Clinical, laboratory and psychological aspects of moderate COVID-19 in cardiovascular patients one month after discharge from the hospital

Abstract

Aim. To study clinical, laboratory and psychological aspects of moderate coronavirus disease 2019 (COVID-19) in cardiovascular patients one month after discharge from the hospital.Material and methods. The study included 88 patients with cardiovascular diseases hospitalized for COVID-19. After 1 month, 72 respondents continued the participation in the study. Medical history collection, physical examination, and diagnostic investigations were performed. We used the Hospital Anxiety and Depression Scale (HADS) by Zigmond A. S., Snaith R. P., Beck Anxiety Inventory scale, Mini-mental State Examination (MMSE) scale for assessing mental status.Results. One month after discharge, there was a decrease in the number of patients with signs of impaired respiratory system, such as cough, shortness of breath, chest congestion, while a decrease in exercise tolerance persists was revealed in 80,5% (out of 95,5% during hospiatalization), generalized weakness and increased sweating — in 69,5%. In addition, 38,9% of patients noted a noticeable, newly reported, hair loss. Attention is drawn to the high prevalence of neurological symptoms during hospiatalization, including dizziness, severe headaches not relieved by analgesics and non-steroidal anti-inflammatory drugs, lethargy, disorientation of place and time, and in some cases even hallucinations. Some of the symptoms persist after 1 month: 55,5% note a decrease in memory, 36% — feelings of fear and anxiety, 63,9% — sleep disorders in the form of frequent nocturnal awakenings (19,4%), insomnia (16,6%), long falling asleep (11,1%). Some of the respondents revealed unfavorable events over the past month as follows: blood pressure (BP) destabilization in the form of episodes of BP increase and decrease during the day — 36,0%, hypertensive crisis — 14,0%. There was an increase in the number of patients with subclinical and clinical depression (p<0,05). There was also an increase in the number of patients with hypercholesterolemia compared with inhospital data by 15,5%.Conclusion. One month after discharge, the respiratory symptoms naturally decrease, but new symptoms appear, such as shortness of breath during exercise, fatigue, unsteady gait, hair loss, and increased sweating. There was an increase in the number of patients with subclinical and clinical depression on the HADS scale. Among laboratory parameters, an increase in the number of patients with increased level of total cholesterol and low-density lipoproteins was revealed.