The course of chronic heart failure in patients after COVID-19 against the background of active cytomegalovirus infection

Abstract

Background. A new coronavirus infection may be complicated in the post-COVID period by the development of adverse cardiovascular events associated with chronic heart failure.
 Aim. To study the features of the course of chronic heart failure in patients after COVID-19 infection against the background of active cytomegalovirus infection.
 Material and methods. The study included 102 patients with chronic heart failure with reduced and intermediate left ventricular ejection fractions, who underwent COVID-19 in mild and moderate forms. The control group consisted of 61 patients with chronic heart failure and no COVID-19. Within 6 months after the infection with COVID-19, the features of the course of chronic heart failure were assessed. Quantitative determination of deoxyribonucleic acid (DNA) of cytomegalovirus in blood plasma was carried out by polymerase chain reaction. To assess the risk of adverse events, the odds ratio (OR) with a 95% confidence interval (95% CI) was calculated. Quantitative data were presented as median and interquartile range (25th and 75th percentiles).
 Results. After coronavirus infection, the risk of an unfavorable course of chronic heart failure (OR=6.237; 95% CI=2.91113.362; p=0.001), hospitalization due to decompensation of chronic heart failure (OR=5.9; 95% CI=1.31326.504; p=0.033), an increase in the functional class of heart failure by 1 class or more (OR=4.19; 95% CI=1.63610.736; p=0.009), development of atrial fibrillation paroxysms (OR=3.832; 95% CI=1.38510.599, p=0.014), significantly increased. The number of copies of cytomegalovirus DNA in patients who underwent COVID-19 was significantly higher in the group of patients with an unfavorable course of chronic heart failure compared to the same group, in which patients did not tolerate COVID-19 2238.5 (1888.5; 2647.5) and 1411.5 (1112.5; 1684.5) copies/ml, respectively (p 0.001).
 Conclusion. Patients with chronic heart failure after 6 months of COVID-19 infection are at high risk of developing adverse cardiovascular events against the background of active cytomegalovirus infection.