RV DYSFUNCTION AND PULMANARY HYPERTENSION AS A LONG-TERM SEQUELAE OF COVID 19 ILLNESS: A STUDY AMONG PATIENTS OF SOUTH EAST ASIAN REGION

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Himanshu Mahla
Lalit Kumar
Dr. Navdeep Singh Sidhu
Neeraj Chaturvedi
Manisha Keshav
Shashi Mohan Sharma
Rajeev Bagarhatta
V.V. Agrawal
Dr Shiwani Dadarwal

Keywords

COVID 19, Pulmonary artery systolic pressure (PASP), Tricuspid annular plane systolic excursion (TAPSE), Transthoracic 2d Echocardiography, CT severity index (CTSI), C- Reactive protein (CRP)

Abstract

Objectives- To study the Echocardiographic manifestations of covid 19 illness among patients admitted in our facility, Correlate MAPSE, TAPSE, PASP, CRP levels, and CTSI among covid 19 patients with their 28-day outcome as survivors and non-survivors and to look for evidence of residual RV dysfunction and Pulmonary hypertension using TTE after 1 year of follow-up.


Study design- Prospective observational study at various medical wards and ICUs in SMS Medical College and associated hospitals.


Methods- 258 patients with a COVID-19 RT-PCR positive report from a throat or a nasal swab within 72 hours of admission were included in the study. Each patient underwent a complete clinical assessment and routine blood investigations including CRP levels were done. A complete transthoracic echocardiogram was done within 48 hours of admission. Patients also underwent a HRCT chest and CTSI scores were estimated. All patients were followed for a period of 28 days. The MAPSE, TAPSE, PASP, CTSI and CRP levels were then correlated with the outcome of the patient. The survivors again underwent a TTE at 1 year after their recovery from covid-19 illness to look for residual RV dysfunction by TAPSE and the development of pulmonary hypertension as measured by PASP using Bernoulli’s equation.


Results-Amongst patient of covid 19 illness the MAPSE, TAPSE, PASP, CTSI and CRP levels all correlated well with outcome of patients. While most covid-19 survivors recovered from their illness yet some patients showed evidence of persistent RV dysfunction and pulmonary hypertension even after 1 year of follow up

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