Delayed Effect of COVID-19 Infection on Right Ventricular Function and Geometry

Background: Coronavirus disease 2019 (COVID-19) has spread rapidly and triggered a terrible global pandemic that involves more than 200 countries/regions. This study aimed to detect subtle right ventricle (RV) dysfunction and structural changes in recovered patient from Covid -19 within 3 month of discharge using speckle tracking derived strain and conventional echo and to detect all predictors associated with RV dysfunction relevant to hospital outcome. Methods: This prospective observational cohort single center study included 200 patients post recovery from moderate to severe COVID 19 infection within the first three month after discharge who were admitted at Cardiology Specialized Hospital, Kobry El Kobba Medical Military Complex. Patients were sub-classified according to results of right ventricular free-wall longitudinal strain (RVFwLS): Group A: 172 patients with no RV affection, normal (≤ -20%). Group B: 28 patients with with RV affection, abnormal (> −20%). Results: RVfwLS, and RVGLS had significant p-value in predicting mortality post-COVID-19 infection. The area under curve (AUC) for RVfwLS was 0.634 (95% confidence interval (CI)=0.491-0.777; P=0.045) indicating acceptable discriminative ability. The AUC for right ventricular global longitudinal strain was 0.631 (95% CI=0.492-0.771; P=0.049) indicating acceptable discriminative ability. Conclusion: Early detection and management of RV dysfunction in this population may be crucial in preventing long-term cardiovascular complications. The findings of this study highlight the critical role of RV dysfunction as a predictor of mortality and poor outcomes in post-COVID-19 patients.