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Prehospital Period in Patients with COVID-19: Cardiovascular Comorbidity and Pharmacotherapy During the First Epidemic Wave (Hospital Registry Data)

https://doi.org/10.20996/1819-6446-2021-12-13

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Abstract

Aim. Based on the data from the register of patients with COVID-19 and community-acquired pneumonia (CAP), analyze the duration of the prehospital period, cardiovascular comorbidity and the quality of prehospital pharmacotherapy of concomitant cardiovascular diseases (CVD).

Material and methods. Patients were included to the study which admitted to the FSBI "NMHC named after N.I. Pirogov" of the Ministry of Health of the Russian Federation with a suspected or confirmed diagnosis of COVID-19 and/or CAP. The data for prehospital therapy, information from medical histories and a patients’survey in the hospital or by telephone contact 1-2 weeks after discharge were study. The duration of the prehospital stage was determined from the date of the appearance of clinical symptoms of coronavirus infection to the date of hospitalization.

Results. The average age of the patients (n=1130; 579 [51.2%] men and 551 [48.8%] women) was 57.5±12.8 years. The prehospital stage was 7 (5,0; 10,0) days and did not differ significantly in patients with the presence and absence of CVD, but was significantly less in the deceased than in the surviving patients, as well as in those who required artificial lung ventilation (ALV). 583 (51.6%) patients had at least one CVD. Cardiovascular comorbidity was registered in 222 (42.7%) patients with hypertension, 210 (95.5%) patients with coronary heart disease (CHD), 104 (91.2%) patients with atrial fibrillation (AF). The inclusion of non-cardiac chronic diseases in the analysis led to an increase in the total proportion of patients with concomitant diseases to 65.8%. Approximately a quarter of hypertensive patients did not receive antihypertensive therapy, a low proportion of patients receiving antiplatelet agents and statins for CHD was revealed – 53% and 31.8%, respectively, anticoagulants for AF – 50.9%.

Conclusion. The period from the onset of symptoms to hospitalization was significantly shorter in the deceased than in the surviving patients, as well as in those who required ALV. The proportion of people with a history of at least one CVD was about half of the entire cohort of patients. In patients with CVD before COVID-19 disease, a low frequencies of prescribing antihypertensive drugs, statins, antiplatelet agents and anticoagulants (in patients with AF) were recorded at the prehospital stage.

About the Authors

S. Yu. Martsevich
National Research Center for Therapy and Preventive Medicine
Russian Federation

Sergey Yu. Martsevich.

Moscow.



M. M. Lukyanov
National Research Center for Therapy and Preventive Medicine
Russian Federation

Mikhail M. Loukianov.

Moscow.



M. M. Pulin
N.I. Pirogov National Medical and Surgical Center
Russian Federation

Andrey A. Pulin.

Moscow.



N. P. Kutishenko
National Research Center for Therapy and Preventive Medicine
Russian Federation

Natalia P. Kutishenko.

Moscow.



E. Yu. Andreenko
National Research Center for Therapy and Preventive Medicine
Russian Federation

Elena Yu. Andreenko.

Moscow.



V. P. Voronina
National Research Center for Therapy and Preventive Medicine
Russian Federation

Victoria P. Voronina.

Moscow.



V. A. Dindikova
National Research Center for Therapy and Preventive Medicine
Russian Federation

Valeria A. Dindikova.

Moscow.



N. A. Dmitrieva
National Research Center for Therapy and Preventive Medicine
Russian Federation

Nadezhda A. Dmitrieva.

Moscow.



A. V. Zagrebelnyy
National Research Center for Therapy and Preventive Medicine
Russian Federation

Alexander V. Zagrebelnyy.

Moscow.



O. V. Lerman
National Research Center for Therapy and Preventive Medicine
Russian Federation

Olga V. Lerman.

Moscow.



A. N. Makoveeva
National Research Center for Therapy and Preventive Medicine
Russian Federation

Anna N. Makoveeva.

Moscow.



E. Yu. Okshina
National Research Center for Therapy and Preventive Medicine
Russian Federation

Elena Yu. Okshina.

Moscow.



A. A. Smirnov
National Research Center for Therapy and Preventive Medicine
Russian Federation

Alexander A.Smirnov.

Moscow.



E. V. Kudryashov
National Research Center for Therapy and Preventive Medicine
Russian Federation

Egor V. Kudryashov.

Moscow.



I. V. Budaeva
National Research Center for Therapy and Preventive Medicine
Russian Federation

Irina V. Budaeva.

Moscow.



E. S. Nikoshnova
National Research Center for Therapy and Preventive Medicine
Russian Federation

Elena S. Nikoshnova.

Moscow.



O. E. Karpov
N.I. Pirogov National Medical and Surgical Center
Russian Federation

Oleg E. Karpov.

Moscow.



O. M. Drapkina
National Research Center for Therapy and Preventive Medicine
Russian Federation

Oxana M. Drapkina.

Moscow.



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Review

For citation:


Martsevich S.Yu., Lukyanov M.M., Pulin M.M., Kutishenko N.P., Andreenko E.Yu., Voronina V.P., Dindikova V.A., Dmitrieva N.A., Zagrebelnyy A.V., Lerman O.V., Makoveeva A.N., Okshina E.Yu., Smirnov A.A., Kudryashov E.V., Budaeva I.V., Nikoshnova E.S., Karpov O.E., Drapkina O.M. Prehospital Period in Patients with COVID-19: Cardiovascular Comorbidity and Pharmacotherapy During the First Epidemic Wave (Hospital Registry Data). Rational Pharmacotherapy in Cardiology. 2021;17(6):873-879. (In Russ.) https://doi.org/10.20996/1819-6446-2021-12-13

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)