Characterization of blood biomarkers in prospective follow-up of patients with cardiovascular pathology in combination with type 2 diabetes mellitus after COVID-19 associated pneumonia.

The study of the characteristics and dynamics of laboratory biomarkers in patients with cardiovascular diseases (CVD) with type 2 diabetes mellitus who underwent COVID-19-associated pneumonia is of great clinical importance for preventing the risk of adverse events. IN the study we used data from 65 patients in the present work. Patients were divided into 2 groups: group 1 included patients with CVD: arterial hypertension (AH) in combination with coronary artery disease (CAD) without DM2 (n=45), group 2 included patients with CVD and DM2 (n=20). Patients were examined at baseline in the infectious disease hospital and 3 months after discharge. During laboratory examination of blood biosamples we evaluated parameters of general blood test; biochemical and immunologicai parameters; elastic properties of the vascular wall. The analyzed leukocyte parameters and their index coefficients - increase in NLR ratio (neutrophils/lymphocytes) and decrease in LYM/CRP ratio (lymphocytes/CRP) were more significantly changed in DM2 group. Patients in both groups had a significant excess of baseline max CRP concentrations with decrease in parameters after 3 months, but with persistent excess values in group 2. Three months after discharge patients with DM2 had levels of hs-CRP, IL-1ß and TNFa and NT-proBNP, that exceeded both the reference values and those in group 1, which reflected the presence of more pronounced vascular inflammatory potential for possible adverse events in this group of patients in post-COVID period. The method of multiple regression showed that DM2 is an independent risk factor for increased stiffness of the vascular wall. Thus, dynamic control of laboratory parameters has prognostic value in assessing the nature of the course of COVID-19 associated pneumonia in patients with CVD and DM2 developing an algorithm for personalized monitoring of patients in the post-COVID period with the aim of timely prevention of unwanted vascular complications.

Estimation of erythrocyte parameters of general blood analysis in patients with SARS-CoV-2 -associated pneumonia.

The study of the features and dynamics of the erythrocyte parameters of general blood analysis in patients with cardiovascular diseases who underwent SARS-CoV-2 associated pneumonia is of great practical importance. That was a prospective study. The study included 106 patients with SARS-CoV-2-associated pneumonia. All patients were divided into 2 groups. The first group included 51 patients without CVD, the second group included 55 patients with CVD .Patients in both groups underwent laboratory examination of blood samples at the time of hospitalization and 3 months after discharge from the hospital. Parameters of the erythroid series of the general blood test were assessed. Among inflammatory biomarkers, we examined the concentration of C-reactive protein (CRP), high-sensitivity CRP (hs-CRP) and homocysteine. Initially all patients underwent computed tomography of the chest organs. Revealed what indicators of the erythroid series in the groups of patients with and without CVD had significant differences in a number of parameters: ESR; RDW-SD and RDW-CV with significant excess of parameters in group 2. Three months after discharge from the hospital, patients in both groups had a significant increase in HCT, MCV, MCH. There was detected decrease in both groups in MCHC, RDW-CV (p<0.001 for all parameters), ESR level in group 2.At baseline, CRP exceeded reference values in both groups of patients, reaching maximum values in group 2. After 3 months CRP decreased significantly only in group 1. Increased CRP was associated with elevated hs-CRP in 3 months after discharge and elevated homocysteine levels in both groups, indicating the persistence of prolonged inflammatory vascular reaction in patients after SARS-CoV-2 associated pneumonia, more pronounced in group 2 patients. RDW-CV over 13.6 and lymphocytes / CRP less than 0.6 increase the likelihood of having lung tissue damage over 50% by 9.3 and 5.9 times, respectively. Thus, the data obtained confirm that RDW-CV, the coefficient of variation of erythrocyte distribution width, associated with the parameters of inflammatory response and the lymphocytes / CRP is lung volume marker and of COVID-19 severity. Careful consideration of already known laboratory parameters allows us to expand the number of indicators influencing the risk of COVID-19 complications and enable an earlier response to a difficult situation.