The phenotype of a patient with COVID-19: the tactics of making a decision on a timely hospitalization


DOI: https://dx.doi.org/10.18565/therapy.2021.6.32-41

Zolotovskaya I.A., Gimatdinova G.R., Davydkin I.L., Sabanova V.D.

Samara State Medical University of the Ministry of Healthcare of Russia
Abstract. The aim: to study the phenotype of a patient with a new confirmed coronavirus infection COVID-19 and to offer an effective way to make decisions about timely hospitalization in real clinical practice.
Material and methods. For the study, we selected patients who received treatment both on an outpatient basis and in a hospital on the basis of Samara State Medical University Clinic in October 2020 with a laboratory-confirmed diagnosis of a new coronavirus infection (in the material obtained with a smear from the nose and oropharynx, SARS-CoV-2 ribonucleic acid was verified by polymerase chain reaction). The primary medical documentation was studied, including anamnesis, taking into account the diseases with which the patient is registered at the dispensary, clinical, laboratory and instrumental data, treatment by class of drugs, and the duration of hospitalization (if confirmed).
Results. The study revealed several significant clinical and demographic indicators, lifestyle factors, concomitant pathological conditions and diseases that form a phenotypically unfavorable type of patient with a confirmed new coronavirus infection COVID-19, suggesting some delayed complications of the disease, who is recommended to consider hospitalization regardless of the severity of clinical indicators.
Conclusion. The currently known clinical criteria, defined by the Temporary Guidelines approved by the Ministry of Healthcare of Russia, allow medical personnel to determine the conditions for the treatment of patients with COVID-19, but do not always really reflect the likelihood of delayed adverse outcomes. Therefore, in the conditions of real clinical practice, there is a need to optimize the routing for patients of this group, which we propose to improve on the basis of our developed method of making decisions on timely hospitalization of patients with confirmed new coronavirus infection COVID-19 (ARGO-VID-19 scale). A new score assessment of the likelihood of long-term adverse outcomes of the disease, based on the analysis of the phenotype of a patient with COVID-19, involves determining the conditions for treatment in this group of patients in order to minimize cases of late hospitalization and reduce the risk of delayed worse outcomes.
Keywords: routing, medical prevention, novel coronavirus infection, SARS-CoV-2, COVID-19, risk group, epidemiology
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About the Autors

Irina A. Zolotovskaya, MD, professor of the Department of hospital therapy with courses of polyclinic therapy and transfusiology, Samara State Medical University of the Ministry of Healthcare of Russia. Address: 443099, Samara, 89 Chapaevskaya Str. E-mail: zolotovskay@list.ru. ORCID: 0000-0002-0555-4016. SPIN-код: 8824-9668
Geliya R. Gimatdinova, clinical resident of the Department of hospital therapy with courses of polyclinic therapy and transfusiology, Samara State Medical University of the Ministry of Healthcare of Russia. Address: 443099, Samara, 89 Chapaevskaya Str. E-mail: gimatdinova1995@icloud.com. ORCID: 0000-0002-7133-1689. SPIN-код: 7846-7653
Igor L. Davydkin, MD, professor of the Department of hospital therapy with courses of polyclinic therapy and transfusiology, director of the Research Institute of Hematology, Transfusiology and Intensive Care, Samara State Medical University of the Ministry of Healthcare of Russia, chief freelance hematologist of the Ministry of Healthcare of the Samara Region. Address: 443099, Samara, 89 Chapaevskaya Str. E-mail: dagi2006@rambler.ru. ORCID: 0000-0003-0645-7645. E-mail: dagi2006@rambler.ru. SPIN-код: 1830-7497
Victoria D. Sabanova, clinical resident of the Department of hospital therapy with courses of polyclinic therapy and transfusiology, Samara State Medical University of the Ministry of Healthcare of Russia. Address: 443099, Samara, 89 Chapaevskaya Str. E-mail: victoria_sabanova@mail.ru. ORCID: 0000-0003-0296-4236. SPIN-код: 9561-0297


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