Кардиометаболические особенности постковидного синдрома у лиц пожилого и старческого возраста с коморбидной патологией

Abstract

Aim: to describe post-COVID-19 cardiometabolic disorders in elderly patients and senile with comorbidities. Patients and Methods: this cross-sectional comparative non-interventional study included 154 patients aged 60–89 years with arterial hypertension (AH), ischemic heart disease (IHD), atrial fibrillation (AF) and type 2 diabetes mellitus (DM2). The patients had similar frequency and nosology of comorbidities. These patients were split into 2 groups: the first group consisting of 79 patients (66 [63; 73] years old) who did not have the novel coronavirus infection in the medical history and the second group consisting of 75 patients (65 [63; 72] years old) who survived mild or moderate SARS-CoV-2 infection. The examination was carried out within 20–24 weeks after the onset of COVID-19. Clinical, laboratory and instrumental parameters were analyzed in the present study. Results: аs compared with group 1, patients from group 2 had a more pronounced atherogenic pattern (total cholesterol 5.44 [4.78; 6.9] mmol/l vs 5.02 [4.05; 5.76] mmol/l (p=0.008), low-density lipoprotein (LDL) — cholesterol 3.11 [2.57; 4.58] mmol/l vs 2.57 [1.95; 3.11] mmol/l (p<0.001), triglycerides 2.5 [1.53; 4] mmol/l vs 1.5 [1.09; 2.47] mmol/l (p<0.001). Also, in group 2 fasting blood glucose levels were higher — 8 [6.65; 11.4] mmol/l vs 6.3 [5.75; 8.1] mmol/l (p<0.001) and glomerular filtration rate was lower 63.8 [57.45; 78.34] ml/min/1.73 m2 vs 70.7 [62; 77.18] ml/min/1.73 m2 (p=0.003). Lower diastolic blood pressure (68 [60; 74] mmHg vs 76 [69; 82] mmHg (p<0.001)) and higher systolic blood pressure (154 [141; 165] mmHg 150 [143; 165] mmHg (p=0.009) was found in patients who had SARS-CoV-2 infection in their medical history. Also, group 2 patients had a higher heart rate — 77 [73; 80] vs 75 [67; 77] beats per min (p=0.002). In addition, a larger diameter of ascending aorta was revealed in patients with the previous COVID-19 infection: 3.5 [3.35; 3.8] cm vs 3.4 [3.2; 3.7] cm (p=0.003). Patients who survived COVID-19 had a higher functional class (FC) of chronic heart failure (CHF) (NYHA) with the predominance of III FC (45.3% vs 22.8% (p=0.004). Group 2 patients compared with group 1 patients had a significantly higher level of NT-proBNP: 128.05 [85.12; 245.21] pg/ml vs 88.4 [38.85; 131.85] pg/ml (p<0.001). Conclusion: adverse cardiometabolic sequela, such as proatherogenic changes in lipid metabolism, hyperglycemia, renal dysfunction, high pulse pressure and a higher heart rate, were found in patients aged 60–89 years with AH, IHD, AF and DM2 who had SARS-CoV-2 infection in their medical history. Despite the prevalence of patients with III FC CHF and higher mean values of NT-proBNP in group 2, the structural markers of myocardial remodeling between the two groups did not differ, except for a larger diameter of ascending aorta in patients who survived the novel coronavirus infection. These differences can be considered as a part of the post-COVID-19 syndrome. KEYWORDS: COVID-19, SARS-CoV-2, novel coronavirus infection, post-COVID-19 syndrome, post-COVID-19 condition, cardiometabolic factors, elderly and senile age, comorbidities. FOR CITATION: Starichkova A.A., Tsygankova O.V., Khidirova L.D. et al. Cardiometabolic characteristics of post-COVID-19 syndrome in elderly and senile patients with comorbidities. Russian Medical Inquiry. 2022;6(9):501–508 (in Russ.). DOI: 10.32364/2587-6821- 2022-6-9-501-508.