Clinical Traits of SARS-CoV-2 Infection
https://doi.org/10.22416/1382-4376-2020-30-6-28-39
Abstract
Aim. Analysis of clinical manifestations, laboratory and instrumental examination data in SARS-CoV-2 patients with taking into account the disease severity and outcome.
Materials and methods. The study included 92 patients with confirmed coronavirus infection, including 15 lethal cases, hospitalised at the Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology of the Sechenov University in April 2020. The analysis included demographic data, the presence of concomitant diseases, chest computed tomography (CT) results, laboratory tests (including SARS-CoV-2-diagnostic PCR, general and metabolic blood panels, coagulogram) and the duration of disease.
Results. Patients infected with SARS-CoV-2 usually exhibit lymphopenia (p ≤ 0.001), leucocytosis, the elevated neutrophils (p ≤ 0.05), neutrophil-lymphocyte ratio (p ≤0,05), C-reactive protein (p ≤ 0.05), ferritin (p ≤ 0.05), D-dimer (p ≤ 0.05) and fibrinogen (p ≤ 0.05), altered prothrombin time (p ≤ 0.05) and INR (p ≤ 0.05). In a critical coronavirus infection, the pulmonary lesion exceeds 50% (corresponds to CT3 — CT4). The risk of critical SARS-CoV-2 infection increases with elder age (p ≤ 0.001), associates with the male gender and presence of concomitant diseases, such as obesity (p < 0.01), diabetes mellitus (p < 0.001), hypertension (p ≤ 0.001), CHD (p ≤ 0.001) and atrial fibrillation (p <0.05).
Conclusion. The risk of severe and adverse coronavirus infection is significantly higher in elder comorbid patients.
About the Authors
O. Yu. ZolnikovaRussian Federation
Oksana Yu. Zolnikova — Cand. Sci. (Med.), Ass. Prof., Department of Internal Disease Propaedeutics Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, bld. 1
N. L. Dzhakhaya
Russian Federation
Natalia L. Dzhakhaya — Cand. Sci. (Med.), Assoc. Prof., Chair of Internal Disease Propaedeutics, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, bld. 1
N. D. Potskherashvili
Russian Federation
Nino D. Potskhverashvili — Cand. Sci. (Med.), doctor, Pulmonology Department, Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, bld. 1
K. B. Puzakov
Russian Federation
Kirill B. Puzakov — Cand. Sci. (Med.), Head of the Department of X-ray Diagnostics, Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, bld. 1
O. Yu. Кiseleva
Russian Federation
Olga Yu. Kiseleva — Head of the Department of Resuscitation and Intensive Care, Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, bld. 1
N. I. Kokina
Russian Federation
Nataliya I. Kokina — Cand. Sci. (Med.), Ass. Prof., Department of Internal Disease Propaedeutics; Departmental Head, Pulmonology Department, Clinic for Propaedeutics of Internal Diseases, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, bld. 1
E. R. Buklis
Russian Federation
Elvira R. Buklis —Cand. Sci. (Med.), Physician, Department of Pulmonology, Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, bld. 1
T. V. Roshchina
Russian Federation
Tatiana V. Roshchina — Cand. Sci. (Med.), Physician, Department of Pulmonology, Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, bld. 1
I. I. Коmkova
Russian Federation
Inna I. Komkova — Cand. Sci. (Med.), Physician, Department of Pulmonology, Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology
119435, Moscow, Pogodinskaya str., 1, bld. 1
References
1. www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance
2. https://www.rosminzdrav.ru/ministry/med_covid19
3. Wang D., Hu B., Hu C., Zhu F., Liu X., Zhang J., et al. Clinical characteristics of 138 hospitalized patients with 2019 novelcoronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–9. DOI: 10.1001/jama.2020.1585
4. Yi Y., Lagniton P., Ye S., Li E., Xu R. COVID-19: what has been learned and to be learned about the novel coronavirus disease. Int J Biol Sci. 2020;16(10):1753–66. DOI: 10.7150/ijbs.45134
5. Lunkov V.D., Maevskaya M.V., Tsvetaeva E.K., Mendez A.G., Zharkova M.S., Tkachenko P.E., Ivashkin V.T. Neutrophil to Lymphocyte Ratio as a Predictor of Adverse Outcome in Patients with Decompensated Liver Cirrhosis. Rus J Gastroenterol Hepatol Coloproctol. 2019;29(1):47–61 (In Russ.). DOI: 10.22416/1382-43762019-29-1-47-61
6. Liu J., Liu Y., Xiang P. Lin Pu L., Xiong H., Li Ch., et al. Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. J Transl Med. 2020;18:206. DOI: 10.1186/s12967-02002374-0
7. Xu H., Zhong L., Deng J., Peng J., Dan H., Zeng X., et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci. 2020;12:8. DOI: 10.1038/s41368-020-0074-x
8. Liao Y.C., Liang W.G., Chen F.W., Hsu J.H., Yang J.J., Chang M.S. IL-19 induces production of IL-6 and TNF-alpha and results in cell apoptosis through TNFalpha. J Immunol. 2002;169(8):4288–97. DOI: 10.4049/jimmunol.169.8.4288
9. Fischer K., Hoffmann P., Voelkl S., Meidenbauer N., Ammer J., Edinger M., et al. Inhibitory effect of tumor cell-derived lactic acid on human T cells. Blood. 2007;109(9):3812–9. DOI: 10.1182/blood-2006-07-035972
10. Tan L., Wang Q., Zhang D., Ding J., Huang Q., Tang Y.Q., et al. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther. 2020;5(1):33. DOI: 10.1038/s41392-020-0148-4
11. Ivashkin V.T., Sheptulin A.A., Zolnikova O.Yu., Okhlobystin A.V., Poluektova E.A., Trukhmanov A.S., et al. New Coronavirus Infection (COVID-19) and Digestive System. Rus J Gastroenterol Hepatol Coloproctol. 2020;30(3):7–13 (In Russ.). DOI: 10.22416/1382-4376-2020-30-3-7
12. Liu R., Ma Q., Han H., Su H., Liu F., Wu K., et al. The value of urine biochemical parameters in the prediction of the severity of coronavirus disease 2019. Clin Chem Lab Med. 2020 ;58(7):1121–4. DOI: 10.1515/cclm-2020-0220
13. Ling Y., Xu S.B., Lin Y.X., Tian D., Zhu Z.Q., Dai F.H., et al. Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients. Chin Med J (Engl). 2020;133(9):1039–43. DOI: 10.1097/CM9.0000000000000774
Supplementary files
Review
For citations:
Zolnikova O.Yu., Dzhakhaya N.L., Potskherashvili N.D., Puzakov K.B., Кiseleva O.Yu., Kokina N.I., Buklis E.R., Roshchina T.V., Коmkova I.I. Clinical Traits of SARS-CoV-2 Infection. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020;30(6):28-39. (In Russ.) https://doi.org/10.22416/1382-4376-2020-30-6-28-39