By Jarrett Renshaw and Joseph Ax

PHILADELPHIA (Reuters) -Pennsylvania Lieutenant Governor John Fetterman won the state's Democratic primary on Tuesday with nearly 60 percet of the vote in a critical U.S. Senate race --despite having been hospitalized since Friday after suffering a stroke.

Fetterman, a progressive Democrat whose easy victory over centrist Rep. Conor Lamb came just hours after Fetterman's campaign said he had a pacemaker implanted to address the irregular heart rhythms that caused the stroke, has said doctors expect a full recovery.

The Republican senatorial primary in Pennsylvania remained too close to call, with TV celebrity Mehmet Oz -- endorsed by former President Donald Trump -- vying for the party's nomination against former hedge fund executive David McCormick and conservative political commentator Kathy Barnette.

"If you'll allow me to be brutally honest for a second, 2022 is going to be hard year for Democrats," Fetterman said in an email to supporters.

The tattooed, goateed Democrat, who prefers shorts and hoodies to suits, added that "a typical Democrat, running a typical campaign, is going to struggle. To win PA, we're gonna have to do things differently."

Meanwhile, Rep. Ted Budd, also backed by Trump, won the Republican Senate nomination in North Carolina on Tuesday, while Republican freshman Rep. Madison Cawthorn lost his seat after a series of scandals.

The Pennsylvania and North Carolina Senate races will play a critical role in November's midterm elections in which President Joe Biden's fellow Democrats are fighting to retain their slim majorities in the House of Representatives and Senate. Both seats are currently held by retiring Republican senators.

Budd, who beat former Governor Pat McCrory in the primary, will face Democratic former state Supreme Court Chief Justice Cheri Beasley, who easily won her party's nomination in the race to succeed Senator Richard Burr.

Cawthorn, a staunch Trump ally, failed to fend off a challenge in a House primary from state Senator Chuck Edwards. With more than 60 percent of the expected vote tallied, Cawthorn trailed and conceded the race to Edwards.

Cawthorn, at 26 the House's youngest member, has angered his party's leaders with a string of embarrassing episodes, including claiming that conservative leaders invited him to a cocaine-fueled orgy, attempting twice to bring a gun onto a plane and having a video surface that showed him nude and gyrating against someone.

Republicans are positioned to regain control of the House, which could enable them to frustrate Biden's legislative agenda. Biden's public approval rating is at 42 percent, with 50 percent of Americans disapproving of his performance, according to a Reuters/Ipsos opinion poll completed on Tuesday.

Democrats have a better chance of keeping control of the Senate, currently split 50-50 between the parties with Vice President Kamala Harris holding the tie-breaking vote.

In Pennsylvania, Barnette's rise -- along with that of state senator and gubernatorial candidate Doug Mastriano, a far-right candidate who has echoed Trump's 2020 election lies -- worried some establishment Republicans that the duo could prove too extreme for voters in the general election. Mastriano won the nomination last night in a field of four candidates.

Pennsylvania officials said voters requested 908,000 absentee or mail-in ballots. State law prevents these from being processed until Election Day.

Trump As Kingmaker?

Trump has endorsed more than 150 candidates as he tries to solidify his status as his party's kingmaker, though his picks have not always prevailed. His support helped author J.D. Vance win the Ohio Senate primary, but his favored candidate lost in Nebraska's gubernatorial race last week.

Barnette, seeking to become Pennsylvania's first Black U.S. senator, has called her rivals insufficiently conservative. She was photographed marching toward the U.S. Capitol on January 6, 2021, alongside members of the extremist Proud Boys group shortly before a mob of Trump supporters stormed the building in a failed bid to overturn his 2020 election loss.

Barnette's campaign told NBC she did not take part in or condone the destruction of property and has no connection to the Proud Boys.

Trump last week endorsed Mastriano, who was also present outside the Capitol on the day of the riot. Mastriano played a significant role in the Trump campaign's failed effort to overturn the state's presidential results based on false claims of voting fraud.

Mastriano has said he would pursue a statewide abortion ban, after a leaked draft opinion showed the Supreme Court is poised to overturn Roe v. Wade, the 1973 decision legalizing abortion nationwide.

State Attorney General Josh Shapiro, who ran unopposed for the Democratic nomination, has vowed to protect abortion rights. Shapiro said on Tuesday that he was isolating at home after testing positive for COVID-19.

In Idaho, meanwhile, incumbent Republican Governor Brad Little easily defeatedTrump-backed primary challenger Janice McGeachin, the state's far-righ lieutenant governor.

Primary elections are also taking place in Kentucky and Oregon.