Change of functional state in cardiological patients before and after coronoviral infection

Abstract

   Goal — was to assess the quality of life and the functional state of the cardiovascular system of patients who have had COVID-19, to outline the further tactics of recovery of the cardiovascular system.   Materials and methods. The study included 131 patients, men (n = 84) and women (n = 47), aged 41–76 years, with the presence of cardiovascular disease. Patients for a long time 4.4 ± 1.3 years, are under outpatient supervision in polyclinic No. 3, Makhachkala. Of the 131 patients included in the study: ischemic heart disease: angina pectoris I-II functional class was in n = 59 (45.0 %), arterial hypertension in n = 72 (55.0 %). All patients filled out the World Health Organization’s quality of life questionnaire, daily monitoring of electrocardiography, blood pressure, echocardiography and other types of examination was performed. The research was carried out in accordance with the norms and principles of the Declaration of Helsinki.   Results. After 2 months. after the COVID-19 illness, the survey showed that 62 patients (47.3 %) (p = 0.0026) were dissatisfied with the quality of life, before the illness, this figure was (28.3 %). Another 69 patients (52.7 %) are not satisfied with their state of health (p = 0.0048), against (30.4 %) — before coronavirus disease. Physical pain interferes with life — 48 patients (36.6 %) (p = 0.0019), before illness, only (24.5 %), and so on. Thus, the change in the status of quality of life “before and after” was statistically significant, p < 0.05. After 2 months. after coronavirus disease and discharge from the hospital, the daily monitoring of electrocardiography showed that in patients with exertional angina pectoris I-II functional class, ischemic and arrhythmic indicators were significant compared with the primary data p < 0.05. At the same time, the data of daily monitoring of electrocardiography in patients with arterial hypertension reached the indicators of patients with angina pectoris I-II functional class. The results of 24-hour monitoring of blood pressure before and after coronavirus disease showed that patients with increased numbers of systolic and diastolic blood pressure increased, with grade II arterial hypertension by n = 7, and with grade III. by n = 6. Hypertensive crisis began to be noted, almost every third patient had 16 (22.2 %), only 2 (2.8 %) patients were hospitalized with a stroke. Initial and after COVID-19, echocardiographic parameters were as follows, a significant decrease in left ventricular end-diastolic volume from 133.2 ± 4.2 to 127.0 ± 3.4, end-systolic volume from 77.3 ± 2.6 to 72.4 ± 7.01. The total ejection fraction significantly decreased in comparison with the initial data: from 49.6 ± 4.2 to 41.9 ± 7.3. There was a significant decrease in stroke volume from 61.7 ± 4.1 to 54.0 ± 5.8.   Conclusion. After analyzing the laboratory and instrumental data of the patients’ examination, we noticed that the real functional state decreased by a quarter in comparison with the initial indicators. But the survey of the quality of life showed that patients tend to overestimate the problems of their functional state by up to 30–40 %. At the same time, almost one third of our patients have developed post-ovarian syndrome, most of them developed depression, anxiety and fear for their health.