medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-23-335-342medsovet-7314Research ArticleCOVID-19Повторные госпитализации пациентов c COVID-19: причины, особенности, исходыHospital readmissions of patients with COVID-19: causes, features, outcomeshttps://orcid.org/0000-0003-3718-3018ПотанинаО. Н.PotaninaO. N.

Потанина Ольга Николаевна - аспирант кафедры пропедевтики внутренних болезней.

199034, Санкт-Петербург, Университетская наб., 7/9

Olga N. Potanina - Postgraduate Student, Department of Internal diseases propedeutics, St Petersburg State University.

7-9, Universitetskaya Emb., St Petersburg, 199034

potaninaon@gmail.comhttps://orcid.org/0000-0001-9239-4294АйрапетянС. А.AyrapetyanS. A.

Айрапетян Самвел Артурович - студент медицинского факультета.

199034, Санкт-Петербург, Университетская наб., 7/9

Samvel A. Ayrapetyan - Student of Medical Faculty, St Petersburg State University.

7-9, Universitetskaya Emb., St Petersburg, 199034

ayrapetyan.samvel23@yandex.ruhttps://orcid.org/0000-0002-1915-2237МазуренкоС. О.MazurenkoS. O.

Мазуренко Сергей Олегович - доктор медицинских наук, профессор, заведующий кафедрой пропедевтики внутренних болезней, СПбГУ; главный терапевт, ГБ Святого Георгия.

199034, Санкт-Петербург, Университетская наб., 7/9; 194291, Санкт-Петербург, Северный проезд, д. 1

Sergey O. Mazurenko - Dr. Sci. (Med.), Professor, Head of the Department of Internal Diseases Propedeutics, St Petersburg State University; Chief Therapist, St George City Hospital.

7-9, Universitetskaya Emb., St Petersburg, 199034; 1, Severny Proezd, St Petersburg, 194291

dr_mazurenko@mail.ruhttps://orcid.org/0000-0002-1838-9961CтрижелецкийВ. В.StrizheletskyV. V.

Cтрижелецкий Валерий Викторович - доктор медицинских наук, профессор кафедры госпитальной хирургии, СПбГУ; главный врач, ГБ Святого Георгия.

199034, Санкт-Петербург, Университетская наб., 7/9; 194291, Санкт-Петербург, Северный проезд, д. 1

Valery V. Strizheletsky - Dr. Sci. (Med.), Professor of the Department of Hospital Surgery, St Petersburg State University; Chief Physician, St George City Hospital.

7-9, Universitetskaya Emb., St Petersburg, 199034; 1, Severny Proezd, St Petersburg, 194291

strival@mail.ruhttps://orcid.org/0000-0002-7113-0641ПальчиковаЛ. С.PalchikovaL. S.

Пальчикова Людмила Сергеевна - заведующий терапевтическим отделением.

194291, Санкт-Петербург, Северный проезд, д. 1

Ludmila S. Palchikova - Head of the therapeutics Department, St George City Hospital.

1, Severny Proezd, St Petersburg, 194291

mila-naumova-92@mail.ruhttps://orcid.org/0000-0002-8114-9821ТепляковаН. А.TeplyakovaN. A.

Теплякова Наталья Александровна - заведующий клинико-экспертным отделением.

194291, Санкт-Петербург, Северный проезд, д. 1

Natalya A. Teplyakova - Head of the Clinical Expert Department, St George City Hospital.

1, Severny Proezd, St Petersburg, 194291

april-1966@mail.ruhttps://orcid.org/0000-0002-5040-6768ЕрмолаеваЛ. Г.ErmolaevaL. G.

Ермолаева Лариса Геннадьевна - кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней.

199034, Санкт-Петербург, Университетская наб., 7/9

Larisa G. Ermolaeva - Cand. Sci. (Med.), Associate Professor of the Department of Internal diseases propedeutics, St Petersburg State University.

7-9, Universitetskaya Emb., St Petersburg, 199034

larerm@mail.ruhttps://orcid.org/0000-0002-1738-8385ГомонЮ. М.GomonIu. M.

Гомон Юлия Михайловна - кандидат медицинских наук, врач клинический фармаколог, ГБ Святого Георгия; ассистент кафедры клинической фармакологии и доказательной медицины, ПСПбГМУ им. ак. И.П. Павлова.

194291, Санкт-Петербург, Северный пр., д. 1; 197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8

Iuliia M. Gomon - Cand. Sci. (Med.), Clinical Pharmacologist, St. George City Hospital; Assistant of the Department of Clinical Pharmacology and Evidence-based Medicine, Pavlov First Saint Petersburg State Medical University.

194291, St. Petersburg, Severny Proezd, 1; 6-8, Lev Tolstoy St., St Petersburg, 197022

gomonmd@yandex.ruhttps://orcid.org/0000-0003-4168-1853СемиголовскийН. Ю.SemigolovskiiN. Yu.

Семиголовский Никита Юрьевич – доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней.

199034, Санкт-Петербург, Университетская наб., 7/9

Nikita Yu. Semigolovskii - Dr. Sci. (Med.), Professor of the Department of Internal Diseases Propedeutics, St Petersburg State University.

7-9, Universitetskaya Emb., St Petersburg, 199034

semigolovski@yandex.ruСанкт-Петербургский государственный университетРоссияSt Petersburg State UniversityRussian FederationСанкт-Петербургский государственный университет; Городская больница Святого ГеоргияРоссияSt Petersburg State University; St George City HospitalRussian FederationГородская больница Святого ГеоргияРоссияSt George City HospitalRussian FederationГородская больница Святого Георгия; Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. ПавловаРоссияSt George City Hospital; Pavlov First Saint Petersburg State Medical UniversityRussian Federation202219012023023335342Copyright © Потанина О.Н., Айрапетян С.А., Мазуренко С.О., Cтрижелецкий В.В., Пальчикова Л.С., Теплякова Н.А., Ермолаева Л.Г., Гомон Ю.М., Семиголовский Н.Ю., 20232023Потанина О.Н., Айрапетян С.А., Мазуренко С.О., Cтрижелецкий В.В., Пальчикова Л.С., Теплякова Н.А., Ермолаева Л.Г., Гомон Ю.М., Семиголовский Н.Ю.Potanina O.N., Ayrapetyan S.A., Mazurenko S.O., Strizheletsky V.V., Palchikova L.S., Teplyakova N.A., Ermolaeva L.G., Gomon I.M., Semigolovskii N.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7314Введение

Введение. В среднем каждый десятый пациент, прошедший стационарное лечение по поводу новой коронавирусной инфекции (COVID-19), будет госпитализирован снова. На сегодняшний день причины повторного поступления и характеристика данных случаев представлены недостаточно полно.

Цель

Цель. Выполнить анализ случаев повторной госпитализации пациентов, перенесших COVID-19, для выявления причин повторного поступления, особенностей клинической картины и данных обследования, а также исходов лечения.

Материалы и методы

Материалы и методы. Исследование выполнено ретроспективно на основе электронных историй болезни Санкт-Петербургской городской больницы Святого Великомученика Георгия. Критерии включения: 1) наличие двух или более госпитализаций в течение 2020–2021 гг.; 2) новая коронавирусная инфекция, подтвержденная методом полимеразной цепной реакции во время первой госпитализации или в течение 14 дней до нее, и/или выявление при первичной компьютерной томографии изменений в легких, с высокой вероятностью связанных с COVID-19. Указанным критериям соответствовали 102 пациента.

Результаты

Результаты. В 85% случаев причиной повторного поступления стали симптомы респираторной инфекции; в 13% – тромботические события (тромбоэмболия легочной артерии, острое нарушение мозгового кровообращения, тромбоз глубоких вен нижних конечностей); 12% – выраженный болевой синдром различных локализаций; 11% – инфекционно-воспалительные процессы; 9% – антибиотик-ассоциированная диарея; 5% – фибрилляция предсердий и реже другие патологии. У пациентов с респираторными симптомами обнаруживались большая степень дыхательной недостаточности, увеличение объема пораженной легочной ткани и повышение содержания различных маркеров воспаления в крови при сравнении с данными первичного обследования. В 9% повторная госпитализация закончилась летальным исходом.

Выводы

Выводы. Ведущей причиной повторного стационарного лечения пациентов с COVID-19 являются симптомы реактивации инфекции с рядом показателей, свидетельствующих о большей тяжести данной «второй волны» заболевания. Требуются дальнейшие исследования для выработки оптимальных рекомендаций для уменьшения риска повторного стационарного лечения.

Introduction

Introduction. On average, 10% of patients hospitalized due to new coronavirus infection (COVID-19) will be readmitted. To date, the reasons for readmission and the characteristics of these cases are not fully presented.

The aim of the study was to analyze readmissions of COVID-19 patients to identify the causes of readmission, clinical features, examination data and treatment outcomes.

Materials and methods

Materials and methods. The study was performed retrospectively by using electronic records of the medical cases of the St. Petersburg City Hospital of St. George. Inclusion criteria: 1) the presence of two or more hospitalizations during 2020–2021; 2) COVID-19 confirmed by polymerase chain reaction within 14 days before or during the first hospitalization, or the detection of changes in the lungs with a high probability associated with COVID-19 during primary computed tomography. One hundred and two people met the specified criteria.

Results

Results. In 85% of cases, the cause of re-admission was symptoms of respiratory infection; in 13% – thrombotic events (pulmonary embolism, acute cerebrovascular accident, deep vein thrombosis of the lower extremities); 12% – severe pain syndrome of various localizations; 11% - infectious and inflammatory processes; 9% – antibiotic-associated diarrhea; 5% – atrial fibrillation and less often other pathologies. Patients with respiratory symptoms had a high degree of respiratory failure, an increase in the volume of affected lung tissue and an increase in the content of various markers of inflammation in the blood when compared with the data of the initial examination. Nine percent of patients died during hospitalization.

Conclusions

Conclusions. The leading cause of repeated inpatient treatment of COVID-19 patients were symptoms of reactivation of the infection with a number of indicators of a greater severity of this “second wave” of the disease. Further studies are required to reduce the risk of repeated inpatient treatment.

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The authors declare that there are no conflicts of interest present.