ASSESSMENT OF THE CLINICAL CONDITION OF PATIENTS IN THE EARLY REHABILITATION PERIOD OF COVID-19

Abstract

Purpose of the study: assessment of the functional status of patients with postcoid syndrome using the PCFS scale and determination of its relationship with the severity of damage to the pulmonary parenchyma and cardiac changes.
Material and research methods. The study included 281 patients with clinical manifestations of postcoid syndrome (main group) and 20 patients who had undergone COVID-19, in whom the infection ended in complete recovery (comparison group). All patients underwent an assessment of the functional status of patients after suffering COVID-19 was carried out using the PCFS method - Post-COVID-19 Functional Status (https://osf.io/qgpdv/), electrocardiographic (ECG) and echocardiographic (EchoCG) studies.
Research results. In the main group of patients, the average score of the questionnaire was 13.34 ± 0.83 points. There were 13 patients (4.63%) in patients with postcoid syndrome who determined a violation of their functional status; 1 point was 13 people (4.63%), 2 points - 90 people (32.03%), 3 points - 117 people (41.64%), 4 points - 61 people (21.71%). In the comparison group, patients who underwent COVID-19 rated their functional status violations due to infection at 0 points. It was determined that the groups significantly differed in the volume of lung damage at the peak of infection (p <0.05), while by the early rehabilitation period the differences were leveled. Patients of the main group with different severity of postcoid syndrome according to PCFS did not differ in terms of the volume of lesions of the pulmonary parenchyma and the value of saturation. According to the results of ECG examination, cardiac arrhythmias were recorded significantly more often in patients in the main group than in the comparison group (66.19% and 25%, chi square 13.3, p <0.001). The results of the echocardiography of the study found that in the patients of the main group, compared with the comparison group, there was a significantly greater size of the LV and RV of the heart (p <0.05), a lower LVEF (p <0.01) and a higher value of the mean pressure in the PA ( p <0.05). Patients with a higher PCFS score are characterized by large sizes of both ventricles (p <0.05 significant difference for LV and p <0.01 for RV) and low LV ejection fraction (p <0.001). The value of LVEF in patients of the main group strongly negatively correlated with the PCFS score (r = -0.73, p <0.01), which indicates a significant contribution of cardiovascular syndrome to a decrease in the functional status of patients who underwent COVID-19.
Conclusion. The PCFS scale is an effective, simple and quick way of identifying patients with postcoid syndrome in the early resilience period. The severity of PCFS did not depend on the lesion of the pulmonary parenchyma. The low functional status of patients is associated with a more pronounced violation of the structural and functional state of the myocardium.