Cardiovascular pathologies in post-covid syndrome
Authors: Noniashvili M , Tamar Saralidze T S , Tamar Svanidze T S , Tamar Kandashvili T K , David Malidze D M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Objective
Problems of cardiovascular system and kidney function often follows the disease of Covid-19. Our aim was revealing and evaluation of cardiovascular disorders and kidney problems in patients who recovered from Covid-19.

Materials and methods
46 patients with Covid-19 infection, aged 29 to 64, were examined upon entering the clinic and after 2 months in outpatient department. (38 were women and 8 men, average age was 46, 1+_10.3 years). Along with clinical laboratory examination, echocardiography and ECG-Holter monitoring was performed in dynamic. Daily proteinuria, creatinine clearance and glomerular filtration rate were calculated. Patients who previously had arterial hypertension or any other disease of the cardiovascular system were not included in the study.
Results of the study: Among the complaints that patients revealed 2 months after clinical onset of Covid-19, most frequent was discomfort and stinging pain in precordial area without irradiation that was not related to physical exertion. Cardialgia was observed in acute period and after two months in 30% and 25% of patients, respectively. 15% of patients revealed shortness of breath and palpitations during slight physical exertion in the acute period, while at repeated examination the specified symptom remained in 6%.
Special attention was paid in our study to the dynamics of blood pressure. 24% of patients had elevated blood pressure at baseline. Blood pressure readings was increased in 28% of patients after 14 days. The average values of blood pressure during two months were 135, 5+_14.3 mmHg - systolic and 89.7+_10.7 mmHg- diastolic. After 2 months 26% of patients maintained arterial hypertention (AH) within the first stage. According to echocardiographic data, ventricular diastolic dysfunction was observed in 58% of patients in acute period and in 44% after two months. There were no signs of myocardial systolic dysfunction in dynamics.
During the initial examination, diminished creatinine clearance (&lt;90ml/min) and glomerular filtration rate (&lt;90ml/min/1.73m2) disorders were observed in 42% and 62% of patients, respectively and microalbuminuria in 69% of patients. After 2 months microalbuminuria was maintained in 60% of patients, while decreased renal function (creatinine clearance and GFR) was observed in 33% of patients.

Conclusion
Cardialgia, AH and signs of diastolic dysfunction were the main clinical manifestations of cardiovascular system dysfunction. The data of our study shows that probability of the formation of AH is highly increased after Covid-19 infection. Long-lasting microalbuminuria and a decrease in the renal filtering capabilities can also be revealed in every third patient after Covid-19 infection.
The results of the study indicate the necessity of the monitoring of the patients after Covid-19 for timely diagnosis of AH and kidney disfunction to prevent development of unexpected cardiovascular events and kidney failure.