Background and Objectives: Cardiac involvement in COVID-19 has been confirmed during the acute stage of the infection. However, the prevalence and spectrum of post-infectious cardiac dysfunction remain incompletely clarified. The objective of our study was to evaluate the frequency of echocardiographic changes 2 years after hospitalization for moderate and severe COVID-19 in patients with no previously known cardiac pathology. Material and Methods: We conducted a retrospective cohort study analyzing severity markers of COVID-19 infection and echocardiographic parameters assessed ≥2 years after the acute illness, based on recent guideline recommended algorithm for echocardiographic diagnostic of left ventricular (LV) dysfunction. Results: The study included 50 Caucasian patients, 60% male, 54% aged < 65 years, and 32% with severe forms of the disease. The primary comorbidities were hypertension, obesity, and diabetes. COVID-19 severity correlated with the computed tomography (CT) lung lesion score and a neutrophil-to-lymphocyte ratio >6 but was not associated with post-COVID-19 echocardiographic changes. Left ventricular ejection fraction (LVEF) was reduced in only 18% of cases, but global longitudinal strain (GLS) impairment was observed in 46% of patients, contributing to the LV systolic subclinical dysfunction in 61%. Impaired LV diastolic disfunction with normal pressure filling was present in 30.61% of cases and with elevated pressure 10.2%. Conclusions: COVID-19 is an independent predictive factor for GLS impairment, which can indicate myocardial contractile dysfunction, even in patients with asymptomatic heart disease. This underscores the importance of regular echocardiographic monitoring for patients recovering from moderate to severe COVID-19.

The cardiovascular risk imposed by chronic kidney disease is significantly enhanced, and carotid atherosclerosis is an early indicator of systemic vascular damage. In this review, we summarize available data relative to primary prevention strategies for carotid atherosclerosis in chronic kidney disease (CKD) with a focus on risk-adapted and stage-specific management. We conducted a narrative review of the literature. A structured literature search was performed in major databases (PubMed, Scopus, Web of Science and Google Scholar), focusing on studies published between 2012 and 2025, including observational studies, randomized controlled trials, and international guideline recommendations. The review focuses on blood pressure management, lipid-lowering therapy, glycemic control, antiplatelet therapy, as well as lifestyle interventions and screening strategies in patients with CKD without a history of cerebrovascular events. CKD-specific processes, such as inflammation, endothelial dysfunction and vascular calcification, may influence the progression of carotid plaques, highlighting the need to improve traditional and non-traditional risk factor management. The focus of prevention continues to emphasize blood pressure (BP) and lipid control as well. At the same time, routine carotid screening and systematically implemented antiplatelet therapy have no known benefit, but the potential for elevated bleeding risk, especially in advanced CKD. Primary prevention should therefore focus on optimal medical treatment, as well as disease-specific strategies according to CKD stage. Additional CKD-specific studies with carotid endpoints are necessary.

Prolonged hospitalization in cardiac patients is associated with increased morbidity and healthcare resource utilization, yet early biological factors linked to extended length of stay remain insufficiently defined. This study aimed to explore an integrative framework combining oral health parameters and targeted gut microbial markers to identify factors associated with prolonged hospitalization in cardiac patients. A comparative observational design was applied, including patients with short-term hospitalization (1–4 days) and prolonged hospitalization (≥25 days). Oral health status was evaluated using a standardized dental protocol at admission and longitudinally in patients with prolonged hospitalization. Targeted qRT-PCR-based quantification of selected gut bacterial markers was performed at admission and reassessed after one and two weeks. Temporal changes were calculated relative to baseline, and multivariate logistic regression models adjusted for age, sex, and major cardiac diagnoses were used to explore associations with prolonged hospitalization. Short-term hospitalized patients (n = 27) exhibited minimal oral health variation (+2%) and stable marker profiles. In contrast, patients with prolonged hospitalization (n = 30 for oral health; n = 18 for microbial markers) showed progressive changes over time. Oral health impairment increased by 3% after one week and 16% after two weeks, while targeted microbial marker variation showed modest directional changes. Integrative models combining oral health parameters and targeted microbial markers suggested potential complementary information alongside clinical variables, within the limits of an exploratory framework and limited sample size. These findings support the relevance of multidomain clinical and biological monitoring in the early identification of patients at risk for prolonged hospitalization.