Covid-19 and ischemic heart disease: clinical manifestations, biomarkers, treatment and follow-up

Abstract

Funding AcknowledgementsType of funding sources: None. The aim of the study: To research the correlation between in-hospital mortality and markers of systemic inflammation in patients with COVID-19 with Ischemic heart disease (IHD) and to evaluate hematological indices under the influence of using quercetin and arginine in basic therapy.Material and methodsThe data from 52 case histories of patients with COVID-19 and IHD, who were hospitalized from February till April 2021, has been analyzed. 40 patients who recovered and were discharged from the hospital were included to group I, 12 patients who died were included to group II. The evaluation of hematological indices under the influence of adding metabolic drugs in the complex therapy was determined in 27 patients from group I, which was also divided into 2 subgroups. Subgroup I A, which consisted of 17 patients, received water-soluble quercetin and subgroup I B (10 patients) - arginine hydrochloride. The severity of systemic inflammation syndrome in the selected groups of patients was evaluate by the number of leukocytes and the cellular composition of peripheral blood on admission of patients to the hospital and on the basis of obtained data the values of hematological integral indices were calculated: blood leukocyte shift index (BLSI) according to N.I. Yabluchansky, neutrophil-lymphocyte ratio (NLR), leukocyte index of intoxication (LII) was determined by J. Kalf-Kalif, nuclear index by G.A. Dashtayantz, neutrophil-to-monocyte ratio (NMR), lymphocyte-to-eosinophil ratio (LER), lymphocyte-to-monocyte ratio (LMR), allergy index (AI).ResultsPatients from group II, who died of cardiovascular complications associated with COVID-19, had a significantly higher level of systemic inflammatory response, which is manifested by a significant increase of the total number of white blood cells (16,85±5,25) × 109/L, in contrast to patients of group I, who were discharged with recovery (5,81±1,75) × 109/L (p<0,05), and had the increasing number of neutrophil percentage (88,09±2,99) % against to (67,71±9,85) % (p<0,05), with a decrease in the percentage of peripheral blood lymphocytes (6,25±1,42) % in patients from group II against (18,13±4,25) % in patients of group I. The patients of clinical group II had the increasing of a number of hematological indices - BLSI: (9,28±2,16) against group I (2,47±0,95) (р<0,05), NLR: (26,99±11,11) against (4,01±2,36) and also the increase of NMR in group II (14,81±3,49) comparing to group I (6,22±2,18) (р<0,05). The obtained results analysis of the distribution of hematological indices in patients of subgroups I A and I B after adding quercetin and arginine to the basic therapy in the inpatient phase of treatment showed that a significant difference between the indicators is not observed.ConclusionsThe results of the study not only suggest new markers of mortality from severe COVID-19, but also identify potential ways of treatments.