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"Latar Belakang : Infeksi COVID-19 telah diketahui masih dapat menyebabkan gejala sampai 90 hari dan bahkan lebih, meski infeksi akutnya telah berlalu. Hal ini disebabkan karena adanya fenomena sindroma pasca COVID-19. Mekanisme kejadian tersebut sampai saat ini masih belum diketahui pasti. Hal tersebut diduga kuat akibat adanya fibrosis di beberapa organ, terutama jantung dan paru. Sementara itu, beberapa studi telah menyebutkan bahwa sST2 merupakan penanda fibrosis jantung. Meskipun demikian, sampai saat ini belum ada penelitian yang mencoba mengetahui faktor-faktor apa saja yang memiliki hubungan dengan kejadian fibrosis pasca infeksi COVID-19. Kadar sST2 pada pasien komorbid kardiovaskular tanpa COVID-19 dan populasi orang sehat, khususnya di Indonesia juga belum diketahui.Tujuan : Mengetahui perbandingan kadar sST2 pada pasien komorbid kardiovaskular 12 minggu pasca infeksi COVID-19 dengan pasien komorbid kardiovaskular tanpa COVID-19 dan populasi orang sehat, serta hubungannya dengan faktor-faktor admisi.Metode : Penelitian ini merupakan studi observasional potong lintang. Kadar sST2 pada pasien 12 minggu pasca infeksi COVID-19 dibandingkan dengan komorbid kardiovaskular akan dibandingkan dengan kelompok kontrol, yaitu kontrol 1 yang merupakan pasien komorbid kardiovaskular tanpa COVID-19 dan kontrol 2 yang merupakan populasi orang sehat. Kelompok kontrol dipilih menggunakan metode matching. Hubungan faktor klinis dan laboratoris saat dengan kadar sST2 pada pasien 12 minggu pasca infeksi COVID-19 dianalisis menggunakan analisis multivariat.Hasil : Terdapat 162 subjek yang menyelesaikan rangkaian penelitian yang terdiri atas 100 subjek dengan penyintas COVID-19 disertai komorbiditas kardiovaskular (kelompok kasus), 31 subjek dengan komorbiditas kardiovaskular tanpa COVID-19 (kelompok kontrol 1), dan 31 subjek sehat tanpa riwayat COVID-19 dan komorbiditas kardiovaskular (kelompok kontrol 2). Ketiga kelompok memiliki karakteristik yang sama. Terdapat perbedaan signifikan rerata nilai sST2 antara kelompok kasus dibandingkan kontrol 1 dan kontrol 2 (2786 ± 73 vs 2666 ± 162 pg/l, p <0.001 dan 2786 ± 73 vs 2517.15 ± 321 pg/l, p < 0.001), serta kontrol 1 dibandingkan kontrol 2 (2666 ± 162 pg/l vs 2517.15 ± 321 pg/l, p < 0.001). Analisis multivariat menunjukkan PaO2 (p < 0.001) dan nilai CT (p = 0.04) memiliki hubungan dengan kadar sST2 pada pasien 12 minggu pasca infeksi COVID-19.Kesimpulan : Terdapat perbedaan signifikan antara kadar sST2 sebagai penanda fibrosis jantung pada ketiga kelompok subjek penelitian, dengan kadar sST2 lebih tinggi pada subjek dengan penyintas COVID-19 disertai komorbiditas kardiovaskular. Terdapat hubungan PaO2 dan nilai CT saat admisi dengan kadar sST2.

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Background : Recent findings showed that symptoms associated with COVID-19 infection may persist up to 90 days even after the acute disease period has passed. This condition is now termed as post COVID-19 syndrome. Several pathophysiologic mechanisms of this event had been proposed, all of which still needed further elaboration. One of the proposed mechanisms involves fibrotic processes in several organs, especially heart and the lungs. SST2 has been suggested as a novel biomarker for cardiac fibrosis. However data are still needed to further elucidate the factors which are associated with the incidence of fibrosis post COVID-19 infection. Furthermore, data regarding sST2 levels in patients with cardiovascular comorbidities and in healthy subjects are still limited.

Objective : Knowing the differences on sST2 levels between subjects with cardiovascular comorbidities 12 weeks post COVID-19 infection, those without history of COVID-19 but with cardiovascular comorbidities, and healthy population, as well as knowing its relationship with admission factors.

Methods : This study is a cross-sectional observational study on patients 3 months after COVID-19 infection presented with cardiovascular comorbidities. Age and sex-matched control groups were used as comparison. The results were compared with a group without history of COVID-19 and healthy populations. Relationship between admission factors was assessed using multivariate analysis

Results : 162 subjects completed the study series, consisting of 100 subjects with COVID-19 survivors with cardiovascular comorbidities (case group), 31 subjects with cardiovascular comorbidities without COVID-19 (control group 1), and 31 healthy subjects without a history of COVID-19 and cardiovascular comorbidities (control group 2). All three groups had similar characteristics. There was a significant difference in the mean sST2 value between the case groups compared to control 1 and control 2 (2786 ± 73 vs 2666 ± 162 pg/l, p < 0.001 and 2786 ± 73 vs 2517.15 ± 321 pg/l, p < 0.001 respectively), and control 1 compared to control 2 (2666 ± 162 pg/l vs 2517.15 ± 321 pg/l, p < 0.001). Multivariate analysis revealed PaO2 (p < 0.001 and CT values (p = 0.04) as admission factor associated with increased sST2 3 months after initial COVID-19 infection.

Conclusion : SST2 levels were found to be significantly different between the three groups, with the highest level on the case group (subjects with history of COVID-19 and cardiovascular comorbidities). Factors upon admissions which include Arterial oxygen partial pressure (PaO2) (p < 0.001) and CT value (p = 0.04) were found to be associated with increased sST2 levels."

"Latar Belakang: Telah diketahui infeksi COVID-19 dapat menetap menjadi sindroma pasca COVID-19. Magnetic Resonance Imaging (MRI) kardiak memiliki nilai diagnostik tinggi untuk menilai karakteristik jaringan miokard. Belum diketahui secara pasti efek jangka panjang COVID-19 terhadap jaringan miokardium serta faktor-faktor admisi yang memiliki pengaruh terhadap prevalensi sindroma pasca-COVID-19 pada populasi dengan penyakit kardiovaskular. Tujuan: Mengevaluasi prevalensi fibrosis miokardium dengan MRI kardiak pada pasien dengan penyakit kardiovaskular dan riwayat COVID-19 1 tahun pascaperawatan, serta mengidentifikasi faktor admisi yang berpengaruh terhadap fibrosis miokardium. Metode: Kohort prospektif dengan menilai parameter MRI kardiak pada pasien terkonfirmasi COVID-19 dengan penyakit kardiovaskular 1 tahun pascaperawatan. Selanjutnya, dilakukan analisa temuan MRI kardiak terhadap kelompok kontrol tanpa riwayat COVID-19 yang telah di-matching berdasarkan umur, jenis kelamin, dan faktor resiko. Analisa multivariat dilakukan untuk mengetahui faktor admisi yang memiliki hubungan dengan kejadian fibrosis miokardium. Hasil: Total 32 subjek dengan penyakit KV dan riwayat COVID-19 1 tahun pascaperawatan dengan 49 subjek kontrol disertakan dalam studi ini. Terdapat peningkatan yang signifikan pada parameter MRI kardiak yaitu proporsi abnormal T1 relaxation time (65,5% vs 36,7%; p-value=0,011) serta late gadolinum enhancement (LGE) skar noniskemik 62,5% vs 29,8%;p-value=<0,001) pada kelompok dengan riwayat COVID-19 dibanding kontrol. Tidak ditemukan faktor admisi yang berpengaruh terhadap peningkatan LGE noniskemik/T1 abnormal. Kesimpulan: Terdapat peningkatan prevalensi fibrosis miokardium pada pasien dengan penyakit KV dan riwayat COVID-19 1 tahun pascaperawatan dibanding kontrol dinilai melalui MRI kardiak. Tidak terdapat hubungan antara faktor admisi dengan fibrosis miokardium 1 tahun pascaperawatan COVID-19.

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Background: Presently, it has been acknowledged that COVID-19 infection may persist longer as Post-acute COVID-19 Syndrome. Cardiac Magnetic Resonance Imaging (cMRI) possesses a high diagnostic value to evaluate myocardial tissue characteristics. Data are still limited regarding longer implications of COVID-19 infection towards myocardial tissues and predictive admission factors in patients with Cardiovascular Diseases (CVD).

Aim(s): To evaluate the prevalences of myocardial fibrosis using cMRI in patients with CVD and one year post-COVID-19 hospitalization and identifying admission factors in correlation with myocardial fibrosis. 

Method(s): Prospective cohort to assess cMRI parameters in patients with CVD and history of COVID-19 one year post-hospitalization. The results were then compared with the age-, sex-, risk factors-matched control group without prior of COVID-19 infection. Lastly, multivariat analysis was done to identify relations between admission factors and myocardial fibrosis. 

Result(s): A total of 32 subjects with CVD one year post-COVID-19 hospitalization and 49 controls were included in this study. Significant increases of cMRI parameters, namely abnormal T1 relaxation time (65.5% vs 36.7%; p-value=0.011) and non-ischemic late gadolinum enhancement (LGE) (62.5% vs 29.8%;p-value=<0.001) were observed in the population with prior COVID-19 infection compared to control. No admission factors were found to be related with the increases in nonischemic LGE/abnormal T1.

Conclusion: There is a significant increase of myocardial fibrosis prevalence in patients with CVD one year post-COVID-19 hospitalization compared to control assessed through cMRI parameters. No relationships were found between admission factors and myocardial fibrosis. "

"Latar Belakang : Infeksi COVID-19 dewasa ini telah diketahui memiliki implikasi jangka panjang meski periode akut telah tertangani, suatu fenomena yang dinamakan long COVID syndrome atau sindrom pasca COVID-19. Patofisiologi dari kejadian ini masih belum diketahui dengan jelas. Studi melaporkan bahwa sindrom pasca COVID-19 melibatkan beberapa organ, diantaranya adalah sistem kardiovaskular. Pemeriksaan nilai LV GLS dan RV LS pada ekokardiografi dinilai akurat dalam mendeteksi disfungsi miokard dan fibrosis endomiokardial. Selain itu, hingga saat ini, data mengenai faktor-faktor saat admisi sebagai prediktor terhadap kejadian sindrom pasca COVID-19 masih terbatas. Tujuan : Mengetahui nilai parameter ekokardiografi LV GLS dan RV LS sebagai penanda disfungsi miokard dan fibrosis jantung serta mengidentifikasi faktor-faktor saat admisi yang berpengaruh terhadap kejadian sindrom pasca COVID-19.Metode : Penelitian ini adalah deskriptif-analisis menggunakan metode potong lintang. Pemilihan subjek dilakukan dengan metode consecutive sampling. Pemeriksaan ekokardiografi termasuk pemeriksaan global longitudinal strain (GLS) dilakukan oleh dua orang observer 4 bulan pasca perawatan rumah sakit. Selanjutnya, analisis multivariat berupa regresi linear dilakukan untuk mengetahui faktor admisi yang berpengaruh terhadap perbedaan nilai GLS pada kelompok penelitian. Hasil : 100 subjek dengan komorbiditas kardiovaskular dan riwayat COVID-19 memenuhi kriteria dan syarat penelitian. Ditemukan nilai penurunan nilai LV-GLS pada kelompok ini. Subjek dengan komorbiditas kardiovaskular tanpa riwayat COVID-19 (n=31, kontrol 1) yang telah melalui proses matching berdasarkan usia, gender, dan faktor resiko, serta subjek sehat (n-31, kontrol 2) sebagai pembanding validitas GLS. Terdapat perbedaan signifikan rerata nilai LV GLS antar 3 kelompok (p<0.05, rerata ±SB -16.17 ± 3.379, -19.48 ± 1.141, -21.48 ± 1.777 berturut-turut untuk kelompok kasus, kontrol 1, kontrol 2), dengan nilai paling rendah pada kelompok kasus. Faktor saat admisi yaitu status CAD memiliki hubungan yang signifikan (p 0.038) dengan penurunan LV GLS pada pasien post covid-19 dengan komorbid kardiovaskular. Kesimpulan : Terdapat penurunan nilai LV GLS yang signifikan pada sindrom pasca COVID-19 disertai komorbiditas kardiovaskular. CAD merupakan prediktor penurunan fungsi maupun fibrosis jantung sebagai manifestasi sindrom pasca COVID-19.

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Background : Recently, COVID-19 infection has been known to have a longer implication, even after the initial acute phase has been managed, a phenomenon termed as long COVID syndrome or “sindroma pasca COVID-19”. The exact pathophysiological mechanism of this event is still unknown. Previous studies reported that long COVID syndrome involves multiple organs, one of which is the cardiovascular system. Measurement of echocardiography LV GLS and RV LS values are reported to be accurate to detect myocardial dysfunction and endomyocardial fibrosis. Moreover, up until now, data regarding admission factors as predictors for long COVID syndrome incidences are still limited.

Objective : Assessing echocardiography LV GLS and RV LS values as a marker for myocardial dysfunction and heart fibrosis and identifying admission factors which may predict the incidence of long COVID syndrome

Methods : This is an observational study with a cross-sectional using a consecutive sampling method. Echocardiography including global longitudinal strain (GLS) measurement was done by two examiners 3 months after initial hospitalization. Multivariate analysis linear regression was subsequently used to investigate admission factors which are associated with differences in GLS measurement.

Results : Total of 100 subjects with cardiovascular comorbidities and prior COVID-19 infection were enrolled. Echocardiography examination showed lower GLS values in this group compared to the normal population. Age, sex and risk factors-matched subjects with cardiovascular comorbidity without a history of COVID-19 (n=31, Control 1) and healthy subjects (n-31, Control 2) were subsequently used as comparisons to validate GLS results. There were significant differences in LV-GLS levels between the three groups, with the lowest values measured in the case group (p<0.05, mean ±SD -16.17 ± 3.379, -19.48 ± 1.141, -21.48 ± 1.777 respectively for case, control 1, and control 2 groups). A history of coronary artery disease upon admission was found to be associated with decreased LV GLS values in recovered COVID-19 patients with cardiovascular comorbidity.

Conclusion : LV GLS values significantly decrease in long COVID syndrome with cardiovascular comorbidities. Having a previous history of CAD upon admission may serve as predictors of deteriorated functions or heart fibrosis as manifestations of long COVID syndrome. "