Материалы доступны только для специалистов сферы здравоохранения.
Чтобы посмотреть материал полностью
Авторизуйтесь
или зарегистрируйтесь.
COVID-19 у больных, получающих лечение программным гемодиализом: анализ результатов первого года пандемии - Журнал Терапевтический архив №11 Инфекционные болезни 2021
COVID-19 у больных, получающих лечение программным гемодиализом: анализ результатов первого года пандемии
Зубкин М.Л., Фролова Н.Ф., Ким И.Г., Ушакова А.И., Усатюк С.С., Исхаков Р.Т., Дьякова Е.Н., Червинко В.И., Володина Е.В., Томилина Н.А., Крюков Е.В. COVID-19 у больных, получающих лечение программным гемодиализом; анализ результатов первого года пандемии. Терапевтический архив. 2021;93(11):1325–1333. DOI: 10.26442/00403660.2021.11.201215
________________________________________________
Материалы доступны только для специалистов сферы здравоохранения.
Чтобы посмотреть материал полностью
Авторизуйтесь
или зарегистрируйтесь.
Аннотация
Обоснование. Представления о прогнозе новой коронавирусной инфекции у больных, получающих лечение гемодиализом (ГД), в настоящее время достаточно противоречивы. Практически отсутствует информация об эффективности и безопасности терапии заболевания у этих пациентов.
Цель. Изучить особенности течения COVID-19, прогностические факторы, связанные с фатальным исходом, а также эффективность и трансформацию терапии на разных этапах первого года пандемии у больных, получающих лечение программным ГД.
Материалы и методы. В одноцентровое ретроспективное неконтролируемое исследование включили 653 гемодиализных больных с COVID-19, которые с 1 апреля до 31 декабря 2020 г. получали лечение в Московском городском научно-практическом центре нефрологии и патологии трансплантированной почки ГБУЗ ГКБ №52.
Результаты. За анализируемый период летальность составила 21,0%. Независимыми предикторами неблагоприятного исхода COVID-19 у гемодиализных пациентов оказались распространенность легочного поражения (по данным компьютерной томографии – КТ стадии 3–4), высокий индекс коморбидности и применение искусственной вентиляции легких. Подходы к лечению COVID-19 в разные периоды наблюдения существенно модифицировались. На более поздних этапах расширилось использование иммуномодулирующих препаратов (моноклональные антитела к интерлейкину-6 и кортикостероиды). При назначении тоцилизумаба летальность составила 15,1%, а тоцилизумаба и дексаметазона – 13,3%; в отсутствие их применения – 37,8% (р<0,001). Назначение тоцилизумаба в первые 3 сут после госпитализации у больных со стадиями КТ-1–2 оказалось связано с более благоприятным исходом болезни: умер 1 из 29 vs 6 из 20 пациентов, получивших препарат в более поздние сроки (p<0,04). У больных со стадиями КТ-3–4 достоверных различий частоты летального исхода в зависимости от сроков назначения тоцилизумаба не установлено.
Заключение. COVID-19 у гемодиализных больных может проявляться тяжелым течением с неблагоприятным прогнозом. Неотложными задачами являются выделение надежных предикторов исхода болезни и разработка эффективных методов лечения в этой популяции.
Ключевые слова: хроническая болезнь почек, гемодиализ, COVID-19, иммуномодуляторы
Materials and methods. Single-centre retrospective uncontrolled study included 653 COVID-19 HD-patients treated at Moscow City Nephrology Centre from April 1 to December 31, 2020.
Results. This period mortality rate was 21.0%. Independent predictors of COVID-19 unfavourable outcome in HD patients were pulmonary lesion extension (CT grades 3–4), high comorbidity index, and mechanical ventilation. Approaches to COVID-19 treatment modified significantly at different periods. Immunomodulatory drugs (monoclonal antibodies to IL-6, corticosteroids) were used largely at later stages. With tocilizumab administration, mortality was 15.1%, tocilizumab together with dexamethasone – 13.3%; without them – 37.8% (р<0,001). Tocilizumab administration in the first 3 days after hospitalization of patients with CT grades 1–2 was associated with more favourable outcomes: 1 out of 29 died vs 6 out of 20 (tocilizumab administered at later periods); p<0.04. There was no significant difference in death frequency in patients with CT grades 3–4 depending on tocilizumab administration time.
Conclusion. COVID-19 in HD patients can manifest in a severe course with unfavourable outcome. It is urgent to identify reliable disease outcome predictors and develop efficient treatment in this population.
Keywords: chronic kidney disease, haemodialysis, COVID-19, immunomodulators
Цель. Изучить особенности течения COVID-19, прогностические факторы, связанные с фатальным исходом, а также эффективность и трансформацию терапии на разных этапах первого года пандемии у больных, получающих лечение программным ГД.
Материалы и методы. В одноцентровое ретроспективное неконтролируемое исследование включили 653 гемодиализных больных с COVID-19, которые с 1 апреля до 31 декабря 2020 г. получали лечение в Московском городском научно-практическом центре нефрологии и патологии трансплантированной почки ГБУЗ ГКБ №52.
Результаты. За анализируемый период летальность составила 21,0%. Независимыми предикторами неблагоприятного исхода COVID-19 у гемодиализных пациентов оказались распространенность легочного поражения (по данным компьютерной томографии – КТ стадии 3–4), высокий индекс коморбидности и применение искусственной вентиляции легких. Подходы к лечению COVID-19 в разные периоды наблюдения существенно модифицировались. На более поздних этапах расширилось использование иммуномодулирующих препаратов (моноклональные антитела к интерлейкину-6 и кортикостероиды). При назначении тоцилизумаба летальность составила 15,1%, а тоцилизумаба и дексаметазона – 13,3%; в отсутствие их применения – 37,8% (р<0,001). Назначение тоцилизумаба в первые 3 сут после госпитализации у больных со стадиями КТ-1–2 оказалось связано с более благоприятным исходом болезни: умер 1 из 29 vs 6 из 20 пациентов, получивших препарат в более поздние сроки (p<0,04). У больных со стадиями КТ-3–4 достоверных различий частоты летального исхода в зависимости от сроков назначения тоцилизумаба не установлено.
Заключение. COVID-19 у гемодиализных больных может проявляться тяжелым течением с неблагоприятным прогнозом. Неотложными задачами являются выделение надежных предикторов исхода болезни и разработка эффективных методов лечения в этой популяции.
Ключевые слова: хроническая болезнь почек, гемодиализ, COVID-19, иммуномодуляторы
________________________________________________
Materials and methods. Single-centre retrospective uncontrolled study included 653 COVID-19 HD-patients treated at Moscow City Nephrology Centre from April 1 to December 31, 2020.
Results. This period mortality rate was 21.0%. Independent predictors of COVID-19 unfavourable outcome in HD patients were pulmonary lesion extension (CT grades 3–4), high comorbidity index, and mechanical ventilation. Approaches to COVID-19 treatment modified significantly at different periods. Immunomodulatory drugs (monoclonal antibodies to IL-6, corticosteroids) were used largely at later stages. With tocilizumab administration, mortality was 15.1%, tocilizumab together with dexamethasone – 13.3%; without them – 37.8% (р<0,001). Tocilizumab administration in the first 3 days after hospitalization of patients with CT grades 1–2 was associated with more favourable outcomes: 1 out of 29 died vs 6 out of 20 (tocilizumab administered at later periods); p<0.04. There was no significant difference in death frequency in patients with CT grades 3–4 depending on tocilizumab administration time.
Conclusion. COVID-19 in HD patients can manifest in a severe course with unfavourable outcome. It is urgent to identify reliable disease outcome predictors and develop efficient treatment in this population.
Keywords: chronic kidney disease, haemodialysis, COVID-19, immunomodulators
Полный текст
Список литературы
1. World Health Organization. Coronavirus disease (COVID-2019) situation reports. Available at: https://www.who.int/emergencies/diseases/novelcoronavirus-2019/situation-reports. Accessed: 16.03.2020.
2. Томилина Н.А., Фролова Н.Ф., Артюхина Л.Ю., и др. COVID-19: связь с патологией почек. Нефрология и диализ. 2021;23(2):147‑59 [Tomilina NA, Frolova NF, Artyukhina LYu. et al. Covid-19: relationship with kidney diseases. Nefrologiia i dializ. 2021;23(2):147‑59 (in Russian)]. DOI:10.28996/2618-9801-2021-2-147-159.
3. 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
4. Pei G, Zhang Z, Peng J, et al. Renal Involvement and Early Prognosis in Patients with COVID-19 Pneumonia. JASN. 2020(31):1157-65. DOI:10.1001/jama.2020.2648
5. Ronco C, Reis T, Husain-Syed F. Management of Acute Kidney Injury in Patients With COVID-19. Lancet Respir Med. 2020;(8)7:738-42. DOI:10.1016/S2213-2600(20)30229-0
6. Зелтынь-Абрамов Е.М., Белавина Н.И., Фролова Н.Ф, и др. Факторы риска неблагоприятного прогноза у пациентов на программном гемодиализе с COVID-19. Акцент на сердечно-сосудистую коморбидность (опыт одного центра). Нефрология и диализ. 2020;22:9‑20 [Zeltyn-Abramov EM, Belavina NI, Frolova NF, et al. Risk factors of adverse prognosis in patients on maintenance hemodialysis with Covid-19. Focus on cardivascular comorbidity (single center experience). Nefrologiia i dializ. 2020;22:9-20 (in Russian)]. DOI:10.28996/2618-9801-2020-Special_Issue-9-20.
7. Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19). Версия 8.1 (1.10.2020). Временные методические рекомендации. М.: Минздрав РФ, 2020 [Profilaktika, diagnostika i lechenie novoi koronavirusnoi infektsii (COVID-19). Versiia 8.1 (1.10.2020). Vremennye metodicheskie rekomendatsii. Moscow: Minzdrav RF, 2020 (in Russian)].
8. Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307(23):2526‑33. DOI:10.1001/jama.2012.5669
9. Hemmelgarn BR, Manns BJ, Quan H, Ghali WA. Adapting the Charlson Comorbidity Index for use in patients with ESRD. Am J Kidney Dis. 2003;42(1):125-32.
DOI:10.1016/s0272-6386(03)00415-3
10. Yi Y, Lagniton PNP, Ye S, et al. COVID-19: what has been learned and to be learned about the novel coronavirus disease. Int J Biol Sci. 2020;6(10):1753-66.
DOI:10.7150/ijbs.45134. eCollection 2020
11. Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA Cardiol. 2020;5(7):831-40. DOI:10.1001/jamacardio.2020.1286
12. Scarpioni R, Manini A, Valsania T, et al. Covid-19 and its impact on nephropathic patients: the experience at Ospedale "Guglielmo da Saliceto" in Piacenza. G Ital Nefrol. 2020;37(2):1-5.
13. Covid-19 Registro ERA-EDTA. Available at: https://www.era-edta.org/en/registry/covid-19. Accessed: 03.08.2020.
14. Alberici F, Delbarba E, Manenti C, et al. Management of patients on dialysis and with kidney transplantation during the SARS‑CoV-2 (COVID-19) pandemic in Brescia, Italy. Kidney Int Rep. 2020;5(5):580‑5. DOI:10.1016/j.ekir.2020.04.001
15. Ma Y, Diao B, Lv X, et al. 2019 novel coronavirus disease in hemodialysis (HD) patients: Report from one HD center in Wuhan China. MedRxiv. 2020. DOI:10.1101/2020.02.24.20027201
16. Wang R, Liao C, He H, et al. COVID-19 in hemodialysis patients: a report of 5 cases. Am J Kidney Dis. 2020;76(1):141-6.
DOI:10.1053/j.ajkd.2020.03.009
17. Ugur M, Ebru HAS, Ozlem KA, et al. Incidence and Immunologic Analysis of Coronavirus Disease (COVID-19) in Hemodialysis Patients: A Single-Center Experience. Exp Clin Transplant. 2020;18(3):275-83. DOI:10.6002/ect.2020.0194
18. Clarke C, Prendecki M, Dhutia A, et al. High Prevalence of Asymptomatic COVID-19 Infection in Hemodialysis Patients Detected Using Serologic Screening. J Am Soc Nephrol. 2020;31(9):1969-75. DOI:10.1681/ASN.2020060827
19. Зубкин М.Л., Шило В.Ю., Новикова Л.И., и др. Частота инфицирования SARS-CoV-2 среди больных, получающих лечение программным гемодиализом. Инфекционные болезни: новости, мнения, обучение. 2021 (в печати) [Zubkin ML, Shilo VIu, Novikova LI, et al. Frequency of SARS-CoV-2 infection in hemodialysis patients.Нужен перевод. Infektsionnye bolezni: novosti, mneniia, obuchenie. 2021;10(3):23-32 (in Russian)].
DOI:10.33029/2305-3496-2021-10-3-23-32
20. Фролова Н.Ф., Ким И.Г., Ушакова А.И., и др. COVID-19 у больных, получающих лечение программным гемодиализом. Инфекционные болезни: новости, мнения, обучение. 2021;10(1):14-23 [Frolova NF, Kim IG, Ushakova AI, et al. COVID-19 in hemodialysis patients. Infektsionnye bolezni: novosti, mneniia, obuchenie. 2021;10(1):14-23 (in Russian)]. DOI:10.33029/2305-3496-2021-10-1-14-23
21. Goicoechea M, Camara LAS, Macías N, et al. COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain. Kidney Int. 2020;98(1):27-34. DOI:10.1016/j.kint.2020.04.031
22. Valeri AM, Robbins-Juarez SY, Stevens JS, et al. Presentation and Outcomes of Patients with ESKD and COVID-19. J Am Soc Nephrol. 2020;31(7):1409-15. DOI:10.1681/ASN.2020040470
23. Ng JH, Hirsch JS, Wanchoo R, et al. Outcomes of patients with end-stage kidney disease hospitalized with COVID-19. Kidney Int. 2020;98(6):1530-9. DOI:10.1016/j.kint.2020.07.030
24. Grasselli G, Zangrillo A, Zanella A, et al. COVID-19 Lombardy ICU Network. 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
25. Fisher M, Yunes M, Mokrzycki MH, et al. Chronic Hemodialysis Patients Hospitalized with COVID-19: Short-term Outcomes in the Bronx, New York. Kidney 360. 2020;1(8):755-62.
DOI:10.34067/KID.0003672020
26. Xiong F, Tang H, Liu L, et al. Clinical Characteristics of and Medical Interventions for COVID-19 in Hemodialysis Patients in Wuhan, China. J Am Soc Nephrol. 2020;31(7):1387-97.
DOI:10.1681/ASN.2020030354
27. Corbett RW, Blakey S, Nitsch D, et al. Epidemiology of COVID-19 in an Urban Dialysis Center. J Am Soc Nephrol. 2020;31(8):1815-23. DOI:10.1681/ASN.2020040534
28. Manganaro M, Baldovino S. First considerations on the SARS CoV 2 epidemic in the Dialysis Units of Piedmont and Aosta Valley, Northern Italy. J Nephrol. 2020;33(3):393-5. DOI:10.1007/s40620-020-00732-1
29. Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes Metab Syndr. 2020;14(4):303-10.
DOI:10.1016/j.dsx.2020.04.004
30. Scheen AJ. Obesity and risk of severe COVID-19. Rev Med Suisse. 2020;16(695):1115-9.
31. Li X, Wang L, Yan S, et al. Clinical characteristics of 25 death cases with COVID-19: a retrospective review of medical records in a single medical center, Wuhan, China. Int J Infect Dis. 2020;94:128-32. DOI:10.1016/j.ijid.2020.03.053
32. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395(10229):1054-62.
DOI:10.1016/S0140-6736(20)30566-3
33. Liu W, Zhou P, Chen K, et al. Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis. CMAJ. 2020;192(27):734-44. DOI:10.1503/cmaj.200647
34. Hernandez AV, Roman YM, Pasupuleti V, et al. Hydroxychloroquine or Chloroquine for Treatment or Prophylaxis of COVID-19. Ann Intern Med. 2020;173(4):287-96. DOI:10.7326/L20-0945
35. Kim MS, An MH, Kim WJ, Hwang TH. Comparative efficacy and safety of pharmacological interventions for the treatment of COVID-19: a systematic review and network meta-analysis. PLoS Med. 2020;17(12):e1003501. DOI:10.1371/journal.pmed.1003501
36. Jorgensen SCJ, Tse CLY, Burry L, Dresser LD. Baricitinib: A review of pharmacology, safety and emerging clinical experience in COVID-19. Pharmacotherapy. 2020;40(8):843-56. DOI:10.1002/phar.2438
37. Hariyanto TI, Hardyson W, Kurniawan A. Efficacy and Safety of Tocilizumab for Coronavirus Disease 2019 (Covid-19) Patients: A Systematic Review and Meta-analysis. Drug Res (Stuttg). 2021;71(5):265-74. DOI:10.1055/a-1336-2371
38. Alunno A, Najm A, Mariette X, et al. Immunomodulatory therapies for SARS-CoV-2 infection: a systematic literature review to inform EULAR points to consider. Ann Rheum Dis. 2021;80(6):803-15. DOI:10.1136/annrheumdis-2020-219725
39. Tleyjeh IM, Kashour Z, Damlaj M, et al. Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis. Clin Microbiol Infect. 2021;27(2):215-27.
DOI:10.1016/j.cmi.2020.10.036.
2. Tomilina NA, Frolova NF, Artyukhina LYu. et al. Covid-19: relationship with kidney diseases. Nefrologiia i dializ. 2021;23(2):147‑59 (in Russian). DOI:10.28996/2618-9801-2021-2-147-159.
3. 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
4. Pei G, Zhang Z, Peng J, et al. Renal Involvement and Early Prognosis in Patients with COVID-19 Pneumonia. JASN. 2020(31):1157-65. DOI:10.1001/jama.2020.2648
5. Ronco C, Reis T, Husain-Syed F. Management of Acute Kidney Injury in Patients With COVID-19. Lancet Respir Med. 2020;(8)7:738-42. DOI:10.1016/S2213-2600(20)30229-0
6. Zeltyn-Abramov EM, Belavina NI, Frolova NF, et al. Risk factors of adverse prognosis in patients on maintenance hemodialysis with Covid-19. Focus on cardivascular comorbidity (single center experience). Nefrologiia i dializ. 2020;22:9-20 (in Russian). DOI:10.28996/2618-9801-2020-Special_Issue-9-20.
7. Profilaktika, diagnostika i lechenie novoi koronavirusnoi infektsii (COVID-19). Versiia 8.1 (1.10.2020). Vremennye metodicheskie rekomendatsii. Moscow: Minzdrav RF, 2020 (in Russian).
8. Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307(23):2526‑33. DOI:10.1001/jama.2012.5669
9. Hemmelgarn BR, Manns BJ, Quan H, Ghali WA. Adapting the Charlson Comorbidity Index for use in patients with ESRD. Am J Kidney Dis. 2003;42(1):125-32. DOI:10.1016/s0272-6386(03)00415-3
10. Yi Y, Lagniton PNP, Ye S, et al. COVID-19: what has been learned and to be learned about the novel coronavirus disease. Int J Biol Sci. 2020;6(10):1753-66. DOI:10.7150/ijbs.45134. eCollection 2020
11. Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA Cardiol. 2020;5(7):831-40. DOI:10.1001/jamacardio.2020.1286
12. Scarpioni R, Manini A, Valsania T, et al. Covid-19 and its impact on nephropathic patients: the experience at Ospedale "Guglielmo da Saliceto" in Piacenza. G Ital Nefrol. 2020;37(2):1-5.
13. Covid-19 Registro ERA-EDTA. Available at: https://www.era-edta.org/en/registry/covid-19. Accessed: 03.08.2020.
14. Alberici F, Delbarba E, Manenti C, et al. Management of patients on dialysis and with kidney transplantation during the SARS‑CoV-2 (COVID-19) pandemic in Brescia, Italy. Kidney Int Rep. 2020;5(5):580‑5. DOI:10.1016/j.ekir.2020.04.001
15. Ma Y, Diao B, Lv X, et al. 2019 novel coronavirus disease in hemodialysis (HD) patients: Report from one HD center in Wuhan China. MedRxiv. 2020. DOI:10.1101/2020.02.24.20027201
16. Wang R, Liao C, He H, et al. COVID-19 in hemodialysis patients: a report of 5 cases. Am J Kidney Dis. 2020;76(1):141-6.
DOI:10.1053/j.ajkd.2020.03.009
17. Ugur M, Ebru HAS, Ozlem KA, et al. Incidence and Immunologic Analysis of Coronavirus Disease (COVID-19) in Hemodialysis Patients: A Single-Center Experience. Exp Clin Transplant. 2020;18(3):275-83. DOI:10.6002/ect.2020.0194
18. Clarke C, Prendecki M, Dhutia A, et al. High Prevalence of Asymptomatic COVID-19 Infection in Hemodialysis Patients Detected Using Serologic Screening. J Am Soc Nephrol. 2020;31(9):1969-75. DOI:10.1681/ASN.2020060827
19. Zubkin ML, Shilo VIu, Novikova LI, et al. Frequency of SARS-CoV-2 infection in hemodialysis patients.Нужен перевод. Infektsionnye bolezni: novosti, mneniia, obuchenie. 2021;10(3):23-32 (in Russian).
DOI:10.33029/2305-3496-2021-10-3-23-32
20. Frolova NF, Kim IG, Ushakova AI, et al. COVID-19 in hemodialysis patients. Infektsionnye bolezni: novosti, mneniia, obuchenie. 2021;10(1):14-23 (in Russian). DOI:10.33029/2305-3496-2021-10-1-14-23
21. Goicoechea M, Camara LAS, Macías N, et al. COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain. Kidney Int. 2020;98(1):27-34. DOI:10.1016/j.kint.2020.04.031
22. Valeri AM, Robbins-Juarez SY, Stevens JS, et al. Presentation and Outcomes of Patients with ESKD and COVID-19. J Am Soc Nephrol. 2020;31(7):1409-15. DOI:10.1681/ASN.2020040470
23. Ng JH, Hirsch JS, Wanchoo R, et al. Outcomes of patients with end-stage kidney disease hospitalized with COVID-19. Kidney Int. 2020;98(6):1530-9. DOI:10.1016/j.kint.2020.07.030
24. Grasselli G, Zangrillo A, Zanella A, et al. COVID-19 Lombardy ICU Network. 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
25. Fisher M, Yunes M, Mokrzycki MH, et al. Chronic Hemodialysis Patients Hospitalized with COVID-19: Short-term Outcomes in the Bronx, New York. Kidney 360. 2020;1(8):755-62.
DOI:10.34067/KID.0003672020
26. Xiong F, Tang H, Liu L, et al. Clinical Characteristics of and Medical Interventions for COVID-19 in Hemodialysis Patients in Wuhan, China. J Am Soc Nephrol. 2020;31(7):1387-97.
DOI:10.1681/ASN.2020030354
27. Corbett RW, Blakey S, Nitsch D, et al. Epidemiology of COVID-19 in an Urban Dialysis Center. J Am Soc Nephrol. 2020;31(8):1815-23. DOI:10.1681/ASN.2020040534
28. Manganaro M, Baldovino S. First considerations on the SARS CoV 2 epidemic in the Dialysis Units of Piedmont and Aosta Valley, Northern Italy. J Nephrol. 2020;33(3):393-5. DOI:10.1007/s40620-020-00732-1
29. Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes Metab Syndr. 2020;14(4):303-10.
DOI:10.1016/j.dsx.2020.04.004
30. Scheen AJ. Obesity and risk of severe COVID-19. Rev Med Suisse. 2020;16(695):1115-9.
31. Li X, Wang L, Yan S, et al. Clinical characteristics of 25 death cases with COVID-19: a retrospective review of medical records in a single medical center, Wuhan, China. Int J Infect Dis. 2020;94:128-32. DOI:10.1016/j.ijid.2020.03.053
32. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395(10229):1054-62.
DOI:10.1016/S0140-6736(20)30566-3
33. Liu W, Zhou P, Chen K, et al. Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis. CMAJ. 2020;192(27):734-44. DOI:10.1503/cmaj.200647
34. Hernandez AV, Roman YM, Pasupuleti V, et al. Hydroxychloroquine or Chloroquine for Treatment or Prophylaxis of COVID-19. Ann Intern Med. 2020;173(4):287-96. DOI:10.7326/L20-0945
35. Kim MS, An MH, Kim WJ, Hwang TH. Comparative efficacy and safety of pharmacological interventions for the treatment of COVID-19: a systematic review and network meta-analysis. PLoS Med. 2020;17(12):e1003501. DOI:10.1371/journal.pmed.1003501
36. Jorgensen SCJ, Tse CLY, Burry L, Dresser LD. Baricitinib: A review of pharmacology, safety and emerging clinical experience in COVID-19. Pharmacotherapy. 2020;40(8):843-56. DOI:10.1002/phar.2438
37. Hariyanto TI, Hardyson W, Kurniawan A. Efficacy and Safety of Tocilizumab for Coronavirus Disease 2019 (Covid-19) Patients: A Systematic Review and Meta-analysis. Drug Res (Stuttg). 2021;71(5):265-74. DOI:10.1055/a-1336-2371
38. Alunno A, Najm A, Mariette X, et al. Immunomodulatory therapies for SARS-CoV-2 infection: a systematic literature review to inform EULAR points to consider. Ann Rheum Dis. 2021;80(6):803-15. DOI:10.1136/annrheumdis-2020-219725
39. Tleyjeh IM, Kashour Z, Damlaj M, et al. Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis. Clin Microbiol Infect. 2021;27(2):215-27.
DOI:10.1016/j.cmi.2020.10.036.
2. Томилина Н.А., Фролова Н.Ф., Артюхина Л.Ю., и др. COVID-19: связь с патологией почек. Нефрология и диализ. 2021;23(2):147‑59 [Tomilina NA, Frolova NF, Artyukhina LYu. et al. Covid-19: relationship with kidney diseases. Nefrologiia i dializ. 2021;23(2):147‑59 (in Russian)]. DOI:10.28996/2618-9801-2021-2-147-159.
3. 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
4. Pei G, Zhang Z, Peng J, et al. Renal Involvement and Early Prognosis in Patients with COVID-19 Pneumonia. JASN. 2020(31):1157-65. DOI:10.1001/jama.2020.2648
5. Ronco C, Reis T, Husain-Syed F. Management of Acute Kidney Injury in Patients With COVID-19. Lancet Respir Med. 2020;(8)7:738-42. DOI:10.1016/S2213-2600(20)30229-0
6. Зелтынь-Абрамов Е.М., Белавина Н.И., Фролова Н.Ф, и др. Факторы риска неблагоприятного прогноза у пациентов на программном гемодиализе с COVID-19. Акцент на сердечно-сосудистую коморбидность (опыт одного центра). Нефрология и диализ. 2020;22:9‑20 [Zeltyn-Abramov EM, Belavina NI, Frolova NF, et al. Risk factors of adverse prognosis in patients on maintenance hemodialysis with Covid-19. Focus on cardivascular comorbidity (single center experience). Nefrologiia i dializ. 2020;22:9-20 (in Russian)]. DOI:10.28996/2618-9801-2020-Special_Issue-9-20.
7. Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19). Версия 8.1 (1.10.2020). Временные методические рекомендации. М.: Минздрав РФ, 2020 [Profilaktika, diagnostika i lechenie novoi koronavirusnoi infektsii (COVID-19). Versiia 8.1 (1.10.2020). Vremennye metodicheskie rekomendatsii. Moscow: Minzdrav RF, 2020 (in Russian)].
8. Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307(23):2526‑33. DOI:10.1001/jama.2012.5669
9. Hemmelgarn BR, Manns BJ, Quan H, Ghali WA. Adapting the Charlson Comorbidity Index for use in patients with ESRD. Am J Kidney Dis. 2003;42(1):125-32.
DOI:10.1016/s0272-6386(03)00415-3
10. Yi Y, Lagniton PNP, Ye S, et al. COVID-19: what has been learned and to be learned about the novel coronavirus disease. Int J Biol Sci. 2020;6(10):1753-66.
DOI:10.7150/ijbs.45134. eCollection 2020
11. Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA Cardiol. 2020;5(7):831-40. DOI:10.1001/jamacardio.2020.1286
12. Scarpioni R, Manini A, Valsania T, et al. Covid-19 and its impact on nephropathic patients: the experience at Ospedale "Guglielmo da Saliceto" in Piacenza. G Ital Nefrol. 2020;37(2):1-5.
13. Covid-19 Registro ERA-EDTA. Available at: https://www.era-edta.org/en/registry/covid-19. Accessed: 03.08.2020.
14. Alberici F, Delbarba E, Manenti C, et al. Management of patients on dialysis and with kidney transplantation during the SARS‑CoV-2 (COVID-19) pandemic in Brescia, Italy. Kidney Int Rep. 2020;5(5):580‑5. DOI:10.1016/j.ekir.2020.04.001
15. Ma Y, Diao B, Lv X, et al. 2019 novel coronavirus disease in hemodialysis (HD) patients: Report from one HD center in Wuhan China. MedRxiv. 2020. DOI:10.1101/2020.02.24.20027201
16. Wang R, Liao C, He H, et al. COVID-19 in hemodialysis patients: a report of 5 cases. Am J Kidney Dis. 2020;76(1):141-6.
DOI:10.1053/j.ajkd.2020.03.009
17. Ugur M, Ebru HAS, Ozlem KA, et al. Incidence and Immunologic Analysis of Coronavirus Disease (COVID-19) in Hemodialysis Patients: A Single-Center Experience. Exp Clin Transplant. 2020;18(3):275-83. DOI:10.6002/ect.2020.0194
18. Clarke C, Prendecki M, Dhutia A, et al. High Prevalence of Asymptomatic COVID-19 Infection in Hemodialysis Patients Detected Using Serologic Screening. J Am Soc Nephrol. 2020;31(9):1969-75. DOI:10.1681/ASN.2020060827
19. Зубкин М.Л., Шило В.Ю., Новикова Л.И., и др. Частота инфицирования SARS-CoV-2 среди больных, получающих лечение программным гемодиализом. Инфекционные болезни: новости, мнения, обучение. 2021 (в печати) [Zubkin ML, Shilo VIu, Novikova LI, et al. Frequency of SARS-CoV-2 infection in hemodialysis patients.Нужен перевод. Infektsionnye bolezni: novosti, mneniia, obuchenie. 2021;10(3):23-32 (in Russian)].
DOI:10.33029/2305-3496-2021-10-3-23-32
20. Фролова Н.Ф., Ким И.Г., Ушакова А.И., и др. COVID-19 у больных, получающих лечение программным гемодиализом. Инфекционные болезни: новости, мнения, обучение. 2021;10(1):14-23 [Frolova NF, Kim IG, Ushakova AI, et al. COVID-19 in hemodialysis patients. Infektsionnye bolezni: novosti, mneniia, obuchenie. 2021;10(1):14-23 (in Russian)]. DOI:10.33029/2305-3496-2021-10-1-14-23
21. Goicoechea M, Camara LAS, Macías N, et al. COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain. Kidney Int. 2020;98(1):27-34. DOI:10.1016/j.kint.2020.04.031
22. Valeri AM, Robbins-Juarez SY, Stevens JS, et al. Presentation and Outcomes of Patients with ESKD and COVID-19. J Am Soc Nephrol. 2020;31(7):1409-15. DOI:10.1681/ASN.2020040470
23. Ng JH, Hirsch JS, Wanchoo R, et al. Outcomes of patients with end-stage kidney disease hospitalized with COVID-19. Kidney Int. 2020;98(6):1530-9. DOI:10.1016/j.kint.2020.07.030
24. Grasselli G, Zangrillo A, Zanella A, et al. COVID-19 Lombardy ICU Network. 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
25. Fisher M, Yunes M, Mokrzycki MH, et al. Chronic Hemodialysis Patients Hospitalized with COVID-19: Short-term Outcomes in the Bronx, New York. Kidney 360. 2020;1(8):755-62.
DOI:10.34067/KID.0003672020
26. Xiong F, Tang H, Liu L, et al. Clinical Characteristics of and Medical Interventions for COVID-19 in Hemodialysis Patients in Wuhan, China. J Am Soc Nephrol. 2020;31(7):1387-97.
DOI:10.1681/ASN.2020030354
27. Corbett RW, Blakey S, Nitsch D, et al. Epidemiology of COVID-19 in an Urban Dialysis Center. J Am Soc Nephrol. 2020;31(8):1815-23. DOI:10.1681/ASN.2020040534
28. Manganaro M, Baldovino S. First considerations on the SARS CoV 2 epidemic in the Dialysis Units of Piedmont and Aosta Valley, Northern Italy. J Nephrol. 2020;33(3):393-5. DOI:10.1007/s40620-020-00732-1
29. Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes Metab Syndr. 2020;14(4):303-10.
DOI:10.1016/j.dsx.2020.04.004
30. Scheen AJ. Obesity and risk of severe COVID-19. Rev Med Suisse. 2020;16(695):1115-9.
31. Li X, Wang L, Yan S, et al. Clinical characteristics of 25 death cases with COVID-19: a retrospective review of medical records in a single medical center, Wuhan, China. Int J Infect Dis. 2020;94:128-32. DOI:10.1016/j.ijid.2020.03.053
32. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395(10229):1054-62.
DOI:10.1016/S0140-6736(20)30566-3
33. Liu W, Zhou P, Chen K, et al. Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis. CMAJ. 2020;192(27):734-44. DOI:10.1503/cmaj.200647
34. Hernandez AV, Roman YM, Pasupuleti V, et al. Hydroxychloroquine or Chloroquine for Treatment or Prophylaxis of COVID-19. Ann Intern Med. 2020;173(4):287-96. DOI:10.7326/L20-0945
35. Kim MS, An MH, Kim WJ, Hwang TH. Comparative efficacy and safety of pharmacological interventions for the treatment of COVID-19: a systematic review and network meta-analysis. PLoS Med. 2020;17(12):e1003501. DOI:10.1371/journal.pmed.1003501
36. Jorgensen SCJ, Tse CLY, Burry L, Dresser LD. Baricitinib: A review of pharmacology, safety and emerging clinical experience in COVID-19. Pharmacotherapy. 2020;40(8):843-56. DOI:10.1002/phar.2438
37. Hariyanto TI, Hardyson W, Kurniawan A. Efficacy and Safety of Tocilizumab for Coronavirus Disease 2019 (Covid-19) Patients: A Systematic Review and Meta-analysis. Drug Res (Stuttg). 2021;71(5):265-74. DOI:10.1055/a-1336-2371
38. Alunno A, Najm A, Mariette X, et al. Immunomodulatory therapies for SARS-CoV-2 infection: a systematic literature review to inform EULAR points to consider. Ann Rheum Dis. 2021;80(6):803-15. DOI:10.1136/annrheumdis-2020-219725
39. Tleyjeh IM, Kashour Z, Damlaj M, et al. Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis. Clin Microbiol Infect. 2021;27(2):215-27.
DOI:10.1016/j.cmi.2020.10.036.
________________________________________________
2. Tomilina NA, Frolova NF, Artyukhina LYu. et al. Covid-19: relationship with kidney diseases. Nefrologiia i dializ. 2021;23(2):147‑59 (in Russian). DOI:10.28996/2618-9801-2021-2-147-159.
3. 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
4. Pei G, Zhang Z, Peng J, et al. Renal Involvement and Early Prognosis in Patients with COVID-19 Pneumonia. JASN. 2020(31):1157-65. DOI:10.1001/jama.2020.2648
5. Ronco C, Reis T, Husain-Syed F. Management of Acute Kidney Injury in Patients With COVID-19. Lancet Respir Med. 2020;(8)7:738-42. DOI:10.1016/S2213-2600(20)30229-0
6. Zeltyn-Abramov EM, Belavina NI, Frolova NF, et al. Risk factors of adverse prognosis in patients on maintenance hemodialysis with Covid-19. Focus on cardivascular comorbidity (single center experience). Nefrologiia i dializ. 2020;22:9-20 (in Russian). DOI:10.28996/2618-9801-2020-Special_Issue-9-20.
7. Profilaktika, diagnostika i lechenie novoi koronavirusnoi infektsii (COVID-19). Versiia 8.1 (1.10.2020). Vremennye metodicheskie rekomendatsii. Moscow: Minzdrav RF, 2020 (in Russian).
8. Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307(23):2526‑33. DOI:10.1001/jama.2012.5669
9. Hemmelgarn BR, Manns BJ, Quan H, Ghali WA. Adapting the Charlson Comorbidity Index for use in patients with ESRD. Am J Kidney Dis. 2003;42(1):125-32. DOI:10.1016/s0272-6386(03)00415-3
10. Yi Y, Lagniton PNP, Ye S, et al. COVID-19: what has been learned and to be learned about the novel coronavirus disease. Int J Biol Sci. 2020;6(10):1753-66. DOI:10.7150/ijbs.45134. eCollection 2020
11. Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA Cardiol. 2020;5(7):831-40. DOI:10.1001/jamacardio.2020.1286
12. Scarpioni R, Manini A, Valsania T, et al. Covid-19 and its impact on nephropathic patients: the experience at Ospedale "Guglielmo da Saliceto" in Piacenza. G Ital Nefrol. 2020;37(2):1-5.
13. Covid-19 Registro ERA-EDTA. Available at: https://www.era-edta.org/en/registry/covid-19. Accessed: 03.08.2020.
14. Alberici F, Delbarba E, Manenti C, et al. Management of patients on dialysis and with kidney transplantation during the SARS‑CoV-2 (COVID-19) pandemic in Brescia, Italy. Kidney Int Rep. 2020;5(5):580‑5. DOI:10.1016/j.ekir.2020.04.001
15. Ma Y, Diao B, Lv X, et al. 2019 novel coronavirus disease in hemodialysis (HD) patients: Report from one HD center in Wuhan China. MedRxiv. 2020. DOI:10.1101/2020.02.24.20027201
16. Wang R, Liao C, He H, et al. COVID-19 in hemodialysis patients: a report of 5 cases. Am J Kidney Dis. 2020;76(1):141-6.
DOI:10.1053/j.ajkd.2020.03.009
17. Ugur M, Ebru HAS, Ozlem KA, et al. Incidence and Immunologic Analysis of Coronavirus Disease (COVID-19) in Hemodialysis Patients: A Single-Center Experience. Exp Clin Transplant. 2020;18(3):275-83. DOI:10.6002/ect.2020.0194
18. Clarke C, Prendecki M, Dhutia A, et al. High Prevalence of Asymptomatic COVID-19 Infection in Hemodialysis Patients Detected Using Serologic Screening. J Am Soc Nephrol. 2020;31(9):1969-75. DOI:10.1681/ASN.2020060827
19. Zubkin ML, Shilo VIu, Novikova LI, et al. Frequency of SARS-CoV-2 infection in hemodialysis patients.Нужен перевод. Infektsionnye bolezni: novosti, mneniia, obuchenie. 2021;10(3):23-32 (in Russian).
DOI:10.33029/2305-3496-2021-10-3-23-32
20. Frolova NF, Kim IG, Ushakova AI, et al. COVID-19 in hemodialysis patients. Infektsionnye bolezni: novosti, mneniia, obuchenie. 2021;10(1):14-23 (in Russian). DOI:10.33029/2305-3496-2021-10-1-14-23
21. Goicoechea M, Camara LAS, Macías N, et al. COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain. Kidney Int. 2020;98(1):27-34. DOI:10.1016/j.kint.2020.04.031
22. Valeri AM, Robbins-Juarez SY, Stevens JS, et al. Presentation and Outcomes of Patients with ESKD and COVID-19. J Am Soc Nephrol. 2020;31(7):1409-15. DOI:10.1681/ASN.2020040470
23. Ng JH, Hirsch JS, Wanchoo R, et al. Outcomes of patients with end-stage kidney disease hospitalized with COVID-19. Kidney Int. 2020;98(6):1530-9. DOI:10.1016/j.kint.2020.07.030
24. Grasselli G, Zangrillo A, Zanella A, et al. COVID-19 Lombardy ICU Network. 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
25. Fisher M, Yunes M, Mokrzycki MH, et al. Chronic Hemodialysis Patients Hospitalized with COVID-19: Short-term Outcomes in the Bronx, New York. Kidney 360. 2020;1(8):755-62.
DOI:10.34067/KID.0003672020
26. Xiong F, Tang H, Liu L, et al. Clinical Characteristics of and Medical Interventions for COVID-19 in Hemodialysis Patients in Wuhan, China. J Am Soc Nephrol. 2020;31(7):1387-97.
DOI:10.1681/ASN.2020030354
27. Corbett RW, Blakey S, Nitsch D, et al. Epidemiology of COVID-19 in an Urban Dialysis Center. J Am Soc Nephrol. 2020;31(8):1815-23. DOI:10.1681/ASN.2020040534
28. Manganaro M, Baldovino S. First considerations on the SARS CoV 2 epidemic in the Dialysis Units of Piedmont and Aosta Valley, Northern Italy. J Nephrol. 2020;33(3):393-5. DOI:10.1007/s40620-020-00732-1
29. Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes Metab Syndr. 2020;14(4):303-10.
DOI:10.1016/j.dsx.2020.04.004
30. Scheen AJ. Obesity and risk of severe COVID-19. Rev Med Suisse. 2020;16(695):1115-9.
31. Li X, Wang L, Yan S, et al. Clinical characteristics of 25 death cases with COVID-19: a retrospective review of medical records in a single medical center, Wuhan, China. Int J Infect Dis. 2020;94:128-32. DOI:10.1016/j.ijid.2020.03.053
32. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395(10229):1054-62.
DOI:10.1016/S0140-6736(20)30566-3
33. Liu W, Zhou P, Chen K, et al. Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis. CMAJ. 2020;192(27):734-44. DOI:10.1503/cmaj.200647
34. Hernandez AV, Roman YM, Pasupuleti V, et al. Hydroxychloroquine or Chloroquine for Treatment or Prophylaxis of COVID-19. Ann Intern Med. 2020;173(4):287-96. DOI:10.7326/L20-0945
35. Kim MS, An MH, Kim WJ, Hwang TH. Comparative efficacy and safety of pharmacological interventions for the treatment of COVID-19: a systematic review and network meta-analysis. PLoS Med. 2020;17(12):e1003501. DOI:10.1371/journal.pmed.1003501
36. Jorgensen SCJ, Tse CLY, Burry L, Dresser LD. Baricitinib: A review of pharmacology, safety and emerging clinical experience in COVID-19. Pharmacotherapy. 2020;40(8):843-56. DOI:10.1002/phar.2438
37. Hariyanto TI, Hardyson W, Kurniawan A. Efficacy and Safety of Tocilizumab for Coronavirus Disease 2019 (Covid-19) Patients: A Systematic Review and Meta-analysis. Drug Res (Stuttg). 2021;71(5):265-74. DOI:10.1055/a-1336-2371
38. Alunno A, Najm A, Mariette X, et al. Immunomodulatory therapies for SARS-CoV-2 infection: a systematic literature review to inform EULAR points to consider. Ann Rheum Dis. 2021;80(6):803-15. DOI:10.1136/annrheumdis-2020-219725
39. Tleyjeh IM, Kashour Z, Damlaj M, et al. Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis. Clin Microbiol Infect. 2021;27(2):215-27.
DOI:10.1016/j.cmi.2020.10.036.
Авторы
М.Л. Зубкин*1–3, Н.Ф. Фролова1, И.Г. Ким1,2, А.И. Ушакова1, С.С. Усатюк1, Р.Т. Исхаков1, Е.Н. Дьякова1, В.И. Червинко3, Е.В. Володина2, Н.А. Томилина4, Е.В. Крюков5
1 ГБУЗ «Городская клиническая больница №52» Департамента здравоохранения г. Москвы, Москва, Россия;
2 ФБУН «Московский научно-исследовательский институт эпидемиологии и микробиологии им. Г.Н. Габричевского» Роспотребнадзора, Москва, Россия;
3 Филиал ФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» Минобороны России, Москва, Россия;
4 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России,
Москва, Россия;
5 ФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» Минобороны России, Санкт-Петербург, Россия
*m-zubkin@yandex.ru
1 Moscow City Clinical Hospital №52, Moscow, Russia;
2 Gabrichevsky Research Institute of Epidemiology and Microbiology, Moscow, Russia;
3 Branch of the Kirov Military Medical Academy, Moscow, Russia;
4 Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia;
5 Kirov Military Medical Academy, Saint Petersburg, Russia
*m-zubkin@yandex.ru
1 ГБУЗ «Городская клиническая больница №52» Департамента здравоохранения г. Москвы, Москва, Россия;
2 ФБУН «Московский научно-исследовательский институт эпидемиологии и микробиологии им. Г.Н. Габричевского» Роспотребнадзора, Москва, Россия;
3 Филиал ФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» Минобороны России, Москва, Россия;
4 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России,
Москва, Россия;
5 ФГБВОУ ВО «Военно-медицинская академия им. С.М. Кирова» Минобороны России, Санкт-Петербург, Россия
*m-zubkin@yandex.ru
________________________________________________
1 Moscow City Clinical Hospital №52, Moscow, Russia;
2 Gabrichevsky Research Institute of Epidemiology and Microbiology, Moscow, Russia;
3 Branch of the Kirov Military Medical Academy, Moscow, Russia;
4 Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia;
5 Kirov Military Medical Academy, Saint Petersburg, Russia
*m-zubkin@yandex.ru
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.
