RESUMEN
Despite the impressive progress in diagnosis and management of acute COVID-19, data regarding the consequences of this infection are just emerging. The World Health Organization has proposed the term post-COVID condition (PCC) to describe the wide range of sequelae of acute COVID-19. With more than 200 million confirmed cases of COVID-19, PCC may develop into a major problem for many years to come for the millions of COVID-19 survivors worldwide. Few studies were conducted in primary care, and very few studies have focused exclusively on children and adolescents. Objective. To review existing data on PCC. Analysis of manuscripts published in peer-reviewed journals and clinical protocols. PCC is characterized by a wide range of systemic, cardio-pulmonary, gastrointestinal, neurological, and psychosocial symptoms. Conclusion. Although PCC prevalence is difficult to estimate due to methodological limitations of the existing studies, there is no doubt that this problem is a significant healthcare burden. There is a need for further observational and interventional studies to establish optimal PCC prevention and management strategies. © 2021 Vestnik Tomskogo Gosudarstvennogo Universiteta, Matematika i Mekhanika. All rights reserved.
RESUMEN
AIM: In a retrospective study, we evaluated factors associated with the early development of septic shock in patients with severe COVID-19. MATERIALS AND METHODS: We collected medical records of the intensive care unit patients submitted by the local COVID-19 hospitals across Russia to the Federal Center for the Critical Care at the Sechenov First Moscow State Medical University (Sechenov University). Septic shock in crticially ill patients requiring mechanical ventilation was defined as a need in vasopressors to maintain blood pressure. RESULTS: We studied 1078 patients with severe COVID-19 who were admitted to the intensive care units for respiratory support. There were 611 males and 467 females. The mean age was 61.013.7 years. Five hundred twenty five medical records (48.7%) were received from the Moscow hospitals, 159 (14.7%) from the Moscow region, and 394 (36.5%) from the hospitals located in 58 regions of the Russian Federation. In 613 (56.9%) patients, diagnosis of SARS-CoV-2 infection was confirmed by PCR, and in the other cases it was established on the basis of the clinical picture and the results of the chest CT scan. Septic shock developed in 214 (19.9%) of 1078 patients. In the logistic regression model, the risk of septic shock in patients older than 50 years was higher than in patients of a younger age (OR 2.34; 95% CI 1.533.67; p0.0001). In patients with more severe SARS-CoV-2 infection, there was an increase in the prevalence of cardiovascular diseases, including coronary heart disease and atrial fibrillation, type 2 diabetes and malignant tumors. The risk of septic shock in patients with three or more concomitant diseases was higher than in patients without any concomitant chronic diseases (OR 1.76; 95% CI 1.762.70). CONCLUSION: The risk of septic shock in patients with acute respiratory distress syndrome induced by SARS-CoV-2 is higher in patients older than 50 years with concomitant diseases, although a severe course of the disease is also possible in younger patients without any concomitant disorders.