Changes of the Electrical Axis of the Heart and Dyslipidemia as Possible Markers of Cardiovascular Damage in Patients after COVID-19

N. T. Mirzoev, G. G. Kutelev, V. Ivanov, D. V. Cherkashin, K. Shulenin, R. Makiev
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Abstract

Aim: To study the correlation of laboratory and instrumental indicators with the severity of the COVID-19 and to assess the dynamics of changes of the lipid profile and the electrical axis of the heart of patients in the acute period of the disease and after recovery. Design: Retrospective observational study. Materials and Methods. A retrospective analysis of medical histories of 30 young patients (18–44 years) without cardiovascular diseases, who underwent two-stage treatment at the Military Medical Academy named after S.M. Kirov with diagnoses: «COVID-19, virus identified» (U07.1, ICD-10) and «Post COVID-19 condition» (U09.9, ICD-10) in the period from April to December 2021. Results. The study found that individuals after COVID-19 had an increase in total cholesterol concentrations (6.51 [5.62–6.79] mmol/l), lowdensity lipoprotein (3.89 [3.34–4.52] mmol/l) and very low-density lipoprotein (1.06 ± 0.72 mmol/l) as opposed to acute period of COVID-19, where the lipid spectrum remained within normal values. In addition, an electrocardiogram analysis showed dynamics of the alpha angle changed from 42 ± 11 to 25 ± 17 degrees of patients after the elimination of SARS-CoV-2, with the deviation of the electrical axis of the heart to the left was detected of the first time in 5 (17%) patients after COVID-19. Conclusion. Individuals after COVID-19, who have been identified for the first time as having dyslipidemia and deviation of the electrical axis of the heart to the left, as well as high levels of inflammation markers can be considered by candidates for high-tech imaging techniques to eliminate damage of the cardiovascular system. Keywords: novel coronavirus disease; SARS-CoV-2; electrocardiography; electrical axis of the heart; dyslipidemia; cardiovascular complications.
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心脏电轴变化和血脂异常可能是COVID-19患者心血管损伤的标志物
目的:研究实验室及仪器指标与新冠肺炎严重程度的相关性,评价患者在疾病急性期及康复后血脂及心脏电轴的变化动态。设计:回顾性观察性研究。材料与方法。回顾性分析了30名无心血管疾病的年轻患者(18-44岁)的病史,这些患者在以S.M.基洛夫命名的军事医学院接受了两阶段治疗,诊断为:“COVID-19,病毒鉴定”(U07.1, ICD-10)和“后COVID-19状态”(U09.9, ICD-10),期间为2021年4月至12月。结果。研究发现,与COVID-19急性期相比,个体在COVID-19后总胆固醇浓度(6.51 [5.62-6.79]mmol/l),低密度脂蛋白(3.89 [3.34-4.52]mmol/l)和极低密度脂蛋白(1.06±0.72 mmol/l)升高,而急性期脂质谱保持在正常值范围内。此外,心电图分析显示,在新冠病毒消除后,患者的α角动态由42±11度变为25±17度,5例(17%)患者在新冠病毒消除后首次检测到心脏电轴向左偏移。结论。在COVID-19之后,首次发现患有血脂异常和心脏电轴向左偏移的个体,以及高水平的炎症标志物,可以被考虑采用高科技成像技术来消除心血管系统的损害。关键词:新型冠状病毒病;SARS-CoV-2;心电描记法;心脏电轴;血脂异常;心血管并发症。
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