Русский
Dynamics of the main demographic and clinical characteristics of COVID-19: The experience of a Moscow regional infectious diseases hospital converted at the beginning of the pandemic
DOI: https://dx.doi.org/10.18565/epidem.2021.11.1.25-9
Stashko T.V., Meskina E.R., Shilkina I.M., Osipov A.A.
1) M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia; 2) Domodedovo Central Town Hospital, Domodedovo, Moscow Region, Russia
Materials and methods. Data on hospitalizations from the conversion of the first specialized hospital for COVID-19 were retrospectively analyzed, by assessing the age and gender of the patients, comorbidity, nosological entity, disease severity, hospitalization length, and the need for mechanical ventilation. Diagnosis of the forms of COVID-19 severity and treatment of patients were done according to the Temporary Guidelines of the Ministry of Health of the Russian Federation.
Results. Prior to the spread of SARS-CoV-2, the unit worked as an observation facility for hospitalizations of citizens with acute respiratory viral infections from Moscow airports. A total of 662 patients (315 men and 347 women), including 89.2% of Russian citizens, were hospitalized with suspected novel coronavirus infection in January to June 2020. As the pandemic spread, the patients’ mean age increased progressively, and the number of patients with concomitant diseases rose. However, the hospitalization rate did not change substantially for patients with grades 2–3 respiratory insufficiency. The maximum number of oxygen-dependent persons was recorded in April and May (52.2–52.7%). Hospitalized patients who for the first time required mechanical ventilation in April accounted for 9.5%; these in May were maximum (13.2%). The daily load of newly hospitalized patients in April and May was approximately the same: (8.2 and 8.3 patients per day, respectively); in June it decreased slightly and amounted to 6.4 patients per day.
Conclusion. The example of the first converted unit shows a clear stage-by-stage organizational response to the spread of COVID-19 in the Moscow Region. At the peak of morbidity, hospitalization of patients with severe forms of the disease and high-risk factors in specialized hospitals is justified. Hospitalization of patients over 65 years of age with severe comorbid diseases and a low probability of COVID-19 in specially designated hospitals can be useful for optimizing routing and providing specialized medical care.
Literature
1. Wang Y., Wang Y., Chen Y., Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J. Med. Virol. 2020; 92(6): 568–76. doi: 10.1002/jmv.25748 2. Miller I.F., Becker A.D., Grenfell B.T., Metcalf C.J.E. Disease and healthcare burden of COVID-19 in the United States. Nat. Med. 2020. doi: 10.1038/s41591-020-0952-у 3. Geographic distribution of COVID-19. European Centre for Disease Prevention and Control. https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases 4. Nussbaumer-Streit B., Mayr V., Dobrescu A.I., Chapman A., Persad E., Klerings I. et al. Quarantine alone or in combination with other public health measures to control COVID-19: a rapid review. Cochrane Database Syst. Rev. 2020; 4(4): CD013574. doi: 10.1002/14651858.CD013574 5. Islam N., Sharp S.J., Chowell G., Shabnam S., Kawachi I., Lacey B. et al. Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries. BMJ 2020; 370: m2743. doi: 10.1136/bmj.m2743 6. Choi J.Y. COVID-19 in South Korea. Postgrad. Med. J. 2020; 96(1137): 399–402. doi:10.1136/postgradmedj-2020-137738 7. Grant M.C., Geoghegan L., Arbyn M., Mohammed Z., McGuinness L., Clarke EL et al. The prevalence of symptoms in 24,410 adults infected by the novel coronavirus (SARS-CoV-2; COVID-19): A systematic review and meta-analysis of 148 studies from 9 countries. PLoS ONE 2020; 15(6): e0234765. https://doi.org/10.1371/journal.pone. 0234765 8. Madjid M., Safavi-Naeini P., Solomon S.D., Vardeny O. Potential Effects of Coronaviruses on the Cardiovascular System: A Review. JAMA Cardiol. 2020; (10): 1001. doi:10.1001/jamacardio.2020.1286 9. Liang W., Liang H., Ou L., Chen B., Chen A., Li C., et al. Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19. JAMA Intern. Med. 2020: e202033. doi: 10.1001/jamainternmed.2020.2033
About the Autors
Tatiana V. Stashko, Junior Researcher, Unit for Childhood Infections, Department of Therapy, M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia; stashko.tatyana@mail.ru; https://orcid.org/0000-0001-9654-9863
Elena R. Meskina, MD; Head, Unit for Childhood Infections, Department of Therapy, M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia; meskinaelena@rambler.ru; https://orcid.org/0000-0002-1960-6868
Irina M. Shilkina, Head, Unit for Infections, Domodedovo Central Town Hospital; Principal Out-of-Staff Infectiologist, Ministry of Health of the Moscow Region, Domodedovo, Moscow Region, Russia; shim-48@mail.ru
Andrey A. Osipov, Chief Doctor, Domodedovo Central Town Hospital; Domodedovo, Moscow Region, Russia; dcgb1@mail.ru
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