THE ROLE OF MARKERS OF INFLAMMATION AND MYOCARDIAL DAMAGE IN PREDICTING THE OUTCOME OF COVID 19 INFECTION IN PATIENTS WITH CORONARY HEART DISEASE

Objective. Comprehensive assessment of laboratory parameters of inflammation and myocardial damage in patients with coronary heart disease (CHD) and identification of the most informative prognostic markers of the outcome of acute viral disease (COVID 19).

Materials and methods. Clinical and laboratory data of 39 patients with CHD aged from 40 to 75 years, hospitalized with the diagnosis of covid-pneumonia, were investigated. Patients were divided into groups depending on the severity of the infectious process (moderate and severe) and the outcome of the disease (favorable and lethal). The control group consisted of persons with CHD of appropriate age who did not have coronavirus infection (15 persons).

Results. Increased markers of inflammation and thrombosis in blood (C-reactive protein (CRP), ferritin, interleukin 6 (IL6), D-dimer) were observed in patients with CHD during acute period of coronavirus infection. We revealed direct correlation between serum IL6 levels and such markers of myocardial damage as creatine phosphokinase MB (CPK-MB) (r = 0,6, p<0,01), myoglobin (r = 0,5, p<0,05), creatine phosphokinase (CPK) (r = 0,6, p<0,01), lactate dehydrogenase (LDH) (r = 0,7, p<0,01), and between CRP and the concentration of stimulating growth factor IL1RL1, a risk factor for heart failure (r = 0,7, p<0,05 for mild, and r = 0,6, p<0,01 for severe).

The values of natriuretic peptide (NT-proBNP) over 26,70 pg/ml, LDH over 531 U/L and IL6 over 35,4 pg/ml during acute period of coronavirus infection were found to be markers of adverse outcome in patients with COVID pneumoniae and CHD. CPK-MB values over 10 units/l and myoglobin values over 2,7 ng/ml can be considered as additional criteria.

Conclusion. Coronavirus infection against the background of CHD is accompanied by the activation of inflammatory reactions in the body, intensification of thrombosis processes. Damage of the cardiac muscle is associated with the severity of the infectious process and inflammation. Clinical and laboratory markers associated with high mortality in patients with coronary heart disease during the acute period of coronavirus infection were identified.

Ключевые слова: , , , ,
Автор(ы): N. A. Bokhan, O. Y. Poluliakh, I. V. Kornelyuk, T. A. Mityukova, S. V. Gubkin