Relevance. The combination of coronavirus disease (COVID-19) with arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD) is associated with decreased saturation, general clinical signs of inflammation, coagulopathies and worsens the course and prognosis of the disease. That is why it is important to identify all possible risk factors for complicated pathology for the prevention and timely treatment of this category of patients. Objective: to study the feature of coronavirus disease in patients with AH and COPD. Materials and methods. A total of 101 patients aged 30 to 80 years with COVID-19 were examined. The first group included 26 people with COVID-19 and COPD (GOLD 2, groups A, B), and the second group included 75 patients with COVID-19 and AH (I-III stages, 1-3 grade). The parameters of the general blood test, biochemical blood test, coagulation testing, D-dimer, C-reactive protein (CRP), and ferritin in the blood were studied. Results. Patients with COVID-19 and COPD had higher erythrocyte sedimentation rate (p> 0,05) and leukocytosis (p <0,05), as well as increased concentrations of creatinine (p < 0,05) and urea (p < 0,01) that indicates the presence of renal pathology. Patients with COVID-19 and AH had significantly lower prothrombin time (p < 0,05) and international normalized ratio (p < 0,05), as well as a higher prothrombin index (p <0,05), which indicates the benefits of the procoagulant properties of blood in this category of patients. The level of D-dimer (p> 0,05), CRP (p> 0,05), and ferritin (p <0,05) was higher in patients of the 2nd group, which indicates a more severe course of coronavirus disease, as well as more high risks of thromboembolic complications. Conclusions. The features of coronavirus disease in patients with hypertension indicate a more severe course of the pathology and a high risk of thromboembolic complications, as evidenced by the procoagulant properties of blood and a high level of D-dimer, CRP, and ferritin. According to the data of clinical and laboratory examinations in patients with COPD and COVID-19, there was a significant increase in creatinine, urea, and leukocytosis, which may indicate the addition of renal pathology.
Relevance. Tissue plays a complex physiological role and may therefore progress to COVID-19 and heart failure. Objective is to evaluate the definition and myocardial biomarkers in a patient with viral disease in combination with obesity and heart failure. Materials and methods. 89 patients with coronavirus COVID-19 and heart failure were examined. All patients underwent anthropometric measurements and calculation of body mass index, general clinical treatment, levels of reactive protein, ferritin, procalcitonin, interleukin-6, as well as myocardial markers NTproBNP and troponin I. Results. Among 89 patients, obesity and overweight were diagnosed in 60.7% of cases (41.6% and 19.1%, respectively) and only 39.3% of the weight was in the normal range. Against the background of obesity on COVID-19 pneumonia and heart failure, a statistical increase in the level of C-reactive protein (87.79 ± 16.16 mg / l) was found in patients with COVID-19 pneumonia and non-obesity heart failure (48.79 ± 8.3; mg / l p = 0.036). The statistical value of the level of troponin I (0.04 (0.00; 0.09) on a gas mask in obese patients was noted) (0.01 (0.00; 0.05) ng / ml; p = 0.024). Conclusion. The growth of C-reactive protein in the body with obesity in pneumonia COVID-19 and heart failure confirms the important role of adipose tissue in induction and maintenance. Ectopic fat depots located in the thickness of the heart may also be involved in the development of inflammatory changes in the myocardium, a laboratory sign that is the growth of troponin I.
Background. COVID-19 may cause or worsen cardiac dysfunction and patients with pre-existing cardiovascular disease, including heart failure (HF), who have an increased risk of severe and fatal outcomes of COVID-19. The study aimed to determine the role of soluble suppression of tumorigenesis-2 protein (sST2) and natriuretic peptide test (NT-proBNP) in predicting the severe course and in-hospital mortality of patients with COVID-19 and hypertension. Materials and methods. One hundred and fifteen patients with COVID-19 and hypertension were examined. The determination of sST2 and NT-proBNP in blood serum were done using the enzyme-linked immunosorbent assay. The clinical endpoint was assessed during the hospitalization period (death, hospitalization in the intensive care unit, prolonged hospitalization). The risk of the final event development was calculated for the patients who reached the threshold sST2 concentrations, and, separately, based on the diagnostic values of the NT-proBNP. Results. The cut-off values of sST2 recommended for the diagnosis of HF in our study were reached in 7 (28 %) cases. The risk of final clinical points development in these patients was as follows: OR = 10.67; 95% CI: 1.31–86.9; p = 0.0270. The level of NT-proBNP, which meets the criteria for the diagnosis of HF, was constant in only 10 (11.1 %) individuals (p = 0.0461) and the risk of clinical events developing was equal to OR = 7.0; 95% CI: 1.72–28.6; p = 0.0067. Conclusions. Stratification of patients based on sST2 values, in addition to NT-proBNP parameters, may provide further prognostic value compared to NT-proBNP levels in patients with COVID-19 and HF.
The aim: The purpose of the study is to evaluate the clinical and laboratory features of COVID-19 pneumonia course, the diagnostic significance of laboratory methods for detecting the SARS-CoV-2 virus based on a retrospective analysis. Materials and methods: We studied the case histories of 96 patients who were treated at the Municipal Non-Profit Enterprise “Lviv Clinical Emergency Care Hospital” for the period from 01/07/2020 to 31/07/2020 with a diagnosis of pneumonia, which corresponded to 5 points on the CO -RADS scale. We analyzed the clinical and laboratory signs of COVID-19 pneumonia depending on the results of the Quantitative Reverse Transcription Polymerase Chain Reaction (RT-qPCR) tests to the SARS-CoV-2 infection (positive result of RT-qPCR was observed in the first group and negative – in the second group). Results: In both groups, no clinical differences in the course of the disease were found. The most common symptoms of coronavirus pneumonia were found with the same frequency in both patients with a laboratory-confirmed diagnosis and without it. A positive PCR test in nasopharyngeal and oropharyngeal swabs was more often detected during testing up to 10 days, in patients over 60 years of age and in severe COVID-19. Conclusions: The COVID-19 pneumonia diagnosis should be based on a combination of clinical, laboratory, and radiological signs of this disease. A negative PCR test result does not exclude the diagnosis of coronavirus disease. The test results are influenced by the timing of the sampling, the severity of the disease and the age of the patients.
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