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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">lvrach</journal-id><journal-title-group><journal-title xml:lang="ru">Лечащий Врач</journal-title><trans-title-group xml:lang="en"><trans-title>Lechaschi Vrach</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1560-5175</issn><issn pub-type="epub">2687-1181</issn><publisher><publisher-name>ООО «Издательство "Открытые системы"»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.26295/OS.2020.60.78.003</article-id><article-id custom-type="elpub" pub-id-type="custom">lvrach-199</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Статьи</subject></subj-group></article-categories><title-group><article-title>Клинико-анатомический портрет больных с тяжелым течением инфекции COVID-19</article-title><trans-title-group xml:lang="en"><trans-title>Clinical and anatomical portrait of patients with severe COVID-19</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кебина</surname><given-names>А. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Kebina</surname><given-names>A. L.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">akebina@list.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сычёва</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Sycheva</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Вёрткин</surname><given-names>А. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Vertkin</surname><given-names>A. L.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зайратьянц</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zairatyants</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Погонин</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Pogonin</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Куандыкова</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kuandykova</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Астахова</surname><given-names>О. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Astakhova</surname><given-names>O. I.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Астахова</surname><given-names>Т. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Astakhova</surname><given-names>T. V.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Васильева</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Vasil’eva</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Заиченко</surname><given-names>Д. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Zaichenko</surname><given-names>D. M.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кадушкина</surname><given-names>Ю. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kadushkina</surname><given-names>Yu. A.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Квашнина</surname><given-names>В. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Kvashnina</surname><given-names>V. M.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кириченко</surname><given-names>Ю. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Kirichenko</surname><given-names>Yu. N.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Машарова</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Masharova</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рамазанова</surname><given-names>Ю. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Ramazanova</surname><given-names>Yu. I.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Расько</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Rasko</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Скрябин</surname><given-names>Е. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Skryabina</surname><given-names>E. O.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тамкаева</surname><given-names>М. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Tamkaeva</surname><given-names>M. K.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО МГМСУ им. А. И. Евдокимова МЗ РФ; БУЗ ГКБ им. С. И. Спасокукоцкого ДЗМ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Educational Institution of Higher Education, A. I. Evdokimov Moscow State Medical-Dental University;&#13;
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО МГМСУ им. А. И. Евдокимова МЗ РФ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Educational Institution of Higher Education, A. I. Evdokimov Moscow State Medical-Dental University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>БУЗ ГКБ им. С. И. Спасокукоцкого ДЗМ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>23</day><month>06</month><year>2021</year></pub-date><volume>0</volume><issue>10</issue><fpage>15</fpage><lpage>19</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Кебина А.Л., Сычёва А.С., Вёрткин А.Л., Зайратьянц О.В., Погонин А.В., Куандыкова М.В., Астахова О.И., Астахова Т.В., Васильева М.А., Заиченко Д.М., Кадушкина Ю.А., Квашнина В.М., Кириченко Ю.Н., Машарова А.А., Рамазанова Ю.И., Расько Д.В., Скрябин Е.О., Тамкаева М.К., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Кебина А.Л., Сычёва А.С., Вёрткин А.Л., Зайратьянц О.В., Погонин А.В., Куандыкова М.В., Астахова О.И., Астахова Т.В., Васильева М.А., Заиченко Д.М., Кадушкина Ю.А., Квашнина В.М., Кириченко Ю.Н., Машарова А.А., Рамазанова Ю.И., Расько Д.В., Скрябин Е.О., Тамкаева М.К.</copyright-holder><copyright-holder xml:lang="en">Kebina A.L., Sycheva A.S., Vertkin A.L., Zairatyants O.V., Pogonin A.V., Kuandykova M.V., Astakhova O.I., Astakhova T.V., Vasil’eva M.A., Zaichenko D.M., Kadushkina Y.A., Kvashnina V.M., Kirichenko Y.N., Masharova A.A., Ramazanova Y.I., Rasko D.V., Skryabina E.O., Tamkaeva M.K.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.lvrach.ru/jour/article/view/199">https://journal.lvrach.ru/jour/article/view/199</self-uri><abstract><p>Оценена распространенность соматических заболеваний у пациентов, умерших в стационаре от пневмонии, вызванной вирусом SARS-CoV-2, выявлены наиболее распространенные соматические заболевания у данных пациентов в зависимости от пола и возрастных групп. В исследование включено 110 пациентов, средний возраст 75 1,3 года, болевших вирусной пневмонией, вызванной SARS-CоV-2. Оценивались наличие факторов риска тяжелого течения болезни, соматическая патология, эпидемиологический анамнез, изменения по данным компьютерной томографии и баллы по шкале коморбидности Charlson. В результате исследования были получены следующие данные: cамой частой коморбидной сочетанной патологией у данной группы пациентов является постинфарктный кардиосклероз, ишемическая кардиомиопатия и хроническая ишемия головного мозга. Из факторов риска тяжелого течения коронавирусной инфекции чаще всего встречалась эссенциальная артериальная гипертензия 93,6% (103 пациента), возраст старше 65 лет 81,8% (90 пациентов), сахарный диабет 66,3% (73 пациента) и хроническая сердечная недостаточность 46,3% случаев (51 пациент). В данной группе больных средний индекс коморбидности составил 8,9 0,3. Тяжелое течение с летальным исходом наиболее часто регистрируется у людей старшей возрастной группы с заболеваниями сердечно-сосудистой системы, цереброваскулярной патологией и злокачественными новообразованиями. Даже пациенты молодой и старшей возрастной групп имели факторы риска неблагоприятного прогноза. По данным исследования самые неблагоприятные симптомы (лихорадка выше 38С, одышка и слабость) возникают первыми, за 6 дней до госпитализации, в то время как остальные проявляются чаще за 3-5 дня до госпитализации. Пациенты, у которых имеют место такие факторы риска, как возраст старше 65 лет, артериальная гипертензия и сердечная недостаточность в сочетании с такими симптомами, как лихорадка выше 38С, одышка и слабость, требуют немедленной госпитализации в стационар, вне зависимости от уровня гипоксемии и изменений по данным компьютерной томографии, для дальнейшего наблюдения и лечения в связи с высокой вероятностью летального исхода.</p></abstract><trans-abstract xml:lang="en"><p>The prevalence of somatic diseases in patients with pneumonia caused by SARS-CoV-2 viruses was assessed, the most common somatic diseases in patients, depending on gender and age groups were identified. 110 patients with viral pneumonia caused by SARSCoV-2 were included in the study. The presence of risk factors for the severe course of the disease, somatic pathology, epidemiological history, changes according to computed tomography and scores on the Charlson comorbidity scale were evaluated. The average age of patients with coronavirus infection caused by COVID-19 with an unfavorable outcome was 75 ± 1,3 years. The most common comorbid combined pathology in this group of patients is postinfarction cardiosclerosis, ischemic cardiomyopathy, and chronic cerebral ischemia. Of the risk factors for severe coronavirus infection, essential arterial hypertension is most common 93.6% (103 patients), age over 65 years old 81.8% (90 patients), diabetes mellitus 66.3% of cases (73 patients) and chronic heart failure 46.3% of cases (51 patients). In this group of patients, the average comorbidity index was 8.9 ± 0.3. Severe lethal disease is most often recorded in people of an older age group with diseases of the cardiovascular system, cerebrovascular pathology and malignant neoplasms. Even patients of young and older age groups had risk factors for poor prognosis. According to the study, the most unfavorable symptoms (fever above 38 оС, shortness of breath and weakness) occur first, 6 days before hospitalization, while the rest appear more often 3-5 days before hospitalization. Patients who have such risk factors as age over 65 years, arterial hypertension and heart failure in combination with symptoms such as fever above 38 оС, shortness of breath and weakness require immediate hospitalization, regardless of the level of hypoxemia and changes according to computer tomography, for further observation and treatment due to the high probability of death. </p></trans-abstract><kwd-group xml:lang="ru"><kwd>COVID-19</kwd><kwd>SARS-CoV-2</kwd><kwd>Бронхопульмонология</kwd><kwd>Вирусная пневмония</kwd><kwd>Злокачественные новообразования</kwd><kwd>Инфекции</kwd><kwd>Коморбидность</kwd><kwd>Оториноларингология</kwd><kwd>Сердечно-сосудистые заболевания</kwd><kwd>Соматические заболевания</kwd><kwd>Терапия</kwd><kwd>Цереброваскулярные заболевания</kwd></kwd-group><kwd-group xml:lang="en"><kwd>SARS-CoV-2</kwd><kwd>COVID-19</kwd><kwd>comorbidity</kwd><kwd>viral pneumonia</kwd><kwd>somatic diseases</kwd><kwd>cardiovascular diseases</kwd><kwd>cerebrovascular diseases</kwd><kwd>malignant neoplasms</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Xu Z., Shu T., Kang L. et al. Temporal profiling of plasma cytokines, chemokines and growth factors from mild, severe and fatal COVID19 patients // Sig Transduct Target Ther. 2020; 5: 100. DOI: 10.1038/s41392-020-0211-1.</mixed-citation><mixed-citation xml:lang="en">Xu Z., Shu T., Kang L. et al. Temporal profiling of plasma cytokines, chemokines and growth factors from mild, severe and fatal COVID19 patients // Sig Transduct Target Ther. 2020; 5: 100. DOI: 10.1038/s41392-020-0211-1.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Временные методические рекомендации «Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19)». Министерство здравоохранения Российской федерации. Версия 8 (03.09.2020 г).</mixed-citation><mixed-citation xml:lang="en">Vremennyye metodicheskiye rekomendatsii «Profilaktika, diagnostika i lecheniye novoy koronavirusnoy infektsii (COVID19)». [Interim guidelines «Prevention, diagnosis and treatment of new coronavirus infection (COVID-19).»] Ministerstvo zdravookhraneniya Rossiyskoy federatsii. Versiya 8 (03.09.2020 g).</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Вёрткин А. Л., Румянцев М. А., Скотников А. С. Коморбидность в клинической практике // Архивъ внутренней медицины. 2011; 2: 20-24.</mixed-citation><mixed-citation xml:lang="en">Vertkin A. L., Rumyantsev M. A., Skotnikov A. S. Komorbidnost' v klinicheskoy praktike [Comorbidity in clinical practice] Arkhiv" vnutrenneĭ meditsiny. 2011; 2: 20-24.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Huang S., Wang J., Liu F. et al. COVID-19 patients with hypertension have more severe disease: a multicenter retrospective observational study // Hypertens Res. 2020; 43: 824-831. DOI: 10.1038/s41440-020-0485-2.</mixed-citation><mixed-citation xml:lang="en">Huang S., Wang J., Liu F. et al. COVID-19 patients with hypertension have more severe disease: a multicenter retrospective observational study // Hypertens Res. 2020; 43: 824-831. DOI: 10.1038/s41440-020-0485-2.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Gupta R., Hussain A., Misra A. Diabetes and COVID-19: evidence, current status and unanswered research questions // Eur J Clin Nutr. 2020; 74: 864–870. DOI: 10.1038/s41430-020-0652-1.</mixed-citation><mixed-citation xml:lang="en">Gupta R., Hussain A., Misra A. Diabetes and COVID-19: evidence, current status and unanswered research questions // Eur J Clin Nutr. 2020; 74: 864–870. DOI: 10.1038/s41430-020-0652-1.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Chen L., Yu J., He W. et al. Risk factors for death in 1859 subjects with COVID-19 // Leukemia. 2020; 34: 2173-2183. DOI: 10.1038/s41375-020-0911-0.</mixed-citation><mixed-citation xml:lang="en">Chen L., Yu J., He W. et al. Risk factors for death in 1859 subjects with COVID-19 // Leukemia. 2020; 34: 2173-2183. DOI: 10.1038/s41375-020-0911-0.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">https://apps.who.int/iris/bitstream/handle/10665/332196/WHO2019-nCoV-clinical-2020.5-rus.pdf.</mixed-citation><mixed-citation xml:lang="en">https://apps.who.int/iris/bitstream/handle/10665/332196/WHO2019-nCoV-clinical-2020.5-rus.pdf.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
