Structure of cardiac pathology and some comorbidities, clinical, anamnestic, laboratory and functional characteristics of patients with СOVID-19 (own experience)

Abstract

Objective. Ɍo study clinical, anamnestic, laboratory and functional indices of patients (pts) with COVID-19 who hospitalized in the transformed unit on the basis of the department of myocardial infarction (MI) and cardiac rehabilitation (CR). Materials and methods. The study included 36 pts with COVID-19: the 1 st group (n = 19) consisted of pts ≤ 65 (57.8 ± 7.8) years, the 2nd group (n = 16) -> 65 (72.5 ± 7.0) years. 4 pts were transferred to the intensive care (2 of them died). Biochemical data, blood samples, indices of ECG, EchoCG, blood oxygen saturation were analyzed. 25 pts underwent computed tomography (ɋɌ). Ferritin, procalcitonin and troponin levels were determined according to indications. In addition to cardiac drugs, medications to treat COVID-19 were prescribed. All pts received pronoposition, oxygen support, exercise therapy, apparatus breathing exercises with resistance on inhalation and exhalation as CR. Results. Arterial hypertension (AH) was diagnosed in 15 (78.9%) pts in the 1st group and in 14 (87.5%) pts in the 2nd group, diabetes mellitus (DM) - in 3 (15.8%) and 5 ( 31.3%) pts, atrial fibrillation (AF) - in 10 (52.6%) and 14 (87.5%) (ɪ=0.03), heart failure (HF) above stage I - in 7 (36.8 %) and in 13 (81.2%) pts (ɪ=0.01), respectively. There was a slight increase in erythrocyte sedimentation rate, growth of stab leukocytes and platelets up to (277,8±102,3 and 182,0±55,8)·109/l (ɪ=0,002) in 1st and 2nd group with decrease of lymphocytes. The CRP level increased almost in two times (9.2 ± 6.1 mg / ml) in 1st group and up to (15,6±7,6 mg / ml) in 2nd group (ɪ=0.01) with values of D-dimer 0,29 ± 0.13 and 0,85±0,23 ng / ml (ɪ=0.09), respectively. At the CT scan lung lesions was 27% and 41% (ɪ=0.06), respectively, without clear relationship with blood oxygen saturation: SpO2 at admission was 92% in both groups with an increase of more than 95% at discharge in patients of 1st group and in the majority of patients in 2nd group (ɪ=0,07). The patients were treated in accordance to the current protocols. The stay in clinic was 11.4 and 15.4 days in 1st in 2nd group. Conclusions1. At admission 30.6% of patients were in a serious condition, while a prehospital diagnosis of COVID-19 was established in 57.7%. 2. In the structure of cardiac pathology and comorbidity, acute infection with SARS COV-2 occurred on the background of AH in 82.9% of patients, AF - in 25.7%, heart failure stage IIA - in 57.1%, diabetes - 22.9%. Except of AH, these conditions were significantly more frequent in the group of older patients and were accompanied with higher levels of CRP (3 times higher than normal) and D-dimer, as well as the area of lung lesions according to CT (41% compared to 27% in the first group) in the absence of a relationship with the index of blood oxygen saturation, which increased from ≤92.0% to 94.9% in the older group and up to 97.6% in the group of patients ≤ 65 years of age at discharged.3. COVID-19 therapy was carried out due to current protocols in 2021. All patients received anticoagulants, 60% - dexamethasone (twice as often in group of older patients), 74.3% - vitamin D, 77.1% - antibiotics, with a longer stay (at 3 days) in the clinic in older patients.