Русский
First results of management of patients with bilateral pneumonia caused by a confirmed or probable new COVID-19 coronavirus infection in the reprofiled department of The Russian Clinical and Research Center of Gerontology
DOI: https://dx.doi.org/10.18565/therapy.2020.5.47-55
Kokorin V.A., Manevich T.M., Dubov A.A., Efremkin I.V., Kosmynin V.S., Onuchina Yu.S., Darmaeva I.P., Zolozov S.V., Lobachev E.V., Mandrygina E.L., Sharashkina N.V., Shirin D.A., Naumov A.V., Kotovskaya Yu.V., Milto A.S., Tkacheva O.N.
1) Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow; 2) N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow; 3) Group of companies «United medical systems» LLC «Center for targeted therapy», Moscow
Material and methods. Data of 120 patients admitted to the 3rd Infectious Department of the RCRCG in the period between 17.04 and 26.05.2020 were examined. All patients had bilateral pneumonia on the CT scan. The examination and treatment of patients was carried out in accordance with an internal Protocol developed on the basis of guidelines of the Ministry of healthcare of the Russian Federation and orders of the Moscow Department of health.
Results. The most common complaints were fever (99,2% of cases), weakness (98,4%), dry cough (87,5%), dyspnea (70,8%) and headache (50,0%). The most common comorbidities were arterial hypertension (AH) – in 62 patients (51,7%), obesity – in 42 (35,0%) and diabetes mellitus type 2 – in 18 (15,0%). The presence of COVID-19 was confirmed by PCR in 85 (70,8%) cases, in 35 (29,2%) – the virus was not identified. The moderate severity of the disease was observed in 33 (27,5%) patients, severe – in 81 (67,5%), extremely severe – in 6 (5,0%). The most frequent deviations of laboratory parameters at admission were lymphopenia, elevation of ESR, CRP, D-dimer, fibrinogen and ferritin and proteinuria. For treatment, we used: hydroxychloroquine – in 104 (86,7%) cases (in 88 (73,3%) – together with azithromycin), lopinavir/ritonavir in combination with interferon beta-1b – in 15 (12,5%), low molecular weight heparins – in 119 (99,2%), genetically engineered biological drugs – in 36 (30,0%). Antibacterial therapy was prescribed in 115 (95,8%) patients. Oxygen insufflation required to 54 (45,0%) patients, transfer to the intensive care unit – to 15 (12,5%), mechanical ventilation – to 6 (5,0%). The median duration of hospitalization was 12 [10–15] days. 111 patients (92,5%) were discharged from the clinic with improvement, 5 patients were transferred to other hospitals (4,2%), and 4 patients died (3,3%).
Conclusion. Our analysis is one of the first generalized experience of the management of COVID-19 patients in Russia. A more detailed assessment of the results, experience accumulated in other centers, and ongoing clinical trials will allow to understand better many aspects of the pathogenesis of the disease and to develop more effective approaches to the management of such patients.
Literature
About the Autors
Valentin A. Kokorin, PhD, associate professor, associate professor of the Hospital therapy No. 1 Department of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova Str. Tel.: +7 (916) 132-96-06. E-mail: valentinkokorin@yahoo.com. ORCID: 0000-0001-8614-6542
Tatyana M. Manevich, PhD, neurologist, head of the Department of neurology of the Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (903) 675-88-02. E-mail: nadezda5775@yandex.ru
Alexander A. Dubov, clinical resident of Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (930) 840-85-99. E-mail: dubov-alex94@mail.ru
Ivan V. Efremkin, cardiologist of the Group of companies «United medical systems» LLC «Center for targeted therapy». Address: 125008, Moscow, 39/3 Bolshaya Akademicheskaya Str. Tel.: +7 (929) 562-39-68. E-mail: efremkin.iv@ums-03.ru
Vladimir S. Cosmynin, traumatologist-orthopedist of the Department of orthopedics of the Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (962) 939-31-18. E-mail: dr.kosmynin@gmail.com
Yulia S. Onuchina, PhD, endocrinologist, Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (985) 436-69-31. E-mail: onuchina90@list.ru. ORCID: 0000-0002-0556-1697
Irina P. Darmaeva, cardiologist of the Department of cardiology of the Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (926) 562-50-95
Sergey V. Zolozov, cardiologist of the Department of cardiology of the Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (916) 535-46-16
Eugene V. Lobachev, traumatologist-orthopedist of the Department of orthopedics of the Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (903) 101-43-25
Elena L. Mandrygina, PhD, neurologist of the Department of neurology of the Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (916) 150-66-80
Natalya V. Sharashkina, PhD, geriatrician, head of the Department of General geriatrics and neurogeriatrics of the Russian Clinical and Research Center of Gerontology of the Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (903) 244-27-50
Denis A. Shirin, urologist of the Department of urology of the Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (985) 442-77-47
Anton V. Naumov, MD, professor, head of the laboratory of the musculoskeletal system of the Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (916) 634-67-35. E-mail: nanton78@gmail.com
Yulia V. Kotovskaya, MD, professor, Deputy Director for scientific work of the Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (916) 634-67-35. E-mail: kotovskaya@bk.ru
Anna S. Milto, MD, professor, head of the Clinic of the Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (903) 201-70-06. E-mail: milto_as@rgnkc.ru
Olga N. Tkacheva, MD, professor, Director of the Russian Clinical and Research Center of Gerontology of the N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. Tel.: +7 (985) 211-85-23. E-mail: tkacheva@rgnkc.ru
