Clinical and anatomical portrait of patients with severe COVID-19
https://doi.org/10.26295/OS.2020.60.78.003
Abstract
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.
About the Authors
A. L. Kebina
Federal State Budgetary Educational Institution of Higher Education, A. I. Evdokimov Moscow State Medical-Dental University;
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
A. S. Sycheva
Federal State Budgetary Educational Institution of Higher Education, A. I. Evdokimov Moscow State Medical-Dental University;
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
A. L. Vertkin
Federal State Budgetary Educational Institution of Higher Education, A. I. Evdokimov Moscow State Medical-Dental University;
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
O. V. Zairatyants
Federal State Budgetary Educational Institution of Higher Education, A. I. Evdokimov Moscow State Medical-Dental University
Россия
Россия
Moscow
A. V. Pogonin
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
M. V. Kuandykova
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
O. I. Astakhova
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
T. V. Astakhova
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
M. A. Vasil’eva
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
D. M. Zaichenko
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
Yu. A. Kadushkina
Federal State Budgetary Educational Institution of Higher Education, A. I. Evdokimov Moscow State Medical-Dental University;
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
V. M. Kvashnina
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
Yu. N. Kirichenko
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
A. A. Masharova
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
Yu. I. Ramazanova
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
D. V. Rasko
Federal State Budgetary Educational Institution of Higher Education, A. I. Evdokimov Moscow State Medical-Dental University;
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
E. O. Skryabina
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
M. K. Tamkaeva
City Clinical Hospital named after S. I. Spasokukotsky Department of Health of Moscow
Россия
Россия
Moscow
References
1. 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.
2. 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).
3. Vertkin A. L., Rumyantsev M. A., Skotnikov A. S. Komorbidnost' v klinicheskoy praktike [Comorbidity in clinical practice] Arkhiv" vnutrenneĭ meditsiny. 2011; 2: 20-24.
4. 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.
5. 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.
6. 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.
7. https://apps.who.int/iris/bitstream/handle/10665/332196/WHO2019-nCoV-clinical-2020.5-rus.pdf.
Review
For citations:
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 Yu.A., Kvashnina V.M., Kirichenko Yu.N., Masharova A.A., Ramazanova Yu.I., Rasko D.V., Skryabina E.O., Tamkaeva M.K. Clinical and anatomical portrait of patients with severe COVID-19. Lechaschi Vrach. 2020;(10):15-19. (In Russ.) https://doi.org/10.26295/OS.2020.60.78.003
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