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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

DOI: https://doi.org/10.29296/25877305-2020-11-12
Issue: 
11
Year: 
2020

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.

Keywords: 
infectious diseases
pulmonology
COVID-19
timing of referral
severity of condition
community-acquired pneumonia
computed tomography
hospital
respiratory support



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