Abstract
Objective: Few data have been published regarding the holistic approach of post-Covid patients with a history of hypertension, examining both physical and mental health. The purpose of our prospective study was to follow up cardiorespiratory status, and mental and psychological health of hypertensive patients 3 months after the first day of infection. Design and method: All patients with a history of Sars-Cov-2 infection and good functional status were assessed using cardiorespiratory test, transthoracic echocardiogram, and standardized questionnaires by a comprehensive team of experts (cardiologists, psychiatrists, and psychologists). The population was divided into two groups according to hypertension status. Results: Out of total population of 198 patients (51±15 years, 44.4% males, 6.6% history of coronary heart disease) with COVID-19 infection were assessed. Hypertensives had higher BMI (p<0.001) and BSA (p<0.001) and they were hospitalized in higher percentage (p<0.01). Out of echocardiographic parameters, diastolic dysfunction parameters including left atrial diameter (p<0.001) and E/A ratio (p<0.001) differed significantly between the two groups. LVEF (%) was significantly impaired (56±10% vs. 58±9%, p:0.04) in hypertensives that was depicted in lower values of oxygen consumption (VO2 (ml/kg/min)) both maximum (p<0.001) and during the 1st minute of recovery (p<0.006), metabolic equivalents (METS) at peak, (p<0.001) and HR1st minute recovery (p< 0.001) comparing to normotensives. Systolic blood pressure (mmHg) at rest (p: 0.002), at peak (p: 0.01), and during the 1st minute of recovery (p: 0.001) as well as Borg scale score for dyspnea (p:0.02) were higher while the exercise duration was significantly lower (p<0.001) in hypertensives comparing to normotensives. Similarly, their psychometric tests (DASI METS (p:0.008), Functionality (p:0.036)) were also affected. Finally, using linear regression analysis adjusted for age, gender, hypertension status, and hospitalization, age (p: 0.001) proved to be an independent predictive factor for VO2, VO2_AT, and VO21st minute of recovery in hypertensive patients. Conclusions: To conclude, the current study highlighted the reduced ability to exercise and fragility of patients with a history of hypertension. Age proved to be an independent negative predictor of functionality. Therefore, the need for a more comprehensive approach to the rehabilitation of post-covid patients is mandatory.
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