Организация оказания медицинской помощи больным COVID-19 в неинфекционном стационаре г. Москвы: опыт перепрофилирования
Организация оказания медицинской помощи больным COVID-19 в неинфекционном стационаре г. Москвы: опыт перепрофилирования
Никитин И.Г., Мелехов А.В., Сайфуллин М.А. и др. Организация оказания медицинской помощи больным COVID-19 в неинфекционном стационаре г. Москвы: опыт перепрофилирования. Терапевтический архив. 2020; 92 (11): 31–37.
DOI: 10.26442/00403660.2020.11.000838
DOI: 10.26442/00403660.2020.11.000838
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Аннотация
Цель. Провести анализ работы ФГАУ «НМИЦ ”Лечебно-реабилитационный центр”» в период подъема заболеваемости COVID-19. Подробно описать методологию подготовки и организацию работы учреждения во время перепрофилирования.
Материалы и методы. За период с 13.04.2020 по 10.06.2020 медицинская помощь оказана 354 больным с COVID-19 [возраст 59 (49–70) лет, 56% женщин, индекс массы тела 28,5 (24,9–32,2) кг/м2], госпитализированным на 8-й (6–11) день болезни. Продолжительность госпитализации составила 16 (14–20) койко-дней.
Результаты. При поступлении сумма баллов по шкале NEWS составила 2 (1–4); у выживших больных – 2 (1–3), у умерших – 6 (4–7), p=0,0001. Прогностическая точность шкалы оказалась очень хорошей (площадь под ROC-кривой 0,819). 69 (19,5%) пациентов получали лечение в отделении реанимации в течение 7 (4–13) койко-дней. За время работы умерли 13 пациентов, у 11 из них COVID-19 являлся прямой или косвенной причиной смерти. Общая внутрибольничная летальность составила 3,67%, от COVID-19 – 3,1%. За время работы среди сотрудников, оказывавших медицинскую помощь больным с COVID-19, зарегистрировано 17 случаев заболевания новой коронавирусной инфекцией (2,67%). Кроме того, инфицированы 4 сотрудника, не контактировавших с пациентами; 7 сотрудников заболели до открытия ЛРЦ для работы с пациентами с COVID-19. Никто из заболевших сотрудников не умер.
Заключение. Наш опыт говорит о возможности быстрого решения организационных задач, стоящих перед системой здравоохранения в период пандемии новой коронавирусной инфекции, с хорошим результатом, характеризующимся низкой смертностью госпитализированных больных и низкой заболеваемостью сотрудников, оказывающих медицинскую помощь.
Ключевые слова: COVID-19, пандемия, организация здравоохранения, внутрибольничная летальность, заболеваемость медицинских работников.
Materials and methods. 354 COVID-19 patients were treated from 13.04.2020 to 10.06.2020 [age 59 (4–70) years, 56% women, body mass index 28.5 (24.9–32.2) kg/m2]. Patients were admitted at 8 (6–11) day of sickness. In-hospital stay was 16 (14–20) days.
Results. NEWS scale at the day of admittance was 2 (1–4); 2 (1–3) in patients discharged alive and 6 (4–7) in died patients, p=0.0001. So prognostic accuracy of NEWS scale was confirmed as very well (area under ROC-curve = 0.819). 69 patients (19.5%) were treated at intensive care department for 7 (4–13) days. 13 patients died, 11 of them had COVID-19 as direct or indirect cause of death. Total in-hospital mortality was 3.67%, in-hospital mortality of COVID-19 patients – 3.1%. 17 healthcare workers (HCW), contacted with COVID-19 patients were infected (2.67%). 4 HCW, who had no direct contact with patients were also infected and 7 HCW were infected before the first patient was admitted. No one of them died.
Conclusion. Complex tasks of healthcare organization during COVID-19 pandemic can be solved quickly with acceptable quality, characterized by low levels of patients; mortality and HCW infection.
Keywords: COVID-19, pandemic, medical care organization, in-hospital mortality, healthcare workers infection.
Материалы и методы. За период с 13.04.2020 по 10.06.2020 медицинская помощь оказана 354 больным с COVID-19 [возраст 59 (49–70) лет, 56% женщин, индекс массы тела 28,5 (24,9–32,2) кг/м2], госпитализированным на 8-й (6–11) день болезни. Продолжительность госпитализации составила 16 (14–20) койко-дней.
Результаты. При поступлении сумма баллов по шкале NEWS составила 2 (1–4); у выживших больных – 2 (1–3), у умерших – 6 (4–7), p=0,0001. Прогностическая точность шкалы оказалась очень хорошей (площадь под ROC-кривой 0,819). 69 (19,5%) пациентов получали лечение в отделении реанимации в течение 7 (4–13) койко-дней. За время работы умерли 13 пациентов, у 11 из них COVID-19 являлся прямой или косвенной причиной смерти. Общая внутрибольничная летальность составила 3,67%, от COVID-19 – 3,1%. За время работы среди сотрудников, оказывавших медицинскую помощь больным с COVID-19, зарегистрировано 17 случаев заболевания новой коронавирусной инфекцией (2,67%). Кроме того, инфицированы 4 сотрудника, не контактировавших с пациентами; 7 сотрудников заболели до открытия ЛРЦ для работы с пациентами с COVID-19. Никто из заболевших сотрудников не умер.
Заключение. Наш опыт говорит о возможности быстрого решения организационных задач, стоящих перед системой здравоохранения в период пандемии новой коронавирусной инфекции, с хорошим результатом, характеризующимся низкой смертностью госпитализированных больных и низкой заболеваемостью сотрудников, оказывающих медицинскую помощь.
Ключевые слова: COVID-19, пандемия, организация здравоохранения, внутрибольничная летальность, заболеваемость медицинских работников.
________________________________________________
Materials and methods. 354 COVID-19 patients were treated from 13.04.2020 to 10.06.2020 [age 59 (4–70) years, 56% women, body mass index 28.5 (24.9–32.2) kg/m2]. Patients were admitted at 8 (6–11) day of sickness. In-hospital stay was 16 (14–20) days.
Results. NEWS scale at the day of admittance was 2 (1–4); 2 (1–3) in patients discharged alive and 6 (4–7) in died patients, p=0.0001. So prognostic accuracy of NEWS scale was confirmed as very well (area under ROC-curve = 0.819). 69 patients (19.5%) were treated at intensive care department for 7 (4–13) days. 13 patients died, 11 of them had COVID-19 as direct or indirect cause of death. Total in-hospital mortality was 3.67%, in-hospital mortality of COVID-19 patients – 3.1%. 17 healthcare workers (HCW), contacted with COVID-19 patients were infected (2.67%). 4 HCW, who had no direct contact with patients were also infected and 7 HCW were infected before the first patient was admitted. No one of them died.
Conclusion. Complex tasks of healthcare organization during COVID-19 pandemic can be solved quickly with acceptable quality, characterized by low levels of patients; mortality and HCW infection.
Keywords: COVID-19, pandemic, medical care organization, in-hospital mortality, healthcare workers infection.
Список литературы
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14. Ayerbe L, Risco C, Ayis S. The association between treatment with heparin and survival in patients with Covid-19. J Thromb Thrombolysis. 2020;50(2):298-301. doi: 10.1007/s11239-020-02162-z
15. Borobia AM, Carcas AJ, Arnalich F, et al. A Cohort of Patients with COVID-19 in a Major Teaching Hospital in Europe. J Clin Med. 2020;9(6):E1733. doi: 10.3390/jcm9061733
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18. Rosenberg ES, Dufort EM, Udo T, et al. Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State. JAMA. 2020;323(24):2493-502. doi: 10.1001/jama.2020.8630.
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22. Li X, Xu S, Yu M, et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020;146(1):110-8. doi: 10.1016/j.jaci.2020.04.006
23. Rastad H, Karim H, Ejtahed HS, et al. Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease. Diabetol Metab Syndr. 2020;12:57. doi: 10.1186/s13098-020-00565-9
24. Lai X, Wang M, Qin C, et al. Coronavirus Disease 2019 (COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China. JAMA Netw Open. 2020;3(5):e209666. doi: 10.1001/jamanetworkopen.2020.9666
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2. Order of the Ministry of Health of the Russian Federation fr om March 19, 2020, № 198n "About the temporary procedure for organizing the work of medical organizations in order to implement measures to prevent and reduce the risks of the spread of a new coronavirus infection COVID-19" (In Russ.)
https://www.garant.ru/products/ipo/prime/doc/73669697/
3. Order of the Government of the Russian Federation from April 2, 2020, № 844-r “About the approval of the lists of organizations and their structural subdivisions carrying out medical services, subordinate to federal executive authorities and private medical organizations that are being reassigned for provision of medical care to patients with a confirmed diagnosis of new coronavirus infection COVID-19 or with suspicion for new coronavirus infection COVID-19 in the inpatient settings" (In Russ.)
http://www.garant.ru/hotlaw/federal/1343391/
4. Letter of the Ministry of Health of the Russian Federation from 24.03.2020 № 30-1/10/2-24 "About the minimal requirements for buildings and premises wh ere it is planned to organize additional infectious beds for the treatment of patients with COVID-19" (In Russ.) https://www.garant.ru/products/ipo/prime/doc/73754076/
5. Royal College of Physicians. National Early Warning Score (NEWS): Standardising the assessment of acute-illness severity in the NHS. Report of a working party. London: RCP, 2012. www.rcplondon.ac.uk/file/32/download?token=5NwjEyTq
6. Sbiti-Rohr D, Kutz A, Christ-Crain M, et al. The National Early Warning Score (NEWS) for outcome prediction in emergency department patients with community-acquired pneumonia: results from a 6-year prospective cohort study. BMJ Open. 2016;6:e011021. doi: 10.1136/bmjopen-2015-011021
7. Astafyeva MN, Bagin VA, Moldovanov AV, et al. Comparison of the qSOFA and NEWS scores and the SIRS criteria in predicting outcomes in emergency department patients with and without infection: results from a prospective observational study. Clinical microbiology and antimicrobial chemotherapy. 2019;21(1):18-25 (In Russ.) doi: 10.36488/cmac.2019.1.18-25
8. Wahidi MM, Lamb C, Murgu S, et al. American Association for Bronchology and Interventional Pulmonology (AABIP) statement on the use of bronchoscopy and respiratory specimen collection in patients with suspected or confirmed COVID-19 infection. J Bronchology Interv Pulmonol. 2020;24(4):52-4. doi: 10.1097/LBR.0000000000000681
9. SanPiN 2.1.7.2790-10. Sanitary and Epidemiological Requirements for Medical Waste Management (approved by the Chief State Sanitary Doctor of the Russian Federation from 09.12.2010 (In Russ.) http://base.garant.ru/12183219/
10. Prevention, diagnosis, and treatment of new coronavirus infection (COVID-19). Temporary guidelines. Version 7 dated from 06/03/2020 (In Russ.) https://static-0.rosminzdrav.ru/system/attachments/attaches/000/050/584/original/03062020_%D0%9CR_CO...
11. Anesthetic and resuscitation services for patients with the new coronavirus infection COVID-19. Methodological recommendations, 2020 (In Russ.)
https://edu.rosminzdrav.ru/fileadmin/user_upload/specialists/COVID-19/dop-materials/11_05_2020/Metre...
12. Grasselli G, Zangrillo A, Zanella A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323(16):1574-81. doi: 10.1001/jama.2020.5394
13. Lara Álvarez MÁ, Rogado Revuelta J, Obispo Portero B, et al. COVID-19 mortality in cancer patients in a Madrid hospital during the first
3 weeks of the epidemic. Med Clin (Barc). 2020;155(5):202-4. doi: 10.1016/j.medcli.2020.05.005
14. Ayerbe L, Risco C, Ayis S. The association between treatment with heparin and survival in patients with Covid-19. J Thromb Thrombolysis. 2020;50(2):298-301. doi: 10.1007/s11239-020-02162-z
15. Borobia AM, Carcas AJ, Arnalich F, et al. A Cohort of Patients with COVID-19 in a Major Teaching Hospital in Europe. J Clin Med. 2020;9(6):E1733. doi: 10.3390/jcm9061733
16. Lee LYW, Cazier JB, Starkey T, et al. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet. 2020;395(10241):1919-26. doi: 10.1016/S0140-6736(20)31173-9
17. Palaiodimos L, Kokkinidis DG, Li W, et al. Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism. 2020;108:154262. doi: 10.1016/j.metabol.2020.154262
18. Rosenberg ES, Dufort EM, Udo T, et al. Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State. JAMA. 2020;323(24):2493-502. doi: 10.1001/jama.2020.8630.
19. Du RH, Liang LR, Yang CQ, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J. 2020;55(5):2000524. doi: 10.1183/13993003.00524-2020
20. Liu Y, Du X, Chen J, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020;81(1):e6-e12. doi: 10.1016/j.jinf.2020.04.002
21. Zhang L, Yan X, Fan Q, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020;18(6):1324-29. doi: 10.1111/jth.14859
22. Li X, Xu S, Yu M, et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020;146(1):110-8. doi: 10.1016/j.jaci.2020.04.006
23. Rastad H, Karim H, Ejtahed HS, et al. Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease. Diabetol Metab Syndr. 2020;12:57. doi: 10.1186/s13098-020-00565-9
24. Lai X, Wang M, Qin C, et al. Coronavirus Disease 2019 (COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China. JAMA Netw Open. 2020;3(5):e209666. doi: 10.1001/jamanetworkopen.2020.9666
25. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. doi: 10.1001/jama.2020.2648
26. Wong SC, Kwong RT, Wu TC, et al. Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong. J Hosp Infect. 2020;105(2):119-27. doi: 10.1016/j.jhin.2020.03.036
27. Kluytmans M, Buiting A, Pas S, et al. SARS-CoV-2 infection in 86 healthcare workers in two Dutch hospitals in March 2020. medRxiv. 2020:2020.03.23.20041913. doi: 10.1101/2020.03.23.20041913
28. Fusco FM, Pisaturo M, Iodice V, et al. COVID-19 infections among Healthcare Workers in an Infectious Diseases specialized setting in Naples, Southern Italy: results of a cross-sectional surveillance study. J Hosp Infect. 2020;105(4):596-600. doi: 10.1016/j.jhin.2020.06.021
29. Team CC-R. Characteristics of health care personnel with COVID-19 – United States, February 12 – April 9, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):477-81. doi: 10.15585/mmwr.mm6915e6
30. Hunter E, Price DA, Murphy E, et al. First experience of COVID-19 screening of health-care workers in England. Lancet. 2020;395(10234):e77-8. doi: 10.1016/S0140-6736(20)30970-3
2. Приказ Министерства здравоохранения РФ от 19 марта 2020 г. №198н «О временном порядке организации работы медицинских организаций в целях реализации мер по профилактике и снижению рисков распространения новой коронавирусной инфекции COVID-19». [Order of the Ministry of Health of the Russian Federation fr om March 19, 2020, № 198n "About the temporary procedure for organizing the work of medical organizations in order to implement measures to prevent and reduce the risks of the spread of a new coronavirus infection COVID-19" (In Russ.)]. https://www.garant.ru/products/ipo/prime/doc/73669697/
3. Распоряжение Правительства РФ от 2 апреля 2020 г. №844-р «Об утверждении перечней организаций и их структурных подразделений, осуществляющих медицинскую деятельность, подведомственных федеральным органам исполнительной власти, и частных медицинских организаций, которые перепрофилируются для оказания медицинской помощи пациентам с подтвержденным диагнозом новой коронавирусной инфекции COVID-19 или с подозрением на новую коронавирусную инфекцию COVID-19 в стационарных условиях» [Order of the Government of the Russian Federation from April 2, 2020, № 844-r “About the approval of the lists of organizations and their structural subdivisions carrying out medical services, subordinate to federal executive authorities and private medical organizations that are being reassigned for provision of medical care to patients with a confirmed diagnosis of new coronavirus infection COVID-19 or with suspicion for new coronavirus infection COVID-19 in the inpatient settings" (In Russ.)]. http://www.garant.ru/hotlaw/federal/1343391/
4. Письмо Министерства здравоохранения РФ от 24.03.2020 №30-1/10/2-24 «О минимальных требованиях к зданиям и помещениям, где планируется организация дополнительных инфекционных коек для лечения пациентов с COVID-19» [Letter of the Ministry of Health of the Russian Federation from 24.03.2020 № 30-1/10/2-24 "About the minimal requirements for buildings and premises wh ere it is planned to organize additional infectious beds for the treatment of patients with COVID-19" (In Russ.)]. https://www.garant.ru/products/ipo/prime/doc/73754076/
5. Royal College of Physicians. National Early Warning Score (NEWS): Standardising the assessment of acute-illness severity in the NHS. Report of a working party. London: RCP, 2012. www.rcplondon.ac.uk/file/32/download?token=5NwjEyTq
6. Sbiti-Rohr D, Kutz A, Christ-Crain M, et al. The National Early Warning Score (NEWS) for outcome prediction in emergency department patients with community-acquired pneumonia: results from a 6-year prospective cohort study. BMJ Open. 2016;6:e011021. doi: 10.1136/bmjopen-2015-011021
7. Астафьева М.Н., Багин В.А., Молдованов А.В. и др. Сравнение шкал qSOFA, NEWS и критериев SIRS в прогнозе исходов у пациентов приемного отделения в зависимости от наличия инфекции: результаты проспективного наблюдательного исследования. Клин. микробиология и антимикроб. химиотерапия. 2019;21(1)18-25. doi: 10.36488/cmac.2019.1.18-25 [Astafyeva MN, Bagin VA, Moldovanov AV, et al. Comparison of the qSOFA and NEWS scores and the SIRS criteria in predicting outcomes in emergency department patients with and without infection: results from a prospective observational study. Clinical microbiology and antimicrobial chemotherapy. 2019;21(1):18-25 (In Russ.)]. doi: 10.36488/cmac.2019.1.18-25
8. Wahidi MM, Lamb C, Murgu S, et al. American Association for Bronchology and Interventional Pulmonology (AABIP) statement on the use of bronchoscopy and respiratory specimen collection in patients with suspected or confirmed COVID-19 infection. J Bronchology Interv Pulmonol. 2020;24(4):52-4. doi: 10.1097/LBR.0000000000000681
9. СанПиН 2.1.7.2790-10. Санитарно-эпидемиологические требования к обращению с медицинскими отходами (утверждены Главным государственным санитарным врачом РФ 09.12.2010) [SanPiN 2.1.7.2790-10. Sanitary and Epidemiological Requirements for Medical Waste Management (approved by the Chief State Sanitary Doctor of the Russian Federation from 09.12.2010 (In Russ.)]. http://base.garant.ru/12183219/
10. Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19). Временные методические рекомендации. Версия 7 от 03.06.2020 [Prevention, diagnosis, and treatment of new coronavirus infection (COVID-19). Temporary guidelines. Version 7 dated from 06/03/2020 (In Russ.)]. https://static-0.rosminzdrav.ru/system/attachments/attaches/000/050/584/original/03062020_%D0%9CR_CO...
11. Анестезиолого-реанимационное обеспечение пациентов с новой коронавирусной инфекцией COVID-19. Методические рекомендации, 2020 [Anesthetic and resuscitation services for patients with the new coronavirus infection COVID-19. Methodological recommendations, 2020 (In Russ.)]. https://edu.rosminzdrav.ru/fileadmin/user_upload/specialists/COVID-19/dop-materials/11_05_2020/Metre...
12. Grasselli G, Zangrillo A, Zanella A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323(16):1574-81. doi: 10.1001/jama.2020.5394
13. Lara Álvarez MÁ, Rogado Revuelta J, Obispo Portero B, et al. COVID-19 mortality in cancer patients in a Madrid hospital during the first
3 weeks of the epidemic. Med Clin (Barc). 2020;155(5):202-4. doi: 10.1016/j.medcli.2020.05.005
14. Ayerbe L, Risco C, Ayis S. The association between treatment with heparin and survival in patients with Covid-19. J Thromb Thrombolysis. 2020;50(2):298-301. doi: 10.1007/s11239-020-02162-z
15. Borobia AM, Carcas AJ, Arnalich F, et al. A Cohort of Patients with COVID-19 in a Major Teaching Hospital in Europe. J Clin Med. 2020;9(6):E1733. doi: 10.3390/jcm9061733
16. Lee LYW, Cazier JB, Starkey T, et al. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet. 2020;395(10241):1919-26. doi: 10.1016/S0140-6736(20)31173-9
17. Palaiodimos L, Kokkinidis DG, Li W, et al. Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism. 2020;108:154262. doi: 10.1016/j.metabol.2020.154262
18. Rosenberg ES, Dufort EM, Udo T, et al. Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State. JAMA. 2020;323(24):2493-502. doi: 10.1001/jama.2020.8630.
19. Du RH, Liang LR, Yang CQ, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J. 2020;55(5):2000524. doi: 10.1183/13993003.00524-2020
20. Liu Y, Du X, Chen J, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020;81(1):e6-e12. doi: 10.1016/j.jinf.2020.04.002
21. Zhang L, Yan X, Fan Q, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020;18(6):1324-29. doi: 10.1111/jth.14859
22. Li X, Xu S, Yu M, et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020;146(1):110-8. doi: 10.1016/j.jaci.2020.04.006
23. Rastad H, Karim H, Ejtahed HS, et al. Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease. Diabetol Metab Syndr. 2020;12:57. doi: 10.1186/s13098-020-00565-9
24. Lai X, Wang M, Qin C, et al. Coronavirus Disease 2019 (COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China. JAMA Netw Open. 2020;3(5):e209666. doi: 10.1001/jamanetworkopen.2020.9666
25. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. doi: 10.1001/jama.2020.2648
26. Wong SC, Kwong RT, Wu TC, et al. Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong. J Hosp Infect. 2020;105(2):119-27. doi: 10.1016/j.jhin.2020.03.036
27. Kluytmans M, Buiting A, Pas S, et al. SARS-CoV-2 infection in 86 healthcare workers in two Dutch hospitals in March 2020. medRxiv. 2020:2020.03.23.20041913. doi: 10.1101/2020.03.23.20041913
28. Fusco FM, Pisaturo M, Iodice V, et al. COVID-19 infections among Healthcare Workers in an Infectious Diseases specialized setting in Naples, Southern Italy: results of a cross-sectional surveillance study. J Hosp Infect. 2020;105(4):596-600. doi: 10.1016/j.jhin.2020.06.021
29. Team CC-R. Characteristics of health care personnel with COVID-19 – United States, February 12 – April 9, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):477-81. doi: 10.15585/mmwr.mm6915e6
30. Hunter E, Price DA, Murphy E, et al. First experience of COVID-19 screening of health-care workers in England. Lancet. 2020;395(10234):e77-8. doi: 10.1016/S0140-6736(20)30970-3
________________________________________________
2. Order of the Ministry of Health of the Russian Federation fr om March 19, 2020, № 198n "About the temporary procedure for organizing the work of medical organizations in order to implement measures to prevent and reduce the risks of the spread of a new coronavirus infection COVID-19" (In Russ.)
https://www.garant.ru/products/ipo/prime/doc/73669697/
3. Order of the Government of the Russian Federation from April 2, 2020, № 844-r “About the approval of the lists of organizations and their structural subdivisions carrying out medical services, subordinate to federal executive authorities and private medical organizations that are being reassigned for provision of medical care to patients with a confirmed diagnosis of new coronavirus infection COVID-19 or with suspicion for new coronavirus infection COVID-19 in the inpatient settings" (In Russ.)
http://www.garant.ru/hotlaw/federal/1343391/
4. Letter of the Ministry of Health of the Russian Federation from 24.03.2020 № 30-1/10/2-24 "About the minimal requirements for buildings and premises wh ere it is planned to organize additional infectious beds for the treatment of patients with COVID-19" (In Russ.) https://www.garant.ru/products/ipo/prime/doc/73754076/
5. Royal College of Physicians. National Early Warning Score (NEWS): Standardising the assessment of acute-illness severity in the NHS. Report of a working party. London: RCP, 2012. www.rcplondon.ac.uk/file/32/download?token=5NwjEyTq
6. Sbiti-Rohr D, Kutz A, Christ-Crain M, et al. The National Early Warning Score (NEWS) for outcome prediction in emergency department patients with community-acquired pneumonia: results from a 6-year prospective cohort study. BMJ Open. 2016;6:e011021. doi: 10.1136/bmjopen-2015-011021
7. Astafyeva MN, Bagin VA, Moldovanov AV, et al. Comparison of the qSOFA and NEWS scores and the SIRS criteria in predicting outcomes in emergency department patients with and without infection: results from a prospective observational study. Clinical microbiology and antimicrobial chemotherapy. 2019;21(1):18-25 (In Russ.) doi: 10.36488/cmac.2019.1.18-25
8. Wahidi MM, Lamb C, Murgu S, et al. American Association for Bronchology and Interventional Pulmonology (AABIP) statement on the use of bronchoscopy and respiratory specimen collection in patients with suspected or confirmed COVID-19 infection. J Bronchology Interv Pulmonol. 2020;24(4):52-4. doi: 10.1097/LBR.0000000000000681
9. SanPiN 2.1.7.2790-10. Sanitary and Epidemiological Requirements for Medical Waste Management (approved by the Chief State Sanitary Doctor of the Russian Federation from 09.12.2010 (In Russ.) http://base.garant.ru/12183219/
10. Prevention, diagnosis, and treatment of new coronavirus infection (COVID-19). Temporary guidelines. Version 7 dated from 06/03/2020 (In Russ.) https://static-0.rosminzdrav.ru/system/attachments/attaches/000/050/584/original/03062020_%D0%9CR_CO...
11. Anesthetic and resuscitation services for patients with the new coronavirus infection COVID-19. Methodological recommendations, 2020 (In Russ.)
https://edu.rosminzdrav.ru/fileadmin/user_upload/specialists/COVID-19/dop-materials/11_05_2020/Metre...
12. Grasselli G, Zangrillo A, Zanella A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323(16):1574-81. doi: 10.1001/jama.2020.5394
13. Lara Álvarez MÁ, Rogado Revuelta J, Obispo Portero B, et al. COVID-19 mortality in cancer patients in a Madrid hospital during the first
3 weeks of the epidemic. Med Clin (Barc). 2020;155(5):202-4. doi: 10.1016/j.medcli.2020.05.005
14. Ayerbe L, Risco C, Ayis S. The association between treatment with heparin and survival in patients with Covid-19. J Thromb Thrombolysis. 2020;50(2):298-301. doi: 10.1007/s11239-020-02162-z
15. Borobia AM, Carcas AJ, Arnalich F, et al. A Cohort of Patients with COVID-19 in a Major Teaching Hospital in Europe. J Clin Med. 2020;9(6):E1733. doi: 10.3390/jcm9061733
16. Lee LYW, Cazier JB, Starkey T, et al. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet. 2020;395(10241):1919-26. doi: 10.1016/S0140-6736(20)31173-9
17. Palaiodimos L, Kokkinidis DG, Li W, et al. Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism. 2020;108:154262. doi: 10.1016/j.metabol.2020.154262
18. Rosenberg ES, Dufort EM, Udo T, et al. Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State. JAMA. 2020;323(24):2493-502. doi: 10.1001/jama.2020.8630.
19. Du RH, Liang LR, Yang CQ, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J. 2020;55(5):2000524. doi: 10.1183/13993003.00524-2020
20. Liu Y, Du X, Chen J, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020;81(1):e6-e12. doi: 10.1016/j.jinf.2020.04.002
21. Zhang L, Yan X, Fan Q, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020;18(6):1324-29. doi: 10.1111/jth.14859
22. Li X, Xu S, Yu M, et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020;146(1):110-8. doi: 10.1016/j.jaci.2020.04.006
23. Rastad H, Karim H, Ejtahed HS, et al. Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease. Diabetol Metab Syndr. 2020;12:57. doi: 10.1186/s13098-020-00565-9
24. Lai X, Wang M, Qin C, et al. Coronavirus Disease 2019 (COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China. JAMA Netw Open. 2020;3(5):e209666. doi: 10.1001/jamanetworkopen.2020.9666
25. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. doi: 10.1001/jama.2020.2648
26. Wong SC, Kwong RT, Wu TC, et al. Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong. J Hosp Infect. 2020;105(2):119-27. doi: 10.1016/j.jhin.2020.03.036
27. Kluytmans M, Buiting A, Pas S, et al. SARS-CoV-2 infection in 86 healthcare workers in two Dutch hospitals in March 2020. medRxiv. 2020:2020.03.23.20041913. doi: 10.1101/2020.03.23.20041913
28. Fusco FM, Pisaturo M, Iodice V, et al. COVID-19 infections among Healthcare Workers in an Infectious Diseases specialized setting in Naples, Southern Italy: results of a cross-sectional surveillance study. J Hosp Infect. 2020;105(4):596-600. doi: 10.1016/j.jhin.2020.06.021
29. Team CC-R. Characteristics of health care personnel with COVID-19 – United States, February 12 – April 9, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):477-81. doi: 10.15585/mmwr.mm6915e6
30. Hunter E, Price DA, Murphy E, et al. First experience of COVID-19 screening of health-care workers in England. Lancet. 2020;395(10234):e77-8. doi: 10.1016/S0140-6736(20)30970-3
Авторы
И.Г. Никитин1,2, А.В. Мелехов1,2, М.А. Сайфуллин1,2, С.С. Агафонов1, С.А. Бедрицкий1, А.А. Вишнинский1, Н.А. Гультяева1, Э.Р. Гусейнов1, Н.А. Ермаков1, Е.А. Зорин1, Ю.В. Королева1, Д.В. Кудрявцев1, А.П. Маневский1, А.А. Неговский1, В.С. Петровичев1, Б.Э. Рудаков1, А.И. Рулева1, А.Б. Серебряков1, А.Р. Ситников1, Н.Ф. Федосова1, Е.В. Хаммад1, А.А. Аврамов1, А.И. Агаева2, К.Ю. Голубых2
1 ФГАУ «Национальный медицинский исследовательский центр ”Лечебно-реабилитационный центр”» Минздрава России, Москва, Россия;
2 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
1 National Medical Research Center of Treatment and Rehabilitation, Moscow, Russia;
2 Pirogov Russian National Research Medical University, Moscow, Russia
1 ФГАУ «Национальный медицинский исследовательский центр ”Лечебно-реабилитационный центр”» Минздрава России, Москва, Россия;
2 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
________________________________________________
1 National Medical Research Center of Treatment and Rehabilitation, Moscow, Russia;
2 Pirogov Russian National Research Medical University, Moscow, Russia
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