Peculiarities of COVID-19 coronavirus infection course in patients with comorbid pathology


DOI: https://dx.doi.org/10.18565/therapy.2022.6.11-26

Sycheva A.S., Malyavina M.A., Tebueva L.V., Grigorievsky E.D., Kebina A.L., Vertkin A.L., Solodov A.A., Semenyakin I.V., Levchenko O.V., Yanushevich O.O.

1) A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia; 2) Clinical medical center of A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia
Abstract. In the context of the COVID-19 pandemic, patients with chronic diseases could be related to the most vulnerable population groups.
The aim of research was to study the incidence and structure of comorbid pathology in patients with extremely severe coronavirus infection course, and to identify the most significant factors determining adverse treatment outcome in comorbid patients with SARS-CoV-2 infection.
Material and methods. Survey sample (n=96) was consisted of patients hospitalized with symptoms of COVID-19 infection, aged 21 to 92 years old. The total sample was divided into two groups: the first group consisted of comorbid patients (n=22) aged 21–69 years, the second one – of comorbid patients (n=74) aged 29–92 years. Medical history, demographic parameters (age, sex), data of objective examination, clinical blood test, investigation of C-reactive protein, IL-6 levels, coagulogram (prothrombin time, INR, ACTV, fibrinogen, D-dimer), CT pulmonary scan results on admission and in dynamics, modes of anti-inflammatory and anticoagulant therapy, oxygen support, detected complications, as well as terms of transfer to ICU and treatment outcomes were analyzed.
Results and conclusion. In the comorbid patient group, 63 patients died and 11 were discharged with improvement of condition, whereas in the non-comorbid patient group there were 13 deaths among the 22 examined patients. The most frequently diagnosed conditions were hypertension (n=62; 98,4%), obesity (n=32; 50,8%), type 2 diabetes mellitus (n=26; 41,3%), and chronic renal disease (n=25; 39,7%). Patients with comorbidity were found to have a higher mortality rate and were more likely to be transferred to NIVL and ALV than patients without comorbidity. Patients with lethal outcome had more complications and a higher comorbidity index comparatively to those whose hospitalization ended with discharge. Bacterial complications were also more frequent in patients with comorbidity, 63,6% comparatively to 27,3% in patients without comorbidity.
Keywords: pathomorphological study, viral pneumonia, COVID-19, comorbid conditions, chronic renal disease, hypertension
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About the Autors

Alexandra S. Sycheva, assistant at the Department of therapy, clinical pharmacology and emergency medicine, deputy chief physician for outpatient clinical work of the Clinical Medical Center of the University Hospital, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 20/1 Delegatskaya Str. E-mail: docsycheva@gmail.com. ORCID: https://orcid.org/0000-0001-8804-9914
Maria A. Malyavina, clinical resident of the Department of therapy, clinical pharmacology and emergency medicine, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 20/1 Delegatskaya Str. E-mail: mari_malyavina173@mail.ru. ORCID: https://orcid.org/0000-0002-7500-110X
Lyuaza V. Tebueva, 6th year student of A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 20/1 Delegatskaya Str. E-mail: Lyuaza.tebueva@mail.ru. ORCID: https://orcid.org/0000-0002-0818-8330
Evgeny D. Grigorievsky, neurosurgeon of the clinic for 184 beds, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127206, Moscow, 9а/1 Vucheticha Str. E-mail: grigorevskiyed@gmail.com. ORCID: https://orcid.org/0000-0002-1473-9901
Anastasia L. Kebina, assistant at the Department of therapy, clinical pharmacology and emergency medicine, deputy chief physician for medical work of the Clinical Medical Center of the University Hospital, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address:111398, Moscow, 1А/1 Kuskovskaya Str. E-mail: akebina@list.ru. ORCID: https://orcid.org/0000-0002-7570-9650
Arkady L. Vertkin, Dr. med. habil., professor, head of the Department of therapy, clinical pharmacology and emergency medicine, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 20/1 Delegatskaya Str. E-mail: kafedrakf@mail.ru. ORCID: https://orcid.org/0000-0001-8975-8608
Alexander A. Solodov, Dr. med. habil., professor of the Department of neurosurgery and neuroreanimation, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia, chief physician of the Clinical Medical Center, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia, anesthesiologist-resuscitator of the highest qualification category. Address:111398, Moscow, 1А/1 Kuskovskaya Str. E-mail: docsol@mail.ru. ORCID: https://orcid.org/0000-0002-8263-1433
Igor V. Semenyakin, Dr. med. habil., associate professor of the Department of urology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 20/1 Delegatskaya Str. E-mail: dr.semeniakin@gmail.com. ORCID: https://orcid.org/0000-0003-0059-4980
Oleg V. Levchenko, Dr. med. habil., professor, vice-rector for medical work, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 20/1 Delegatskaya Str. E-mail: truovl@gmail.com. ORCID: https://orcid.org/0000-0003-0857-9398
Oleg O. Yanushevich, Dr. med. habil., professor, academician of RAS, rector of A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127006, Moscow, 20/1 Delegatskaya Str. E-mail: msmsu@msmsu.ru. ORCID: https://orcid.org/0000-0003-0059-4980


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