Journal of Clinical Medicine

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Dr. Amir Gal-Oz

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Department of Anesthesiology and Intensive Care, Tel Aviv Sourasky Medical Center, Tel Aviv 6997801, Israel
Interests: drivers of AKI; renal replacement therapy; systemic physiological changes after myocardial infarction; systemic physiological changes in COVID-19 patients; echocardiography

Special Issue Information

Dear colleagues,

Much has been written in the professional literature about the COVID-19 pandemic. After over three years of managing patients afflicted with this illness, and while many questions have been elucidated, much remains to be discovered about the long-term outcomes of this disease. We know that cardiac disability remains a significant problem in the developed world—specifically for patients with previous cardiac interventions, myocardial infarctions, and cardiac surgery. Cardiac rehabilitation has been at the forefront of optimizing these patients after their cardiac insults.

In this Special Issue, we focus on the long-term consequences of the novel coronavirus, focusing on the challenges towards rehabilitation and recovery—including the ever-ubiquitous "long COVID."

While many challenges remain, our understanding of the cardiac implications of this disease in the acute, subacute, and chronic rehabilitative states has improved drastically. Here, we present a review of the professional literature, with the goal of focusing on patient care in the rehabilitative phase as we continue to treat patients afflicted with this challenging disease.

Dr. Amir Gal-Oz
Guest Editor

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Keywords

COVID-19
echocardiography
cardiac rehabilitation
long COVID
chronic inflammatory state
cardiac restructuring

Published Papers (2 papers)

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Research

10 pages, 774 KiB

Open AccessArticle

Utility of NICaS Non-Invasive Hemodynamic Monitoring in Critically Ill Patients with COVID-19

by Wisam Zabeeda, Jonah Benjamin Cohen, Anat Reiner Benaim, Shiri Zarour, Yael Lichter, Idit Matot and Or Goren

J. Clin. Med. 2024, 13(7), 2072; https://doi.org/10.3390/jcm13072072 - 3 Apr 2024

Viewed by 711

Abstract

(1) Background: COVID-19 presented many challenges to effective treatments, such as managing cardiovascular insufficiency while mitigating risks to healthcare providers. This study utilized NICaS, a non-invasive hemodynamic monitor that provides advanced data via whole-body impedance analysis. We investigated the associated trends in hemodynamic parameters obtained by the NICaS device and their correlation with in-hospital all-cause mortality during COVID-19 hospitalization in the intensive care unit. (2) Methods: Data from 29 patients with COVID-19 admitted to the intensive care unit and monitored with NICaS between April 2020 and February 2021 were analyzed retrospectively. (3) Results: Decreasing cardiac output and cardiac power were significantly associated with death. Total peripheral resistance was significantly increasing in non-survivors as was total body water percentage. Those admitted with a heart rate above 90 beats per minute had a significantly reduced survival. (4) Conclusions: Non-invasive hemodynamic monitoring via the NICaS device is simple and effective in evaluating critically ill patients with COVID-19 and may help guide clinical management via remote monitoring. Controlling tachycardia may help ensure adequate oxygen supply-demand ratio. A hint toward a beneficiary effect of a restrictive fluid balance may be observed. Full article

(This article belongs to the Special Issue Cardiac Rehabilitation in the COVID-19 Pandemic Era)

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17 pages, 1222 KiB

Open AccessArticle

Post-Severe-COVID-19 Cardiopulmonary Rehabilitation: A Comprehensive Study on Patient Features and Recovery Dynamics in Correlation with Workout Intensity

by Andreea Dumitrescu, Gabriela Doros, Voichita Elena Lazureanu, Susa Septimiu-Radu, Felix Bratosin, Ovidiu Rosca, Harshkumar Patel, Tamara Mirela Porosnicu, Gabriela Mut Vitcu, Andrei Mirea, Cristian Oancea, Stefan Mihaicuta, Emil Robert Stoicescu and Paula Irina Barata

J. Clin. Med. 2023, 12(13), 4390; https://doi.org/10.3390/jcm12134390 - 29 Jun 2023

Cited by 3 | Viewed by 1456

Abstract

The aftermath of severe COVID-19 frequently involves considerable cardiopulmonary damage, necessitating rehabilitation. This study aimed to evaluate the impact of COVID-19 on cardiopulmonary health and assess the effectiveness of various rehabilitative interventions. Conducted between September 2021 and September 2022, this prospective study included patients who had been diagnosed with severe COVID-19 and admitted at the “Victor Babes” Infectious Diseases and Pulmonology Hospital, Timisoara, Romania. The patients were stratified into low- and high-intensity rehabilitation groups. The rehabilitation protocols were individually tailored, and the patient recovery was closely monitored over a 3-month period. Our cohort comprised 84 patients, with a mean age of 56.3 years for the low-intensity group (n = 42) and 53.1 years for the high-intensity group (n = 42). Both groups showed significant improvements in the lung injury area, need for oxygen supplementation, ejection fraction, systolic pulmonary artery pressure, and forced vital capacity. Additionally, considerable enhancements were observed in maximal voluntary ventilation, FEV1, FEV1/FVC ratio, peak expiratory flow, and forced expiratory flow at 25–75%. The work intensity also demonstrated substantial improvements from the initial testing to the 3-month mark in both groups. This study provides evidence that personalized, targeted rehabilitation strategies can improve long-term cardiopulmonary health in patients recovering from severe COVID-19, proving both low-intensity and high-intensity training as sufficient to improve heart and lung function if performed correctly and over a relatively short duration of 3 months. The study findings underscore the importance of implementing comprehensive cardiopulmonary rehabilitation protocols in the care of post-COVID-19 patients and highlight the value of stratified rehabilitation intensity based on individual patient dynamics and recovery features. Full article

(This article belongs to the Special Issue Cardiac Rehabilitation in the COVID-19 Pandemic Era)

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