Study of Assessment of Right Ventricular Function by 3D Echocardiography in Healthcare Workers Recovered from COVID-19 Infection
Authors: Mousa Abdalrahman , Zahran Mohamed , Gomaa Yasser , Rashad Mohamed 
Published: November 2024

Abstract

Background
Right ventricular dysfunction (RVD) has been described as a potential predictor of poor outcomes in small preliminary studies, but its prevalence and associated outcomes in patients with COVID-19 are far from being elucidated. Visual examination is the most commonly used method to quantify right ventricular function (RVF). So far, the problem for echocardiographers was the unreliable estimation of RVEF via 2D echocardiography since it is not able to calculate true volumes. This limitation is overcome with 3D echocardiography, which does not rely on geometric assumptions but calculates true 3D volumes. The RVEF derived by 3D echocardiography proved to be an independent predictor of adverse cardiovascular outcomes in patients with various cardiovascular diseases. Aim of study: To assess Right ventricular functions and dimensions using 3D echocardiography in health care workers recovered from COVID-19 infection.

Patients and Methods
This study has been conducted in Ain Shams University Hospitals on 50 adult health care workers recovered from Proved (+VE PCR)COVID 19 infection at least 4-8 weeks prior to the study. All the included health care workers were either having history of mild or moderate COVID 19 infection. The patients were recruited during the period from septemper 2022 to march 2023. The entire study population was evaluated via 2D & 3D echocardiography.

Results
Our study assessed the RV functions and volumes using 2D & 3D echocardiography. The results of our study showed that RV systolic function as being assessed by FAC was found to be normal in 39 patients (78.0%) and impaired in 11 patients (22.0%). TAPSE was found to be normal in 42 patients (84.0%) and impaired in 8 patients (16.0%). While peak systolic velocity (S`) was found to be normal in 40 patients (80.0%) and impaired in 10 patients (20.0%). Among the 50 studied patients, there were 32 affected patients (64.0%) vs 18 normal patients (36.0%) as being assessed by RVEF. From the affected 32 patients by 3D Echo, 21 nurses were affected (65.6%) while 11 doctors only were affected (34.4%) and this was statistically highly significant with P value ≤0.001. In the affected patients, the mean duration from the infection was 11 months while it was 16 months in the normal patients and this was statistically highly significant with P value ≤ 0.001. From the affected 32 patients, there were 17 patients having chest pain during the infection (53.1% of the affected patients) while 4 patients only had chest pain durin the infection and normal RV function by 3D Echo (22% of the normal patients) and this was statistically significant with P value 0.034. From the normal 18 patients, there were 12 patients having fever (66.7%) while there were 11 affected paients having fever from the the total 32 affected patients (34.4%) and this was statistically significant with P value 0.02.

Conclusion
We concluded that the RV function is significantly impaired in the post-COVID health care workers. It is found that the 3D Echo is better to assess RV function and to detect the subclinical impairment as The RVEF measured by 3D Echocardiography is imapaired in 64% of patients while the RV FAC measured by 2D Echocardiography is imapired in just 22% of patients.