Mild forms of COVID-19: the clinical course features in patients with chronic obstructive pulmonary disease


DOI: https://dx.doi.org/10.18565/therapy.2021.8.7-13

Ladnov D.V., Kulik V.V., Kirpichnikov S.I., Shaporova N.L.

Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia
Abstract. It is known that some concomitant pathological conditions can affect the course of COVID- 19.
Purpose of the study: comparison of the clinical course of mild forms of COVID-19 in patients with COPD and in patients without significant comorbid pathology observed on an outpatient basis.
Material and methods. The study was conducted in 36 outpatients. 18 patients with concomitant COPD made up the study group and 18 patients were included in the comparison group. The duration of the disease, the maximum body temperature, the total leukocyte level, the ESR level, the level of C-reactive protein, fibrinogen, and the APTT index were studied. Statistical processing was carried out using the JASP program (version 0.14.1.0).
Results. Analysis of the duration of the disease showed that in the main group the average number of days of illness (18,4±6,7) was significantly higher than in the comparison group (14,7±2,8; p=0,026). The maximum body temperature in both groups did not differ significantly (p=0,868). A significant difference in the level of leukocytes was found: in the main group it was higher than in patients without comorbid pathology (6,8±1,7×109/L and 5,6±1,6×109/L, respectively; p=0,046). There was no significant difference in the level of C reactive protein (p=0,759), fibrinogen (p=0,681), APTT (p=0,837) and in the level of ESR (p=0,715) between the two groups.
Conclusion. A significant increase in the duration of COVID-19 and an increase in the level of leukocytes were found in the group of patients with COPD. For the rest of the clinical and laboratory parameters, there were no significant differences between the main group and the comparison group. significant difference between groups. The mild course of COVID-19 in patients with concomitant COPD, who were observed on an outpatient basis, has features of the course of a viral infection.
Keywords: COVID-19, general practice, chronic obstructive pulmonary disease
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Literature


  1. Dong E., Du H., Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020; 20(5): 533–34. doi: 10.1016/S1473-3099(20)30120-1.

  2. Letko M., Marzi A., Munster V. Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B betacoronaviruses. Nat Microbiol. 2020; 5(4): 562–69. doi: 10.1038/s41564-020-0688-y.

  3. Baughn L.B., Sharma N., Elhaik E. et al. Targeting TMPRSS2 in SARS-CoV-2 Infection. Mayo Clin Proc. 2020; 95(9): 1989–99. doi: 10.1016/j.mayocp.2020.06.018.

  4. Leung J.M., Yang C.X., Tam A. et al. ACE-2 expression in the small airway epithelia of smokers and COPD patients: implications for COVID-19. Eur Respir J. 2020; 55(5): 2000688. doi: 10.1183/13993003.00688-2020.

  5. Елшин Н.Д., Чухловин А.Б., Кузубова Н.А. с соавт. Роль ангиотензинпревращающего фермента при хронической обструктивной болезни легких. Ученые записки Санкт-Петербургского государственного медицинского университета имени академика И.П. Павлова. 2017; 3: 65–70. [Elshin N.D., Chukhlovin A.B., Kuzubova N.A. et al. A role of angiotensin-converting enzyme in chronic obstructive pulmonary disease summary. Uchenyye zapiski Sankt-Peterburgskogo gosudarstvennogo meditsinskogo universiteta imeni akademika I. P. Pavlova = The Scientific Notes of the Pavlov University. 2017; 3: 65–70. (In Russ.)]. https://dx.doi.org/10.24884/1607-4181-2017-24-3-65-70.

  6. Yang J., Zheng Y., Gou X. et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020; 94: 91–95. doi: 10.1016/j.ijid.2020.03.017.

  7. Guan W.J., Liang W.H., Zhao Y. et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020; 55(5): 2000547. doi: 10.1183/13993003.00547-2020.

  8. Шестакова М.В., Викулова О.К., Исаков М.А., Дедов И.И. Сахарный диабет и COVID-19: анализ клинических исходов по данным регистра сахарного диабета российской федерации. Проблемы эндокринологии. 2020; 1: 35–46. [Shestakova M.V., Vikulova O.K., Isakov M.А., Dedov I.I. Diabetes and COVID-19: analysis of the clinical outcomes according to the data of the russian diabetes registry. Problemy endokrinologii = Problems of Endocrinology. 2020; 1: 35–46 (In Russ.)]. https://dx.doi.org/10.14341/probl12458.

  9. Глыбочко П.В., Фомин В.В., Авдеев С.Н. с соавт. Клиническая характеристика 1007 больных тяжелой SARS-CoV-2 пневмонией, нуждавшихся в респираторной поддержке. Клиническая фармакология и терапия. 2020; 2: 21–29 [Glybochko P., Fomin V., Avdeev S. et al. Clinical characteristics of 1007 intensive care unit patients with SARS-CoV-2 pneumonia. Klinicheskaya farmakologiya i terapiya = Clinical pharmacology and therapy. 2020; 2: 21–29 (In Russ.)]. https://dx.doi.org/10.32756/0869- 5490-2020-2-21-29.

  10. Министерство здравоохранения Российской Федерации. Временные методические рекомендации: профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19). Версия 7 (03.06.2020). Доступ: http://www.consultant.ru/document/cons_doc_LAW_354163 (дата обращения – 01.10.2021). [Ministry of Healthcare of Russia. The temporary guidelines: Prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 7 (June 03, 2020). Available at: http://www.consultant.ru/document/cons_doc_LAW_354163 (date of access – 01.10.2021) (In Russ.)].

  11. Министерство здравоохранения Российской Федерации. Временные методические рекомендации: профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19). Версия 8 (03.09.2020). Доступ: http://www.consultant.ru/document/cons_doc_LAW_361302 (дата обращения – 01.10.2021). [Ministry of Healthcare of Russia. The temporary guidelines: Prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 8 (September 03, 2020). Available at: http://www.consultant.ru/document/cons_doc_LAW_361302 (date of access – 01.10.2021) (In Russ.)].

  12. Министерство здравоохранения Российской Федерации. Временные методические рекомендации: профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19). Версия 9 (26.10.2020). Доступ: https://www.consultant.ru/document/cons_doc_LAW_366070 (дата обращения – 01.10.2021). [Ministry of Healthcare of Russia. The temporary guidelines: Prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 9 (October 26, 2020). Available at: https://www.consultant.ru/document/cons_doc_LAW_366070 (date of access – 01.10.2021) (In Russ.)].

  13. Министерство здравоохранения Российской Федерации. Временные методические рекомендации: профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19). Версия 10 (08.02.2021). Доступ: http://www.consultant.ru/document/cons_doc_LAW_354163 (дата обращения – 01.10.2021). [Ministry of Healthcare of Russia. The temporary guidelines: Prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 10 (February 08, 2021). Available at: http://www.consultant.ru/document/cons_doc_LAW_354163 (date of access – 01.10.2021) (In Russ.)].


About the Autors

Dmitry V. Ladnov, general practitioner physician of the Center for General Medicine at the Polyclinic with a clinical diagnostic center, Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia. Address: 197022, Saint Petersburg, 6–8 Lva Tolstogo Str. Tel.: +7 (952) 240-65-16. ORCID: 0000-0002-5400-2306
Vladislav V. Kulik, general practitioner physician of the Center for General Medicine at the Polyclinic with a clinical diagnostic center, Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia. Address: 197022, Saint Petersburg, 6–8 Lva Tolstogo Str. Tel.: +7 (921) 863-31-62. ORCID: 0000-0003-4177-3264
Sergey I. Kirpichnikov, general practitioner, head of the Center for General Medicine at the Polyclinic with a clinical diagnostic center, Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia. Address: 197022, Saint Petersburg, 6–8 Lva Tolstogo Str. Tel.: +7 (911) 011-70-61. ORCID: 0000-0002-7848-8144
Natalia L. Shaporova, MD, professor, head of Department of general medical practice (family medicine), Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia. Address: 197022, Saint Petersburg, 6–8 Lva Tolstogo Str. Tel.: +7 (921) 758-98-74. ORCID: 0000-0002-6457-5044


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