Open AccessImpact of optimal therapy for noncommunicable diseases on the course and outcome of COVID-19 inpatients
Author(s) -
И А Фролова,
E. I. Tarlovskaya,
С. В. Романов,
Olga P. Abaeva,
А. А. Фролов
Publication year - 2022
Publication title -
rossijskij kardiologičeskij žurnal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.141
H-Index - 14
eISSN - 2618-7620
pISSN - 1560-4071
DOI - 10.15829/1560-4071-2022-4845
Subject(s) - medicine , clinical endpoint , concomitant , covid-19 , intensive care unit , pharmacotherapy , disease , combination therapy , emergency medicine , intensive care medicine , infectious disease (medical specialty) , clinical trial
Aim . To carry out a comparative analysis of the impact of optimal and suboptimal therapy for noncommunicable diseases (NCDs) at the prehospital stage on the severity and outcomes of coronavirus disease 2019 (COVID-19). Material and methods . The study included 158 patients hospitalized with a diagnosis of COVID-19 and having one or more concomitant NCDs. Patients were divided into two groups depending on the quality of initial therapy for NCDs: group 1 — patients receiving treatment that does not meet modern clinical guidelines, taking drugs not regularly or not taking them at all (n=100; 63%), and group 2 — patients receiving treatment in accordance with current clinical guidelines, taking regularly prescribed therapy (n=58; 37%). The primary endpoint was inhospital death, while secondary endpoints — duration of fever, length of intensive care unit (ICU) stay, length of hospital stay. Results . Inhospital mortality was significantly higher in the 1st group of patients compared with the 2nd group (18,0% vs 1,7%, p=0,002). Analysis of secondary endpoints revealed that patients of the 1st group (nonoptimal therapy), in comparison with the 2nd group (optimal therapy), had significantly longer period of fever (10 [7; 12] vs 9 [7; 10] days, p=0,03), longer ICU (0 [0; 3] vs 0 [0; 0] days, p<0,001) and hospital stay (10 [8; 14] vs 8 [7; 11] days, p=0,001). Conclusion . Patients who received standard NCD therapy before admission to the infectious disease hospital, in accordance with current clinical guidelines and who regularly take drugs, have a more favorable course of COVID-19 at the hospital stage and a lower inhospital mortality rate than patients with suboptimal therapy who are not adherent to treatment or not receiving drugs, but having indications for taking them.