Objective. Evaluation of the effect of the presence of CHF and/or CKD or their symptoms in patients on the incidence and/or mortality from SARS-CoV-2.
Materials and methods. A retrospective case-control study was conducted, and 165 patients were included in the final analysis. For statistical processing of the data obtained, the R language and the RStudio software environment was used.
Results. Only 18 of all the patients included had COVID-19. By the method of cluster analysis, all patients were divided into three clusters: the first one included 53.9% of patients, the second one - 21.2% and the third one - 24.8%. Patients with COVID were included in the first cluster (12 patients), in the second cluster there was only 1 patient with COVID, in the third - 5 (X-squared = 3.1, df = 2, P value = 0.22). Cluster 3 was characterized by changes Echo-CG indices, demonstrating higher values of ESV, EDD, LVPW, IVS and lower EF than in other clusters (patients with severe CHF). Cluster 2 was characterized by a lower GFR throughout the entire follow-up period, as well as negative dynamics of GFR (45 [38, 35; 57, 65] mL/ min) during the year (patients with severe CKD). Cluster 1 was represented by remaining patients. Assessment of the symptoms (dyspnea, edema, bendopnea, ascites) in the studied cohort of patients revealed significant differences only in the presence of the symptom of bendopnea (P value = 0.015), and the odds ratio of COVID-19 was higher in the group of patients with symptom of bendopnea
(OR = 5,8 (1.2; 26.7).
Conclusion. Thus, despite the high potential risk of illness and/or death from COVID-19 in clusters 3 and 2 (i.e., the group of patients with severe CHF and CKD, respectively), no increase in morbidity and/or mortality from COVID-19 was revealed. On the contrary, the COVID incidence in cluster 1, which included patients with more favorable clinical indicators of CHF and CKD, was higher, but did not reach the statistical significance (P = 0.222). Apparently, it was attributable to the greater mobility of patients in this category as compared to patients in clusters 2 and 3.

Keywords: heart failure, dyspnea, chronic kidney disease, bendopnea, COVID-19, SARS-CoV-2, decompensation, infection