{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:59:23Z","timestamp":1760057963996,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T00:00:00Z","timestamp":1741305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection may be associated with impaired cardiac function, especially in severe cases requiring hospitalization. Impedance cardiography (ICG) is a noninvasive method for assessing cardiac function. It could be useful for the early detection of hemodynamic dysfunction, particularly in patients with a severe course of COVID-19. Aim: This study aimed to analyze and compare the hemodynamic profiles of patients hospitalized with SARS-CoV-2-induced pneumonia to those of a control group. Methods: This prospective, observational, clinical study included 30 hospitalized patients (both men and women, mean age: 48 years) diagnosed with COVID-19 pneumonia (COVID group). Their data were compared to those of a retrospective control group (CG). The study participants were propensity score-matched based on clinical characteristics, including age, blood pressure (BP), and body mass index (BMI). ICG measurements of hemodynamic profiles were performed using a Niccomo device and included heart rate (HR), stroke volume index (SI), cardiac index (CI), velocity index (VI), acceleration index (ACI), Heather index (HI), systemic vascular resistance index (SVRI), and thoracic fluid content (TFC). Results: Patients with COVID-19 showed significantly higher HR (p &lt; 0.0001) and SVRI (p = 0.0003) and lower values for several cardiac function parameters, including SI (p &lt; 0.0001), VI (p &lt; 0.0001), ACI (p = 0.004), and HI (p &lt; 0.0001). Additionally, 11 patients (37%) in the COVID group had a low SI (&lt;35 mL\/m2), compared to only 1 patient (3%) in the control group (p &lt; 0.0001). A statistically significant difference in left ventricular ejection fraction (LVEF) was also observed (p &lt; 0.0001), although absolute values remained within the normal range. Conclusions: SARS-CoV-2 infection negatively affects the cardiovascular system, leading to impaired heart function even in low-risk patients. Impedance cardiography may serve as a simple, noninvasive tool for identifying individuals with cardiac dysfunction following COVID-19 pneumonia.<\/jats:p>","DOI":"10.3390\/jcm14061806","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T09:38:46Z","timestamp":1741340326000},"page":"1806","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impaired Cardiovascular Hemodynamics in Patients Hospitalized with COVID-19 Pneumonia"],"prefix":"10.3390","volume":"14","author":[{"given":"Barbara","family":"Domino","sequence":"first","affiliation":[{"name":"Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnieszka","family":"W\u0142ochacz","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5242-7522","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Maciorowska","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9629-5680","authenticated-orcid":false,"given":"Krzysztof","family":"K\u0142os","sequence":"additional","affiliation":[{"name":"Department of Internal Diseases, Infectious Diseases and Allergology, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6444-4124","authenticated-orcid":false,"given":"Andrzej","family":"Chcia\u0142owski","sequence":"additional","affiliation":[{"name":"Department of Internal Diseases, Infectious Diseases and Allergology, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma\u0142gorzata","family":"Banak","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8997-6568","authenticated-orcid":false,"given":"Beata","family":"Uzi\u0119b\u0142o-\u017byczkowska","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1909-0993","authenticated-orcid":false,"given":"Pawe\u0142","family":"Krzesi\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Diseases, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1093\/ehjci\/jeaa178","article-title":"Global evaluation of echocardiography in patients with COVID-19","volume":"21","author":"Dweck","year":"2020","journal-title":"Eur. Heart J.\u2014Cardiovasc. Imaging"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1093\/cvr\/cvaa106","article-title":"COVID-19 and the cardiovascular system: Implications for risk assessment, diagnosis, and treatment options","volume":"116","author":"Guzik","year":"2020","journal-title":"Cardiovasc. Res."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Scudiero, F., Silverio, A., Muraca, I., Russo, V., DiMaio, M., Silvestro, A., Personeni, D., Citro, R., Enrico, M., and Galasso, G. (2021). Long-term prognostic impact of right ventricular dysfunction in patients with COVID-19. J. Pers. Med., 12.","DOI":"10.3390\/jpm12020162"},{"key":"ref_4","first-page":"e13788","article-title":"Cardiac arrhythmias amongst hospitalised Coronavirus 2019 (COVID-19) patients: Prevalence, characterisation, and clinical algorithm to classify arrhythmic risk","volume":"75","author":"Orlev","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1093\/cvr\/cvaa230","article-title":"Endothelial dysfunction in COVID-19: A position paper of the ESCWorking Group for Atherosclerosis and Vascular Biology, and the ESC Council of Basic Cardiovascular Science","volume":"116","author":"Evans","year":"2020","journal-title":"Cardiovasc. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1042\/CS20220235","article-title":"Vascular dysfunction in COVID-19 patients: Update on SARS-CoV-2 infection of endothelial cells and the role of long non-coding RNAs","volume":"136","author":"Pelisek","year":"2022","journal-title":"Clin. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Salamanna, F., Maglio, M., Landini, M.P., and Fini, M. (2020). Body Localization of ACE-2: On the Trail of the Keyhole of SARS-CoV-2. Front. Med., 7.","DOI":"10.3389\/fmed.2020.594495"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"713","DOI":"10.2217\/bmm-2020-0201","article-title":"Cardiovascular disease as a biomarker for an increased risk of COVID-19 infection and related poor prognosis","volume":"14","author":"Ielapi","year":"2020","journal-title":"Biomark. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.dsx.2020.03.013","article-title":"Cardiovascular disease and COVID-19","volume":"14","author":"Bansal","year":"2020","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1001\/jamacardio.2020.0950","article-title":"Association of Cardiac Injury With Mortality in Hospitalized Patients with COVID-19 in Wuhan, China","volume":"5","author":"Shi","year":"2020","journal-title":"JAMA Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1001\/jamacardio.2020.1017","article-title":"Cardiovascular Implications of Fatal Outcomes of Patients with Coronavirus Disease 2019 (COVID-19)","volume":"5","author":"Guo","year":"2020","journal-title":"JAMA Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e007220","DOI":"10.1161\/CIRCHEARTFAILURE.120.007220","article-title":"Approach to Acute Cardiovascular Complications in COVID-19 Infection","volume":"13","author":"Ranard","year":"2020","journal-title":"Circ. Heart Fail."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1056\/NEJMc2010418","article-title":"Out-of-Hospital Cardiac Arrest during the COVID-19 Outbreak in Italy","volume":"383","author":"Baldi","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.resuscitation.2020.04.005","article-title":"In-hospital cardiac arrest outcomes among patients with COVID-19 pneumonia in Wuhan, China","volume":"151","author":"Shao","year":"2020","journal-title":"Resuscitation"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e2011122","DOI":"10.1001\/jamanetworkopen.2020.11122","article-title":"Assessment of Hypokalemia and Clinical Characteristics in Patients with Coronavirus Disease 2019 in Wenzhou, China","volume":"3","author":"Chen","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.1016\/j.jacc.2005.12.071","article-title":"Utility of impedance cardiography for the identification of short-term risk of clinical decompensation in stable patients with chronic heart failure","volume":"47","author":"Packer","year":"2006","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_17","first-page":"65","article-title":"Impedance cardiography\u2014A modern tool for monitoring therapy of cardiovascular diseases","volume":"67","author":"Gielerak","year":"2009","journal-title":"Kardiol. Pol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1093\/ehjci\/jex244","article-title":"Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: An expert consensus document of the European Association of Cardiovascular Imaging","volume":"18","author":"Galderisi","year":"2017","journal-title":"Eur. Heart J.-Cardiovasc. Imaging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1002\/jcu.23094","article-title":"Echocardiographic assessment of cardiac function after mild coronavirus disease 2019: A preliminary report","volume":"50","author":"Domino","year":"2022","journal-title":"J. Clin. Ultrasound"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e000349","DOI":"10.1136\/tsaco-2019-000349","article-title":"The utility of impedance cardiography in hemodynamic monitoring of patients with sepsis","volume":"4","author":"Butz","year":"2019","journal-title":"Trauma Surg. Acute Care Open"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1111\/j.1553-2712.2010.00705.x","article-title":"The use of impedance cardiography in predicting mortality in emergency department patients with severe sepsis and septic shock","volume":"17","author":"Napoli","year":"2010","journal-title":"Acad. Emerg. Med."},{"key":"ref_22","first-page":"352","article-title":"What does impedance cardiography add more to the assessment of left ventricular diastolic function in essential hypertension?","volume":"39","author":"Gielerak","year":"2015","journal-title":"Pol. Merkur. Lekarski"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Jurek, A., Krzesi\u0144ski, P., Gielerak, G., Witek, P., Zieli\u0144ski, G., Kazimierczak, A., Wierzbowski, R., Banak, M., and Uzi\u0119b\u0142o-\u017byczkowska, B. (2021). Cushing\u2019s Disease: Assessment of Early Cardiovascular Hemodynamic Dysfunction with Impedance Cardiography. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.751743"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1093\/ehjci\/jeaa136","article-title":"The role of cardiovascular imaging for myocardial injury in hospitalized COVID-19 patients","volume":"21","author":"Cosyns","year":"2020","journal-title":"Eur. Heart J.\u2014Cardiovasc. Imaging"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Urban, S., Fu\u0142ek, M., B\u0142aziak, M., Iwanek, G., Jura, M., Fu\u0142ek, K., Guzik, M., Garus, M., Gajewski, P., and Lewandowski, \u0141. (2022). COVID-19 Related Myocarditis in Adults: A Systematic Review of Case Reports. J. Clin. Med., 11.","DOI":"10.3390\/jcm11195519"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1161\/CIRCULATIONAHA.120.050754","article-title":"COVID-19-associated Non-Occlusive Fibrin Microthrombi in the Heart","volume":"143","author":"Bois","year":"2021","journal-title":"Circulation"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"283","DOI":"10.4329\/wjr.v13.i9.283","article-title":"Role of cardiac magnetic resonance imaging in the diagnosis and management of COVID 19 related myocarditis: Clinical and imaging considetions","volume":"13","author":"Atri","year":"2021","journal-title":"World J. Radiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1001\/jamacardio.2020.3557","article-title":"Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19)","volume":"5","author":"Puntmann","year":"2020","journal-title":"JAMA Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/6\/1806\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:49:02Z","timestamp":1760028542000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/6\/1806"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,7]]},"references-count":28,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["jcm14061806"],"URL":"https:\/\/doi.org\/10.3390\/jcm14061806","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,3,7]]}}}