Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya11995410.26442/00403660.2022.11.201402Research ArticlePredictors of severe course of new coronavirus infection (COVID-19): study designMishchenkoTatyana A.poli263@mail.ruhttps://orcid.org/0000-0001-5464-9903ErmakovaPolina A.poli263@mail.ruhttps://orcid.org/0000-0002-6919-8137ErmakovaAnna A.poli263@mail.ruhttps://orcid.org/0000-0002-0723-0189TsellerLyudmila P.poli263@mail.ruhttps://orcid.org/0000-0003-4975-9301RogozhkinaYulia A.poli263@mail.ruhttps://orcid.org/0000-0002-4689-2513VerteletskayaMargarita I.poli263@mail.ruhttps://orcid.org/0000-0001-8461-5165BurakevichOlga A.poli263@mail.ruhttps://orcid.org/0000-0002-9443-770XKardashinaZarina Z.poli263@mail.ruhttps://orcid.org/0000-0002-6525-0620Tyumen State Medical UniversityCity Polyclinic №6Regional Educational and Methodological Center «MIAC»261220229411124612512512202225122022Copyright © 2022, Consilium Medicum2022<p><strong>Aim.</strong> To identify predictors of the severe course of a new coronavirus infection.</p>
<p><strong>Materials and methods. </strong>A retrospective analysis of 120 clinical case histories of patients hospitalized in hospitals in Tyumen with a confirmed diagnosis of COVID-19 within one year (01.08.202001.08.2021) was carried out. The patients were divided into two groups: 1st with a favorable outcome (<em>n=</em>96), 2nd with an unfavorable (fatal) outcome (<em>n=</em>24). For a more complete analysis, scales for assessing the clinical condition of patients (SHOCK-COVID), severity assessment (NEWS2) were used. Information processing was carried out in the IBM.SPSS.Statistics-19 program (USA).</p>
<p><strong>Results. </strong>As a result of the study, the median age for the 1st group was significantly lower (58 years) than for patients of the 2nd group (69 years; <em>p=</em>0.029). A certain set of laboratory parameters for group 2 patients deviate significantly from the reference values (C-reactive protein CRP 7.6 [4.7; 15.2] mg/dl, D-dimer 1.89 [1.36; 5.3] mcg/ml, ferritin 605 [446.7; 792] ng/ml). When analyzed in groups, taking into account the main markers of the severity of the disease, using the V.Yu. Mareev CCAS-COVID (Clinical Condition Assessment Scale) scale, for the 1st group, the sum of the set of parameters was 6 [2; 7] points, which corresponds to the average severity of coronavirus infection, for the 2nd group 13 [9; 16] points severe course. For patients of the 2nd group, a significant increase in the indicators of an unfavorable prognosis was revealed in comparison with the 1st group.</p>
<p><strong>Conclusion. </strong>Thus, in this study, the level of CRP, ferritin, D-dimer, the percentage of lung tissue damage according to computed tomography results, SaO<sub>2</sub> were significantly associated with an unfavorable prognosis.</p>predictorsclinical courseCOVID-19concomitant pathologiesпредикторыклиническое течениеCOVID-19сопутствующие патологии[Министерство здравоохранения РФ. Временные методические рекомендации «Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19)». Версия 6 от 28.04.2020. Режим доступа: https://static-1.rosminzdrav.ru/system/attachments/attaches/000/050/116/original/28042020_%D0%9CR_COVID-19_v6.pdf. Ссылка активна на 20.02.2022 [Ministerstvo zdravookhraneniia RF. Vremennye metodicheskie rekomendatsii "Profilaktika, diagnostika i lechenie novoi koronavirusnoi infektsii (COVID-19)". Versiia 6 ot 28.04.2020. Available at: https://static-1.rosminzdrav.ru/system/attachments/attaches/000/050/116/original/28042020_%D0%9CR_COVID-19_v6.pdf. Accessed: 20.02.2022 (in Russian)].][Попова К.Н., Жуков А.А., Зыкина И.Л., и др. Шкала NEWS2 в практике работы инфекционного госпиталя для больных COVID-19. Внедрение и результаты. Вестник анестезиологии и реаниматологии. 2021;18(1):7-16 [Popova КN, Zhukov AA, Zykina IL, et al. NEWS2 score in the practice of infectious diseases hospital in COVID-19 patients. Implementation and results. Messenger of Anesthesiology and Resuscitation. 2021;18(1):7-16 (in Russian)]. DOI:10.21292/2078-5658-2021-18-1-7-16][Мареев В.Ю., Беграмбекова Ю.Л., Мареев Ю.В. Как оценивать результаты лечения больных с новой коронавирусной инфекцией (COVID-19)? Шкала Оценки Клинического Состояния (ШОКС-КОВИД). Кардиология. 2020;60(11):35-41 [Mareev VYu, Begrambekova YuL, Mareev YuV. How evaluate results of treatment in patients with COVID-19. Symptomatic Hospital and Outpatient Clinical Scale for COVID-19 (SHOCS-COVID). Kardiologiia. 2020;60(11): 35-41 (in Russian)]. DOI:10.18087/cardio.2020.11.n1439][Charlson ME, Pompei P, Ales KL, McKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis. 1987;40(5):373-83. DOI:10.1016/0021-9681(87)90171-8][Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with Coronavirus Disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020;180(7):1-11. DOI:10.1001/jamainternmed.2020.0994][Drucker DJ. Coronavirus infections and type 2 diabetes shared pathways with therapeutic implications. Endocr Rev. 2020;41(3):bnaa011. DOI:10.1210/endrev/bnaa011][Petrilli CM, Jones SA, Yang J, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ. 2020;369:m1966. DOI:10.1136/bmj.m1966][Li B, Yang J, Zhao F, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020;109(5):531-8. DOI:10.1007/s00392-020-01626-9][Wang B, Li R, Lu Z, Huang Y. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging (Albany NY). 2020;12(7):6049-57. DOI:10.18632/aging.103000][Lighter J, Phillips M, Hochman S, et al. Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission. Clin Infect Dis. 2020;71:896-97. DOI:10.1093/cid/ciaa415][Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 Patients. AJR Am J Roentgenol. 2020;215(1):87-93. DOI:10.2214/AJR.20.23034][Глыбочко П.В., Фомин В.В., Моисеев С.В., и др. Исходы у больных с тяжелым течением COVID-19, госпитализированных для респираторной поддержки в отделения реанимации и интенсивной терапии. Клиническая фармакология и терапия. 2020;29(3):25-36 [Glybochko PV, Fomin VV, Moiseev SV, et al. Clinical outcomes of patients with COVID-19 admitted for respiratory support to the intensive care units in Russia. Clinical Pharmacology and Therapy. 2020;29(3):25-36 (in Russian)]. DOI:10.32756/0869-5490-2020-3-25-36][Ларина В.Н., Головко М.Г., Ларин В.Г. Влияние коронавирусной инфекции (COVID-19) на сердечно-сосудистую систему. Вестник Российского государственного медицинского университета. 2020;2:5-13 [Larina VN, Golovko MG, Larin VG. Possible effects of coronavirus infection (COVID-19) on the cardiovascular system. Bulletin of RSMU. 2020;2:5-13 (in Russian)]. DOI:10.24075/vrgmu.2020.020][Андреева А.В., Маркова Т.Н., Анциферов М.Б. Особенности ведения пациентов с сахарным диабетом и COVID-19. Доктор.Ру. 2021;20(2):11-20 [Andreeva AV, Markova TN, Antsiferov MB. Management of Patients with Diabetes Mellitus and COVID-19. Doctor.Ru. 2021;20(2):11-20 (in Russian)]. DOI:10.31550/1727-2378-2021-20-2-11-20][Charpentier E, Soulat G, Fayol A, et al. Visual lung damage CT score at hospital admission of COVID-19 patients and 30-day mortality. Eur Radiol. 2021;31(11):8354-63. DOI:10.1007/s00330-021-07938-2][Lippi G, Favaloro EJ. D-dimer is associated with severity of coronavirus disease 2019: a pooled analysis. Thromb Haemost. 2020;120(5). DOI:10.1055/s-0040-1709650][Zhang L, Yan X, Fan Q, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020;18(6):1324-9. DOI:10.1111/jth.14859][Liu F, Li L, Xu M, et al. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. J Clin Virol. 2020;127:104370. DOI:10.1016/j.jcv.2020.104370][Cheng L, Li H, Li L, et al. Ferritin in the coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. J Clin Lab Anal. 2020;34(10):e23618. DOI:10.1002/jcla.23618]