Сoronavirus infection COVID-19 and features of its treatment in a patient with cardiovascular pathology. Clinical case

Patients with cardiovascular disease represent a particularly vulnerable population in a pandemic of the coronavirus infection COVID-19. They are more at risk of infection, a severe course of the disease, as well as a higher mortality rate compared to a healthy population. Currently, there are no randomized clinical trials to determine the most effective approaches to treatment in this category of patients. The presented clinical example demonstrates the possibilities of using various groups of drugs recommended for the treatment of COVID-19, and the high efficiency of treatment with an interleukin-6 receptor inhibitor (IL-6) in a patient with severe new coronavirus infection and the presence of concomitant cardiovascular pathology. © 2020, Media Sphera Publishing Group. All rights reserved.

ENDOTHELIAL COMPLICATIONS IN HYPERTENSIVE PATIENTS WITH OBESITY OR NORMAL BODY WEIGHT AFTER COVID-19

Objective: To study the contribution of a COVID-19 to endothelial dysfunction in hypertensive patients with obesity or normal body weight. Design and method: 59 hypertensive patients, male and female, aged 20-50 years (40.2 ± 6.7 years), with blood pressure (BP) under control, without diabetes, non-smokers were included in the study. All of them were divided into three groups: I (n = 13) - patients with obesity (body mass index (BMI) > 30 kg/m2) and 1 month after COVID-19;II (n = 11) - patients with normal body weight (BMI < 25 kg/m2) and 1 month after COVID-19;III (n = 25) - patients with obesity (BMI > 30 kg/m2) without COVID-19. Patients of Ith and IIIth groups were comparable in BMI and BP levels. LDL-cholesterol and triglycerides levels, office systolic BP and diastolic BP, flow-mediated dilation (FMD) study to assessed endothelial function, were performed in all groups. Calculation was done with software STATISTICA 6.0. Results: Post-COVID-19 patients with obesity had significantly higher levels LDL-cholesterol and triglycerides, systolic BP and diastolic BP then in post- COVID-19 patients with normal body weight: 3.5 ± 0.7 mmol/l vs 3.02 ± 0.62 mmol/l (p < 0.05), 3.5 ± 2.9 mmol/l vs 1.10 ± 0.3 mmol/l (p < 0.05), 141 ± 9.6 mmHg vs 123 ± 10.3 mmHg (p < 0.05), 89.5 ± 10.01 mmHg vs 76 ± 8.8 mmHg (p < 0.05) respectively. FMD were significantly lower in patients with obesity and COVID-19 (3.6 ± 2.9%, p < 0.05) then in patients with normal body weight and COVID-19 (8.7 ± 3.4%, p < 0,05) and in patients with obesity without COVID-19 (4.2 ± 3.6%, p < 0.05). Conclusions: Our study highlights that chronic impairment of systemic vascular endothelial function in patients with obesity, when intensified by the detrimental effects of SARS-CoV-2 over the endothelium, may explain their worse outcomes in COVID-19. However, obesity itself is one of important factors contributing to deterioration of endothelial function.

Features of the course and approaches to the treatment of coronavirus infection COVID- 19 patients with cardiovascular diseases

Patients with cardiovascular disease represent a particularly vulnerable population in a pandemic of the coronavirus infection COVID -19. They are more at risk of infection, a severe course of the disease, as well as a higher mortality rate compared to a healthy population. Currently, there are no randomized clinical trials to determine the most effective approaches to treatment in this category of patients. The presented clinical example demonstrates the possibilities of using various groups of drugs recommended for the treatment of COVID-19, and the high efficiency of treatment with an interleukin-6 receptor inhibitor (IL-6) in a patient with severe new coronavirus infection and the presence of concomitant cardiovascular pathology. Пациенты с наличием сердечно-сосудистых заболеваний (ССЗ) представляют особую уязвимую группу населения в условиях пандемии коронавирусной инфекции COVID -19. Они наиболее подвержены риску заражения, тяжелому течению заболевания, а также более высокой летальности по сравнению со здоровой популяцией. В настоящее время отсутствуют рандомизированные клинические исследования, позволяющие определить наиболее эффективные подходы к лечению у данной категории больных. Представленный клинический пример демонстрирует возможности применения различных групп препаратов, рекомендованных для лечения COVID-19 и высокую эффективность терапии ингибитором рецептора интерлейкина - 6 (ИЛ-6) у пациента с тяжелым течением новой коронавирусной инфекции и наличием сопутствующей сердечно-сосудистой патологии.