CARDIOPULMONARY STATUS AND RIGHT VENTRICLE FUNCTIONALITY IN HYPERTENSIVE PATIENTS HOSPITALIZED OR NOT FOR SARS-COV-2 INFECTION

Abstract

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 COVID19 affects the functional status of hypertensive patients, using cardiopulmonary test and echocardiographic parameters, 3 months after the infection onset. 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 34 subjects who were hospitalized for Sars-Cov-2 infection and Group II included 28 subjects without need for hospitalization. Results: Out of total population of 198 patients with COVID19 infection, 62 subjects had a hypertension history (mean age: 61±10 years, 58.1 % males, history of coronary artery disease: 16.1%) and they were evaluated 3 months after the symptoms’ onset. Hospitalized patients were older (63±8 vs. 52±11 years, p<0.001). Analysis of cardiopulmonary test parameters, oxygen consumption (ml/kg/min) both maximum (21±4 vs. 23.5±4, p: 0.01) and during the 1st minute of recovery (15.5±2 vs. 21±25, p: 0.02), VO2_AT (17±4 vs. 27.5±32) and PETCO2 (39±4 vs. 38±19 mmHg, p: 0.03) were impaired comparing to non-hospitalized subjects. Out of echocardiographic parameters, diameter of left atrium (mm), differed significantly between two groups (41±6 vs.38±5 p: 0.02). The absolute mean value of right ventricle strain (RVLS, (%): 13±8 vs. 23±3, p:0.04) was impaired to hospitalized despite a similar left ventricle ejection fraction between two groups. Using linear regression analysis adjusted for age, gender and hospitalization, hospitalization (p: 0.001) proved to be independent predictive factor for RVLS in hypertensive patients. Conclusions: To conclude our study highlighted 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.