Long-term cardiac sequelae in patients referred into a diagnostic post-COVID-19 pathway: the Different Impacts on the Right and Left Ventricles

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. This monocentric cohort study included 160 consecutive patients 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 data about the acute phase along with information about the follow up visit, including ECG and Echocardiographic parameters, were recorded. At an average follow-upfollow up of 5 months, echocardiography showed morpho-functional changes characteristics of both right (RV) and left (LV) ventricles, such as RV dilation, increased pressure in the pulmonary circulation, and biy-ventricular systolic-diastolic dysfunction. When examined using multivariate analysis, independent of age, sex, and co-morbidities, RV and LV changes were significantly associated with chest High Resolution computed tomography score and hemodynamic Instability (HI) and with C-reactive protein, respectively. 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.