Русский
Clinical and laboratory characteristics of severe forms of new coronavirus infection
DOI: https://dx.doi.org/10.18565/therapy.2022.3.7-13
Ponezheva Z.B., Grishaeva А.А., Alimova L.K., Burdakova E.A., Makashova V.V., Krasnova S.V.
1) Central Research Institute of Epidemiology of Rospotrebnadzor, Moscow; 2) Infectious Clinical Hospital No. 2 of the Moscow Healthcare Department
The purpose of the study: to determine the clinical and laboratory features of severe forms of COVID- 19 in order to identify the most significant predictors of a lethal outcome.
Material and methods. Clinical and laboratory observations of 200 patients diagnosed with severe COVID-19, aged 18 to 90 years, was carried out. All patients underwent a standard examination. In addition, the levels of IL-6 in blood serum in dynamics were measured by ELISA. Depending on the outcome of the disease, the patients were divided into 2 groups: the 1st group – survivors, n=110 and the 2nd group – lethal, n=90.
Results. The studied group consisted of 200 patients with severe course of New Coronavirus Infection: 116 men (58%) and 84 women (42%). The overall mortality was 45%. Fever (85,5%), shortness of breath (81%), catarrhal (63,5%) and asthenic (77%) syndromes prevailed among the symptoms that were present in patients upon hospitalization. During examination complete blood count, the average level of leukocytes in the study group was 9,41±5,66×109/l, erythrocytes – 4,44±0,7×1012/l, platelets – 206,66±90,89×109/l. The average level of CRP was 120,54±94,78 mg/l, LDH – 635,49±392,1 U/l, ferritin – 759,8±462,64 ng/ml. According to computed tomography performed at hospitalization, 7,5% of patients had CT-1, 28,5% – CT-2, 46% – CT-3, 18% – CT-4. Acute respiratory distress syndrome (ARDS), thromboembolic and bacterial complications were the most common complications that occurred during hospitalization. Remarkably, patients that showed a state of moderate severity in the period before admission to the ICU had the highest average IL-6 value, while the patients in the intensive care unit had lower concentrations of IL-6.
Conclusions. Known predictors of the severe infection course do not allow in some cases to timely diagnose the progression of the disease and the development of complications, which dictates the need to search for new poor prognosis criteria.
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About the Autors
Zhanna B. Ponezheva, Dr. med. habil., head of the Clinical Department of infectious pathology, Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3А Novogireevskaya Str.
E-mail: doktorim@mail.ru. ORCID: https://orcid.org/0000-0002-6539-4878
Antonina A. Grishaeva, junior researcher of the Clinical Department of infectious pathology, Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3А Novogireevskaya Str. E-mail: antoninagrishaeva@yandex.ru. ORCID: https://orcid.org/0000-0002-1326-9274
Lilia K. Alimova, junior researcher of the Clinical Department of infectious pathology, Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3А Novogireevskaya Str. E-mail: ra154.b@yandex.ru. ORCID: https://orcid.org/0000-0002-1814-6281
Elizaveta A. Burdakova, postgraduate student at Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3А Novogireevskaya Str. E-mail: elisobol@yandex.ru. ORCID: https://orcid.org/0000-0002-6729-677Х
Vera V. Makashova, Dr. med. habil, professor, senior researcher of the Clinical Department of infectious pathology, Central Research Institute of Epidemiology of Rospotrebnadzor. Address: 111123, Moscow, 3А Novogireevskaya Str. E-mail: veramakashova@yandex.ru. ORCID: https://orcid.org/0000-0002-0982-3527
Svetlana V. Krasnova, PhD in Medicine, chief physician at Infectious Clinical Hospital No. 2 of the Moscow Healthcare Department. Address: 105275, Moscow, 15 8th Sokolinoy Gory Str. E-mail: krasnovasv@ikb2.ru
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