Remodeling of the right heart and hepatolienal circulation in patients with coronavirus infection

Abstract

Aim. To study the condition of the right heart and hepatolienal circulation in patients three months after COVID-19.Material and Methods. A total of 87 patients aged on average 36.2 years who were treated for COVID-19 three months before underwent echocardiography and the study of hepatolienal blood flow. Patients were divided into groups: group 1 comprised patients with CT 0; group 2 comprised patients with bilateral pneumonia CT 1–2, and group 3 comprised patients with CT 3–4. Control group comprised 22 patients who did not undergo COVID–19.Results. In patients of group 1, the diastolic velocity of the transtricuspid flow increased by 24% compared to the control p <0.001. The ratio of diastolic velocities E/A and Em/Am decreased in all groups, and the greatest abnormalities were found in group 3. In group 3, systolic pressure in the pulmonary artery increased; the right ventricle, fibrous ring, right branch of the pulmonary artery, and diameters of the inferior vena cava, portal vein, and splenic veins increased. There was a decrease in the flow rate in the splenic vein (14%), and sizes of the liver and spleen increased. Correlations were established between increased pressure in the pulmonary artery and functional parameters of the heart and hepatolienal blood flow as well as between morpho-functional parameters of the heart and indicators of the portal vein, p < 0.001.Conclusion. Three months after the coronavirus infection, patients with mild and moderate severity of the disease developed subclinical abnormalities in the diastolic function of the right ventricle. In patients with severe viral pneumonia, there was also increased pressure in pulmonary artery; the dilatations of the right ventricle, pulmonary artery, splenic vein, and portal veins developed along with a decrease in the flow rate in the splenic vein and increases in the liver and spleen.