Influence of clinical features in acute COVID-19 infection on the course of post-COVID syndrome

The COVID-19 coronavirus pandemic caused by the SARS-CoV-2 virus has resulted in global morbidity and high mortality worldwide. According to case histories, for a long time (from six months to 2-3 years) after acute COVID-19 infection, patients experience severe fatigue, increased fatigue, an increase in the incidence of acute respiratory viral infections per year, an increase in the recurrence of skin diseases, allergies, exacerbation of pulmonary pathology, urinary tract diseases, an increase in the recurrence of chronic infectious diseases such as herpesvirus and papillomavirus infections, and an aggravation of chronic cardiovascular and other somatic diseases of various organs and systems. Patients were examined at least six months after recovery from acute COVID-19. Such persistent post-infectious consequences are known as post-COVID syndrome. When assessing post-COVID syndrome, it is necessary to identify the main clinical syndromes of multiorgan pathology characteristic of post-COVID patients. Endocrine and cardiac manifestations of post-COVID syndrome can be a consequence of direct damage by the virus, immunological and inflammatory damage, as well as iatrogenic complications. Objective of the study: to assess the impact of the severity of acute COVID-19 on the course of post-COVID syndrome. Research objectives: 1. To analyze the severity of clinical manifestations of the symptom complex of cardiovascular damage in post-COVID patients depending on the degree of lung damage in the acute period of COVID-19. 2. To analyze the severity of clinical manifestations of endocrine system pathology, including newly diagnosed, in post-COVID patients depending on the degree of lung damage in the acute period of COVID-19. Since no statistically significant differences by gender and age were found, all patients were divided into groups by the degree of lung damage in the acute period of COVID-19 according to clinical guidelines for the diagnosis and treatment of a new coronavirus infection. This study showed that the clinical picture of post-COVID syndrome is characterized by a pronounced diversity of the formation of multiple organ pathology, both newly diagnosed and manifested in an increase in the frequency of exacerbations of chronic diseases. Conclusions: 1. According to the data obtained, reliable differences were obtained between groups CT0 and CT1-2, as well as CT0 and CT3-4: the frequency of exacerbations of cardiovascular diseases in the post-COVID period is significantly higher in groups with lung damage in the acute period of COVID-19 compared to the group of patients without lung damage. These data indicate that cardiovascular disorders are directly related to the severity of COVID-19, viral load, and were detected most frequently (68%) in post-COVID patients who had a severe coronavirus infection. 2. According to the data obtained, the frequency of glucose metabolism disorders, including those detected for the first time, significantly increased in the post-COVID period in patients with lung damage in the acute period of infection, while no significant differences were found in thyroid diseases, with the exception of AIT. Perhaps these disorders are also associated, on the one hand, with the use of corticosteroid therapy in the acute period of coronavirus infection, and on the other hand, with disruption of the regulatory mechanisms of the endocrine and immune systems under the influence of the SARS-CoV-2 virus, which once again confirms our assumptions about the formation of multiple organ pathology in post-COVID patients.