Topical issues of cardiovascular disease in patients with new coronoviral infection COVID-19. Clinical and morphological study

Abstract

In about 30% of cases, Sars-CoV-2 pneumonia is complicated by damage to the cardiovascular system – myocardial infarction, pulmonary embolism, strokes, which are often fatal. There is still little data on the relationship between clinical manifestations and structural changes in the cardiovascular system during a new coronavirus infection. The material for the study was the data of the case histories and autopsies of 185 patients suffering from COVID-19 infection in the period September–December 2020. In the deceased patients, a higher percentage of lung tissue damage was recorded on CT data, and a low level of oxygen saturation at the time of hospitalization. Most of the patients had a history of cardiovascular disease, diabetes mellitus, chronic kidney disease, and cancer. The pronounced course of systemic immune inflammation was manifested by a high average level of indicators such as D-dimmer, ferritin, C-reactive protein and fibrinogen. Among the causes of death, respiratory failure prevailed against the background of infectious-toxic shock. Damage to the cardiovascular system was manifested by the development of acute myocardial infarction, pulmonary embolism, stroke. Evaluation of the data of postmortem examination revealed a higher prevalence of stroke and a lower incidence of pulmonary embolism and acute myocardial infarction. In a histological study, damage to the cardiovascular system is represented by direct damage to the myocardium in the form of microcytolysis of cardiomyocytes with the development of necrotic areas. The data obtained from the analysis of the study results allow us to draw conclusions about the relationship between the severity of the course of a new coronavirus infection and the frequency of damage to the cardiovascular system, as well as make assumptions about individual links in the pathogenesis of cardiovascular disease in COVID-19 (1 figure, 2 tables, bibliography: 10 refs).

Keywords

acute cerebrovascular accident / acute myocardial infarction / D-dimer / ferritin / new coronavirus infection / pulmonary embolism / troponin

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RIGHTS & PERMISSIONS

Zbyshevskaya E.V., Makeeva T.I., Bitakova F.I., Bakholdina M.N., Sivtsova E.V., Semenova G.M., Zaytseva O.B.