The dissertation is devoted to the identification of risk factors and early prediction of a severe course of coronavirus disease - 19 at the stage of hospitalization in elderly and senile patients.
To realize the goal of the dissertation research, 320 patients at the stage of hospitalization were involved (48.8% women and 51.2% men, aged from 45 to 90 years, average - 60.3 ± 13.6 years), among whom 270 (84 .4%) of patients recovered and discharged from the hospital as a result of coronavirus disease-19, and 50 (15.6%) patients died as a result of the disease. The main group of the study was elderly and senile patients (60 - 90 years) – 180 (56.3%), the comparison group - middle-aged patients (45 - 59 years) – 140 (43.7%). An immunoenzymatic study to determine the levels of IL-6 and IL-10 in blood plasma was conducted in 77 hospitalized patients, the control group consisted of 17 relatively healthy donors, statistically similar in age and gender (p >0.05).
The examination was carried out the day after the hospitalization of the patients, on average – 9.2±3.5 days after the appearance of the first symptoms of the disease.
The aim of the study. To improve the forecasting of the severe course of the coronavirus disease (COVID-19) in elderly and senile patients based on a comprehensive analysis and comparison of clinical and anamnestic features, general laboratory indicators and the content of interleukin-6 and interleukin-10 in the blood serum.
Scientific novelty of the obtained results.
New scientific data were obtained on the peculiarities of the course of COVID-19 in hospitalized elderly and senile patients, the role of comorbid pathology, which significantly aggravates the course of COVID-19 and is associated with a severe course of the disease and the risk of death, was confirmed. It was determined that the most influential (from p<0.05 to p<0.001) risk factors are coronary heart disease (OR=4.49), arterial hypertension (OR=2.33), other heart diseases (OR=7.23 ), obesity of the I-III stage (OR=2.97), diabetes mellitus (OR=2.38), clinical signs such as fever (OR=3.44), shortness of breath (OR=9.47), lymphopenia (OR=3.82), hyperglycemia (OR=4.69), increased C-RР (OR=5.96), especially above 100 mg/l (OR=115.3), decreased saturation (SpO2) to 92% and less (OR=11,52), increased markers of kidney damage and hypercoagulation; comprehensive consideration of these factors ensured the creation of a prognostic algorithm for determining the risk of an adverse course of the coronavirus disease-19 in hospitalized elderly patients.
New scientific data have been obtained that testify to the marker role of the IL-10/IL-6 ratio in the acute phase of COVID-19 and allow this indicator to be considered an early predictor of a severe and critical course of the disease.
Added scientific data that the levels of serum interleukins 6 and 10 are important biomarkers of the severe course of coronavirus disease-19. It was determined that an increase in the level of IL-6 in patients with COVID-19 may be associated with age, especially in the age range of 70-79 years (rs = 0.381, p = 0.001), and a number of comorbid pathologies and clinical conditions, among which are particularly significant are coronary artery disease, obesity, fever, increased systolic blood pressure, and a decrease in the level of blood saturation
