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Current, effectiveness of therapy and outcomes of new coronavirus infection: preliminary analysis

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1. Title Title of document Current, effectiveness of therapy and outcomes of new coronavirus infection: preliminary analysis
2. Creator Author's name, affiliation, country Sergey A. Sayganov; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Vadim I. Mazurov; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Igor G. Bakulin; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Elguja L. Lataria; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country S A Artyushkin; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Olga Yu. Chizhova; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Irina A. Ruslyakova; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Natalia A. Prokofieva; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Tatiana S. Fil; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Daridzhan B. Tsurtsumiya; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Sergey V. Tikhonov; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Mariya I. Skalinskaya; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Irina A. Rasmagina; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Marianna K. Alieva; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country E A Trofimov; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Nataliay V. Bakulina; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Elena V. Kolmakova; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Anna D. Sheyko; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
2. Creator Author's name, affiliation, country Lia N. Belousova; North-Western State Medical University named after I.I. Mechnikov; Russian Federation
3. Subject Discipline(s)
3. Subject Keyword(s) new coronavirus infection; SARS-CoV-2 (COVID-19); comorbidity; cytokine storm syndromes; data analysis; therapy
4. Description 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.

5. Publisher Organizing agency, location Eco-Vector
6. Contributor Sponsor(s)
7. Date (DD-MM-YYYY) 21.08.2020
8. Type Status & genre Peer-reviewed Article
8. Type Type Research Article
9. Format File format PDF (Rus),
10. Identifier Uniform Resource Identifier https://journals.eco-vector.com/vszgmu/article/view/34932
10. Identifier Digital Object Identifier (DOI) 10.17816/mechnikov202012227-38
10. Identifier Digital Object Identifier (DOI) (PDF (Rus)) 10.17816/mechnikov34932-28640
10. Identifier Digital Object Identifier (DOI) (PDF (Eng)) 10.17816/mechnikov34932-29177
10. Identifier Digital Object Identifier (DOI) (PDF (简体中)) 10.17816/mechnikov34932-42508
11. Source Title; vol., no. (year) HERALD of North-Western State Medical University named after I.I. Mechnikov; Vol 12, No 2 (2020)
12. Language English=en ru
13. Relation Supp. Files Fig. 1. Antibacterial drugs prescribed before hospitalization (67KB) doi: 10.17816/mechnikov34932-24832
Fig. 2. The structure of concomitant pathology (271KB) doi: 10.17816/mechnikov34932-24833
Fig. 3. Distribution of patients depending on the degree of lung involvement (CT) (42KB) doi: 10.17816/mechnikov34932-24834
Fig. 4. The volume of lung damage according to CT data, depending on the degree of respiratory failure (97KB) doi: 10.17816/mechnikov34932-24835
Fig. 5. The use of different classes of drugs at the hospital stage (48KB) doi: 10.17816/mechnikov34932-24836
Fig. 6. Frequency of use of various anti-cytokine drugs (65KB) doi: 10.17816/mechnikov34932-24837
Fig. 7. The frequency and structure of adverse events in the use of anticytokine drugs (84KB) doi: 10.17816/mechnikov34932-24838
Fig. 8. Outcomes of the disease depending on gender (54KB) doi: 10.17816/mechnikov34932-24839
Fig. 9. Outcomes of the disease depending on body mass index (82KB) doi: 10.17816/mechnikov34932-24840
Fig. 10. Outcomes of the disease depending on the volume of lung damage (according to CT) (48KB) doi: 10.17816/mechnikov34932-24841
14. Coverage Geo-spatial location, chronological period, research sample (gender, age, etc.)
15. Rights Copyright and permissions Copyright (c) 2020 Sayganov S.A., Mazurov V.I., Bakulin I.G., Lataria E.L., Artyushkin S.A., Chizhova O.Y., Ruslyakova I.A., Prokofieva N.A., Fil T.S., Tsurtsumiya D.B., Tikhonov S.V., Skalinskaya M.I., Rasmagina I.A., Alieva M.K., Trofimov E.A., Bakulina N.V., Kolmakova E.V., Sheyko A.D., Belousova L.N.
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