MORPHO-FUNCTIONAL CHANGES AND CARDIAC ARRHYTHMIAS IN PATIENTS WITH MILD TO MODERATE CORONAVIRUS INFECTION (COVID-19)

The aim of the research. To study morpho-functional changes, frequency and nature of cardiac arrhythmias in patients with mild and moderate forms of coronavirus infection (COVID 19).

Materials and methods. Echocardiography and Holter ECG monitoring were performed 3 months after the coronavirus infection, of 40 patients were examined. The patients were divided into 2 groups: 1 - 21 patients with upper respiratory tract lesions; 2-19 patients with bilateral pneumonia, the average age of patients was 35,7 years. Statistical data processing was performed using the program Statistica 10,0.

Results. According to echocardiography, the peak diastolic rate of on the tricuspid valve, the speed and peak gradient of tricuspid regurgitation in group 2 increased, and the E/A ratio decreased, P <0,001. The amplitude of the atrial peak of Am on the fibrous ring of the tricuspid valve in groups 1st and 2nd increased by 14% and 19% compared to the control, and the Em/Am ratio decreased by 25% and 34%, respectively, isovolumetric contraction and relaxation in patients of groups 1st and 2nd increased in comparison with the control group, p <0,001. In addition, patients in group 2 showed increased pressure in the pulmonary artery in comparison with the control. In group 1 patients speed decreased the rate of regional myocardial deformation of the basal segments of the septum, anterior-septum region, and posterior wall of the left ventricle decreases, P <0,001. In group 2 patients, a decrease in regional velocity was detected in the basal segment of the lower wall, in the middle segments (septum, anterior-septum, anterior, lateral), and in the posterior segment of the left ventricle, P<0,001. in 26,3% of group 2 patients and 10,5% of group 1, free fluid was detected in the pericardial cavity. In both groups, cardiac arrhythmias were detected, most often in patients in group 2. The relationship between the coronavirus activity parameter and the structural and functional parameters of the myocardium, P <0,001, was established.

Conclusion. Damage to the cardiovascular system after a coronovirus infection occurs in 71% of patients with mild and 95% of moderate severity and is characterized by a decrease in the rate of regional LV myocardial deformation, as well as heart rhythm disorders. In patients with pneumonia, these changes were more pronounced and were also accompanied by structural and functional disorders in the form of impaired diastolic function of the right ventricle and increased pressure in the pulmonary artery.

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