The Dark Side of Long COVID-19: Impaired Cardiac Function, Quality of Life and Functional Capacity in Egyptian Long COVID-19 Patients

The Dark Side of Long COVID-19: Impaired Cardiac Function, Quality of Life and Functional Capacity in Egyptian Long COVID-19 Patients

Ghadeer Abdelhafez Abdellatef Assal , Lamyaa Said El Bagoury , Prithwish Banerje , Yasser Alaaeldin Mahmoud Abdellatif , Mona Mostafa Rayan , Mohamed Farouk Allam

 

QJM: An International Journal of Medicine, Volume 118, Issue Supplement_1, November 2025, hcaf224.078, https://doi.org/10.1093/qjmed/hcaf224.078

 

Abstract

Introduction. Long COVID-19 remains a complex health issue, with dyspnea being one of the most prevalent symptoms. While most studies have focused on its respiratory effects, its impact on cardiac function has received less attention. This study aimed to assess how Long COVID-19 affects functional capacity, cardiac function, and quality of life, providing a more comprehensive understanding of its long-term consequences.

Methodology. The present study included 34 patients with Long COVID- 19 who presented to Ain Shams University Hospitals (Cairo, Egypt) between February 2022 and December 2022, at least four weeks after acute COVID-19 infection. Patients exhibited varying degrees of initial disease severity and reported symptoms such as dyspnea, chest pain, or palpitations. Each participant underwent assessment using the Euro Quality of Life (EuroQol) questionnaire, the 6- Minute Walk Test (6MWT), and echocardiography, including two-dimensional left ventricular global longitudinal strain (GLS).

Results. Dyspnea was the most frequently reported cardiovascular symptom, affecting 94.1% of patients, followed by chest pain (67.6%) and palpitations (64.7%). The study population ranged in age from 18 to 67 years, with a predominance of females (85.3%). Only 2.9% were smokers, while 76.5% had pre-existing chronic conditions, most commonly atopy and vitamin D deficiency. All patients reported a significantly decreased quality of life compared to their pre-COVID-19 state (P < 0.001). Notably, 25% of participants exhibited oxygen desaturation during the 6MWT, and 20.6% had impaired GLS (defined as GLS above -16%). Patients with abnormal GLS were more likely to have diabetes mellitus, a history of oxygen therapy during acute infection, and less colchicine use compared to those with normal GLS (GLS below -18%). Furthermore, abnormal GLS correlated with reduced walking distance in the 6MWT, diastolic dysfunction, and impaired right ventricular (RV) systolic function, as indicated by decreased tricuspid annular plane systolic excursion (TAPSE) measurements.

Conclusion. Long COVID-19 significantly affects functional capacity and quality of life. A subset of patients demonstrates subtle left ventricular systolic dysfunction, as evidenced by impaired GLS despite a preserved ejection fraction. These findings highlight the need for long-term cardiac follow-up and potential management strategies to address lingering cardiovascular impairments in Long COVID-19 patients.

 

Keywords. Long COVID-19, Dyspnea, Quality of life, 6-Minute Walk Test, Echocardiography, Global longitudinal strain, EuroQOL questionnaire, Post-COVID syndrome

https://academic.oup.com/qjmed/article-abstract/118/Supplement_1/hcaf224.078/8341257?redirectedFrom=fulltext&login=false

 

Lactose Intolerance in Infants with Gastrointestinal Disturbances

Lactose Intolerance in Infants with Gastrointestinal Disturbances

May F. Nassar , Ehab K. Emam , Mohamed F. Allam , Haya E. Ibrahim , Ahmed M. Abdel-Qwie

QJM: An International Journal of Medicine, Volume 118, Issue Supplement_1, November 2025, hcaf224.211. 

https://doi.org/10.1093/qjmed/hcaf224.212

 

Abstract

Background. Lactose intolerance (LI) occurs when the body lacks sufficient lactase enzyme, preventing the proper digestion of lactose, a sugar found in milk and dairy products. In contrast, cow’s milk protein allergy (CMPA) is an immune system reaction to specific proteins in cow’s milk.

Objectives. To determine the prevalence of LI in infants with a positive Cow’s Milk-related Symptom Score (CoMiSS), which can lead to misdiagnosis as CMPA, and to elucidate the clinical and laboratory findings in formula-fed infants suspected of having LI and managed with a lactose-free diet

Patients and Methods. A cross-sectional diagnostic study was conducted on thirty infants younger than one year was recruited who presented with GIT symptoms and a CoMiSS of 12 or higher. Patients were evaluated at baseline, 2 weeks after initiating a lactose-free diet, and 2 weeks after reintroduction of lactose. Assessments Lactose Intolerance in Infants with Gastrointestinal Disturbancesincluded anthropometric measurements, CoMiSS, and the Pediatric Quality of Life Inventory (PedsQL).

Results. The mean (SD) age was 4.1±1.83 and ranged between 2 and 10 months. The current study demonstrated a significant reduction in the percentage of patients with a CoMiSS score of 12 or higher, from 100% to 26.7%, following the introduction of a lactose-free diet. Weight z-score, weight-for-length z-score, and MUAC significantly improved at week 2, indicating the effectiveness of the lactose-free regimen. These parameters remained stable between weeks 2 and 4 after rechallenge. Total PedsQL scores increased significantly (p = 0.006) after the lactose-free diet and decreased significantly (p = 0.021) after rechallenge, suggesting a correlation between symptom severity and quality of life. A negative correlation was observed between CoMiSS scores and both weight z-score and PedsQL.

Conclusion. Approximately three-quarters of patients with GI symptoms and a positive CoMiSS experienced improvement after eliminating lactose. A lactose-free diet had a beneficial impact on anthropometric measurements and quality of life in suspected cases of LI with a positive CoMiSS score. It is advisable to consider LI as a potential diagnosis for patients with GI symptoms and a positive CoMiSS score before attributing symptoms to CMPA.

 

Keywords. Lactose Intolerance, Cow’s Milk Protein Allergy, Lactose Free Regimen, Cow’s Milk-Related Symptom Score, Pediatric Quality of Life Inventory

 

Webpage. https://academic.oup.com/qjmed/article-abstract/118/Supplement_1/hcaf224.211/8341397?redirectedFrom=fulltext&login=false