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The timing of referral and the severity of condition in patients with lung damage and suspected novel coronavirus infection on admission to hospital during the beginning of the pandemic


E. Vdoushkina*, Candidate of Medical Sciences; Professor E. Borodulina**, MD; L. Povalyaeva,
Candidate of Medical Sciences; A. Sukhanova; K. Zhilinskaya; A. Sutyagin Samara State Medical University,
Ministry of Health of Russia

During the beginning of the pandemic, when a patient with lung damage was admitted to a hospital unit of pulmonology, the algorithm of a physician’s actions included diagnosis of coronavirus infection (COVID-19), determination of the severity of condition, and hospitalization decision. Objective: to study the severity of condition in patients with lung damage and a high probability of the novel coronavirus infection and the timing of referral to the general hospital’s unit of pulmonology during the beginning of the pandemic. Subjects and methods. According to the hospital admission time after disease onset, the investigators formed 2 groups: 1) less than 7 days after disease onset (n = 94); 2) more than 7 days (n = 49). Reverse transcriptase polymerase chain reaction (RT-PCR) and chest computed tomography (CT) were used to diagnose lung damage with a high probability of COVID-19 infection. Results. The majority of patients were admitted within the first week after the onset of symptoms (66%), while 55% of cases had moderate disease. The swabs positive for SARS-CoV-2 were 32%. At the initial stage of the novel coronavirus (COVID-19) infection pandemic, there were no significant differences in lung damage with negative and positive PCR test results for SARS-CoV-2. By taking into account the commonness of manifestations in lung damages, the patients with a negative PCR test for SARS-CoV-2 were diagnosed with the novel coronavirus COVID-19 infection that was highly probable by CT, which allowed a decision to transfer a healthcare facility to the operating mode of a coronavirus hospital.

infectious diseases
timing of referral
severity of condition
community-acquired pneumonia
computed tomography
respiratory support

  1. Singhal T. A Review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatr. 2020; 87 (4): 281–6. DOI: 10.1007/s12098-020-03263-6
  2. Teo J. Early Detection of Silent Hypoxia in Covid-19 Pneumonia Using Smartphone Pulse Oximetry. J Med Syst. 2020; 44 (8): 134. DOI: 10.1007/s10916-020-01587-6.
  3. Borodulina E.A., Shirobokov Ja.E., Gladunova E.P. i dr. Diagnostika i farmakoterapija virus-assotsiirovannyh porazhenij legkih. Klinicheskaja farmakologija i terapija 2020; 29 (4): 61–6 [Borodulina E.A., Shirobokov Y.E., Gladunova E.P. et al. Virus-associated lung disease. Klinicheskaya farmakologiya i terapiya = Clin Pharmacol Ther. 2020; 29 (3): 61–6 (in Russ.)]. DOI: 10.32756/0869-5490-2020-3-61-66
  4. Rothe C., Schunk M., Sothmann P. et al. Transmission of 2019-nCoV infection from asymptomatic contact in Germany. N Engl J Med. 2020; 382 (10): 970–1. DOI: 10.1056/NEJMc2001468
  5. Ihle-Hansen H., Berge T., Tveita A. et al. COVID-19: Symptoms, course of illness and use of clinical scoring systems for the first 42 patients admitted to a Norwegian local hospital. Tidsskr Nor Laegeforen. 2020; 140 (7). DOI: 10.4045/tidsskr.20.0301
  6. Samorodskaja I.V., Kljuchnikov I.V. Problemy diagnostiki i lechenija COVID-19 na klinicheskom primere. Vrach. 2020; 31 (4): 19–25 [Samorodskaya I., Klyuchnikov I. The problems of COVID-19 diagnosis and treatment: a clinical case example. Vrach. 2020; 31 (4): 19–25 (in Russ.)] DOI: 10.29296/25877305-2020-04-04
  7. Kudlaj D.A., Shirobokov Ja.E., Gladunova E.P. i dr. Diagnostika COVID-19. Sposoby i problemy obnaruzhenija virusa SARS-COV-2 v uslovijah pandemii. Vrach. 2020; 31 (8): 5–10 [Kudlay D., Shirobokov Ya., Gladunova E. et al. Diagnosis of COVID-19. Methods and problems of virus SARS-CoV-2 detection under pandemic conditions. Vrach. 2020; 31 (8): 5–10 (in Russ.)].
  8. Starshinova A.A., Kushnareva E.A., Malkova A.M. i dr. Novaja koronavirusnaja infektsija: osobennosti klinicheskogo techenija, vozmozhnosti diagnostiki, lechenija i profilaktiki infektsii u vzroslyh i detej. Voprosy sovremennoj pediatrii. 2020; 19(2): 123–31 [Starshinova A.A., Kushnareva E.A., Malkova A.M. et al. New Coronaviral Infection: Features of Clinical Course, Capabilities of Diagnostics, Treatment and Prevention in Adults and Children. Current Pediatrics. 2020; 19 (2): 123–31 (in Russ.)].
  9. Fang Y., Zhang H., Xu Y. et al. CT Manifestations of Two Cases of 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology. 2020; 295 (1): 208–9. DOI: 10.1148/radiol.2020200280
  10. Pan F., Ye T., Sun P. et al. Time course of lung changes on chest CT during recovery from 2019 Novel Coronavirus (COVID-19) pneumonia. Radiology. 2020; 295 (3): 715–21. DOI: 10.1148/radiol.2020200370
  11. Mungmunpuntipantip R., Wiwanitkit V. Uncertainty in using chest computed tomography in early coronavirus disease (COVID-19). Can J Anaesth. 2020; 67 (7): 897. DOI: 10.1007/s12630-020-01639-y
  12. Onder G., Rezza G., Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 2020; 323 (18): 1775–6. DOI: 10.1001/jama.2020.4683
  13. Singh A.K., Gupta R., Misra A. Comorbidities in COVID-19: outcomes in hypertensive cohort and controversies with renin angiotensin system blockers. Diabetes Metab Syndr. 2020; 14 (4): 283–7. DOI: 10.1016/j.dsx.2020.03.016
  14. Yang J., Zheng Y., Gou X. et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Infect Dis. 2020; 94: 91–5. DOI: 10.1016/j.ijid.2020.03.017
  15. Chan-Yeung M., Xu R.H. SARS: epidemiology. Respirology. 2003; 8 (Suppl. 1): S9–14. DOI: 10.1046/j.1440-1843.2003.00518.x
  16. Zou L., Ruan F., Huang M. et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020; 382 (12): 1177–9. DOI: 10.1056/NEJMc2001737