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Post a Comment Current, effectiveness of therapy and outcomes of new coronavirus infection: preliminary analysis
- Authors: Sayganov S.A.1, Mazurov V.I.1, Bakulin I.G.1, Lataria E.L.1, Artyushkin SA1, Chizhova O.Y.1, Ruslyakova I.A.1, Prokofieva N.A.1, Fil T.S.1, Tsurtsumiya D.B.1, Tikhonov S.V.1, Skalinskaya M.I.1, Rasmagina I.A.1, Alieva M.K.1, Trofimov EA1, Bakulina N.V.1, Kolmakova E.V.1, Sheyko A.D.1, Belousova L.N.1
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Affiliations:
- North-Western State Medical University named after I.I. Mechnikov
- Issue: Vol 12, No 2 (2020)
- Pages: 27-38
- Section: Original research
- URL: https://journal-vniispk.ru/vszgmu/article/view/34932
- DOI: https://doi.org/10.17816/mechnikov202012227-38
- ID: 34932
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Abstract
Relevance. Verification of a new coronavirus infection (COVID-19) requires clear algorithms for the diagnosis and treatment of patients, depending on clinical, laboratory and instrumental dates. Timely and informed decisions on optimizing management tactics and prescribing proactive anti-inflammatory therapy before development of a complete symptom complex life threatening conditions are needed in some cases.
Aim of the study. To analyze the course and outcomes of a new coronavirus infection, depending on the initial characteristics of the patients and treatment options.
Materials and methods. A preliminary analysis of the case histories of 129 people hospitalized in the center for treating patients with a new coronavirus infection at North-Western State Medical University n.a. I.I. Mechnikov was made by random sampling. Among the hospitalized patients there were 67 men (51.9%), the average age was 57.9 ± 16.4 years, 62 women (48.1%), and the average age was 60.2 ± 13.6 years. During hospitalization, all patients underwent standard clinical laboratory and instrumental examination, as well as determination of saturation (SpO2), markers of the cytokine storm (CRP, ferritin, AST, D-dimer, fibrinogen, lymphocytes), compute tomography (CT) of the lungs. The effectiveness and safety of therapy was evaluated by the outcome (recovery, death), as well as by the presence of adverse events in the background of the therapy. Statistical processing of the research results was carried out using the Statistica 12 for Windows application software package, the significance of differences between the two relative values was evaluated using the Student t-test (t > 2, p < 0.05).
Results. Fatal outcomes were significantly more frequently recorded among patients of older age groups and males. The presence of concomitant diseases such as obesity, diabetes mellitus, pathology of the cardiovascular system was accompanied by more frequent fatal outcomes. That allows considering comorbidity as a risk factor for severe course and poor prognosis of COVID-19. However, in general, in the presence of the indicated forms of concomitant diseases, it was not possible to establish significant differences with the outcomes of COVID-19, which may be due to an insufficient amount of patients. Predictors of fatal outcome was low values of saturation, the presence of respiratory failure, a significant amount of lung tissue damage (CT-3-4), as well as high values of CRP, ferritin, AST, D-dimer, neutrophilia, lymphopenia, thrombocytopenia. The use of anticytokine drugs (ACD) in complex therapy can be considered a favorable predictor of outcome, which indicates the advisability of wider use. The materials of the study allow not only a preliminary assessment of the course and effectiveness of complex therapy using anticytokine drugs with COVID-19 in patients with comorbid diseases, but also to develop therapeutic and diagnostic algorithms in patients of this category.
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##article.viewOnOriginalSite##About the authors
Sergey A. Sayganov
North-Western State Medical University named after I.I. Mechnikov
Email: sergey.sayganov@szgmu.ru
ORCID iD: 0000-0001-8325-1937
Scopus Author ID: 56512453000
professor, MD, PhD, Head of the Chair of Hospital Therapy and Cardiology n.a. M.S. Kushakovsky, rector of "North-West State Medical University n.a. I.I. Mechnikov" Ministry of Health of Russia, Saint Petersburg, Russia
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Vadim I. Mazurov
North-Western State Medical University named after I.I. Mechnikov
Email: maz.nwgmu@yandex.ru
ORCID iD: 0000-0002-0797-2051
D. Sci. (Med.), Prof., RAS academician, Head of the research institute of Rheumatology North-Western State Medical University named after I.I. Mechnikov, head of Department of Therapy, Rheumatology, Examination of Temporary Disability and Quality of Medical Care named after E.E.Eichwald FSBEI HE North-Western State Medical University named after I. I. Mechnikov
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Igor G. Bakulin
North-Western State Medical University named after I.I. Mechnikov
Email: igbakulin@yandex.ru
ORCID iD: 0000-0002-6151-2021
SPIN-code: 5283-2032
Scopus Author ID: 6603812937
ResearcherId: P-4453-2014
Dean of the medical faculty, Professor, doctor of medical Sciences, head of the Department of propaedeutics of internal diseases of gastroenterology and dietetics named after S. M. Rys
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Elguja L. Lataria
North-Western State Medical University named after I.I. Mechnikov
Email: Elguja.Lataria@szgmu.ru
MD, PhD, associate Professor, Vice-Rector for Clinical Work, Head Doctor of Clinics North-West State Medical University named after I.I. Mechnikov "Ministry of Health of Russia, Saint Petersburg, Russia
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41S A Artyushkin
North-Western State Medical University named after I.I. Mechnikov
Email: Sergei.Artyushkin@szgmu.ru
ORCID iD: 0000-0003-4482-6157
Vice Rector for Academic Affairs of North-Western
State Medical University named after I.I.Mechnikov,
Saint Petersburg, Russia Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41
Olga Yu. Chizhova
North-Western State Medical University named after I.I. Mechnikov
Email: Ochizhova@gmail.com
ORCID iD: 0000-0002-1716-7654
MD, PhD, Professor of the Chair of the Propedeutics of Internal Diseases, Gastroenterology and Dietology n.a. S.M. Ryss North-Western State Medical University n.a. I.I. Mechnikov, Saint Petersburg, Russia
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Irina A. Ruslyakova
North-Western State Medical University named after I.I. Mechnikov
Email: Irina.Ruslyakova@szgmu.ru
ORCID iD: 0000-0003-1507-833X
MD, PhD, assistant of the Chair of propaedeutics of internal diseases, gastroenterology and dietetics n.a. S.M. Ryss North-Western State Medical University n.a. I.I. Mechnikov, anesthetist-resuscitator, head of the intensive care unit for the patients of the therapeutic profile of the Clinic North-Western State Medical University n.a. I.I. Mechnikov, Saint Petersburg, Russia
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Natalia A. Prokofieva
North-Western State Medical University named after I.I. Mechnikov
Email: Natalya.Prokofeva@szgmu.ru
ORCID iD: 0000-0003-3105-4530
Head of the therapeutic department of the Clinic North-Western State Medical University n.a. I.I. Mechnikov, Saint Petersburg, Russia
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Tatiana S. Fil
North-Western State Medical University named after I.I. Mechnikov
Email: Tatyana.Fil@szgmu.ru
ORCID iD: 0000-0002-2859-4942
MD, PhD, Head of the gastroenterological department of the Clinic North-Western State Medical University n.a. I.I. Mechnikov, Saint Petersburg, Russia
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Daridzhan B. Tsurtsumiya
North-Western State Medical University named after I.I. Mechnikov
Email: D.Tcurtcumiya@szgmu.ru
ORCID iD: 0000-0001-7806-9364
MD, PhD, associate Professor of the Chair of Internal Medicine, Clinical Pharmacology and Nephrology North-Western State Medical University n.a. I.I. Mechnikov, Saint Petersburg, Russia
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Sergey V. Tikhonov
North-Western State Medical University named after I.I. Mechnikov
Email: sergeyvt2702@gmail.com
ORCID iD: 0000-0001-5720-3528
SPIN-code: 6921-5511
MD, PhD, associate Professor of the Chair of Internal Medicine, Clinical Pharmacology and Nephrology North-Western State Medical University n.a. I.I. Mechnikov
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Mariya I. Skalinskaya
North-Western State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: mskalinskaya@yahoo.com
ORCID iD: 0000-0003-0769-8176
Associate proffessor of the Chair of the Propedeutics of Internal Diseases, PhD Gastroenterology and Dietology n.a. S.M. Riss
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Irina A. Rasmagina
North-Western State Medical University named after I.I. Mechnikov
Email: irenerasmagina@gmail.com
ORCID iD: 0000-0003-3525-3289
resident of the Chair of the Propedeutics of Internal Diseases, Gastroenterology and Dietology n.a. S.M. Riss North-Western State Medical University n.a.I.I.Mechnikov, Saint Petersburg, Russia
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Marianna K. Alieva
North-Western State Medical University named after I.I. Mechnikov
Email: diezirrhose@gmail.com
ORCID iD: 0000-0002-0763-6111
resident of the Chair of the Propedeutics of Internal Diseases, Gastroenterology and Dietology n.a. S.M. Riss North-Western State Medical University n.a.I.I.Mechnikov, Saint Petersburg, Russia
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41E A Trofimov
North-Western State Medical University named after I.I. Mechnikov
Email: trofimov-zeka@mail.ru
ORCID iD: 0000-0003-3236-4485
associate professor, MD, PhD, associate professor of the Сhair of therapy, rheumatology, examination of temporary disability and quality of medical care n.a. E. E. Eichwald North-Western State Medical University n.a. I.I. Mechnikov.
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Nataliay V. Bakulina
North-Western State Medical University named after I.I. Mechnikov
Email: nv_bakulina@mail.ru
ORCID iD: 0000-0003-4075-4096
Scopus Author ID: 7201739080
ResearcherId: N-7299-2014
http://www.researcherid.com/rid/N-7299-2014
professor, MD, PhD, Head of the Chair of Internal Medicine, Clinical Pharmacology and Nephrology North-Western State Medical University n.a. I.I. Mechnikov, Saint Petersburg, Russia
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Elena V. Kolmakova
North-Western State Medical University named after I.I. Mechnikov
Email: Elena.Kolmakova@szgmu.ru
ORCID iD: 0000-0002-3438-5004
MD, PhD, associate Professor of the Chair of Internal Medicine, Clinical Pharmacology and Nephrology North-Western State Medical University n.a. I.I. Mechnikov, Saint Petersburg, Russia
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Anna D. Sheyko
North-Western State Medical University named after I.I. Mechnikov
Email: knopfchenanka@gmail.com
ORCID iD: 0000-0002-1677-433X
student
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41Lia N. Belousova
North-Western State Medical University named after I.I. Mechnikov
Email: liya-belousova@yandex.ru
ORCID iD: 0000-0003-4778-1767
MD, PhD, associate professor of the Chair of the Propedeutics of Internal Diseases, Gastroenterology and Dietology n.a. S.M. Riss North-Western State Medical University n.a.I.I.Mechnikov, Saint Petersburg, Russia
Russian Federation, 191015, Saint-Petersburg, Kirochnaya street, 41References
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