | |
Any | 3 (23) |
Non-Obstructive Coronary Artery Disease | 2 (15) |
Aberrant Coronary Artery | 1 (8) |
CMR findings | |
Any | 5 (45) |
Myocarditis | 3 (27) |
Myopericarditis | 1 (9) |
Hypertrophic obstructive cardiomyopathy | 1 (9) |
CPET findings | |
CV Restraint | 5 (42) |
PFT findings | |
Any | 27 (33) |
Obstruction | 13 (16) |
Restriction | 5 (6) |
Reduced Diffusing Capacity | 9 (11) |
HRCT findings | |
Any | 22 (51) |
Interstitial Changes | 9 (21) |
Fibrotic Changes | 4 (10) |
Ground Glass Opacities | 7 (17) |
Lung Nodules | 2 (5) |
New CV Diagnoses (n = 9) | No New CV Diagnoses (n = 87) | p-Value | |
---|---|---|---|
Demographic Details | |||
Age, years | 52 (41–54) | 56 (45–66) | 0.139 |
Male | 2 (22) | 42 (48) | 0.173 |
Cardiovascular Background | |||
Prior CV Disease | 0 (0) | 15 (17) | 0.346 |
CV Risk Factors | |||
Any | 5 (56) | 64 (74) | 0.263 |
Pre-diabetes/Diabetes Mellitus | 1 (11) | 33 (38) | 0.152 |
Hypertension | 2 (22) | 20 (23) | 0.949 |
Dyslipidemia | 2 (22) | 54 (62) | 0.069 |
Obesity | 4 (44) | 26 (30) | 0.454 |
Present Smoking | 1 (11) | 9 (10) | 1.000 |
Acute COVID Data | |||
Symptoms During Acute COVID | 9 (100) | 86 (99) | 1.000 |
Acute COVID Severity, per NIH Criteria | 0.450 | ||
Mild | 2 (22) | 38 (44) | |
Moderate | 4 (44) | 26 (30) | |
Severe | 3 (33) | 23 (26) | |
Hospitalization | |||
Frequency | 2 (22) | 26 (30) | 1.000 |
Length, days | 18 (17–20) | 8 (5–18) | 0.784 |
Invasive Ventilation | 0 (0.0) | 1 (4) | NA |
Abnormal Tests Results | |||
ECG | 1 (33) | 9 (47) | 1.000 |
TTE | 1 (50) | 1 (17) | 0.464 |
Serum Biomarkers (hs-cTn and/or NT-proBNP) | 1 (25) | 2 (11) | 0.453 |
Time from COVID Diagnosis to Examination, days | 152 (75–214) | 141 (112–195) | 0.912 |
COVID Vaccination Doses | 0.399 | ||
0 | 2 (25) | 6 (9) | |
1 | 2 (25) | 25 (36) | |
2 | 4 (50) | 38 (55) |
New CV Diagnoses (n = 9) | No New CV Diagnoses (n = 87) | p-Value | |
---|---|---|---|
Symptoms | |||
Any | 8 (89) | 86 (99) | 1.000 |
Fatigue | 7 (78) | 41 (47) | 0.159 |
Dyspnea | 7 (78) | 47 (54) | 0.291 |
Chest Pain | 4 (44) | 36 (41) | 1.000 |
Palpitations | 6 (67) | 30 (35) | 0.076 |
Dizziness/Vertigo | 1 (11) | 3 (3) | 0.330 |
Pre-syncope/Syncope | 0 (0) | 2 (2) | 1.000 |
NYHA Class Functional Status | 0.444 | ||
I | 4 (44) | 39 (45) | |
II | 5 (56) | 36 (41) | |
III | 0 (0) | 12 (14) | |
IV | 0 (0) | 0 (0) | |
Symptom Non-Improvement | 4 (44) | 40 (46) | 0.816 |
ECG Findings | |||
Any | 4 (44) | 28 (32) | 0.475 |
Rhythm Disorders | 0 (0) | 3 (3) | 1.000 |
Rate Disorders | 0 (0) | 0 (0) | 1.000 |
Conduction Disorders | 2 (22) | 10 (11) | 0.319 |
ST-T changes | 3 (33) | 17 (20) | 0.387 |
TTE Findings | |||
Any | 4 (44) | 27 (31) | 0.471 |
LV Systolic Dysfunction | 1 (11) | 3 (3) | 0.246 |
RV Systolic Dysfunction | 0 (0) | 1 (1) | 1.000 |
Grade2 and up Diastolic Dysfunction | 0 (0) | 2 (2) | 0.863 |
LA Dilatation | 2 (22) | 4 (5) | 0.017 |
≥Moderate Valvular Dysfunction | 1 (11) | 0 (0) | 1.000 |
Systolic Pulmonary Hypertension | 1 (11) | 0 (0) | 0.700 |
Pericardial Effusion | 2 (22) | 16 (18) | 0.124 |
Cardiac Provocation Test Findings | |||
Any | 3 (50) | 3 (7) | 0.200 |
Ischemic Findings | 0 (0) | 2 (5) | 1.000 |
Atrial Fibrillation | 0 (0) | 1 (2) | 1.000 |
Chronotropic Incompetence | 3 (50) | 0 (0) | 1.000 |
Age-Adjusted CV Fitness | 0.453 | ||
Good | 1 (17) | 14 (42) | |
Average | 2 (33) | 12 (36) | |
Low | 3 (50) | 7 (21) | |
Holter ECG findings | 0.139 | ||
Any | 2 (40) | 3 (10) | |
Inappropriate Sinus Tachycardia | 1 (20) | 0 (0) | |
Atrial Tachycardia | 1 (20) | 0 (0) | |
Non-Sustained Ventricular Tachycardia | 0 (0) | 1 (3) | |
Couplet Ventricular Premature Beats | 0 (0) | 1 (3) | |
1st degree AV block | 0 (0) | 1 (3) | |
CCT findings | 1.000 | ||
Any | 0 (0) | 3 (27) | |
Non-Obstructive Coronary Artery Disease | 0 (0) | 2 (18) | |
Aberrant Coronary Artery | 0 (0) | 1 (9) | |
CMR findings | 0.242 | ||
Any | 4 (67) | 1 (20) | |
Myocarditis | 3 (50) | 0 (0) | |
Myopericarditis | 1 (17) | 0 (0) | |
Hypertrophic obstructive cardiomyopathy | 0 (0) | 1 (20) | |
CPET findings | |||
CV Restraint | 2 (100) | 3 (30) | 0.152 |
PFT findings | |||
Any | 6 (67) | 21 (29) | 0.054 |
Obstruction | 5 (56) | 8 (11) | 0.084 |
Restriction | 0 (0) | 5 (69) | 0.076 |
Reduced Diffusing Capacity | 1 (11) | 8 (11) | 0.243 |
HRCT findings | |||
Any | 3 (43) | 19 (54) | 0.691 |
Interstitial Changes | 1 (14) | 8 (23) | 0.362 |
Fibrotic Changes | 1 (14) | 3 (9) | 0.846 |
Ground Glass Opacities | 0 (0) | 7 (20) | 0.124 |
Lung Nodules | 1 (14) | 1 (3) | 0.632 |
New, Potentially COVID-Related CV Diagnoses | Symptom Non-Improvement | |||
---|---|---|---|---|
OR (95% CI) | p Value | OR (95% CI) | p Value | |
Baseline Clinical Variables | ||||
Age (continuous) | 0.96 (0.92–1.01) | 0.144 | 1.01 (0.97–1.04) | 0.755 |
Sex Male | 0.31 (0.06–1.56) | 0.154 | 1.04 (0.39–2.76) | 0.939 |
Prior CV Disease | 0.90 (0.86–1.23) | 0.655 | 0.38 (0.09–1.57) | 0.179 |
CV Risk Factors | 0.45 (0.11–1.82) | 0.262 | 1.31 (0.43–4.03) | 0.632 |
Acute COVID Parameters | ||||
Severity | ||||
Moderate vs. Mild | 2.92 (0.50–17.15) | 0.235 | 1.40 (0.54–3.61) | 0.491 |
Severe vs. Mild | 2.48 (0.39–15.96) | 0.340 | 0.76 (0.28–2.09) | 0.600 |
≥Moderate vs. Mild | 2.71 (0.53–13.82) | 0.229 | 0.68 (0.25–1.86) | 0.456 |
Severe vs. Non-Severe | 1.39 (0.32–6.02) | 0.659 | 0.82 (0.29–2.34) | 0.713 |
Hospitalization | 0.67 (0.13–3.45) | 0.632 | 0.49 (0.17–1.39) | 0.177 |
Hospitalization Length | 1.11 (0.93–1.34) | 0.251 | 0.93 (0.82–1.05) | 0.218 |
Abnormal In-Hospital ECG | 0.56 (0.04–7.21) | 0.653 | 5.33 (0.62–45.99) | 0.128 |
Abnormal In-Hospital TTE | 5.00 (0.15–166.59) | 0.368 | 2.00 (0.05–78.25) | 0.711 |
Abnormal In-Hospital Cardiac Biomarkers | 2.83 (0.19–41.99) | 0.449 | 0.57 (0.04–7.74) | 0.674 |
COVID Vaccination Status | ||||
COVID Vaccination | 0.29 (0.05–1.74) | 0.174 | 1.57 (0.24–10.24) | 0.640 |
Long COVID Presentation | ||||
Fatigue | 3.93 (0.77–19.98) | 0.099 | 2.00 (0.74–5.39) | 0.170 |
Dyspnea | 2.98 (0.59–15.16) | 0.189 | 1.75 (0.63–4.90) | 0.286 |
Chest Pain | 1.13 (0.28–4.52) | 0.859 | 1.96 (0.73–5.28) | 0.182 |
Palpitations | 3.8 (0.89–16.23) | 0.072 | 1.68 (0.62–4.56) | 0.311 |
Dizziness/Vertigo | 3.50 (0.33–37.69) | 0.302 | 0.79 (0.33–4.28) | 0.673 |
Pre-syncope/Syncope | 2.21 (0.89–10.23) | 0.872 | 3.21 (0.05–5.48) | 0.915 |
NYHA Class Functional Status | ||||
Continuous | 0.53 (0.16–1.74) | 0.294 | 2.38 (1.26–4.49) | 0.008 |
Class II-III vs. I | 0.59 (0.14–2.50) | 0.472 | 2.70 (1.17–6.25) | 0.020 |
Class III vs. I-II | 1.00 (0.99–1.01) | 0.999 | 4.20 (1.06–16.64) | 0.041 |
Work-Up Findings | ||||
Heart Murmur | 0.67 (0.40–2.89) | 0.203 | 1.17 (0.07–19.59) | 0.912 |
Abnormal ECG | 1.69 (0.41–6.94) | 0.473 | 0.50 (0.14–1.76) | 0.280 |
Abnormal TTE | 1.72 (0.43–6.91) | 0.446 | 2.84 (0.94–8.56) | 0.064 |
LVEF (continuous) | 0.96 (0.84–1.11) | 0.582 | 0.98 (0.89–1.09) | 0.737 |
LV Systolic Dysfunction | 1.02 (0.24–19.53) | 0.534 | 0.76 (0.32–4.54) | 0.863 |
LA Dilatation | 2.71 (0.48–15.34) | 0.259 | 1.67 (0.26–10.74) | 0.591 |
LAVi (continuous) | 0.97 (0.89–1.12) | 0.940 | 1.00 (0.93–1.08) | 0.976 |
More than Mild Valvular Dysfunction | 2.00 (0.21–19.23) | 0.549 | 4.92 (0.52–46.78) | 0.165 |
PASP (continuous) | 0.91 (0.75–1.11) | 0.368 | 1.18 (0.97–1.45) | 0.104 |
Pericardial Effusion | 2.33 (0.52–10.39) | 0.266 | 6.64 (1.3–33.88) | 0.023 |
Abnormal Provocation Test * | 0.17 (0.02–1.71) | 0.133 | ||
Average/Low (vs Good) Age-Adjusted CV Fitness | 3.68 (0.39–35.14) | 0.257 | 0.90 (0.21–3.82) | 0.886 |
CV Restraint per CPET | 2.89 (0.86–2.56) | 0.811 | 0.75 (0.06–8.83) | 0.819 |
Abnormal Holter ECG | NA | NA | 0.97 (0.64–3.42) | 0.723 |
Abnormal CCT | NA | NA | 1 (0.06–15.99) | 1.000 |
Abnormal CMR | NA | NA | 0.44 (0.04–5.58) | 0.530 |
Abnormal PFT | 4.86 (1.11–21.26) | 0.036 | 2.26 (0.75–6.80) | 0.148 |
Abnormal HRCT | 0.63 (0.12–3.25) | 0.582 | 0.29 (0.07–1.22) | 0.091 |
Outcomes | ||||
New CV Diagnosis | NA | NA | 1.19 (0.27–5.24) | 0.816 |
Symptom Non-Improvement | 1.19 (0.27–5.24) | 0.816 | NA | NA |
New, Potentially COVID-Related CV Diagnoses | Symptom Non-Improvement | |||
---|---|---|---|---|
OR (95% CI) | p Value | OR (95% CI) | p Value | |
Fatigue | 2.89 (0.50–16.72) | 0.235 | ||
Palpitations | 2.60 (0.53–12.73) | 0.240 | ||
NYHA Class Functional Status | ||||
Continuous | 1.76 (0.60–5.14) | 0.303 | ||
Class II-III vs. I | 1.55 (0.40–6.06) | 0.530 | ||
Class III vs. I-II | 3.97 (0.34–46.24) | 0.271 | ||
Pericardial Effusion | ||||
NYHA Class Continuous | 2.26 (0.40–12.70) | 0.353 | ||
NYHA Class II-III vs. I | 2.40 (0.43–13.31) | 0.316 | ||
NYHA Class III vs. I-II | 1.92 (0.33–11.16) | 0.470 | ||
Abnormal PFT | 5.16 (1.12–23.68) | 0.035 | ||
Abnormal HRCT | ||||
NYHA Class Continuous | 1.17 (0.26–4.79) | 0.882 | ||
NYHA Class II-III vs. I | 0.98 (0.24–4.02) | 0.974 | ||
NYHA Class III vs. I-II | 1.17 (0.27–4.78) | 0.872 |
Symptom Improvement (n = 52) | Symptom Non-Improvement (n = 44) | p-Value | |
---|---|---|---|
Demographic Details | |||
Age, years | 53 (42–66) | 57 (45–62) | 0.517 |
Male | 22 (42) | 22 (50) | 0.451 |
Cardiovascular Background | |||
Prior CV Disease | 10 (19) | 5 (11) | 0.290 |
CV Risk Factors | |||
Any | 34 (65) | 35 (80) | 0.124 |
Pre-diabetes/Diabetes Mellitus | 19 (37) | 15 (34) | 0.803 |
Hypertension | 9 (17) | 13 (30) | 0.155 |
Dyslipidemia | 30 (58) | 26 (59) | 0.890 |
Obesity | 17 (33) | 13 (30) | 0.740 |
Present Smoking | 3 (9) | 7 (16) | 0.178 |
Acute Covid Data | |||
Symptoms During Acute COVID | 52 (100) | 43 (98) | 0.458 |
Acute COVID Severity, per NIH Criteria | 0.533 | ||
Mild | 22 (23) | 18 (41) | |
Moderate | 14 (27) | 16 (36) | |
Severe | 16 (31) | 10 (23) | |
Hospitalization | |||
Frequency | 18 (35) | 10 (23) | 0.202 |
Length, days | 11 (5–19) | 7 (5–16) | 0.586 |
Invasive Ventilation | 1 (6) | 0 (0) | NA |
Abnormal Tests Results | |||
ECG | 4 (33) | 6 (60) | 0.391 |
TTE | 1 (25) | 1 (25) | 1.000 |
Serum Biomarkers (hs-cTn and/or NT-proBNP) | 2 (15) | 1 (10) | 0.704 |
Time from COVID Diagnosis to Examination, days | 140 (105–179) | 143 (113–214) | 0.405 |
COVID Vaccination Doses | 0.314 | ||
0 | 6 (15) | 2 (5) | |
1 | 12 (30) | 15 (41) | |
2 | 22 (55) | 20 (54) |
Symptom Improvement (n = 52) | Symptom Non-Improvement (n = 44) | p-Value | |
---|---|---|---|
Symptoms | |||
Any | 52 (100) | 44 (100) | 1.000 |
Fatigue | 22 (42) | 26 (59) | 0.101 |
Dyspnea | 27 (52) | 27 (61) | 0.353 |
Chest Pain | 20 (39) | 20 (46) | 0.489 |
Palpitations | 18 (35) | 18 (41) | 0.526 |
Dizziness/Vertigo | 0 (0) | 4 (9) | 0.041 |
Pre-syncope/Syncope | 1 (1) | 1 (2) | 0.207 |
NYHA Class Functional Status | 0.022 | ||
I | 29 (56) | 14 (32) | |
II | 20 (39) | 21 (48) | |
III | 3 (6) | 9 (21) | |
IV | 0 (0) | 0 (0) | |
ECG Findings | |||
Any | 17 (33) | 15 (34) | 0.658 |
Rhythm Disorders | 2 (4) | 1 (2) | 0.498 |
Conduction Disorders | 6 (12) | 6 (14) | 0.871 |
ST-T changes | 13 (25) | 8 (18) | 0.387 |
TTE Findings | |||
Any | 14 (27) | 17 (39) | 0.274 |
LV Systolic Dysfunction | 3 (6) | 1 (2) | 0.245 |
RV Systolic Dysfunction | 0 (0) | 1 (2) | 0.468 |
Grade2 and up Diastolic Dysfunction | 1 (2) | 1 (2) | 1.000 |
LA Dilatation | 3 (6) | 3 (6) | 0.509 |
≥Moderate Valvular Dysfunction | 1 (2) | 0 (0) | 1.000 |
Systolic Pulmonary Hypertension | 0 (0) | 1 (2) | 0.471 |
Pericardial Effusion | 6 (12) | 12 (27) | 0.060 |
Cardiac Provocation Test Findings | |||
Any | 4 (17) | 2 (8) | 0.666 |
Ischemic Findings | 1 (4) | 1 (4) | 1.000 |
Atrial Fibrillation | 0 (0) | 1 (4) | 0.700 |
Chronotropic Incompetence | 3 (12) | 0 (0) | 0.121 |
Age-Adjusted CV Fitness | 0.831 | ||
Good | 9 (43) | 6 (33) | |
Average | 7 (33) | 7 (39) | |
Low | 5 (24) | 5 (28) | |
Holter ECG findings | 0.141 | ||
Any | 1 (5) | 4 (27) | |
Inappropriate Sinus Tachycardia | 1 (5) | 0 (0) | |
Atrial Tachycardia | 0 (0) | 1 (7) | |
Non-Sustained Ventricular Tachycardia | 0 (0) | 1 (7) | |
Couplet Ventricular Premature Beats | 0 (0) | 1 (7) | |
1st degree AV block | 0 (0) | 1 (7) | |
CCT findings | 1.000 | ||
Any | 1 (25) | 2 (22) | |
Non-Obstructive Coronary Artery Disease | 0 (0) | 2 (22) | |
Aberrant Coronary Artery | 1 (25) | 0 (0) | |
CMR findings | 1.000 | ||
Any | 3 (50) | 2 (40) | |
Myocarditis | 2 (33) | 1 (20) | |
Myopericarditis | 0 (0) | 1 (20) | |
Hypertrophic obstructive cardiomyopathy | 1 (17) | 0 (0) | |
CPET findings | |||
CV Restraint | 2 (40) | 3 (43) | 1.000 |
PFT findings | |||
Any | 12 (27) | 15 (42) | 0.155 |
Obstruction | 4 (9) | 9 (25) | 0.168 |
Restriction | 3 (7) | 2 (6) | 0.628 |
Reduced Diffusing Capacity | 5 (11) | 4 (12) | 0.448 |
HRCT findings | |||
Any | 13 (59) | 9 (45) | 0.361 |
Interstitial Changes | 6 (27) | 3 (15) | 0.346 |
Fibrotic Changes | 2 (9) | 2 (10) | 1.000 |
Ground Glass Opacities | 4 (18) | 3 (15) | 0.876 |
Lung Nodules | 1 (5) | 1 (5) | 1.000 |
New, Potentially COVID-Related CV Diagnosis | 5 (10) | 4 (9) | 1.000 |
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Shechter, A.; Yelin, D.; Margalit, I.; Abitbol, M.; Morelli, O.; Hamdan, A.; Vaturi, M.; Eisen, A.; Sagie, A.; Kornowski, R.; et al. Assessment of Adult Patients with Long COVID Manifestations Suspected as Cardiovascular: A Single-Center Experience. J. Clin. Med. 2022, 11, 6123. https://doi.org/10.3390/jcm11206123
Shechter A, Yelin D, Margalit I, Abitbol M, Morelli O, Hamdan A, Vaturi M, Eisen A, Sagie A, Kornowski R, et al. Assessment of Adult Patients with Long COVID Manifestations Suspected as Cardiovascular: A Single-Center Experience. Journal of Clinical Medicine. 2022; 11(20):6123. https://doi.org/10.3390/jcm11206123
Chicago/Turabian StyleShechter, Alon, Dana Yelin, Ili Margalit, Merry Abitbol, Olga Morelli, Ashraf Hamdan, Mordehay Vaturi, Alon Eisen, Alex Sagie, Ran Kornowski, and et al. 2022. "Assessment of Adult Patients with Long COVID Manifestations Suspected as Cardiovascular: A Single-Center Experience" Journal of Clinical Medicine 11, no. 20: 6123. https://doi.org/10.3390/jcm11206123
APA StyleShechter, A., Yelin, D., Margalit, I., Abitbol, M., Morelli, O., Hamdan, A., Vaturi, M., Eisen, A., Sagie, A., Kornowski, R., & Shapira, Y. (2022). Assessment of Adult Patients with Long COVID Manifestations Suspected as Cardiovascular: A Single-Center Experience. Journal of Clinical Medicine, 11(20), 6123. https://doi.org/10.3390/jcm11206123