Evidence of Pulmonary Hypertension after SARS-CoV-2 Infection in Subjects without Previous Significant Cardiovascular Pathology

Background: Coronavirus (Covid-19) infection represents a serious medical condition, often associated with cardiovascular complications, pulmonary hypertension (PH), and right ventricle dysfunction (RVD). The aim of this study is to show, by means of transthoracic echocardiography (TTE), the presence of an increased estimated systolic pressure in the pulmonary artery (esPAP) and altered right ventricular global longitudinal strain (RV-GLS) in patients without history of PH. Methods: In a group of 91 patients, aged under 55 years, hospitalized for a moderate Covid-19 infection, a thorough cardiologic and TTE examination were performed two months after discharge. Their initial thorax computer-tomography (TCT) images and laboratory data were accessed from the electronic data base of the hospital. Results: We observed an increased prevalence of PH (7.69%) and RVD (10.28%), significantly correlated with the initial levels of the TCT score and inflammatory factors (p ˂ 0.001), but borderline changes were observed in more patients. Multivariate regression analysis showed that these factors and RV-GLS explain 89.5% of elevated esPAP. Conclusions: In COVID-19 infection, PH and RVD are common complications, being encountered after the recovery even in moderate cases. It appears to be a connection between their severity and the extent of the initial pulmonary injury and of the inflammatory response. University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania背景：冠状病毒（COVID-19）感染属于严重临床病症，常伴随心血管并发症、肺动脉高压（pulmonary hypertension, PH）及右心室功能障碍（right ventricle dysfunction, RVD）。本研究旨在通过经胸超声心动图（transthoracic echocardiography, TTE），在无肺动脉高压病史的患者中，证实其存在肺动脉收缩压估算值（esPAP）升高与右心室整体纵向应变（RV-GLS）异常的情况。方法：本研究纳入91名年龄在55岁以下、因中度新型冠状病毒肺炎住院治疗的患者，于出院后2个月对其开展全面的心血管检查及经胸超声心动图检测。研究人员从医院电子数据库中调取了受试者初始的胸部计算机断层扫描（thorax computer-tomography, TCT）影像及实验室检测数据。结果：本研究观察到肺动脉高压（患病率7.69%）与右心室功能障碍（患病率10.28%）的检出率升高，二者与初始胸部CT评分及炎症因子水平显著相关（p < 0.001），同时更多患者出现临界异常改变。多变量回归分析显示，上述因素及右心室整体纵向应变可解释89.5%的肺动脉收缩压估算值升高情况。结论：新型冠状病毒肺炎感染后，肺动脉高压与右心室功能障碍为常见并发症，即便在中度感染患者的康复阶段也可被检出。其严重程度似乎与初始肺损伤范围及炎症反应程度存在关联。罗马尼亚蒂米什瓦拉市"维克多·巴贝什"医科大学，E·穆尔古广场2号，300041 蒂米什瓦拉