Critical values of laboratory tests in outcomes of patients with covid-19

Laboratory monitoring during the SARS-CoV-2 pandemic is essential in providing emergency care to patients with COVID-19. Objective. To determine the critical values of laboratory tests in patients with COVID-19 pneumonia for optimizing the treatment. Material and methods. Case histories of 6151 patients were retrospectively analyzed at the St.-Petersburg City Multi-field Hospital No. 2 redesigned for providing medical care to COVID-19 patients between March 30, 2020 and July 26, 2020. All patients were retrospectively divided into 3 groups: group 1 — patients without mechanical ventilation (n=5646 (92%));group 2 — invasive mechanical ventilation without lethal outcome (n=69 (1%));group 3 — invasive mechanical ventilation with lethal outcome (n=436 (7%)). Results. Considering literature data, we distinguished the following perspective tests: ferritin, leukocyte count, absolute neutrophil count, absolute lymphocyte count, platelet count, C-reactive protein, alanine aminotransferase, aspartate aminotransferase, total bilirubin, troponin I, creatinine, and urea. Medians and 25— 75% percentiles were calculated for all laboratory tests in 3 groups. We compared the results between all groups and assessed their reference intervals for the final choice of critical values. Conclusion. The authors propose to use their results as reference critical values of laboratory tests for assessing the condition of patients with COVID-19 pneumonia. © 2021, Media Sphera Publishing Group. All rights reserved.

One hundred questionnaires from repurposed hospitals: With what forces and means did we fight the «second wave» of covid-19?

In November-December 2020, the Federation of Anesthesiologists and Reanimatologists has conducted a survey of intensive care units (ICU) in 100 hospitals re-profiled for the treatment of COVID-19. There were regional (n=44), city (n=31), district (n=13), inter-district (n=8) and federal (n=4) hospitals from 27 constituent entities of the Russian Federation. Capacity of 59 hospitals was less than 300 beds, 23 hospitals — over 500 beds, 18 hospitals — 300—500 beds. The number of ICU beds exceeded 10% of repurposed beds in 35 hospitals, 5—10% of ICU beds — in 51 hospitals, less than 5% — in 14 hospitals. There were 6—12 patients per one physician in 68 ICUs, less than 6 patients — in 12 ICUs, over 12 patients — in 20 ICUs. Also, there were 3-6 patients per a nurse in 69 ICUs, less than 3 patients — in 2 ICUs, over 6 patients — in 29 ICUs. Over 70% of the repurposed beds were provided with a networked oxygen supply in 61 hospitals, 50—70% — in 25 hospitals, less than 50% — in 14 hospitals. Oxygen flow rate over 10 l/min was provided in 70 hospitals, 5—10 l/min — in 28 hospitals, less than 5 l/min — in 2 hospitals. Over 80% of ICU beds are equipped with ventilators in 78 hospitals, 50—80% — in 15 hospitals, less than 50% — in 7 hospitals. Less than 5% of ventilators have been out of order throughout the pandemic in 62 ICUs, 5—10% — in 20 departments, over 10% — in 18 ICUs. High-flow oxygen therapy was not available in 48 ICUs, ultrasound — in 10 ICUs. ECMO was available only in 17 ICUs. If we consider the pandemic as a model of health system response to non-standard global challenges, these data are essential for critical analysis despite small sample size. © 2021, Media Sphera Publishing Group. All rights reserved.

Results and Prospects of Using Activator of Hematopoietic Stem Cell Differentiation in Complex Therapy for Patients with COVID-19.

The paper presents the results of a standard and complex treatment method using the peptide drug thymus thymalin in patients with COVID-19. One of the mechanisms of the immunomodulatory effect of thymalin is considered to be the ability of this peptide drug to influence the differentiation of human hematopoietic stem cells (HSCs). It was found that, as a result of standard treatment, patients in the control group showed a decrease in the concentration of the pro-inflammatory cytokine IL-6, C-reactive protein, D-dimer. The addition of thymalin to standard therapy accelerated the decline in both these indicators and the indicators of the T cell system. This has helped reduce the risk of blood clots in COVID-19 patients. The revealed properties of the thymus peptide preparation are the rationale for its inclusion in the complex treatment of coronavirus infection. Peptideswith potential biological activity against SARS-CoV-2 virus [29]. Note: Nitrogen atoms are shown in blue, oxygen atoms - in red, carbon atoms - in gray, hydrogen atoms - in white, and phosphorus atoms - in yellow.