RIGHT VENTRICLE FUNCTIONALITY OF HYPERTENSIVE PATIENTS HOSPITALIZED FOR COVID 19 INFECTION

Objective: There is little data concerning the impact of SARS-Cov-2 infection on the cardiopulmonary status and right ventricle (RV) function of patients with arterial hypertension (HTN). The purpose of our study was to investigate whether hospitalization for Covid 19 affects cardiopulmonary and right ventricle functionality status of hypertensive patients. Design and method: All subjects underwent cardiorespiratory exercise using Bruce or modified Bruce protocol where all cardiorespiratory parameters were evaluated. Echocardiographic parameters including right ventricle longitudinal strain were analyzed using an offline program. Subjects with history of HTN were divided into two groups according to hospitalization for Covid-19 infection. Group I included 28 subjects who were hospitalized for Sars-Cov-2 infection and Group II included 34 subjects without need for hospitalization. Results: Sixty-two hypertensive subjects hospitalized for Sars-Cov-2 infection (mean age: 61±10 years, 58.1% males, history of coronary artery disease: 16.1%) were evaluated. Hospitalized patients were older (63±8 vs. 52±11 years, p<0.001). Analysis of cardiorespiratory values showed impaired values of oxygen consumption both at peak (p: 0.01) and during the 1st minute of recovery (p: 0.02). Out of echocardiographic parameters, diastolic dysfunction parameters including left atrial diameter (40 ±6 vs. 35±5 mm, p<0.001) and E/A ratio (0.95±0.34 vs. 1.22±0.43, p<0.001) differed significantly between two groups. Furthermore, the absolute mean value of right ventricle strain (RVLS, (%): 13±8 vs. 23±3, p:0.04) proved to be significantly impaired in hospitalized patients even though left ventricle ejection fraction did not differ between two groups. Finally, using linear regression analysis adjusted for age, gender and hospitalization, hospitalization proved to be independent predictive factor for RVLS in hypertensive patients. Conclusions: To conclude our study highlighted the negative impact of hospitalization for Sars-Cov-2 infection in the capacity for exercise and in right ventricle functionality, implying the severity of disease as a negative independent predictive factor in hypertensive patients.