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Cardiovascular risk among people of all ages during the recovery period after COVID-19 (1-3 months) in the background of morbid obesity of the first stage

The aim of our study is to determine the correlation between obesity and overweight with COVID-19 among people aged over 40 years, in the period from 1 to 3 months after COVID-19 disease. Materials and methods: the group of subjects after COVID-19 consisted of 10 people, including 5 people at the age 40-59 years and 5 people at the age 60 years and older. The control group consisted of 21 individuals without COVID-19 and had a negative PCR test at the time of the survey: 5 individuals aged 40-59 years and 16 individuals aged 60 years and older. The subjects in both groups had cardiovascular risk factors and signs of metabolic syndrome. The subjects have been measured body weight (in kg), height (in cm), body mass index (BMI, in kg / m2), waist circumference (WC, in cm), hip circumference (HC, in cm) with the calculation of the ratio between WC and HC. For the assessment of the state of lipid metabolism, the levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low - density lipoprotein cholesterol (LDL-C), triglycerides (TG) in serum venous blood were determined by standard biochemical methods with the help of automatic biochemical analyzer "Autolab" by "Boehringer Mannheim" using the reagents from company "BIO SYSTEMS" (Spain). Cardiovascular risk indicators were calculated - Castelli index (TC/ HDL-C) and Boizel index (TG to HDL-C), and an updated SCORE-2 scale was used. The composition of the physique was determined using the device "OMRON". To exclude organic cardiac pathology, arrhythmias, and conduction, a standard ECG recording on a Ucard 200 device (Ukraine) was used. The microcirculation of the bulbar conjunctiva (slit lamp, "Zeiss", Germany) has been studied. Statistical data processing was performed using the program Statistica 10.0 (USA). 
Results: in the subjects included in the study, the indicators of general blood tests, which could indicate the presence of inflammation, were without any pathological changes. In accordance with the results of standard ECG, the subjects had no organic cardiac pathology, arrhythmia, and conduction. Younger patients with metabolic syndrome (MS) after COVID-19 had a statistically significantly higher BMI compared with the subgroup without COVID-19. Within each age group, the subjects of both subgroups (excluding COVID-19 and after COVID-19) have had general and visceral obesity rates that were combined with the other markers of metabolic syndrome, including dyslipidemia. It is shown that the calendar age of the patients with overweight after COVID-19 is statistically significantly higher than the calendar age of the patients with the overweight without COVID-19 in the anamnesis. The calendar age of the patients with the obesity of the 1-st grade after COVID-19 was significantly lower than the age of the patients without COVID-19. The indicator of very high cardiovascular risk is determined among the individuals of the senior age group, especially after COVID-19. Patients with high cardiovascular risk have more probabilities for the development of vascular disorders. A close correlation between the number of functioning capillaries and the atherogenicity index (r = 0.99, p <0.05), as well as with the Castelli index (r = 0.99, p <0.05) was found. As conclusions, we have found a connection between obesity and an increase of the indicators of cardiovascular risk 3 months later after past COVID-19. It is obvious that among people with obesity a more severe course of COVID-19 is possible at a younger age than among overweight patients. It is likely that COVID-19 may be the cause of accelerated aging in middle-aged individuals with obesity. However, to verify this assumption, it is necessary to conduct additional examinations to determine the biological age. The detected changes among the people with MS in 1-3 months after COVID-19 may be the basis for the development of post - COVID syndrome and justify the necessity for comprehensive pathogenetic treatment.

Key words: morbid obesity; COVID-19; cardiovascular risk; Castelli index; Boizel index; SCORE-2 scale; capillaroscopy of the bulbar conjunctiva.