New coronavirus infection and elderly patients in primary care
- Authors: Ovakimyan K.V.1, Kuznetsova O.Y.1, Frolova E.V.1, Ambartsumyan R.V.1, Dranets V.S.1, Litvinova A.V.1
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Affiliations:
- North-Western State Medical University named after I.I. Mechnikov
- Issue: Vol 27, No 2 (2023)
- Pages: 55-63
- Section: Original studies
- URL: https://journals.eco-vector.com/RFD/article/view/366923
- DOI: https://doi.org/10.17816/RFD366923
- ID: 366923
Cite item
Abstract
BACKGROUND: The high incidence of COVID-19 has been a major challenge to health systems in virtually every country in the world during the pandemic. Under these conditions, the elderly were especially vulnerable and were at risk for an unfavorable course of the disease. The elderly were not only at higher risk of contracting COVID-19 and had a worse outcome, but they could also experience reduced access to care for existing chronic noncommunicable diseases and be lost to follow-up.
АIM: The aim of the study was to identify risk factors for the development of a severe course of COVID-19 in patients aged 60 years and older who applied for outpatient care during various periods of increased incidence of COVID-19: from March 2020 to February 2022.
MATERIALS AND METHODS: The study was performed on the basis of the Center for Family Medicine of the North-Western State Medical University named after I.I. Mechnikov. A retrospective cohort study is based on an analysis of outpatient records of patients enrolled in the framework of compulsory health insurance, who applied for medical care at Center for Family Medicine and underwent COVID-19 during various periods of increased incidence, namely: from 19.03.2020 to 30.06.2020 (1st period), from 01.10.2021 to 30.11.2021 (2nd period) and from 18.01.2022 to 28.02.2022 (3rd period). Elderly patients were defined as study participants aged 60 years or older.
RESULTS: The study included 343 patients: 137 men (39.9%) and 206 women (60.1%). The number of participants aged 60 and over was 85 (24.8%). It was found that in elderly patients such non-specific symptoms of acute respiratory viral infection as nasal congestion, rhinorrhea, sore throat, increased body temperature up to 38 ℃ (р < 0.05) began to occur significantly more often. The severity of COVID-19 in elderly patients is influenced by the SARS-CoV-2 variant: the incidence of pneumonia and the number of hospitalizations were significantly less during the 3rd period of increase in the incidence (р < 0.05), and the likelihood of developing a severe course of the disease was increased in 33.4 times and 23.8 times in waves 1 and 2, respectively, in comparison with wave 3.
CONCLUSIONS: Over time, nasal congestion, rhinorrhea, sore throat, and an increase in body temperature up to 38 ℃ became significantly more common (p < 0.05). Polymerase chain reaction testing for COVID-19 should be performed in all patients with symptoms of acute respiratory disease, regardless of severity. Pneumonia and hospitalization were significantly less common during the 3rd period of increased incidence (p < 0.05), and the probability of developing a severe course of the disease was increased by 33.4 and 23.8 times in the 1st and 2nd waves, respectively, in compared to the 3rd wave. The data obtained should be taken into account when predicting severe outcomes in outpatients, developing tactics for monitoring and managing such patients.
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About the authors
Karina V. Ovakimyan
North-Western State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: karina.ovakimyan@szgmu.ru
ORCID iD: 0000-0002-5342-3918
SPIN-code: 5900-2849
MD, Cand. Sci. (Med.)
Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015Olga Yu. Kuznetsova
North-Western State Medical University named after I.I. Mechnikov
Email: oukuznetsova@mail.ru
ORCID iD: 0000-0002-2440-6959
SPIN-code: 7200-8861
Scopus Author ID: 24448739500
ResearcherId: O-4056-2014
MD, Dr. Sci. (Med.), Professor
Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015Elena V. Frolova
North-Western State Medical University named after I.I. Mechnikov
Email: elena.frolova@szgmu.ru
ORCID iD: 0000-0002-5569-5175
SPIN-code: 1212-0030
Scopus Author ID: 37037140300
ResearcherId: O-4134-2014
MD, Dr. Sci. (Med.), Professor
Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015Ruzanna V. Ambartsumyan
North-Western State Medical University named after I.I. Mechnikov
Email: ruzanna-ambartsumyan@mail.ru
ORCID iD: 0000-0002-9813-9478
SPIN-code: 7049-9032
MD
Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015Vladimir S. Dranets
North-Western State Medical University named after I.I. Mechnikov
Email: dranecv@mail.ru
ORCID iD: 0000-0003-3039-5202
SPIN-code: 6643-2711
MD
Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015Anna V. Litvinova
North-Western State Medical University named after I.I. Mechnikov
Email: razoom.life@mail.ru
ORCID iD: 0000-0001-7437-1515
SPIN-code: 8301-0225
MD
Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015References
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