Clinical features of ischemic heart disease in patients after COVID-19 infection and coronary artery bypass graft surgery

Abstract

Aim. To evaluate whether the history of coronavirus disease 2019 (COVID-19) in patients undergone  cardiac surgery (coronary artery bypass grafting - CABG) causes alterations in their clinical and laboratory status.Materials and methods. Clinical data of 42 patients undergone CABG in 2019 were analyzed. Informed written consent was obtained from all participants in accordance with the Declaration of Helsinki. Determination of COVID-19 positive or negative status was performed due to results of nasal and throat swabs using reverse transcriptase-polymerase chain reaction (RT-PCR) or positive serum COVID-19 antibodies. Statistical analyses were performed using Jamovi software.Results. In COVID-19 positive patients compared to COVID-19 negative patients: the level of serum cholesterol was significantly  higher: 5,22 [4,03; 6,22] vs. 4.06 [3,56; 4,88] mmol/L, р = 0,005; OR 0,492 [0,282; 0,858] 95% CI, p ratio 0,012; the level of low-density lipoproteins was significantly higher: 3,27 [2,16; 3,96] vs. 2,28 [1,60; 3,08] mmol/L, p 0,014; OR 0,518 [0,294; 0,914] 95% CI, p ratio 0,023; the incidence of chronic kidney disease stage C3a (CKD) was higher: 7 (16,7%) vs. 1 (2,4%), p 0,008; OR 0,0779 [0,00855; 0,710] 95% CI, p ratio 0,024; tendency to a higher serum creatinine: 89,7 [83,0; 105,0] vs. 81,0 [75,0; 90,5] μmol/L, p 0,060; OR 0,976 [0,945; 1,01] 95% CI, p ratio 0,153; tendency to a lower glomerular  filtration rate using  CKD-EPI: 66,1 ± 17,3 vs. 75,7 ± 16,1 ml/min/1,73m2, p 0,034; OR 1,0368 [0,9962; 1,08] 95% CI, p ratio 0,076; tendency to a higher serum D-dimer level: 154 [104; 364] vs. 137 [97; 173] ng/ml, p 0,07; OR 0,997 [0,994; 1,0] 95% CI, p ratio 0,141; tendency to a higher mean heart rate 75 [71; 79,5] vs. 72 [63; 74,5] bpm, p 0,026; PR 0,951 [0,886; 1,02] 95% CI, p ratio 0,169. Heart rate variability parameters haven’t shown statistical significance  between groups.Conclusion. Patients with a history of COVID-19 who underwent CABG had alterations in their clinical and laboratory status. These alterations should be thoroughly investigated to make a forehanded change in their therapy.