The impact of carbohydrate metabolism disorders to the prognosis of chronic heart failure in patients with lung damage due to COVID-19

Introduction. The COVID-19 pandemic causes an increase in cardiovascular pathologies, such as chronic heart failure (CHF) in the post-Covid period. The changes may be associated with inflammation, immune dysregulation, and hyperglycemia. An important task for healthcare is to study the effect of carbohydrate metabolism disorders on CHF in patients after COVID-19. Aim: To study the impact of carbohydrate metabolism disorders on the prognosis of CHF in postCOVID-19 patients. Material and Methods. A retrospective analysis of patients of the Tyumen Cardiology Research Center, Tomsk NMRC (TCRC) (n = 350) was carried out. The patients had COVID-19 in 2020–2021 and were observed at the TСRC from April 10, 2020 to July 11, 2022. The study included 116 patients. Patients were divided into 2 groups: with CHF (n = 63) and without CHF (n = 53). Verification of CHF was carried out according to the clinical guidelines "Chronic Heart Failure" (2020), approved by the Ministry of Health of the Russian Federation. A comprehensive examination (cardiologist examination, laboratory and instrumental examination) of the participants was performed 3 and 12 months after suffering lung damage from COVID-19. Results. Patients with CHF in the post-Covid showed statistically significantly higher levels of HbA1c (p = 0.01), LDL-C (p < 0.01), IL-8 (p < 0.01) compared to patients without CHF. According to the results of ROC analysis, HbA1c predicts the development of CHF in the post-Covid. Area under the ROC is 0.823±0.061 with 95% CI: 0.704-0.42 (p = 0.001). The threshold value for HbA1c is 5.95%. Statistically significant logistic regression model for the development of CHF within a year after COVID-19 was obtained. Model indicators: HbA1c, LDL-C, IL-8, presence of ischemic heart disease. ROC analysis of the model AUC = 0.91 ± 0.04 (p < 0.001). Sensitivity – 90.1%, specificity – 79.3%. Conclusion. HbA1c, LDL-C and IL-8 have a high prognostic significance in the development of CHF in postCOVID-19 patients. A statistically significant model for the prognosis of CHF has been developed.