scholarly journals The value of indicators characterizing the state of the cardiovascular system in assessing the hospital prognosis of COVID-19 patients

Kardiologiia ◽  
2021 ◽  
Vol 61 (10) ◽  
pp. 26-35
Author(s):  
I. V. Kovtyukh ◽  
G. E. Gendlin ◽  
I. G. Nikitin ◽  
A. M. Baymukanov ◽  
A. E. Nikitin ◽  
...  

Background     Heart damage is one of complications of the novel coronavirus infection. Searching for available predictors for in-hospital death and survival that determine the tactic of managing patients with COVID-19, is a challenge of the present time.Aim      To determine the role echocardiographic (EchoCG) parameters in evaluation of the in-hospital prognosis for patients with the novel coronavirus infection, COVID-19.Material and methods  The study included 158 patients admitted for COVID-19. EchoCG was performed for all patients. The role of left ventricular (LV) ejection fraction (EF) was analyzed in various age groups. EchoCG data were compared with the clinical picture, including the severity of respiratory failure (RF), blood oxygen saturation (SрО2), data of computed tomography (CT) of the lungs, and blood concentration of troponin. Comorbidity was analyzed, and the highest significance of individual pathologies was determined.Results LV EF ≤40 % determined the worst prognosis of patients with COVID-19 (p<0.0001), including the age group older than 70 years (р=0.013). LV EF did not correlate with the degree of lung tissue damage determined by CT upon admission (р=0.54) and over time (р=0.23). The indexes that determined an adverse in-hospital prognosis to a considerable degree were pericardial effusion (p<0.0001) and pulmonary hypertension (p<0.0001). RV end-diastolic dimension and LV end-diastolic volume did not determine the in-hospital mortality and survival. Blood serum concentration of troponin I higher than 165.13 µg/l was an important predictor for in-hospital death with a high degree of significance (р<0.0001). Th degree of RF considerably influenced the in-hospital mortality (р<0.0001). RF severity was associated with LV EF (р=0.024). The SpO2 value determined an adverse immediate prognosis with a high degree of significance (р=0.0009). This parameter weakly correlated with LV EF (r=0.26; p=0.0009). Patients who required artificial ventilation (AV) constituted a group with the worst survival rate (р<0.0001). LV EF was associated with a need for AV with a high degree of significance (р=0.0006). Comorbidities, such as chronic kidney disease, postinfarction cardiosclerosis and oncologic diseases, to the greatest extent determined the risk of fatal outcome.Conclusion      EchoCG can be recommended for patients with COVID-19 at the hospital stage to determine the tactics of management and for the in-hospital prognosis.

2021 ◽  
Vol 65 (11-12) ◽  
pp. 27-37
Author(s):  
A. V. Ershov ◽  
V. D. Surova ◽  
V. T. Dolgikh ◽  
T. I. Dolgikh

The aim of the study was to identify the role of cytokine storm in COVID-19, that emerged at the end of 2019, based on the analysis of 80 publications, including 17.4% Russian and 82.6% foreign publications for 2014–2020 with an average impact factor of 11.94 and a maximum of 74.699. This review includes an in-depth discussion of the possible causes and pathogenetic factors of cytokine storm syndrome development caused by COVID-19. The results of research on the use of various principles of cytokine storm correction are provided. It has been established that lung damage and the development of a fatal outcome are caused not by the virus itself, but by the hyperreaction of the body's immune system. The leading role in this process belongs to the cytokine storm, including the action of IL-6.


2020 ◽  
Author(s):  
Zhihua Yu ◽  
Yuhe Ke ◽  
Jiang Xie ◽  
Hao Yu ◽  
Wei Zhu ◽  
...  

Abstract Background:Novel coronavirus disease(COVID-19)has become a worldwide pandemic and precise fatality data by age group are needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death.Methods:A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12th and 19th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was 31st March 2020.Results:The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation(SpO2) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P<0.05) than patients who recovered. Male sex (odds ratio [OR]=13.1, 95% confidence interval[CI] 1.1 to 160.1, P=0.044), body temperature >37.3°C (OR=80.5, 95% CI 4.6 to 1407.6, P=0.003), SpO2≤90% (OR=70.1, 95% CI 4.6 to 1060.4, P=0.002), and NT-proBNP>1800ng/L (OR=273.5, 95% CI 14.7 to 5104.8, P<0.0001) were independent risk factors of in-hospital death. Conclusions:In-hospital fatality among COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO2, and NT-proBNP.


2020 ◽  
pp. 29-35
Author(s):  
A. S. Kaisinova ◽  
A. N. Semukhin ◽  
A. V. Abramtsova ◽  
N. V. Efimenko ◽  
D. I. Velikanov ◽  
...  

The purpose of the study is to develop a medical rehabilitation program for the patients who have come through a new coronavirus infection in the resort of Pyatigorsk. Material and methods. In the conditions of the health center named after S.M. Kirov in Pyatigorsk, a branch of FSBI NCFSCC FMBA of Russia, there have been observed 52 patients who had the new coronavirus infection COVID-19 of moderate severity, at the age from 18 up to 65 years old. Two groups have been formed by simple randomization: in the main group, the patients received normoxic barotherapy against the background of traditional spa therapy for pulmonary patients; in the control group, the patients had only conventional therapy. Results. The inclusion of normoxic barotherapy in the complex of medical rehabilitation of patients who came through the novel coronavirus infection contributed to the increase of tolerance to exercise and improved blood oxygen saturation in 92,9 % of cases, restoration of impaired functions of bronchopulmonary apparatus in 89,3 % and physical and mental health in 85.7 % of cases, which was significantly higher in comparison to similar indicators in the control group. Conclusion. Medical rehabilitation of patients after the new coronavirus infection in the resort is justified and advisable.


2021 ◽  
Vol 31 (5) ◽  
pp. 671-676
Author(s):  
Nikolay V. Ovsyannikov ◽  
Olga A. Bilevich ◽  
Lyudmila A. Zenkova ◽  
Olga V. Vasilieva

The novel coronavirus (COVID-19) pandemic announced by the World Health Organization in March 2020 has brought new tasks to the medical community that require immediate solutions. Recent studies have shown that invasive aspergillosis associated with coronavirus infection caused by COVID-19 often aggravates the course of the disease and leads to death. The article presents a clinical case of acute invasive aspergillosis in a COVID-19 patient with chronic somatic pathology but no risk factors for developing invasive pulmonary aspergillosis. The disease was progressing rapidly and led to a fatal outcome.Conclusion. In the case presented, invasive pulmonary aspergillosis was diagnosed with the help of histological examination of autopsy material.


2020 ◽  
Author(s):  
Zhihua Yu ◽  
Yuhe Ke ◽  
Jiang Xie ◽  
Hao Yu ◽  
Wei Zhu ◽  
...  

Abstract Background:Novel coronavirus disease(COVID-19)has become a worldwide pandemic and precise fatality data by age group are needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death.Methods:A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12th and 19th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was 31st March 2020.Results:The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation(SpO2) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P<0.05) than patients who recovered. Male sex (odds ratio [OR]=13.1, 95% confidence interval[CI] 1.1 to 160.1, P=0.044), body temperature >37.3°C (OR=80.5, 95% CI 4.6 to 1407.6, P=0.003), SpO2≤90% (OR=70.1, 95% CI 4.6 to 1060.4, P=0.002), and NT-proBNP>1800ng/L (OR=273.5, 95% CI 14.7 to 5104.8, P<0.0001) were independent risk factors of in-hospital death. Conclusions:In-hospital fatality among COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO2, and NT-proBNP.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhihua Yu ◽  
Yuhe Ke ◽  
Jiang Xie ◽  
Hao Yu ◽  
Wei Zhu ◽  
...  

Abstract Background Novel coronavirus disease 2019 (COVID-19) has become a worldwide pandemic and precise fatality data by age group is needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death. Methods A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12th and 19th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was on the 31st March 2020. Results The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation (SpO2) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P < 0.05) than patients who recovered. Male sex (odds ratio [OR] = 13.1, 95% confidence interval [CI] 1.1 to 160.1, P = 0.044), body temperature > 37.3 °C (OR = 80.5, 95% CI 4.6 to 1407.6, P = 0.003), SpO2 ≤ 90% (OR = 70.1, 95% CI 4.6 to 1060.4, P = 0.002), and NT-proBNP> 1800 ng/L (OR = 273.5, 95% CI 14.7 to 5104.8, P < 0.0001) were independent risk factors of in-hospital death. Conclusions In-hospital fatality among elderly COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO2, and NT-proBNP.


2020 ◽  
Author(s):  
Zhihua Yu ◽  
Yuhe Ke ◽  
Jiang Xie ◽  
Hao Yu ◽  
Wei Zhu ◽  
...  

Abstract Background : Novel coronavirus disease(COVID-19)has become a worldwide pandemic and precise fatality data by age group are needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death. Methods : A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12 th and 19 th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was 31 st March 2020. Results : The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation(SpO 2 ) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P<0.05) than patients who recovered. Male sex (odds ratio [OR]=13.1, 95% confidence interval[CI] 1.1 to 160.1, P=0.044), body temperature >37.3°C (OR=80.5, 95% CI 4.6 to 1407.6, P=0.003), SpO 2 ≤90% (OR=70.1, 95% CI 4.6 to 1060.4, P=0.002), and NT-proBNP>1800ng/L (OR=273.5, 95% CI 14.7 to 5104.8, P<0.0001) were independent risk factors of in-hospital death. Conclusions: In-hospital fatality among COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO 2 , and NT-proBNP. Key words : Coronavirus disease; SARS-CoV-2; elderly; death; prediction


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1198-1201
Author(s):  
Syed Yasir Afaque

In December 2019, a unique coronavirus infection, SARS-CoV-2, was first identified in the province of Wuhan in China. Since then, it spread rapidly all over the world and has been responsible for a large number of morbidity and mortality among humans. According to a latest study, Diabetes mellitus, heart diseases, Hypertension etc. are being considered important risk factors for the development of this infection and is also associated with unfavorable outcomes in these patients. There is little evidence concerning the trail back of these patients possibly because of a small number of participants and people who experienced primary composite outcomes (such as admission in the ICU, usage of machine-driven ventilation or even fatality of these patients). Until now, there are no academic findings that have proven independent prognostic value of diabetes on death in the novel Coronavirus patients. However, there are several conjectures linking Diabetes with the impact as well as progression of COVID-19 in these patients. The aim of this review is to acknowledge about the association amongst Diabetes and the novel Coronavirus and the result of the infection in such patients.


Author(s):  
Maksim Leonidovich Maksimov ◽  
Albina Ayratovna Zvegintseva ◽  
Lyudmila Yurievna Kulagina ◽  
Albina Zainutdinovna Nigmedzyanova ◽  
Elvina Ramisovna Kadyseva

A review article is based on current foreign sources. The level of cytokines in the peripheral blood can be increased in many diseases, but in some cases there may be an excess of their normal concentration in tens, hundreds or more times with the development of a peculiar clinical picture, which is based on a systemic inflammatory reaction. In the literature this condition has received the figurative name «cytokine storm», which highlights an extremely violent reaction of the immune system with an unknown (often unfavorable) outcome. Close attention of the scientific world and the public to the problem of extremely high levels of cytokines in the peripheral blood (hypercytokinemia) was drawn due to the high frequency of the cytokine storm in the novel coronavirus infection.


2021 ◽  
Vol 100 (4) ◽  
pp. 74-79
Author(s):  
I.M. Kagantsov ◽  
◽  
V.V. Sizonov ◽  
V.G. Svarich ◽  
K.P. Piskunov ◽  
...  

The novel coronavirus infection (SARS-CoV-2), which first appeared in Wuhan, China in December 2019, has been declared a global pandemic by WHO. COVID-19 affects people of all age groups. The disease in children is usually asymptomatic or mild compared to adults, and with a significantly lower death rates. Data on kidney damage in children with COVID-19, as well as the effect of coronavirus infection on the course of diseases of the genitourinary system, are limited, the risks of contracting a new coronavirus infection in children with significant health problems, including those with chronic kidney disease, remain uncertain. The pandemic has affected the activities of surgeons treating diseases of the urinary system in children. Since the prospects for the end of the pandemic are vague, it is necessary to formulate criteria for selecting patients who can and should be provided with routine care in the pandemic. The purpose of this review is to highlight the features of the clinical manifestations and treatment of children with COVID-19, occurring against the background of previous renal pathology or complicating its course.


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