Risk Factors for Post-Covid-19 Syndrome Development in Patients With Arterial Hypertension

Abstract

Objective:To determine risk factors for post-COVID-19 syndrome development in patients with arterial hypertension (AH).Design and method:A total of 81 patients with AH were examined 3–6 months after COVID-19. 48 people (group 1: 27 women, 21 men) suffered from SARS-CoV-2 pneumonia with lungs lesion from 15% to 74%. The patients’ age was 18–87 years old (65 years old on average). In 38 patients chronic ischemic heart disease (IHD) was diagnosed; in 18 – myocardial infarction (MI); in 10 – permanent atrial fibrillation (AF); in 12 – AF paroxysms. 33 people (group 2: 18 women, 15 men) suffered from COVID-19 in the form of an acute respiratory illness without pneumonia. These patients were aged from 41 to 74 (56.9 years old on average). 25 patients had coronary artery disease; 2 – MI; 2 – permanent AF; 4 – AF paroxysms.Results:Comparing to group 2, in group 1 the patients had higher blood pressure; higher left atrial volume index (LAVI) (35.1 ± 3.3 ml/m2 vs. 29.6 ± 3.2 ml/m2; p < 0.05); higher left ventricular (LV) end-diastolic volume index (EDVI) (76.1 ± 8.8 ml/m2 vs. 62.6 ± 10.3 ml/m2; p < 0.05); lower LV ejection fraction (EF) (56.1 ± 8.1% vs. 63.2 ± 3.9%; p < 0.05). In 7 group 1 patients, an increase in the frequency of AF attacks was detected. In group 1 symptoms of inflammation persisted for a long time: higher levels of C-reactive protein (15 ± 4.9 mg/l vs. 5.5 ± 3.8 mg/l), of blood ferritin (275 ± 106.3 mcg/l vs. 155.6 ± 85.8 mcg/l; p < 0.05), of D-dimer (919.3 ± 77.1 ng/ml vs. 609 ± 87.4 ng/ml; p < 0.05) as well as of total cholesterol (5.8 ± 1.2 mmol/l vs. 4.9 ± 1.1 mmol/l; p < 0.05) and of LDL (4.1 ± 1.1 mmol/l vs. 3.2 ± 1.3 mmol/l; p < 0.05).Conclusions:The revealed risk factors were high blood pressure, an increase in LAVI and LV EDVI, a decrease in LVEF, an increase in LDL, previous MI, and an increase in the frequency of AF paroxysms.