COMORBIDITY OF PATIENTS WITH COVID-19 (PATHOLOGICAL STUDIES)

Abstract

Concomitant diseases increase the risk of hospitalization and poor prognosis in COVID-19 patients. However, in most studies devoted to prognostic value of comorbidity, only clinical manifestations were analyzed, which could lead to both under- and overdiagnosis of concomitant diseases and complications. The purpose of the study is to clarify the structure and prevalence of somatic diseases in patients who died in hospital from COVID-19, as well as the correlation of comorbidity with the development of vascular complications. Materials and Methods. A retrospective study examined the medical records of 322 patients (195 women and 127 men, mean age 71.5±12.2) with confirmed fatal COVID-19 and a post-mortem examination. Charlson comorbidity index was used to assess comorbidity. Results. A high incidence of cardiovascular pathology was revealed (96%). During hospitalization, 31 patients developed acute myocardial infarction, including 9 patients with reinfarction and 14 people with previous episodes of angina pectoris. In 10 patients without previous coronary heart disease, obliterating atherosclerosis of the coronary artery was detected. Twenty-three patients developed acute cerebrovascular accident; all of them suffered from arterial hypertension. Atrial fibrillation was observed in 9 patients. Pulmonary embolism was diagnosed in 139 patients, including 17 patients with phlebothrombosis in the lower extremities. Conclusion. Severe fatal COVID-19 is more often observed in elderly people with a high comorbidity level, and the complications depend on the comorbidity profile.