The Specifics of Postcovid Atrial Fibrillation in Elderly and Late-Life Patients With Arterial Hypertension and Ischemic Heart Disease

Abstract

Objective: To study the frequency and conditions for the emergence of atrial fibrillation paroxysms (AFP) in elderly and late-life patients in the postcovid period on the background of comorbid pathology. Design and method: 2 months after SARS-Cov-2-pneumonia, 124 people were examined, 66 of them (41 men and 25 women) aged 68±5.9 years (group 1) and 58 (33 men and 25 women) aged 81±4.3 years (group 2). According to computed tomography (CT) performed during SARS-CoV-2-pneumonia, in group 1, 12 patients (18.2%) had lung lesion volume < 25% (CT1); 34 patients (51.5%) 25-49% (CT2); 18 patients (27.3%) 50-74% (CT3); 2 patients (3%) > 75% (CT4). In group 2, 14 patients (24.1%) had CT1; 18 patients (31.1%) CT2; 21 patients (36.2%) CT3; 5 patients (8.6%) CT4. All patients had arterial hypertension (AH) and coronary heart disease (CHD) on the background of atherogenic dyslipidemia; 59 had type 2 diabetes mellitus (DM), 13 had chronic kidney disease (CKD). Holter monitoring (HM) was performed for all. The content of ferritin, D-dimer, and CRP in the blood plasma was measured for all. Results: According to the HM, in 13 of 66 (19.7%) group 1 patients, AFP were registered, of which 7 patients had 30-40 minutes seizures, 3 patients – about 2 minutes seizures. 3 patients were hospitalized, their sinus rhythm was restored by cardioversion. In 16 of 58 (27.6%) group 2 patients, HM revealed AFP, 2 of them were hospitalized due to the deterioration of their condition, the sinus rhythm was restored by cardioversion. In 7 patients, AFP did not exceed 30 minutes; in another 7 patients, AFP were short, no more than 2-3 minutes. Blood ferritin in group 1 was 175±66.2 ng/ml; in group 2 212±40.2 ng/ml (p = 0.012); D-dimer 501±50.3 ng/ml and 835±53.8 ng/ml, respectively (p = 0.0002); CRP 4.3±2.1 mg/l and 8±3.3 mg/l, respectively (p = 0.0009). Conclusions: 2 months after SARS-CoV-2-pneumonia with a large area of lung damage, elderly and late-life patients with a very high cardiovascular risk have signs of inflammation, and a tendency to increased thrombosis, which probably causes the AFP emergence.