Состояние гемодинамики и вариабельность сердечного ритма у тяжелобольных COVID‐19 в разгар заболевания и в процессе реабилитации:

Abstract

Summary. Background. Hemostasis in COVID-19 has been studied in detail. The state of hemodynamics and heart rate variability (HRV) in patients with COVID-19 at the height of the disease and during rehabilitation has not been fully studied. Objectives: to study microcirculation and HRV in patients with severe COVID-19 during the course of the disease, after discharge from the hospital and after rehabilitation course. Patients/Methods. We examined 43 patients with COVID-19 treated at City Clinical Hospital No 1 (Chita) and underwent rehabilitation at Darasun resort (Trans-Baikal Territory). The control group consisted of 69 people of same sex, age and concomitant diseases. Blood flow and HRV were studied using mDLS sensor (Dynamic Light Scattering, Rehovot, Israel) and an original algorithmic approach. The signal was decomposed into frequency components associated with hemodynamic sources of different shear rates of blood layers (hemodynamic indexes) that largely reflected hemostasis state. Results. In patients with COVID-19, the absolute values of hemodynamic indexes were significantly higher than in controls, it was the evidence of microcir- culatory intensification. The HI1 and HI2 values increased especially sharply, that was associated with increased endothelial and intermediate blood flow. This was also evidenced by an almost 4-fold increase in the HI1/HI3 ratio in seriously ill patients that does not restored after recovery, as well as after rehabilitation. At the same time, at the height of the disease, there was a signif- icant increase of pulse (PULSE 1 and 2) and a sharp decrease of respiratory (RESP1, 2 and 3) oscillatory indexes, that remained stable both in recovered patients and in those who underwent a course of rehabilitation. Conclusions. 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