OBJECTIVE
To describe the methodology for creating and the first results of the prospective hospital registry of patients with suspected or confirmed coronavirus infection (COVID-19) and community-acquired pneumonia (TARGET-VIP)
MATERIAL AND METHODS
The registry included all patients admitted to the National Medical and Surgical Center named after N.I. Pirogov from April 6 to June 2, 2020 with suspected or confirmed coronavirus infection and community-acquired pneumonia. All patients’ data were taken from medical records. An additional survey of patients was performed (in the hospital or during the first 30 days of post-hospital period) in order to clarify data on risk factors, history of somatic and infectious diseases, pre-hospital drug therapy. At the outpatient stage, it is planned to collect data about the dynamics of clinical status and long-term outcomes in patients enrolled into the registry. For this purpose, a special survey of patients or their relatives during telephone contact 1—2, 6, 12 and 24 months after discharge from the hospital will be performed.
RESULTS
The registry included 1.130 patients (age 57.5±12.8 years, 51.2% men). COVID-19 was diagnosed in 60.7% of cases when PCR-tests were positive, and community-acquired pneumonia was confirmed in 94.2% of patents, cardiovascular diseases (CVD) were diagnosed in 52.9% of cases. Among chronic non-cardiac diseases the incidence of digestive diseases (22.1%) and diabetes (16.3%) was maximal, but those with bronchial asthma and anemia — were minimal (3.1 and 3.5%, respectively). CVDs or non-CVDs were revealed in 75.8% of cases. Data on the values of height and body weight were available in the medical records in 97% of cases, but the calculation of body mass index (BMI) was practically not used. The incidence of obesity according to clinical diagnosis was 6.1% while BMI≥30 kg/m2 was revealed in 35.2% of cases. Hydroxychloroquine was administrated in 84.3% of patients, anticoagulants — in 84.2%, antibiotics — in 70.0%, glucocorticoids — in 15.2%, antiviral drugs — in 5.9%, immune-suppressants — in 8.6% of patients. The rate of prescriptions of ACE-inhibitors/angiotensin receptor blockers (53.7%) and beta-blockers (45.6%) was bigger than those of other components of cardiovascular pharmacotherapy in 598 patients with CVD. The hospital mortality rate was 4.2%. Among the age group 65 years and older mortality (9.7%) was 6 times higher than among younger patients (1.6%). Patients who died were 16 years older than survivals. The proportion of patients with coronary artery disease, atrial fibrillation and chronic kidney disease was significantly bigger in non-survivals than in survivals (Odds Ratio after adjustment to age and sex was 2.2, 5.0 and 4.1, respectively; p<0.05).
CONCLUSION
The majority of patients in the TARGET-VIP registry had COVID-19 (60.7% of PCR-tests were positive), community-acquired pneumonia (94.2%), CVDs of non-CVDs (75.8%). The incidence of obesity in clinical diagnosis was 6 times less than those according to the BMI value. The rate of prescription of hydroxychloroquine and anticoagulants was maximal (84.3 and 84.2%, respectively). Hospital mortality was 4.2%. Among the age group 65 years and older, hospital mortality was 6 times higher than among younger patients.
