Features of clinical, laboratory and instrumental parameters of medical workers with arterial hypertension in the hospital period and three months after pneumonia COVID-19

Abstract

Introduction. There is still no understanding of whether the clinical characteristics of COVID-19 (including the recovery period) in health care professionals may differ from the general population. It is logical to assume that a higher viral load of SARS-CoV-2 in health care professionals may lead to worse clinical outcomes, especially in the presence of comorbid cardiovascular pathology. The study aims to scientifically substantiate and develop criteria for assessing the long-term cardinal consequences of COVID-19 in health care workers who are at high biological risk in the performance of their work duties, as well as to evaluate the effectiveness of their treatment. Materials and methods. Of the 350 patients included in the "Prospective Registry of persons with pneumonia associated with COVID-19, 45 of the 67 medical workers suffered from arterial hypertension (AH). The control group consisted of 90 patients with arterial hypertension, comparable to group 1 in age, gender, body mass index, work experience and severity of hypertension. The researchers assessed clinical, laboratory and instrumental parameters in the groups during the hospital period for pneumonia caused by COVID-19 and 3 months after discharge. Symptoms of anxiety, depression (GAD7, PHQ 9 scales), stress (perceived stress scale-10) and quality of life (according to the SF-36 questionnaire) were assessed. Results. In the hospital period, with comparable severity of pneumonia in the groups, duration of hospitalization, stay in intensive care units and intensive care units, genetically engineered biological drugs were more often used in the group of medical workers. 3 months after discharge, the body mass index in both groups corresponded to grade 1 obesity. There were no intergroup differences in the frequency of prescribing groups of drugs. The average values of total cholesterol, low-density lipid cholesterol, very low-density lipid cholesterol, glycated hemoglobin and highly sensitive C-reactive protein were higher than normal in both groups. The left ventricular ejection fraction (LVEF) in both groups corresponded to the norm, however, the group of medical workers was distinguished by higher indicators of systolic and diastolic LV function. A decrease in global longitudinal deformation of the left ventricle was registered in 20.0% of medical workers and in 23.9% of patients in the control group (p=0.798). Symptoms of anxiety on the GAD7 scale were significantly more common in the group of medical workers. Limitation. This study was limited by the duration of follow-up (3 months after COVID-19 pneumonia) and the sample size. Conclusion. Thus, the main criteria for assessing the cardinal consequences of COVID-19 (post-COVID-19 syndrome) health care workers include: high prevalence of arterial hypertension (67.2% of the total number of health care workers); elevated levels of total cholesterol, low-density lipid cholesterol, very low-density lipid cholesterol; presence of subclinical disorders of LV function (high frequency of reduction of LV global longitudinal strain — up to 20.0% of the total number of observations); excess glycated hemoglobin levels; increased levels of highly sensitive C-reactive protein and high average values of the ratio of neutrophils to lymphocytes (NLR) associated with an increase in the number of lymphocytes and a decrease in the number of neutrophils in the long term after COVID-19 pneumonia. In the group of health care workers, there was significantly more frequent detection of anxiety symptoms on the GAD7 scale, which, in our opinion, contributes to an increase in the severity of the course of the cardiac consequences of COVID-19. Ethics. The study was carried out in compliance with medical research protocol from the Committee on Biomedical Ethics of the Tyumen Cardiology Research Center (protocol No. 159 of July 23, 2020).