Evaluation of Right Ventricular Function of Patients with COVID-19 Pneumonia after Discharge with Right Ventricle Early Inflow-Outflow Index

Abstract

Aim The coronavirus disease 2019 (COVID-19) causes many cardiovascular complications. In patients with comorbidities, COVID-19 infection has a more severe course. Although some patients who do not have comorbidities, severe infection and death may occur. In studies, many echocardiographic parameters were found to be impaired in patients with COVID-19 pneumonia. The right ventricular premature inflow-output flow (RVEIO) index is a possible and indirect predictor of the severity of right ventricular dysfunction. The aim of our study is to evaluate the RVEIO index after discharge in patients with moderate-to-severe COVID-19 pneumonia without comorbidities. Methods The study was conducted in a single center, prospectively. One month after discharge, echocardiography and biochemical tests were performed in 57 patients with moderate-to-severe COVID-19 pneumonia without comorbidities. Results Pulmonary artery diameter was found to be significantly larger in the severe group [1.9 (1.8-2) vs. 2 (1.9-2.1); p=0.014]. Pulmonary artery acceleration time [140.92±11.70 vs 114.58±12.03; p=0.001)] and RVOT VTI [23.48±1.96 vs 19.18±2.2; p  <0.001] was significantly lower, while the RVEIO index was [2.51±0.54 vs 3.22±0.92; p<0.001] was found to be significantly higher in the severe group. Conclusion The long-term effects of COVID-19 infection are unknown. Therefore, follow-up studies should be conducted. Echocardiography can be used in the follow-up of inpatients and discharged patients because of its easy accessibility and low cost. Long-term follow-up should be conducted for individuals who had a severe COVID-19 pneumonia and who do not have comorbidities. The RVEIO index may be used in the follow-ups.

Keywords

• COVID‐19
• Pneumonia
• RVEIO Index
• Right Ventricular Function

COVID-19 Pnömonili Hastaların Taburculuk Sonrası Sağ Ventrikül Fonksiyonunun Sağ Ventriküler Erken Giriş-Çıkış İndeksi ile Değerlendirilmesi

Öz

Amaç Koronavirüs hastalığı 2019 (COVID-19) birçok kardiyovaküler komplikasyona neden olmaktadır. Komorbiditesi olan hastalarda, COVID-19 enfeksiyonu daha ağır seyir etmektedir. Bazı hastaların komorbiditesi olmamasına rağmen, ağır enfeksiyon ve ölüm görülebilmektedir. Çalışmalarda COVID-19 pnömonili hastalarda, birçok ekokardiyografi parametresinin bozulduğu saptanmıştır. Sağ ventrikül erken giriş-çıkış akışı (RVEIO) indeksi, sağ ventrikül disfonksiyonunun şiddetinin olası ve dolaylı bir belirtecidir. Çalışmamızın amacı, COVID-19 pnömonisini orta-ciddi geçiren, komorbiditesi olmayan hastalarda taburculuk sonrası RVEIO indeksini değerlendirmektir. Yöntemler Çalışma tek merkezde, prospektif yapıldı. Taburculuktan 1 ay sonra, komorbiditesi olmayan, 57 orta-ciddi COVID-19 pnömonili hastanın ekokardiyografisi ve biyokimyasal testleri yapıldı. Bulgular Pulmoner arter çapı ciddi grupta, anlamlı daha geniş saptandı [1,9 (1,8-2) vs 2 (1,9-2,1); p=0,014]. Pulmoner arter hızlanma süresi [140.92±11.70 vs 114.58±12.03; p=0.001)] ve RVOT VTI [23,48±1,96 vs 19,18±2,2; p  <0,001] anlamlı daha düşük, RVEIO indeksi ise [2,51±0,54 vs 3,22±0,92; p<0,001] ciddi grupta anlamlı daha yüksek saptandı. Sonuç COVID-19 enfeksiyonunun uzun süreli etkilerini bilmiyoruz. Bu nedenle takip çalışmaları yapılmalıdır. Ekokardiyografi tetkiki kolay ulaşılabilir ve az maliyetli olması nedeniyle yatan hastalar ile taburcu edilen hastaların takiplerinde kullanılabilir. Özellikle hastalığı ciddi geçiren, komorbiditeleri olmayan bireylerin bile uzun dönem takipleri yapılmalıdır. Takiplerde RVEIO indeksi kullanılabilir.

Anahtar Kelimeler

• COVID‐19
• Pnömoni
• RVEIO Index
• Sağ Ventrikül Fonksiyonu

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