मस्तिष्क संबंधी विकार

Features of the Course and Therapy of Viral Infection Covid-19 in a Repurposed Infectious Diseases Hospital for Patients Aged 90 Years and Older

Abstract

Evsikov Evgeny Mikhailovich, Teplova Natalya Vadimovna, Vechorko Valery Ivanovich, Bairova Kermen Ivanovna and Dzheksembekov Aldar

Background: According to WHO statistics for 2020, the risk of acute infection, which can lead to death, increases with age. The median age of patients with COVID-19 is 61 years. Mortality-after 80 years of life is 15%. The literature discusses the difficulties of timely diagnosis of Covid-19 in the elderly, which in most of them are associated with asymptomatic disease and its atypical course.

Goal and tasks: To assess the symptoms, the nature of the course of the pathology and clinical diagnostic data and mortality rates in people aged 90 years and older hospitalized with a diagnosis of COVID-19 in a repurposed emergency hospital in the city of Sochi. Moscow from April 12 to August 3, 2020 Material and methods: We retrospectively analyzed the clinical diagnostic data of 108 patients, including 23 men and 85 women aged 90-98 years,

Material and methods: We retrospectively analyzed the clinical diagnostic data of 108 patients, including 23 men and 85 women aged 90-98 years, on average 92.2 ± 1.7, admitted to the hospital for diagnosis and treatment in the period from 04/12/2020 to 12.04.2020. Until 08/03/2020 with diagnoses according to ICD-10: U07.1 U07.1 Coronavirus infection caused by the COVID-19 virus, virus identified (confirmed by laboratory testing regardless of the severity of clinical signs or symptoms); J12.9 J12.9 Community acquired pneumonia. Patients' data were archived in the city computer system DZM KIS EMIAS of the Department of Health of the city of Moscow.

Results: Pneumonia, which complicated the course of Covid-19 in patients aged 90 years and older, was characterized by a bilateral process-in 85% of them, involving 75-80% of the lung parenchyma-in 19.7% of cases, with the development of hydrothorax-in 53%, with a pathological decrease in oxygen saturation-in 67% of patients. In the treatment and prevention of cardiovascular complications in such patients, heparin therapy (in 70.4%), treatment with beta-blockers (in 41.7%), ACE inhibitors and blockers occupied a large place angiotensin receptors (in 31.5%), diuretics (in 27.8%). The use of antimalarial drugs (in 15.7%) and antiviral agents (in 9.3%) was limited due to the blurring of clinical symptoms, possible cardiotoxicity, and insufficiently substantiated drug efficacy. Lethality in patients with Covid-19 complicated by pneumonia, exceeded in patients aged 90 years and older-55%, which was closely associated with adverse cardiovascular premorbid background in 85.5% of them and required the initiation of inpatient diagnostics and therapy as soon as possible.

Conclusion: Covid-19 complicated by pneumonia in a group of people aged 90 years and older, proceeds with blurred clinical symptoms, with neurological manifestations in 20% and intestinal dysfunction in 6% of patients. High mortality rates at the same time require urgent diagnostic and therapeutic measures in stationary conditions.