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№4' 2020

INFECTIOUS DISEASES

International Medical Journal, Vol. 26., Iss. 4, 2020, P. 76−82.


DOI (https://doi.org/10.37436/2308-5274-2020-4-14)

MAIN PREDICTORS OF CORONAVIRUS DISEASE SEVERITY PROGNOSIS


Bobrova O. V., Mikhanovska N. G., Kryvonos K. A., Vorobyov S. M.

V. N. Karazin Kharkiv National University, Ukraine

Coronavirus disease can have a variety of clinical symptoms, ranged from asymptomatic to severe and even critical ones. To date, an information on the epidemiology, clinical features, prevention and treatment of this disease is insufficient, which requires a further study of the problem. To personalize the treatment, it is important to determine the leading clinical and laboratory predictors to forecast the severity of COVID−19. The algorithm of examination of a patient includes the assessment of all complaints, data of the anamnesis of the disease, epidemiological anamnesis. The combination of clinical examination to determine the severity of the patient's condition includes physical examination, the one of diagnostic material using methods of nucleic acid amplification and / or enzyme−linked immunosorbent assay, pulse oximetry. Laboratory, etiological diagnostics, tests and antibodies play an important role. In case of hospitalization of the patients with moderate, severe and extremely severe infection, clinical studies are required such as: general (clinical) and biochemical blood test, coagulogram, diagnosis of disseminated intravascular coagulation syndrome, as well as identification of risk factors. Instrumental and radiological diagnostics include: pulse oximetry with measurement of SpO2 level, computed tomography and ultrasound examination of lungs and pleural cavities, electrocardiography. Comprehensive evaluation of clinical and laboratory data of patients allows to determine a clinically confirmed COVID−19, to route the patient and to start complex therapy in time. A promising direction is the introduction of the method of quantitative diagnostics by polymerase chain reaction on SARS−CoV−2 RNA in the activity of laboratories of Ukraine, which will help to individualize the degree of viral load in patients, improve treatment control.

Key words: COVID−19, predictors of course severity, methods of laboratory diagnostics, quantitative polymerase chain reaction.


REFERENCES


1. Bassetti M. The Novel Chinese Coronavirus (2019−nCoV) Infections: challenges for fighting the storm https://doi. org/10.1111/eci.13209. URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/eci.13209

2. Koronovіrus COVID−19: zagal'na statistika. URL: https://index.minfin.com.ua/reference/coronavirus/ukraine/2020−07/

3. Coronavirus UP date (live). URL: https://www.worldometers.info/coronavirus/

4. Chest CT Findings in Coronavirus Disease−19 (COVID−19): Relationship to Duration of Infection / A. Bernheim et al. // Radiology. 2020. Vol. 295. № 3. doi: 10.1148/radiol.2020200463

5. Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients with Coronavirus Disease 2019 Pneumonia in Wuhan, China / Ch. Wu et al. // JAMA Intern. Med. Published online March 13, 2020. URL: doi:10.1001/jamainternmed.2020.0994

6. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study / N. Chen et al. // Lancet. 2020. Vol. 180 (7). doi: 10.1016/S0140−6736(20)30211−7

7. Severe acute respiratory syndrome−related coronavirus: The species and its viruses − a statement of the Coronavirus Study Group / A. E. Gorbalenya et al. doi: https://doi.org/10.1101/2020.02.07.9378622020

8. Halyabar O., Chang M. H., Hendserson L. A. Calm in the midst of cytokine storm: a collaborative approach to the diagnosis and treatment of hemophagocytic lymphohistiocytosis and macrophage activation syndrome // Pediatric Rheumatology. 2019. № 17. art. 7. URL: https://ped− rheum.biomedcentral.com/articles/10.1186/s12969−019−0309−6

9. European Commission. Novel coronavirus 2019−nCoV URL: https://ec.europa.eu/health/coronavirus_en

10. FDA. Novel coronavirus (2019−nCoV) URL: https://www.fda.gov/emergency−preparedness−andresponse/mcm−is−sues/novel−coronavirus−2019−ncov

11. Cinical features of patients infected with 2019 novel coronavirus in Wuhan, China / Ch. Huang et al. // Lancet. 2020. Vol. 395, iss. 10223. P. 497−506. doi: 10.1016/S0140−6736(20)30183−5

12. Clinical, laboratory and imaging features of COVID−19: A systematic review and meta−analysis / A. J. Rodriguez−Morales et al. // Travel Medicine and Infectious Disease. 2020. Vol. 34, 101623. doi: https://doi.org/10.1016/j.tmaid.2020.101623

13. Evidence of the COVID−19 Virus Targeting the CNS: Tissue Distribution, Host−Virus Interaction, and Proposed Neurotropic Mechanisms / A. M. Baig et al. // ACS Chem. Neurosci. 2020. doi: 10.1021/acschemneuro.0c00122

14. Public Health England. Investigation and initial clinical management of possible cases of novel coronavirus (2019−nCoV) infection. URL: https://www.gov.uk/government/publications/wuhan−novelcoronavirus−initial−investiga−tion−of−possible−cases/investigation−and−initial−clinical−management−ofpossible−cases−of−wuhan−novel−coronavirus−wn−cov−infection. doi: https://doi.org/10.3390/jcm9020488

15. On the Alert for Cytokine Storm: Immunopathology in COVID−19 / L. A. Henderson et al. // Arthritis & Rheumatology. 2020. 15 April. P. 1−5. https://doi.org/10.1002/art.41285

16. CDC. 2019 Novel Coronavirus. URL: https://www.cdc.gov/coronavirus/2019−ncov/index.html

17. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy / N. Tang et al. // J. Thromb. Haemost. 2020 Mar. 27. doi: 10.1111/ jth.14817

18. Therapeutic and triage strategies for 2019 novel coronavirus disease in fever clinics / J. Zhang et al. // Lancet Respir. Med. 2020. № 8 (3). e11−e12. doi: 10.1016/S2213−2600(20)30071−0

19. Correlation of Chest CT and RT−PCR Testing in Coronavirus Disease 2019 (COVID−19) in China: A Report of 1014 Cases / T. Ai et al. // Radiology. 2020. № 296 (2). doi: 10.1148/ radiol.2020200642

20. Pulmonary rehabilitation guidelines in the principle of 4S for patients infected with 2019 novel coronavirus (2019−nCoV). Article in Chinese / F. Yang et al. // J. Tuberc. Respir. Dis. 2020. Vol. 43 (03). P. 180−182. doi: 10.3760/cma.j.issn.1001−0939.2020.0004

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