301 Long term sequelae after COVID-19: the different impact on the right and left ventricles

Abstract

Aims: Most patients who had COVID-19 are still symptomatic after many months post infection, but the long-term outcomes are not yet well-defined. The aim of our prospective/ retrospective study was to define the cardiac sequelae of COVID-19 infection. Methods and results: This monocentric cohort study included 160 consecutive patients (64 females, 60+12 years) who had been discharged from the ward or from the outpatient clinic after a diagnosis of COVID-19 and subsequently referred for a follow-up visit. Clinical features as well as lab and instrumental data about the acute phase of the disease, such as haemodynamic instability (HI), cardiac biomarkers, Ddimer, C-reactive protein (CRP), high resolution CT (HRCT) score along with information about the follow-up visit, including ECG and Conventional and Doppler Tissue Echocardiographic (DTE) parameters, were recorded. The median follow-up time after symptom onset was 5 months. At follow-up visit, the majority of the patients reported dyspnoea and asthenia. Moreover, echocardiography showed morphofunctional changes of both right (RV) and left (LV) ventricles, such as RV dilation, increased pressure in the pulmonary circulation, and by-ventricular systolic-diastolic dysfunction. When examined using multivariate analysis, independent of age, sex, and co-morbidities, RV and LV changes were significantly associated (P<0.05) with HRCT score and HI and with CRP, respectively. Conclusions: Our results suggest that COVID-19 may impact RV and LV differently. Notably, the extent of the pneumonia and HI may affect RV, whereas the inflammatory status may influence LV. A long-term follow-up is warranted to refine and customize the most appropriate therapeutic strategies.