Outpatient treatment of patients with COVID-19: Normative documents and/or clinical thinking

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The legal framework for the provision of medical care, its evaluation and control of quality in Russia requires the attending physician to strictly comply with the provisions of regulatory documents. At the same time, clinical practice shows that the recommended algorithms for the provision of care do not allow in all situations to provide medical care of adequate quality. Analysis of the clinical example shows that in the era of the COVID-19 pandemic, in addition to compliance with the established rules, a thorough assessment of a specific clinical situation in the dynamics of development is necessary and timely correction of treatment and diagnostic measures, including those in excess of the established requirements, are required. The methods of remote monitoring of the patient’s condition need to be improved, since in their current form they do not provide an objective assessment of the patient’s condition. Face-to-face examinations of patients with COVID-19 receiving medical care at home should be carried out at least every 72 hours, regardless of the result of the remote assessment. The absence of the effect of therapy within three days may be an indication for transferring the patient to a higher level of medical care.

作者简介

Valery Vasiliev

North-Western State Medical University named after I.I. Mechnikov; Pediatric Research and Clinical Center for Infectious Diseases

Email: vcubed@ya.ru
ORCID iD: 0000-0002-7336-8805
SPIN 代码: 5644-9877
Researcher ID: O-4773-2014

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, 41, Kirochnaya street, Saint-Petersburg, 191015; Saint-Petersburg

Elena Romanova

North-Western State Medical University named after I.I. Mechnikov

Email: asrom@yandex.ru
ORCID iD: 0000-0002-9887-8561
SPIN 代码: 9435-6838
Scopus 作者 ID: 707096

MD, Cand. Sci. (Med.), Assistant Professor

俄罗斯联邦, 41, Kirochnaya street, Saint-Petersburg, 191015

Galina Startseva

North-Western State Medical University named after I.I. Mechnikov

Email: star661@rambler.ru
SPIN 代码: 8392-2950
Scopus 作者 ID: 442573

MD, Cand. Sci. (Med.), Assistant Professor

俄罗斯联邦, 41, Kirochnaya street, Saint-Petersburg, 191015

Nikolay Kuznetsov

North-Western State Medical University named after I.I. Mechnikov

编辑信件的主要联系方式.
Email: meri-kuz-48@mail.ru
SPIN 代码: 2558-9273

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, 41, Kirochnaya street, Saint-Petersburg, 191015

参考

  1. Prikaz Minzdrava Rossii 19.03.2020 #198n (red. 22.07.2021) “O vremennom poryadke organozatsii raboty meditsinskikh organizatsii v tsekyakh realizatsii mer po profilaktike I snizheniyu riskov rasprostraneniya novoi koronavirusnoi infektsii COVID-19” [Internet]. Available from: http://www.consultant.ru/document/cons_doc_LAW_348101/. Accessed: Oct 26, 2021. (In Russ.)
  2. Vremennyye metodicheskiye rekomendatsii. Profilaktika, diagnostika i lecheniye COVID-19. Versiya 11 (07.05.2021) [Internet]. Available from: https://base.garant.ru/400738625//. Accessed: Oct 26, 2021. (In Russ.)
  3. Pines JM. Profiles in patient safety: Confirmation bias in emergency medicine. Acad Emerg Med. 2006;13(1):90–94. doi: 10.1197/j.aem.2005.07.028
  4. Graber MA. Heuristics and medical errors. Part 2. How to make better medical decisions. Russian Family Doctor. 2021;25(1):45–52. (In Russ.). doi: 10.17816/RFD62009
  5. Romanova ES, Vasilyev VV, Startseva G, et al. Cause of death based on systematic postmortem studies in patients with positive SARS-CoV2 tissue PCR during the COVID-19 pandemic. J Intern Med. 2021;290(3):655–665. doi: 10.1111/joim.13300

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版权所有 © Vasiliev V., Romanova E., Startseva G., 博士 西北国立医科大学经济学教授,传染病学系教授 我 梅奇尼科夫»俄罗斯卫生部。 N., 2021

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