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The aim of the study. To investigate the peculiarities of changes in hormonal and metabolic markers and their relationships with neurovegetative disorders in patients with coronary artery disease after suffering from the COVID-19 coronavirus disease (in the long-COVID period). Materials and methods. 71 patients with coronary artery disease were examined: stable angina pectoris II–III FC (age 69.0 (64.0; 76.0) years): 1 group (main) – 31 patients with coronary artery disease after suffering from the COVID-19 coronavirus disease (in the long-COVID period); Group 2 (comparison) – 40 patients with coronary artery disease who did not have a history of COVID-19. 15 practically healthy people were included in the control group. The concentration of vasopressin, ghrelin, and insulin in blood serum was estimated using immunoenzymatic analysis. The HOMA index is calculated according to the generally accepted formula. Statistical data processing was carried out in accordance with modern requirements. Results. Significant changes in hormonal and metabolic markers were found in patients with coronary artery disease in the long-COVID period in comparison with the control group and with patients without a history of COVID-19: an increase in the concentration of vasopressin by 70.23 % and 33.38 %, insulin by 52.16 % and 32.76 %, glucose level by 31.20 % and 20.00 %, HOMA index by 60.00 % and 35.77 %, reduction of active ghrelin level by 45.71 % and 49.20 % (p < 0.05) respectively. The number of patients with insulin resistance in the 1st group was significantly higher compared to the 2nd group (χ2 = 0.516, p < 0.001). Inverse correlations were established between the level of ghrelin and vasopressin (r = -0.33, p < 0.05), insulin (r = -0.25, p < 0.05) and the HOMA index (r = -0.24, p < 0.05); direct correlation between the level of vasopressin and the HOMA index (r = +0.26, p < 0.05). In addition, a wide range of reliable correlations between the level of vasopressin, ghrelin and the degree of anxiety-depressive, cognitive and autonomic disorders were found in patients with coronary artery disease in the long-COVID period. Conclusions. The obtained results confirm common mechanisms between the development of hormonal and metabolic disorders and the occurrence of anxiety-depressive, cognitive disorders, vegetative imbalance against the background of overstrain of functional adaptation processes in patients with coronary heart disease in the long-COVID period.

The aim of the study. To examine the frequency and spectrum of cognitive, anxiety-depressive, autonomic disorders and their interrelationship in patients with coronary heart disease (CHD) after COVID-19 infection. Materials and methods. The study involved 71 patients with CHD, stable angina pectoris FC II–III (age 69.0 [64.0; 76.0] years): group 1 (main) – 31 CHD patients after COVID-19; group 2 (comparison) – 40 CHD patients without COVID-19 history. Spectral and temporal HRV parameters were assessed using 24-hour Holter ECG monitoring, anxiety-depressive disorders (ADD) – using the HADS scale, cognitive status of patients – according to the MoCa scale. Results. CHD patients after COVID-19 had a higher frequency of ADD detection and a greater anxiety level (16 [10; 24] versus 10 [9; 13] points, p < 0.05), depression (14 [8; 20] versus 11 [10; 12] points, p < 0.05) as compared to patients without previous history of COVID-19. At the same time, the predominance of the anxiety component over the depressive one in patients of both groups has been revealed. In CHD patients after COVID-19, a decrease in the total MoCa scale score has been found as compared to patients without COVID-19: 24 [22; 26] versus 28 [26; 30] points, p < 0.05. There was an association between the total level of anxiety and depression and the severity of cognitive impairment (r = -0.36, p < 0.05). CHD patients exposed to COVID-19 showed an increased sympathetic and parasympathetic tone of the central nervous system within 24 hours, an increased LF/HF ratio during the active period, activation of slow-acting humoral regulation mechanisms amid increasing stress index and centralization index. In the group of patients with CHD after COVID-19, a wide range of correlations between the rate of ADD, cognitive disorders and HRV parameters has been found. Conclusions. Patients with coronary heart disease recovered from COVID-19 have shown an increase in the incidence and degree of ADD and cognitive disorder manifestations which was accompanied by autonomic dysfunction resulting in stress on the functional and adaptive state of the cardiovascular system. The association between ADD, autonomic and cognitive disorders in patients with coronary heart disease after COVID-19 has confirmed the common pathogenetic links of the disorders found.