EFFECTS OF SARS-COV-2 INFECTION ON THE CARDIORESPIRATORY PERFORMANCE BY HYPERTENSION STATUS

Abstract

Objective: Few data have been published regarding the holistic approach of patients with history of arterial hypertension after Sars-Cov-2 infection. The purpose of our study was to examine the impact of Covid-19 in the cardiopulmonary status of hypertensive patients 3 months after the first day of infection. Design and method: All participants who recovered Covid-19 infection underwent cardiorespiratory exercise test using either Bruce or modified Bruce protocol and transthoracic echocardiogram where all parameters were evaluated. The population was separated into two groups based on history of hypertension. Group I included 62hypertensives and Group II included 134normotensive subjects. Results: A total of 198 patients (51±15 years, 44.4% males, 6.6% history of coronary heart disease) were assessed. Hypertensives had higher BMI (30.47±4.68 vs. 26.20 ±5.36 kg/m2, p<0.001) and BSA (2.03±0.24 vs. 1.91±0.45, p<0.001). They were hospitalized in higher percentage comparing to normotensives(54.8% vs. 35.8%, p<0.01). Out of echocardiographic parameters, diastolic dysfunction parameters including left atrial diameter(40 ±6 vs. 35±5mm, p<0.001) and E/A ratio (0.95±0.34 vs. 1.22±0.43, p<0.001) differed significantly between two groups. LVEF(%) was also significantly impaired (56±10% vs. 58±9%, p:0.04) in hypertensives. This finding was depicted in lower oxygen consumption (VO2 (ml/kg/min)) both maximum (22±4 vs.28±7, p<0.001) and during the 1st minute of recovery (19±18 vs.21±23, p<0.006), metabolic equivalents (METS) at peak, 10±13 vs. 10±3, p<0.001) and HR1st minute recovery (124±23 vs. 138±21 bpm, p< 0.001) comparing to normotensives. Systolic blood pressure(mmHg) at rest (132±13 vs. 125±16, p: 0.002), maximum (189±28 vs. 177±26, p: 0.01) and during the 1st minute of recovery (179±29 vs. 162±25, p: 0.001) was higher while the exercise duration was significantly lower (8±3 vs. 9±3 min, p<0.001) in patients with hypertension. Finally, hypertensive subjects reported higher scores in Borg scale for dyspnea (7±2 vs. 6±2, p:0.02) comparing to normotensives. Conclusions: Current study highlighted the negative impact of Sars-Cov-2 infection in the ability of patients with hypertension to exercise. Therefore, the need for a more comprehensive approach for rehabilitation including the modification of risk factors like hypertension and obesity in post-covid patients is mandatory