COMPARATIVE ANALYSIS OF THE GLOMERULAR FILTRATION RATE EFFECT ON THE COURSE OF COVID-19 IN PATIENTS WITH CORONARY HEART DISEASE WITH AND WITHOUT CONCOMITANT CORONAVIRUS DISEASE

Abstract

The research relevance is determined by the COVID-19 pandemic, which has led to serious medical consequences, including high levels of infectiousness, development of diseases accompanied by complications of kidney and cardiovascular system function, and increased mortality. Therefore, the research aims to study and compare the impact of glomerular filtration rate on the course of COVID-19 in patients with and without coronary heart disease. A retrospective analysis of 410 patients with coronavirus was conducted, who were divided into 2 groups: those with chronic coronary heart disease and those without this disease. During the hospital period (14.7 ± 5.3 days), the composite endpoint of all-cause and cardiovascular deaths in combination with major adverse cardiovascular events was assessed. The thresholds for glomerular filtration rate associated with an increase in the incidence of the composite endpoint were determined: for patients with COVID-19, less than 35 mL/min×1.73 m2 (p<0.01); for patients with coronary heart disease and COVID-19, less than 60 mL/min×1.73 m2 (p<0.01). Independent predictors of decreased renal filtration capacity in patients in group 1 were: age over 65 years, type 2 diabetes mellitus, high cholesterol, D-dimer, C-reactive protein, and ferritin. Patients in group 2 were adversely affected by type 2 diabetes mellitus, arterial hypertension, and high levels of D-dimer and C-reactive protein (p < 0.05). The difference was explained by the influence of the applied therapy on the anticoagulant and renin-angiotensin systems. This study will allow to stratify patients with coronavirus in terms of renal impairment and risk factors, as well as to identify effective strategies for their management depending on the glomerular filtration rate

Received: 13.02.2023 | Revised: 21.04.2023 | Accepted: 30.05.2023