Clinical and laboratory features of hospitalized patients with COVID-19 infection and coronary heart disease


DOI: https://dx.doi.org/10.18565/therapy.2022.10.21-30

Markelova O.A., Vezikova N.N., Egorova I.S., Koryakova N.V.

Medical institute of Petrozavodsk State University
Abstract. Results of various studies demonstrate the importance of CAD as a risk factor for poor outcomes in patients with COVID-19.
The aim: to compare the clinical picture, data of laboratory and instrumental studies in COVID-19 patients with CAD and without it.
Material and methods. The study included 147 inpatients from a multidisciplinary hospital with identified COVID19. They were divided into main and control groups depending on the presence or absence of coronary artery disease.
Results. The average age of examined patients was 60,1±15,2 years, the average duration of hospitalization was 11,0±6,7 days. The average age of patients with CAD (main group) was 67.9±9.6 years, without CAD (control group) – 57,7±15,9 years. In CAD group, the incidence of obesity (BMI >30 kg/m2) was significantly lower (17,8 vs 40,2%), and incidence of DM 2, acute myocardial infarction, atrial fibrillation and CHF was significantly higher than in the group without CAD. Also, in the main group, sinus rhythm was significantly more common (82,4 vs 95,2%) and Q wave pathology (11,8 vs 1,0%), the QT interval was longer (0,38±0,04 vs 0,34±0,08 s.), while the ejection fraction was significantly lower (47,86±12,62 vs 60,78±6,89%). The proportion of patients with COVID-19 admitted to the hospital in a severe condition was 2 times higher in the CAD group, they were more likely to experience catarrhal symptoms (28.6 vs. 19.6%) and leg swelling (11,4 vs 3,6%). In the main group, comparatively with the control group, a lower average heart rate was revealed (79,3±14,5 vs 84,6±14,9 beats/min.). The degree of lung damage according to CT of thoracic organs in the groups was approximately the same. Finally, patients with SpO2 <90% (17,1 vs 8,0%) were more than 2 times more likely to occur in CAD group, lower average blood leukocyte level (5,85±3,40 vs 7,65±4,82 × 109 g/l), higher mean sodium levels (140,56±3,83 vs 138,68±4,34 mmol/l) and PTT (44,28±27,71 vs 35,72±6,45 s.), as well as higher mortality rates (5,7 vs 1,8%) were also fixed there.
Conclusion. Patients with COVID-19 in combination with CAD comparatively with patients without CAD were significantly older, more often suffered from hypertension, DM 2, acute myocardial infarction, atrial fibrillation, CHF, more often had pathological Q and QT prolongation on ECG, low ejection fraction, SpO2 <90%, leukopenia, elevated sodium levels, PTT, and urea.
Keywords: multidisciplinary hospital, COVID-19, coronary artery disease
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About the Autors

Olga A. Markelova, employee of the Department of hospital therapy of the postgraduate course in pulmonology, teacher of the course of therapy, Medical Institute of Petrozavodsk State University, pulmonologist at A.V. Baranov Republican Hospital. Address: 185910, Petrozavodsk, 33 Lenina Avenue. E-mail: olga-markelova1979@yandex.ru. ORCID: https://orcid.org/0000-0003-1291-6342
Natalya N. Vezikova, Dr. med. habil., professor, head of the Department of hospital therapy, Medical Institute of Petrozavodsk State University, chief non-staff therapist of the Ministry of Healthcare of the Republic of Karelia. Address: 185910, Petrozavodsk, 33 Lenina Avenue. E-mail: vezikov23@mail.ru.
ORCID: https://orcid.org/0000-0002-8901-3363
Inga S. Egorova, PhD in Medicine, associate professor of the Department of hospital therapy, Medical Institute of Petrozavodsk State University. Address: 185910, Petrozavodsk, 33 Lenina Avenue. E-mail: inga.skopets@gmail.com. ORCID: https://orcid.org/0000-0002-5157-5547
Nina V. Koryakova, PhD in Medicine, associate professor of the Department of hospital therapy, Medical Institute of Petrozavodsk State University. Address: 185910, Petrozavodsk, 33 Lenina Avenue. E-mail: tnk28@inbox.ru. ORCID: https://orcid.org/0000-0002-8931-2435


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