UDC: 578.834.1- 616.24
Kichigin V.A., Abyzov A.S., Oreshnikov E.V., Oreshnikova S.F., Chepurnaya O.P.
Prognostic Significance of Clinical and Laboratory Findings in the New Coronavirus Infection COVID-19
The new coronavirus infection COVID-19 is characterized by high mortality. The aim of the study was to establish the role of gender, age, concomitant diseases, shifts in laboratory findings in predicting fatal outcome in COVID-19 patients. The study was conducted on the basis of emergency medical care hospital (Cheboksary). 182 case histories of COVID-19 patients who underwent inpatient treatment were analyzed, 82 of whom died. The frequency of outcomes in different clinical conditions and laboratory shifts were analyzed, the relative risk (RR) of lethal outcome and its confidence interval were calculated. Mortality is naturally associated with the number of points on the NEWS 2 scale, the extent of pulmonary tissue involvement, no connection with gender was found. The prognostic value of acute kidney injury (RR – 2.57), chronic kidney disease (RR – 1.47), arterial hypertension (RR – 3.04), coronary heart disease (RR – 2.60), chronic nonspecific lung diseases (RR – 1.53), elderly and senile age (RR – 2.84, HR – 4.90), obesity of II-III degrees (RR – 1.97), body weight deficit (RR – 1.82) is shown. The ROC analysis method determined the levels of C-reactive protein in the blood (> 25 mg/l, RR – 3.2), an increase in procalcitonin (RR – 3.80), D-dimer (> 562.8 ng/ml, RR – 3.15), leukocytes (> 9.52×109/l, RR – 2.22), lymphocytes (< 1.15×109/l, RR – 2.04), interleukin-6 (> 13.2 pg/ml, RR – 3.38), fibrinogen (> 6.4 g/l, RR – 1.57), creatinine (> 91.8 mmol/l, RR – 1.95), lactate dehydrogenase (> 558 mmol/l, RR – 2.28), glomerular filtration rate (GFR < 63.8 ml/min / 1.73 m2, RR – 2.55), going beyond which significantly increases the risk of fatal outcome. Hence, along with the known factors in the high-risk group, it is necessary to take into account a specific body mass index, age group, renal function indicators and a number of inflammatory changes in the blood.
- Glybochko P.V., Fomin V.V., Moiseev S.V. et al. Iskhody u bol’nykh s tyazhelym techeniem COVID-19, gospitalizirovannykh dlya respiratornoi podderzhki v otdeleniya reanimatsii i intensivnoi terapii [Outcomes in patients with severe COVID-19 hospitalized for respiratory support in intensive care units]. Klinicheskaya farmakologiya i terapiya, 2020, 29(3), pp. 25–36.
- Mit’kovskaya N.P., Karpov I.A., Arutyunov G.P. et al. Koronavirusnaya infektsiya COVID-19 (obzor mezhdunarodnykh nauchnykh dannykh) [Coronavirus infection COVID-19 (review of international scientific evidence]. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski, 2020, vol. 4, no. 1, pp. 784–815.
- O vremennom poryadke organizatsii raboty meditsinskikh organizatsii v tselyakh realizatsii mer po profilaktike i snizheniyu riskov rasprostraneniya novoi koronavirusnoi infektsii COVID-19: prikaz Minzdrava Rossii ot 19.03.2020 g. no. 198n (s izm. i dop.). Pril. no. 12 [On the temporary procedure for organizing the work of medical organizations in order to implement measures to prevent and reduce the risks of the spread of a new coronavirus infection COVID-19: Order of the Ministry of Health of Russia dated March 19, 2020 no. 198n (as amended and supplemented). Appendix no. 12]. Available at: https://base.garant.ru/73769697.
- Gumerov R.M., Gareeva D.F., Davtyan P.A. et al. Prediktornye syvorotochnye biomarkery porazheniya serdechno-sosudistoi sistemy pri COVID-19 [Predictive serum biomarkers of cardiovascular disease in COVID-19]. Rossiiskii kardiologicheskii zhurnal, 2021, no. 26(S2), p. 4456. DOI: 10.15829/1560-4071-2021-4456.
- Profilaktika, diagnostika i lechenie novoi koronavirusnoi infektsii (COVID-19): vremennye metod. rekomendatsii. Versiya 14 (27.12.2021) [Prevention, diagnosis and treatment of novel coronavirus infection (COVID-19): temporary guidelines. Version 14 (December 12, 2020)]. Available at: https://static0.minzdrav.gov.ru/system/attachments/attaches/000/059/041/original/%D0%92%D0%9C%D0%A0_COVID-19_V14_27-12-2021.pdf.
- Atkins J.L., Masoli J.A.H., Delgado J. et al. Preexisting Comorbidities Predicting COVID-19 and Mortality in the UK Biobank Community Cohort. J Gerontol A Biol Sci Med Sci., 2020, vol. 75(11), pp. 2224–2230. DOI: 10.1093/gerona/glaa183.
- Dessie Z.G., Zewotir T. Mortality-related risk factors of COVID-19: a systematic review and meta-analysis of 42 studies and 423,117 patients. BMC Infect Dis., 2021,vol. 21, p. 855. DOI: 10.1186/s12879-021-06536-3.
- Li J, He X, Yuan Yuan, Zhang W, Li X, Zhang Y, Li S, Guan C, Gao Z, Dong G. Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. Am J Infect Control., 2021, vol. 49(1), pp. 82–89. DOI: 10.1016/j.ajic.2020.06.008.
- MedCalc: site. Available at:https://www.medcalc.org.
- Pya Y., Bekbossynova M., Gaipov A., Lesbekov T.et al. Mortality predictors of hospitalized patients with COVID-19: Retrospective cohort study from Nur-Sultan, Kazakhstan. PLoS ONE, 2021,vol. 16(12), e0261272. DOI: 10.1371/journal. pone.0261272.
- Rai D., Ranjan A., H A., Pandey S. Clinical and Laboratory Predictors of Mortality in COVID-19 Infection: A Retrospective Observational Study in a Tertiary Care Hospital of Eastern India. Cureus., 2021,vol. 13(9), e17660.DOI: 10.7759/cureus.17660.
- Kichigin Vadim A.
- Candidate of Medical Sciences, Associate Professor, Department of Faculty and Hospital Therapy, Chuvash State University, Russia, Cheboksary (email@example.com; ORCID: https://orcid.org/0000-0002-9161-2066)
- Abyzov Aleksey S.
- Assistant Lecturer, Department of Faculty and Hospital Therapy, Chuvash State University, Russia, Cheboksary (firstname.lastname@example.org; ORCID: https://orcid.org/0000-0002-3770-9414)
- Oreshnikov Evgeny V.
- Candidate of Medical Sciences, Deputy Chief Physician, Emergency Hospital; Associate Professor, Department of Faculty and Hospital Therapy, Chuvash State University, Russia, Cheboksary (email@example.com; ORCID: https://orcid.org/0000-0001-8503-0783)
- Oreshnikova Svetlana F.
- Candidate of Medical Sciences, Head of the Department of Anesthesiology and Intensive Care № 2, Emergency Hospital; Associate Professor, Department of Faculty and Hospital Therapy, Chuvash State University, Russia, Cheboksary (firstname.lastname@example.org; ORCID: https://orcid.org/0000-0003-1056-0725)
- Chepurnaya Oksana P.
- Candidate of Medical Sciences, Associate Professor, Department of Faculty and Hospital Therapy, Chuvash State University, Russia, Cheboksary (email@example.com; ORCID: https://orcid.org/0000-0002-5725-5747)
Kichigin V.A., Abyzov A.S., Oreshnikov E.V., Oreshnikova S.F., Chepurnaya O.P. Prognostic Significance of Clinical and Laboratory Findings in the New Coronavirus Infection COVID-19 [Electronic resource] // Acta medica Eurasica. – 2022. – №3. P. 20-28. – URL: https://acta-medica-eurasica.ru/en/single/2022/3/3/. DOI: 10.47026/2413-4864-2022-3-20-28.