I.V. NIKOLAEVA¹, S.E. GUSEVA¹, M.R. GATAULLIN², YU.M. SOZINOVA^1, 2, B.SH. FATKULLIN², L.R. GAYNATULLINA², I. V. SHESTAKOVA³

 ¹Kazan State Medical University, Kazan

²Republic infectious Clinical Hospital named after Prof. A.F. Agafonov, Kazan

³Infectious Clinical Hospital No. 3, Moscow

 Contact details:

Nikolaeva I.V. — MD, Professor, Head of the Department of Infectious Diseases

Address: 49 Butlerov St., Kazan, Russian Federation, 420110, tel.: +7 (843) 267-80-71, e-mail: irinanicolaeva@mail.ru

 We analyzed 72 cases of patients with severe and extremely severe forms of COVID-19 and 62 cases of patients with a moderate form of the disease (control group) hospitalized in the Republican Clinical Infectious Diseases Hospital, Kazan, in 2020. Cases were selected by random sampling. Among patients with a severe form of COVID-19 non-working people over 60 years old (79.2%) with concominant pathology (91.7%) prevailed, of which 53% were women and 47% were men. Obesity occurred in 50% of cases, arterial hypertension in 80.6%, diabetes mellitus in 45.8%, coronary heart disease and post infarction cardiosclerosis in 33%, chronic cerebral ischemia — in 11%, chronic kidney disease — in 8.3%, combined comorbid pathology — in 72.2% of cases. The development of severe forms of COVID-19 was not associated with the later terms of patients’ hospitalization or the peculiarities of antiviral therapy at the outpatient stage. 50-69% of patients with COVID-19 received antibiotics unnecessarily at the outpatient stage. Among patients with a severe form of the disease, the temperature was normal or subfebrile in 19.4% of cases. The duration of positive PCR among patients with severe COVID-19 was 10–14 days in 26.3% and more than 15 days in 5.2% of cases. Cardiovascular insufficiency developed in 55.8% of cases, multiple organ failure in 53.5%, acute respiratory distress syndrome in 53% of patients with severe course. Saturation restored in 43% cases of severe COVID-19 within 25 days, in 37% cases desaturation persisted for more than 25 days. Patients with severe forms of COVID-19 had an increased level of C-reactive protein 148.32 (8–497) mg/l, D-dimers 4206.87 (182–30 008) mg/ml, glucose 10.87 (2–37.59) mmol/l, creatinine 137.84 (37–669) mmol/l, neutrophilia 6.64 (1.8–10.5) x 109/l and lymphopenia 2.13 (0.5–3.5) x 109/l.

Conclusion. Elderly and obese patients, as well as patients with comorbid pathologies (hypertension, diabetes mellitus, cardiovascular diseases) were more likely to develop severe cases. A significant increase of CRP, D-dimers, glucose, creatinine and lymphopenia were important markers of severe forms of COVID-19.

Key words: COVID-19, SARS-CoV-2, severe form.

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