Актуальні інфекційні захворювання
день перший день другий
Актуальні інфекційні захворювання
день перший день другий
Журнал «Актуальная инфектология» Том 8, №5, 2020
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Clinical characteristics of hospitalized patients with coronavirus disease COVID-19
Авторы: T.E. Onishchenko(1), O.V. Riabokon(1), I.O. Kulesh(2), T.B. Matveeva(2), V.V. Cherkasky(2), N.V. Onishchenko(1)
(1) — Zaporizhia State Medical University, Zaporizhia, Ukraine
(2) — CNPE “Regional Infectious Diseases Hospital” ZRC, Zaporizhia, Ukraine
Рубрики: Инфекционные заболевания
Разделы: Медицинские форумы
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At the end of 2019, a new coronavirus appeared in China, which was identified as COVID-19 (SARS-CoV-2) (Lu R. etc, 2020; Joseph A.
Lewnard etc, 2020). Ukraine ranks is 25th among all countries in the world in terms of coronavirus disease incidence. In particular, 185 thousand cases coronavirus disease were recorded in Ukraine, with fatalities more than 2.0 % of cases. Severe course of COVID-19 has associated with the development of acute respiratory distress syndrom, gradual lung damage and multiorgan failure (Albaraa A. Milibari, 2020; Tanu Singhal, 2020). The lack of specific therapy determines particular relevance the study of this infection (David A. Berlin etc, 2020).
Purpose is to analyze the clinical course of coronavirus infection in adults at the present stage according to data Zaporizhzhya Regional Infectious Diseases Hospital for period from March to September 2020.
Material and methods. Under observation, there were 257 patients with coronavirus infection, aged 18 to 88 years, who were treated based on Zaporizhzhya Regional Infectious Diseases Hospital for period from March to September 2020. The diagnosis was confirmed by the detection of SARS-CoV-2 RNA in the study of nasopharyngeal lavage and sputum by polymerase chain reaction.
Results. It was established that among hospitalized patients there were 140 (57.9 %) women, men — 117 (42.1 %). The age structure was dominated by middle-aged (44–60 years) and elderly (60–75 years) age, 92 (35.8 %) and 88 (34.3 %) patients, respectively. There were 30 (11.6 %) patients of senile (75 years and older) age, 13 (5.1 %) and 34 (13.2 %) patients of young (18–25 years) and middle (22–44 years) ages, respectively. Severe course of the disease was registered in most patients — 131 (50.9 %), moderate — in 105 (40.9 %), mild — in 12 (4.7 %) patients. It was found that formation of the severe course coronavirus infection was more often registered among elderly and senile ages, in 70.5 % and 86.7 % of patients, respectively, compared with young and middle-aged, in 5.9 % and 43.4 % patients, respectively. It should be noted that in nine (3.5 %) patients coronavirus infection was extremely severe, with fatal outcome. Almost every fourth (65 — 23.4 %) patient was treated at Department of Anesthesiology and Intensive Care. Complications developed in 253 (98.4 %) patients and were characterized by the development of bronchitis in 47 (18.3 %) patients, pulmonary lesions with pneumonia in 205 (79.8 %) patients, which was determine be X-ray exa-mination chest. The mild course of coronavirus infection in 12 (4.7 %) patients was characterized by short-term subfebrile, pharyngitis (4) and development of bronchitis (8). Moderate course was accompanied by moderate intoxication, asthenovegetative syndromes, myalgia, development of bronchitis in 39 (15.2 %) patients, pneumonia — in 66 (25.7 %) patients. In all patients with severe (131) and extremely severe (9) course of coronavirus infection, bilateral lung damage was observed with formation of polysegmental pneumonia with acute respiratory failure of 2–3 degrees. Concomitant pathology was registered in 43 (16.7 %) patients, was characterized by the presence of several comorbid conditions and was represented by: hypertension (33), coronary heart disease (30), diabetes mellitus (13), COPD (8). In eight (3.1 %) patients coronavirus infection developed on the background of acute diseases (stroke — 6, surgical pathology — 2). It should be noted that presence of concomitant pathology was registered mainly in elderly (19) and senile (17) aged patients.
Conclusions. In the majority (50.9 %) of patients with coronavirus disease COVID-19 prevailed development severe course of the disease, mainly among elderly (70.5 %) and senile (86.7 %) age, with the pre-sence of concomitant pathology in 16.7 % patients. Complications developed in the majority (98.4 %) of patients, were represented by bronchitis in 18.3 % of patients, pneumonia — in 79.8 % of patients. Almost every fourth (23.4 %) patient was treated at Department of Anesthesio-logy and Intensive Care. Fatalities (3.5 %) were recorded exclusively in elderly patients with concomitant chronic pathology.