Peculiarities of the Development of Frederick’s Syndrome as a Marker of the Severe Course of Coronavirus Disease

Frederick’s syndrome is a rare arrhythmic disease of the cardiac conduction system that affects the development or progression of ischemic changes in the myocardium (tissue hypoxemia of cardiomyocytes) caused by hypoxia. Coronavirus infection, affecting the lung parenchyma, leads to respiratory failure, which creates ideal conditions for the clinical manifestations of this complication, the most serious of which is Morgagni—Adams—Stokes syndrome. The latter syndrome is considered an indication for urgent implantation of a pacemaker, which may be impossible in severe oxygen-dependent patients. Objective — to study the peculiarities of the development and course of Frederick’s syndrome in severe coronavirus disease. Materials and methods. We observed 2 patients who developed Frederick’s syndrome during their stay in the infectious disease department due to a severe course of coronavirus disease. The erythrocyte saturation upon admission was 84 %. Both patients were male and over 70 years old. Results and discussion. At the time of hospitalisation with a diagnosed severe course of coronavirus disease, the patients had progressive shortness of breath of mixed origin, chest discomfort, tachypnea, tachycardia, pronounced swelling of the lower limbs, and erythrocyte saturation of 84 %. The identified symptoms were not related to the spatial position of the patient (vertical or horizontal). Electrocardio­graphy revealed the presence of an arrhythmia. Conclusions. Coronavirus infection is a trigger that causes ischemic changes in the heart, among which arrhythmic complications are possible, in particular, Frederick’s syndrome.