SARS-COV-2 VIRUS AND THE CARDIOVASCULAR SYSTEM INTERACTION: CLINICAL CHARACTERISTICS AND PATHOGENESIS

Abstract

Introduction. The coronavirus disease 2019 (COеVID-19) caused by the SARS-CoV-2 virus led to the global pandemic, and by the beginning of August 2021, more than six million people fell ill in Russia. The study of the interaction between the SARS-CoV-2 virus and the cardiovascular system has great importance for the effective treatment of patients with this disease. Aim. The aim of the study was to identify the frequency of cardiovascular complications, based on the analysis of the patient’s medical histories with viral pneumonia caused by SARS-CoV-2 virus. And to compare the results obtained with the data of literary sources and justify their pathogenetic occurrence. Material and methods. 70 medical histories of patients with viral pneumonia caused by the SARS-CoV-2 virus who were admitted to the temporary infectious diseases hospital in Kazan were analyzed. The comorbidity, routine methods of laboratory (Complete blood count, qualitative and quantitative troponin test), and instrumental (ECG, Echo) diagnostics were studied. Descriptive statistics were calculated: median and interquartile range, categorical variables were presented in quantity and percentage. An unpaired t-test was used for the analysis of statistical significance. The critical value was assumed to be p≤0.05. Literature in eLIBRARY.ru, PubMed, GoogleScholar, Web of Science in recent years, mainly in 2020-2021, were analyzed. Results and discussion. Among the comorbidity: hypertension – in 31 (44%) patients, chronic heart failure – in 14 (20%) patients, coronary heart disease – in 10 (14.2%), diabetes mellitus – in 8 (11.4%), and 16 (22%) patients suffered from obesity. The most frequent complications were regurgitation on the valves (57,14%), cardiac arrhythmias (35,7%), of which supraventricular arrhythmias were the most common. There was no dependence of the increased level of Tr I on the degree of respiratory failure. Among patients with elevated Tr I levels, a chronological association with a previous infection with specific symptoms was revealed in all patients with high reliability of the presence of myocarditis in 12 (17,14%) patients. Conclusion. COVID-19 affects not only the respiratory system but also has a significant impact on the cardiovascular system because of the patient's immune response and the probable cytopathic effect of the virus. Key words: coronavirus, COVID-19, SARS-CoV-2, myocarditis, arrhythmia, angiotensin.