Predictors of an unfavorable course of COVID-19
https://doi.org/10.18699/SSMJ20230415
Abstract
The aim of the study was to identify the features of the unfavorable clinical course of a new coronavirus infection.
Material and methods. The analysis of clinical data, laboratory results and comorbidity of 168 patients with a confirmed diagnosis of a new coronavirus infection aged 65,0 [57,0; 74,0] years was carried out. Two groups of patients were distinguished – 126 persons with a moderate course and with clinical recovery in the outcome of the disease and 42 persons with a severe course and a fatal outcome of the disease. Transnosological polymorbidity was assessed by the average number of nosologies corresponding to the three-digit ICD-10 rubricification, transsystemic – by the number of affected systems. Hemogram parameters, blood content of C-reactive protein, creatinine, urea, glucose, prothrombin index, international normalized ratio, activated partial thromboplastin time, platelet count, D-dimer concentration were estimated.
Results. In the group of patients with fatal outcomes, compared to patients with recovery, there were statistically significantly higher indices of transnosological and transsystemic polymorbidity (1.5 and 2 times, respectively), they were more likely to have ischaemic heart disease, myocardial infarction, transient ischemic attack in anamnesis, atrial fibrillation, chronic heart failure; blood concentration of C-reactive protein, fasting glucose, urea, D-dimer in the blood serum was higher, the number of thrombocytes was less.
Conclusions. A high degree of transnosological and transsystemic polymorbidity, a history of myocardial infarction and transient ischemic attack, comorbid chronic heart failure, atrial fibrillation, an increase in D-dimer, CRP content, and a decrease in platelet number are predictors of severe course and the lethal outcome of COVID-19.
About the Authors
V. Ya. Polyakov
Federal Research Center of Fundamental and Translational Medicine
Russian Federation
Russian Federation
Vladimir Ya. Polyakov, doctor of medical sciences
630117, Novosibirsk, Timakova st., 2
Yu. A. Nikolaev
Federal Research Center of Fundamental and Translational Medicine
Russian Federation
Russian Federation
Yuriy A. Nikolaev, doctor of medical sciences
630117, Novosibirsk, Timakova st., 2
Zh. A. Garina
Novosibirsk Regional Hospital No. 1
Russian Federation
Russian Federation
Zhanna A. Garina
630559, Novosibirsk region, vlg. Koltsovo, Administrative Building, 3
I. M. Mitrofanov
Federal Research Center of Fundamental and Translational Medicine
Russian Federation
Russian Federation
Igor M. Mitrofanov, doctor of medical sciences
630117, Novosibirsk, Timakova st., 2
E. V. Sevostyanova
Federal Research Center of Fundamental and Translational Medicine
Russian Federation
Russian Federation
Evgeniya V. Sevostyanova, candidate of medical sciences
630117, Novosibirsk, Timakova st., 2
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