Infection最新文献

{"title":"Clinical heterogeneity and treatment outcomes of extrapulmonary tuberculosis in a low-incidence setting: insights from a prospective cohort study.","authors":"Angela Klingmüller, Marie Feldmann, Samuel Rohr, Lea Helmhold, Lena Junker, Margarete Scherer, Jörg-Janne Vehreschild, Kirsten Schmidt-Hellerau, Ada Hoffmann, Jonathan Jantsch, Alexander Simonis, Victor Suárez, Dominic Rauschning, Natalie Funke, Jakob J Malin, Lena M Biehl, Philipp Schommers, Gerd Fätkenheuer, Clara Lehmann, Jan Rybniker, Isabelle Suárez","doi":"10.1007/s15010-025-02500-4","DOIUrl":"https://doi.org/10.1007/s15010-025-02500-4","url":null,"abstract":"<p><strong>Purpose: </strong>Tuberculosis (TB) remains a leading cause of morbidity and mortality, with 1.3 million deaths in 2022. Extrapulmonary tuberculosis (EPTB) accounts for approximately 20% of all TB cases. We assessed the clinical presentation and challenges during the course of treatment in EPTB patients in a low-incidence setting.</p><p><strong>Methods: </strong>We conducted a prospective cohort study involving 44 EPTB patients at the University Hospital of Cologne, Germany. Clinical data were collected before and during treatment.</p><p><strong>Results: </strong>The cohort comprised 44 patients originating from 21 countries. Two or more invasive procedures were required for microbiological confirmation in 59% (26/44) of the cases. Sputum culture was positive in 18% (8/44) of patients, with 63% (5/8) showing no radiological signs of pulmonary involvement. The median therapy duration was ten months and increased with disease severity. Paradoxical reactions (PR) occurred in 31% (13/42) of the patients. A previously published clinical scoring system assessing EPTB treatment responses showed a favorable treatment outcome in only 68% (21/31) of the patients in this cohort.</p><p><strong>Conclusion: </strong>EPTB exhibits highly variable disease severity and organ involvement. Treatment initiation is often delayed due to diagnostic challenges. Management is complicated by the frequent occurrence of PR, which can lead to treatment durations exceeding standard recommendations. Clinical scores for treatment response assessment may not be reliably applicable, highlighting the need for alternative biomarkers.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistently high burden of acute respiratory infections requiring hospitalization in German pediatric hospitals, fall/winter 2023-2024.","authors":"Svenja Dreßen, Josephine Schneider, Maren Doenhardt, Natalie Diffloth, Tobias Tenenbaum, Dominik T Schneider, Andreas Trotter, Nicole Toepfner, Reinhard Berner","doi":"10.1007/s15010-025-02494-z","DOIUrl":"https://doi.org/10.1007/s15010-025-02494-z","url":null,"abstract":"<p><strong>Purpose: </strong>During fall 2021, children's hospitals in Germany faced a surge in RSV-related hospitalizations, whereas during fall/winter 2022-2023, RSV and influenza infections both led to increased inpatient admissions. Our study prospectively assessed severe acute respiratory infections, their causative pathogens, and the resulting disease burden on German children's hospitals for the fall/winter 2023-2024 season.</p><p><strong>Methods: </strong>From October 3, 2023 through April 16, 2024, children hospitalized with ARI as a primary diagnosis were monitored via a national survey established by the German Society for Pediatric Infectious Diseases (DGPI). Weekly data was collected on total hospital admissions, ARI-related admissions by pathogen (SARS-CoV-2, RSV, influenza, other), ICU admissions with ARI as a primary diagnosis, and respiratory support.</p><p><strong>Results: </strong>Overall, 23% of German children's hospitals (77/334 centers) submitted 1234 survey reports. ARI-related hospital admissions surged starting in November 2023 and peaked in late December 2023 (53.4% of all admissions), in parallel with a peak in the average number of newly-admitted patients (aNA) with RSV (2.5 aNA). In comparison to the 2022/2023 season, fewer newborns and infants were admitted for ARI (4.7%, p < 0.001/1.9%, p = 0.05) and fewer required ICU treatment (5.3%, p = 0.02/5.6%, p = 0.001 respectively). In 74.9% of ICU patients, ventilation support was required-9.1% less than in the previous season.</p><p><strong>Conclusion: </strong>The clinical burden on pediatric hospitals and ICUs is strongly influenced by the changing, annually circulating pathogens and affected age group. Therefore, a continuous, systematic, dynamic collection of ARI data is critical for assessing the ARI-related morbidity and the associated burden on health care systems.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic resistance of urinary pathogens after kidney transplantation: a 10-year single-center survey in Germany.","authors":"P Weber, P Braß, J Jäger, L Jacquet, S Jansen, A Gäckler, C Jürgens, J Reinold, U Eisenberger, P-M Rath, A Kribben, O Witzke, H Rohn","doi":"10.1007/s15010-025-02493-0","DOIUrl":"https://doi.org/10.1007/s15010-025-02493-0","url":null,"abstract":"<p><strong>Purpose: </strong>Urinary tract infections (UTIs) are common complications after kidney transplantation (KT), often resulting in severe outcomes like acute graft failure and sepsis. Factors such as diabetes, age, sex, and type of transplantation significantly influence disease progression. Rising antibiotic resistance complicates treatment, emphasizing the importance of Antimicrobial Stewardship (AMS), particularly during the post-transplant immunosuppression phase. Recent changes in treatment protocols, including a shift away from treating asymptomatic bacteriuria and modifications in antibiotic prescribing, highlight the need for updated resistance trend analyses.</p><p><strong>Methods: </strong>This retrospective study at the University Hospital Essen analyzed urine samples from kidney transplant outpatients from 2013 to 2022. Pathogen identification and resistance testing focused on common UTI pathogens, including Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Enterococcus faecium, and Enterococcus faecalis. Data on antibiotic prescriptions were sourced from the North Rhine Association of Statutory Health Insurance since 2017.</p><p><strong>Results: </strong>Out of 10,508 urine samples collected from 6962 patients, bacterial growth was detected in 4126 samples (39%). Escherichia (E.) coli was the most frequent pathogen (41%). Klebsiella spp., which accounted for 11.7% of all pathogens, showed increasing resistance to piperacillin/tazobactam and ceftazidime. Resistance rates Enterococcus faecalis showing a significant decline in levofloxacin (100% resistance in 2014 in all isolates, compared to 2% in 2022). An increasing concern in our cohort is the prevalence of Extended Spectrum Beta-Lactamase (ESBL)-producing Gram-negative pathogens, particularly Klebsiella spp., which are being detected with greater frequency. In our center, we have observed a significant increase in the use of oral antibiotics recommended for first-line therapy. This shift is attributed to updated guidelines and therapeutic recommendations. Consequently, oral cephalosporins are now rarely used due to their low bioavailability.</p><p><strong>Conclusion: </strong>The study highlights the importance of ongoing surveillance to address antibiotic resistance in KT recipients. Increasing resistance in pathogens like Klebsiella spp. necessitates new antimicrobial strategies. Findings should inform future guidelines to preserve antibiotic effectiveness and improve therapeutic outcomes in this vulnerable patient population.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into dysregulated innate immunity in the pathogenesis of COVID-19-associated pulmonary aspergillosis.","authors":"Hanxue Xiang, Ling Zhang, Miaotian Cai, Yulin Zhang","doi":"10.1007/s15010-025-02495-y","DOIUrl":"https://doi.org/10.1007/s15010-025-02495-y","url":null,"abstract":"<p><p>Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a severe complication arising from the co-infection of viral and fungal pathogens in the lungs, with its incidence notably increasing. Although significant progress has been made in elucidating the pathogenesis of CAPA in recent years, the precise pathophysiological mechanisms underlying this condition remain only partially understood. Current evidence indicates that CAPA primarily results from dysregulation of innate antifungal immune responses. Key contributing factors include epithelial barrier dysfunction, impaired phagocytic activity against fungi, aberrant expression of antimicrobial peptides, immunologic tolerance, and lung dysbiosis, all of which collectively weaken host defense mechanisms. Concurrently, excessive pro-inflammatory responses-driven by cytokine storms and oxidative stress associated with antiviral immunity-further exacerbate lung injury in COVID-19 patients, creating a detrimental feedback loop that impairs immune function and heightens susceptibility to CAPA. In this review, we summarize and discuss recent advances in understanding the role of dysregulated innate immunity in the pathogenesis of CAPA. These insights may inform clinical management strategies and improve outcomes for patients suffering CAPA.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Streptococcus suis endocarditis: prognostic factors and antimicrobial resistance.","authors":"Wilawan Thipmontree, Udomsak Lerssuttipon, Piyapat Chunharas, Rattagan Kajeekul, Atitaya Lewrod, Suganya Yongkiettrakul, Anusak Kerdsin","doi":"10.1007/s15010-025-02497-w","DOIUrl":"https://doi.org/10.1007/s15010-025-02497-w","url":null,"abstract":"<p><strong>Purpose: </strong>Streptococcus suis is an important zoonotic pathogen worldwide. This study aims to identify prognostic factors associated with the development of infective endocarditis (IE) and mortality in patients with S. suis bacteremia.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted by reviewing the medical records of patients with culture-confirmed S. suis infection admitted to a tertiary care hospital in Thailand between 2021 and 2023.</p><p><strong>Results: </strong>Among 200 patients with S. suis bacteremia who underwent echocardiograms, 102 (51%) were diagnosed with IE. Between 2021 and 2023, resistance to penicillin in S. suis increased from 13.0 to 38.7%, while intermediate susceptibility to ceftriaxone rose from 2.2 to 13.3%. Patients with S. suis bacteremia were at higher risk of developing IE if the strains were penicillin-resistant (aPR: 7.94, 95% CI: 1.13-55.80) or if persistent bacteremia was present (aPR: 1.58, 95% CI: 1.27-1.96) in multivariable analysis. Other risk factors included illness duration of more than 14 days (aPR: 2.19, 95% CI: 1.66-2.89) and being under 60 years of age (aPR: 1.42, 95% CI: 1.09-1.83). All-cause in-hospital mortality for patients with S. suis IE was 28.4% (95% CI: 19.9-38.2), higher than that of patients without IE (15.3%, 95% CI: 8.8-24.0). Embolic stroke and acute kidney injury increased the risk of death 3.28-fold (95% CI: 1.82-5.91) and 2.87-fold (95% CI: 1.06-7.79), respectively, after adjusting for confounders.</p><p><strong>Conclusion: </strong>S. suis is a common cause of IE, particularly among antimicrobial-resistant strains, leading to high morbidity and mortality. Echocardiography is recommended for patients with S. suis bacteremia, although managing drug-resistant infections remains challenging.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of patients hospitalized in internal medicine wards adequately treated for bloodstream infections caused by NDM-producing Klebsiella pneumoniae. Results from a real-life retrospective multi-center study in an endemic area.","authors":"Simone Meini, Roberta Del Cesta, Francesco Sbrana, Javier Rosada, Davide Carrara, Maddalena Mura, Benedetta Longo, Roberto Andreini, Giuseppe Linsalata, Alessandro Fedele, Francesco Filidei, Andrea Ripoli, Elisabetta Andreoli, Enrico Tagliaferri, Spartaco Sani","doi":"10.1007/s15010-025-02488-x","DOIUrl":"10.1007/s15010-025-02488-x","url":null,"abstract":"<p><strong>Background: </strong>New Delhi metallo-beta-lactamase (NDM)-producing Klebsiella pneumoniae (NDM-Kp) represents a growing challenge for modern medicine.</p><p><strong>Objectives: </strong>To assess real-life clinical outcomes in patients adequately treated in Internal medicine units (IMUs) for bloodstream infections (BSI) caused by NDM-Kp.</p><p><strong>Methods: </strong>A two-years retrospective study was conducted recruiting 30 consecutive adult patients with NDM-Kp BSI treated with an adequate definitive antibiotic therapy (27 aztreonam plus ceftazidime/avibactam; 3 cefiderocol) in three Italian IMUs located in a highly endemic area.</p><p><strong>Results: </strong>Mean age of patients was 75.3 years, mean Charlson Comorbidity Index (CCI) 7.5. All the patients had rectal colonization. Thirty-day mortality rate was 46.7%; 78.6% of patients who died received an adequate empiric therapy. Non-survivors had mean age, CCI and SOFA score significantly higher compared to survivors (80.1 vs. 71.2, p = 0.036; 8.6 vs. 6.6, p = 0.047; 5.9 vs. 4, p = 0.043, respectively). The percentage of survivors was significantly higher among the 13 cases with community-acquired than in the 17 with hospital-acquired BSI (76.9% vs. 35.3%, p = 0.024). In the multivariate penalized logistic regression analysis, age, CCI, SOFA score and hospital-acquired BSI onset were identified as independent predictors of mortality.</p><p><strong>Conclusion: </strong>This study provides real-life data on clinical outcomes regarding old and highly multimorbid patients hospitalized in IMU for BSI caused by NDM-Kp, showing a very high 30-day mortality even in case of adequate treatment.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"UniteID- a proposal for training pediatric ID specialists supported by an adult ID program.","authors":"Katrin Mehler, Andre Oberthuer, Gerd Faetkenheuer, Michael Weiss, Joerg Doetsch, Sarina K Butzer, Norma Jung","doi":"10.1007/s15010-025-02490-3","DOIUrl":"https://doi.org/10.1007/s15010-025-02490-3","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive analysis of the Global Burden and epidemiological trends of meningitis from 1990 to 2021.","authors":"Chao Tang, Rongshou Han, Jiaxin Yang, Ning Wu, Dian He","doi":"10.1007/s15010-025-02483-2","DOIUrl":"https://doi.org/10.1007/s15010-025-02483-2","url":null,"abstract":"<p><strong>Background: </strong>Despite significant advances in prevention and treatment strategies, meningitis continues to pose a substantial global health challenge. The disease burden demonstrates marked geographical disparities, with disproportionate impact in resource-limited settings, particularly within the \"meningitis belt\" of Sub-Saharan Africa. The global meningitis burden is influenced by a complex interplay of environmental, behavioral, and socioeconomic determinants.</p><p><strong>Methods: </strong>Leveraging the Global Burden of Disease (GBD) 2021 database, we conducted a comprehensive analysis of global meningitis burden from 1990 to 2021. The study employed DisMod-MR 2.1, an advanced Bayesian meta-regression tool, for epidemiological modeling. We implemented age-period-cohort analysis to evaluate mortality trends and utilized the Comparative Risk Assessment framework to assess risk factors. The relationship between socio-demographic index (SDI) and disease burden was examined through Spearman's rank correlation analysis.</p><p><strong>Results: </strong>Our analysis revealed significant geographical and pathogen-specific variations in disease burden. Globally, the age-standardized incidence rate stands at 31.65 per 100,000 with a corresponding mortality rate of 2.95 per 100,000. The disease burden demonstrates a striking gradient across SDI levels, with low SDI regions experiencing the highest burden, approximately 17 times higher than high SDI regions. Neonatal mortality rates remain particularly concerning at 129.69 per 100,000, while under-5 mortality rates stand at 34.50 per 100,000. The Eastern Sub-Saharan African region emerges as an area of particular concern, with disease burden significantly exceeding global averages. Behavioral risks, child and maternal malnutrition, and low birth weight/short gestation emerged as the primary risk factors, each contributing to 0.15 million deaths and 13.41 million DALYs. Strong negative correlations were observed between all risk factors and SDI values (correlation coefficients ranging from - 0.55 to -0.75), indicating higher disease burden in regions with lower socio-demographic development.</p><p><strong>Conclusion: </strong>While substantial progress has been achieved in global meningitis control, particularly in reducing under-5 mortality rates, significant disparities persist between high and low SDI regions. Our findings emphasize the critical need for targeted interventions in resource-limited settings and continued surveillance efforts to address remaining challenges in meningitis control.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased incidence of blood culture contaminations during and after the COVID-19 pandemic.","authors":"Hannah Tolle, Aude Nguyen, Aleece MacPhail, Nasreen Hassoun-Kheir, Marie-Noelle Chraiti, Filippo Boroli, Marie-Céline Zanella, Stephan Harbarth, Gaud Catho, Niccolò Buetti","doi":"10.1007/s15010-024-02469-6","DOIUrl":"https://doi.org/10.1007/s15010-024-02469-6","url":null,"abstract":"<p><strong>Purpose: </strong>Blood culture contamination (BCC) is mainly caused by commensal bacteria, during sample collection. It results in unnecessary antibiotic exposure, prolonged hospitalisation, additional microbiology workup and significant adverse health-economic burden. We aimed to investigate the short- and long-term impact of the COVID-19 pandemic on the incidence of BCC.</p><p><strong>Methods: </strong>We conducted a retrospective, observational cohort study at Geneva University Hospitals (HUG). We included all BCCs from January 2018 to December 2023, collected as part of a prospective hospital-wide surveillance by the infection control team. Data were analyzed using segmented Poisson regression models to evaluate BCC incidence rate ratios (IRRs) across three periods: pre-COVID-19 (2018-2019), during COVID-19 (2020-2021), and post-COVID-19 peak (2022-2023).</p><p><strong>Results: </strong>Out of 456,873 collected blood cultures, 1,247 BCCs were identified (0.27%). The contamination rate per 1000 samples increased from 1.53 pre-COVID-19 to 2.94 during COVID-19 and 3.52 post-COVID-19. Compared to the pre-COVID-period, incidence rate ratios (IRRs) for BCC increased during COVID-19 (IRR 1.84, 95% CI 1.58-2.15) and post-COVID-19 peak (IRR 2.29, 95% CI 1.97-2.66). During COVID-19, proportions of BCC were increased in intensive care units (27.4%, n = 127) and returned to baseline level post-COVID-19 (17.3%, n = 93, p < 0.001); whereas, in other wards, BCC remained elevated (42.2%, n = 227) in the post-COVID-19 period.</p><p><strong>Conclusions: </strong>We observed a significant rise in BCC incidence during and after the COVID-19 peak. The persistently elevated post-peak rates highlight ongoing challenges in regaining optimal aseptic blood culture collection practices and the need for further exploration of persisting factors increasing BCC rates.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac structure and function 1.5 years after COVID-19: results from the EPILOC study.","authors":"Jana Schellenberg, Lynn Matits, Daniel A Bizjak, Peter Deibert, Birgit Friedmann-Bette, Siri Göpel, Uta Merle, Andreas Niess, Norbert Frey, Oliver Morath, Gunnar Erz, Raphael S Peter, Alexandra Nieters, Dietrich Rothenbacher, Winfried V Kern, Jürgen M Steinacker","doi":"10.1007/s15010-025-02481-4","DOIUrl":"https://doi.org/10.1007/s15010-025-02481-4","url":null,"abstract":"<p><strong>Purpose: </strong>Impaired left and right ventricular (LV/RV) function during acute SARS-CoV-2 infection has been predominantly reported in hospitalized patients, but long-term cardiac sequelae in large, well-characterized cohorts remain inconclusive. This study evaluated cardiac structure and function in individuals with post-Coronavirus disease (COVID) syndrome (PCS) compared to recovered controls (CON), focusing on associations with cardiopulmonary symptoms and rapid physical exhaustion (RPE).</p><p><strong>Methods: </strong>This multicenter, population-based study included 1154 participants (679 PCS, 475 age- and sex matched CON; mean age 49 ± 12 years; 760 women) 1.5 years post-infection. Transthoracic echocardiography assessed LV global longitudinal strain (GLS), RV GLS and RV free wall strain (FWS), and other measures. Cardiopulmonary exercise testing (CPET) measured maximum respiratory oxygen uptake (VO₂max) as a marker of cardiopulmonary fitness.</p><p><strong>Results: </strong>PCS participants exhibited significantly lower LV GLS (-20.25% [-21.28 - -19.22] vs. -20.73% [-21.74 - -19.72], p = 0.003), reduced diastolic function (E/A 1.16 [1.04-1.27] vs. 1.21 [1.1-1.32], p = 0.022) and decreased TAPSE (24.45 mm [22.14-26.77] vs. 25.05 mm [22.78-27.32], p = 0.022) compared to CON, even after adjusting for confounders. RV strain values were similar between groups. LV GLS correlated inversely with VO₂max (p = 0.004) and positively with RPE (p = 0.050), though no associations were observed with other cardiopulmonary symptoms.</p><p><strong>Conclusions: </strong>This study demonstrates subtle yet consistent reductions in LV function, specifically LV GLS and diastolic function, and exercise capacity in PCS compared to CON. While these changes are within reference ranges, their potential impact on clinical outcomes warrants further investigation. These findings highlight the need for cardiac assessments and long-term follow-up in symptomatic PCS patients.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}