DOI: https://doi.org/10.22263/2312-4156.2020.3.69
Pryshchepenka V.A., Yupatau H.I., Okulich V.K.
Prognostication of the severe disease course in patients with viral pneumonia presumably caused by COVID-19
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2020;19(3):69-78.
Abstract.
Objectives. To assess the likelihood of a severe course of the disease and the need for oxygen support in patients with viral pneumonia, presumably caused by the COVID-19 virus, when a patient is admitted to a healthcare organization to solve the issue concerning the redistribution of patients movement in healthcare organizations.
Material and methods. Dynamic monitoring was conducted in 81 patients with mild to moderate viral pneumonia, as well as 43 patients with severe course requiring oxygen support and intensive care.
Results. In patients with severe viral pneumonia, relative and absolute lymphopenia, relative and absolute neutrophilia with a shift of the leukocyte formula to the left, increased ESR, hypoproteinemia, hyperglycemia, increased levels of AST, ALT, creatine phosphokinase-MV, LDH, urea, creatinine, electrolyte disturbances were revealed compared to patients with mild to moderate disease course (p<0.05). The age of patients with a severe course of the disease was 45 years and older (p<0.05). In addition, patients with bilateral lung damage are more likely to have a severe course of the disease (p <0.05). Based on the established data, a scale for assessing the likelihood of viral pneumonia was developed, which allows to predict the development of a severe course of the disease with the need for intensive therapy and continuous oxygen support in the form of oxygen insufflation through the face mask or a mechanical ventilation during the first 6 days from the admission to the hospital (or – 133.1, sensitivity – 92.11; specificity – 91.25; p<0.0001). Conclusions. The scale for assessing the likelihood of a severe course of the disease will allow to reveal severely ill patients, to redistribute patients’ flows between healthcare organizations, and to assess the necessity for vacant beds in the «oxygen chambers» and / or intensive care units.
Key words: viral pneumonia, COVID-19, prognosis, SARS-Covid, severe pneumonia.
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Information about authors:
Pryshchepenka V.A. – lecturer of the Chair of Internal Diseases Propedeutics, Vitebsk State Order of Peoples’ Friendship Medical University,
ORCID: https://orcid.org/0000-0003-1097-918X
Yupatau H.I. – Doctor of Medical Sciences, professor, head of the Chair of Internal Diseases Propedeutics, Vitebsk State Order of Peoples’ Friendship Medical University;
Okulich V.K. – Candidate of Medical Sciences, associate professor of the Chair of Clinical Microbiology, Vitebsk State Order of Peoples’ Friendship Medical University,
ORCID: https://orcid.org/0000-0002-8226-6405
Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Internal Diseases Propedeutics. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Viachaslau A. Pryshchepenka.
