OBJECTIVE

To evaluate long-term outcomes and status in patients with cardiovascular multimorbidity (CVM) compared with patients without cardiovascular disease (CVD) 24 months after hospitalization for COVID-19.

MATERIAL AND METHODS

Among the TARGET-VIP registered patients with COVID-19 in-patient diagnosis, the CMM group includes persons with two or more of the following CVDs: artery hypertension (AH), coronary heart disease (CHD), chronic heart failure (CHF), atrial fibrillation (AF). The CMM group included 163 patients (age 73.7±9.6 years; 53.9% men) and group without CVDs — 382 (age 49.4±12.4 years; 58.4% men). A number of patients equal 27 with CMM (age 73.2.±9.9 years; 44.4% men) and 144 patients without CVDs (age 52.2±10.8 years; 52.1% men) from a representative sample of survived subjects were interviewed and examined during an outpatient visit at the end of the observation period (in 28.1±4.6 mths). The information was initially obtained from the medical history and, when observed, from the telephone interviews for a period of 24 months (25.9±4.0 months), electronic databases and outpatient visits.

RESULTS

Patients with CMM compared to the group without CVDs had higher all-cause mortality (19.0 and 3.1%; p=0.001), hospitalization incidence rate (49.7 and 16.5%; p=0.001), but the incidence of upper respiratory tract infection (URTI)/influenza was lower (44.8 and 64.7%; p<0.001). New cases of CHF, AF and oncopathology were statistically significantly more common in the CMM group, and the higher frequency of new cases of AH was in the group without CVDs. According to echocardiography data, the CMM patients had a left ventricular ejection fraction of <50% in 7.4% of cases, the values less than 40% were not recorded. Based on the spirometry results, in group of CMM patients with a reduced ratio of FEV₁/FEVC (<0.7) was higher than in group of patients without CVDs (29.6% and 6.4%; p=0.0002). According to pulseoximetry data, SpO₂ was less than 95% before spirometry more frequently in CMM patients (14.8 and 4.2%; p=0.03), and for all the time of spirometry — 3 times more frequently that in subjects without CVDs (25.9% vs 8.4%; p=0.008). The frequency of pathological changes in lungs detection in CMM patients was 2.2 times higher (57.7% vs 26.5%; p=0.002).

CONCLUSION

Patients suffered from COVID-19 with CMM than those without CVDs for 24 months of observation had higher following indicators: the proportion of all-cause death cases (6.1 times), the frequency of non-fatal cases of myocardial infarction and cerebral stroke and the hospitalization incidence (3 times). The incidence rate of URTI/influenza was lower (1.4 times). COVID-19 patients without CVDs had a higher compliance to vaccination against SARS-CoV-2. The indicators of pulmonary function and SpO₂ were more likely to decline in patients with CMM according to spirometry and pulseoximetry results. The detection rate of pulmonary pathology in multispiral computer tomography was 2.2 times higher in patients with CMM.