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Relevance. Currently, there is a significant increase in the combination of infectious and non-infectious pathology. as well as increasing the attention of researchers to this problem. The purpose. of this article is to review scientific data on the combination of the new coronavirus infection COVID-19 with infectious and non-infectious pathology and to assess the phenomenon of complex comorbidity in relation to this new infection. Results. It was found that patients 60 years and older-all have complex comorbidity, which increases the risk of death by more than 7 times, and the presence of two or more comorbid diseases in patients compared with patients who had no more than one disease, the risk of death increased by 9 times. Conclusion. A high potential of combination with COVID-19 is shown, primarily with tuberculosis, HIV infection, hepatitis B and C, as well as with a large group of opportunistic infections. © Shkarin VV, et al.
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The international AKTIV register presents a detailed description of out-and inpatients with COVID-19 in the Eurasian region. It was found that hospitalized patients had more comorbidities. In addition, these patients were older and there were more men than among outpatients. Among the traditional risk factors, obesity and hypertension had a significant negative effect on prognosis, which was more significant for patients 60 years of age and older. Among comorbidities, CVDs had the maximum negative effect on prognosis, and this effect was more significant for patients 60 years of age and older. Among other comorbidities, type 2 and 1 diabetes, chronic kidney disease, chronic obstructive pulmonary disease, cancer and anemia had a negative impact on the prognosis. This effect was also more significant (with the exception of type 1 diabetes) for patients 60 years and older. The death risk in patients with COVID-19 depended on the severity and type of multimorbidity. Clusters of diseases typical for deceased patients were identified and their impact on prognosis was determined. The most unfavorable was a cluster of 4 diseases, including hypertension, coronary artery disease, heart failure, and diabetes mellitus. The data obtained should be taken into account when planning measures for prevention (vaccination priority groups), treatment and rehabilitation of COVID-19 survivors.
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The organizer of the registers “Dynamics analysis of comorbidities in SARS-CoV-2 survivors” (AKTIV) and “Analysis of hospitalizations of comorbid patients infected during the second wave of SARS-CoV-2 outbreak” (AKTIV 2) is the Eurasian Association of Therapists (EAT). Currently, there are no clinical registries in the Eurasian region designed to collect and analyze information on long-term outcomes of COVID-19 survivors with comorbid conditions. The aim of the register is to assess the impact of a novel coronavirus infection on long-term course of chronic non-communicable diseases 3, 6, 12 months after recovery, as well as to obtain information on the effect of comorbidity on the severity of COVID-19. Analysis of hospitalized patients of a possible second wave is planned for register “AKTIV 2”. To achieve this goal, the register will include men and women over 18 years of age diagnosed with COVID-19 who are treated in a hospital or in outpatient basis. The register includes 25 centers in 5 federal districts of the Russian Federation, centers in the Republic of Armenia, the Republic of Kazakhstan, the Republic of Kyrgyzstan, the Republic of Belarus, the Republic of Moldova, and the Republic of Uzbekistan. The estimated capacity of the register is 5400 patients.
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Relevance. The COVID-19 pandemic is characterized by a long undulating course. One of the directions of the dynamic assessment of the incidence of this infection is, as is known, the characterization of the determinants of the epidemic process and the study of the actual effectiveness of various measures. Aims. Were to study the features of the COVID-19 morbidity in the European, American and Asian regions of the world on the example of individual countries with an assessment of the possible impact of regime-restrictive measures on the daily increase in cases. Materials & methods. A descriptive epidemiological study involved the use of the following data on COVID-19: daily increase in new infections in absolute numbers and relative indicators during 1 June 2020 till 30 November 2020 in five countries (France, Italy, USA, Brazil, India), description and timing of various restrictive measures. Information obtained from open sources (situation reports from WHO, CDC, ECDC, national ministries of health, etc.). Time series characterized, defining sharply differing values, timing and duration of ups and downs, the rate of average daily growth (decline). Statistical analysis was carried out using the IBM SPSS Statistics 26. Results. On average, for the analyzed period of time, 1303 were registered in Italy, 4897, France – 52799, Brazil – 31853, India –50507new cases. The average incidence rate in the compared countries ranged from 500.98 ± 417.06 per 100,000 in India to 4399.43 ± 2390.77 per 100,000 in the US. After the passage of the «first wave» of the incidence of COVID-19, regardless of the region of the world, there was an increase in the daily increase in new cases of SARS-CoV-2 in the summer-autumn period of 2020. Furthermore, with the differences in the morbidity rates in the different countries, there were also characteristics the formation of similar to the region. For the European region (Italy, France), there was a simultaneous beginning of an increase in the incidence in August-September 2020, a similar trend towards exponential growth and synchronous fluctuations in the daily increase in absolute cases of diseases. For the countries of the American region (USA and Brazil), a similar sinusoidal nature of the dynamics of the average daily increase in infection cases and its synchronicity until October 2020 was revealed. The Asian region, on the example of India, had significant differences in the dynamics of the analyzed indicators in comparison with the countries of the European and American regions. Differences in the formation of morbidity in the summer-autumn period were more pronounced between the regions and related to the level of average daily growth, the incidence rate, the month of the maximum rise in the incidence in this period, and trend differences. Comparison of the ongoing isolation measures with the daily increase in cases revealed their discrepancy. This could create the preconditions for the activation of the epidemic process of infection and the ineffectiveness of measures. Conclusions. We found that in the five countries examined, the situation developed according to a similar scenario. Nevertheless, in different regions of the world there was a specificity in the involvement of the territory in the epidemic process. A more in-depth study of the timeliness and completeness of regime-restrictive measures against SOCID-19 should include a comparison with the patterns of formation and manifestations of the epidemic process. In turn, this is important for scientifically based implementation and increasing their effectiveness. © 2021, Numikom. All rights reserved.
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COVID-19 is a severe infection with high mortality. The concept of the disease has been shaped to a greater extent on the basis of large registers from the USA, Spain, Italy, and China. However, there is no information on the disease characteristics in Caucasian patients. Therefore, we created an international register with the estimated capacity of 5,000 patients - Dynamics Analysis of Comorbidities in SARS-CoV-2 Survivors (AKTIV SARS-CoV-2), which brought together professionals from the Russian Federation, Republic of Armenia, Republic of Kazakhstan, and Kyrgyz Republic. The article presents the first analysis of the register involving 1,003 patients. It was shown that the most significant difference of the Caucasian population was the higher effect of multimorbidity on the mortality risk vs other registers. More pronounced effect on mortality of such diseases as diabetes, obesity, hypertension, chronic kidney disease, and age over 60 years was also revealed. COVID-19 - тяжелое инфекционное заболевание с высоким риском летального исхода. Представление о болезни во многом сформировано на основании крупных регистров, выполненных в США, Испании, Италии, КНР. Однако к настоящему времени нет данных по особенностям протекания болезни у пациентов евроазиатского региона. В связи с этим был создан международный регистр, расчетная мощность которого составляет 5000 пациентов, “Анализ динамики Коморбидных заболеваний у пациенТов, перенесшИх инфицироВание SARS-CoV-2” (AКТИВ SARS-CoV-2), работа в котором объединила специалистов Российской Федерации, Республики Армения, Республики Казахстан и Кыргызской Республики. В статье представлен первый анализ регистра, который включил данные 1003 пациентов. Показано, что самым значимым отличием евроазиатской популяции пациентов оказалось гораздо большее влияние полиморбидности на риск летального исхода в сравнении с другими регистрами, а также более выраженное влияние на риск летального исхода в евроазиатской популяции таких заболеваний, как сахарный диабет, ожирение, артериальная гипертензия, хроническая болезнь почек и возраста старше 60 лет.
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Predicting the development of epidemic infection caused by the COVID-19 coronavirus is a matter of the utmost urgency for health care and effective anti-epidemic measures. Given the rapidly changing initial information and the ambiguous quality of data coming from various sources, it is important to quickly optimize the existing prognostic models by using more sophisticated algorithms. The aim of the study is to test the originally developed mathematical algorithms for predicting the development of the COVID-19 epidemic process. MATERIALS AND METHODS: To assess the situation in China, Italy, and the USA, we used the information from Russian- and English-language sources available in official websites. The generally accepted descriptive statistics were used; mathematical modeling was based on linear regression. Statistical data processing was performed using the IBM SPSS Statistics 24.0 and R (RStudio) 3.6.0. RESULTS: We found significant differences not only in the incidence rate of COVID-19 in the countries in question, but also in the death rate. The risk of death associated with COVID-19 is high due to the high number of severe clinical cases of the disease reported from these countries.Two preliminary regression models were created. The first, initial model was based on the increase in new cases of infection - this factor was significantly associated with the outcome; the regression coefficient was 0.02 (95% CI 0.01-0.03). In the second, expanded model, in addition to the increase in new cases, the increase in the number of severe forms of infection was also considered; the regression coefficients were 0.017 (95% CI 0.012-0.022) and 0.01 (95% CI 0.008-0.011), respectively. Adding the second variable contributed to a more accurate description of the available data by the model. CONCLUSION: The developed regression models for infection control and predicting the number of lethal outcomes can be successfully used under conditions of spreading diseases from the group of "new infections" when primary data received from various sourced are changing rapidly and updates of the information are continually required. In addition, our initial model can produce a preliminary assessment of the situation, and the expanded model can increase the accuracy and improve the analytic algorithm.