Clinical features of post-COVID-19 period. Results of the international register “Dynamic analysis of comorbidities in SARS-CoV-2 survivors (AKTIV SARS-CoV-2)”. Data from 6-month follow-up
https://doi.org/10.15829/1560-4071-2021-4708
Abstract
Aim. To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register.
Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 — 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months.
Results. According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure.
Conclusion. According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period.
About the Authors
G. P. ArutyunovRussian Federation
MD, PhD, professor, corresponding member of the Russian Academy of Sciences, President; Head of the Department of Internal Medicine, Honored Doctor of the Russian Federation
E. I. Tarlovskaya
Russian Federation
MD, PhD, Professor, Chairperson of the Eurasian Association of Therapists branch in Nizhny Novgorod; head of the Department of therapy and cardiology
A. G. Arutyunov
Russian Federation
MD, PhD, Professor, Secretary General of the Eurasian Association of Therapists
Yu. N. Belenkov
Russian Federation
Аcademician of RAS, MD, PhD, head of Department of hospital therapy №1 medical faculty
A. O. Konradi
Russian Federation
Сorresponding member of the Russian Academy of Sciences. MD, PhD, Professor, Deputy General Director of scientific work
Yu. M. Lopatin
Russian Federation
MD, PhD, Professor, Head of the Departrment of Cardiology and Functional Diagnostics, Faculty of Advanced Training for Doctors
A. P. Rebrov
Russian Federation
PhD, MD, Professor at the Department of the Internal Medicine
S. N. Tereshchenko
Russian Federation
MD, PhD, Professor, head of the Department of myocardial diseases and heart failure
A. I. Chesnikova
Russian Federation
MD, PhD, Professor, Professor in the Department of Internal Medicine No.1
H. G. Hayrapetyan
Armenia
MD, PhD, professor, Head of Cardiology Center, Head of Cardiology Department
A. P. Babin
Moldova, Republic of
MD, PhD, Associate Professor, Head of the Department of Family Medicine
I. G. Bakulin
Russian Federation
MD, PhD, professor, Dean of the General Medicine Faculty, Head of the department of Propedeutics of Internal Diseases, Gastroenterology and Dietology named after S.M. Ryss, Internal Medicine Adviser to the Ministry of Health (the Northwestern federal district of Russia)
N. V. Bakulina
Russian Federation
MD, PhD, Professor, Head of the department of Internal Diseases, Clinical Pharmacology and Nephrology
L. A. Balykova
Russian Federation
MD, PhD, professor, Director of the Medicine Institute, corresponding member of the Russian Academy of Sciences
A. S. Blagonravova
Russian Federation
MD, PhD, Vice rector for research, professor of epidemiology, microbiology and evidence based medicine
M. V. Boldina
Russian Federation
PhD, associate Professor of the Department of therapy and cardiology
A. R. Vaisberg
Russian Federation
PhD, Associate Professor, Department of Therapy and Cardiology
A. S. Galyavich
Russian Federation
MD, PhD, professor,Chief Cardiologist of the Republic of Tatarstan, Corresponding Member of the Academy of Sciences of the Republic of Tatarstan, Head of the Republican Center for Cardiovascular Diseases of State Autonomous Institution of Health "Interregional Clinical Diagnostic Center"; Head of the Department of Faculty Therapy
V. V. Gomonova
Russian Federation
Deputy Chief Physician
N. Yu. Grigorieva
Russian Federation
MD, PhD, associate Professor, head of the Department of clinical medicine
I. V. Gubareva
Russian Federation
MD, PhD, Associated Professor, head of Internal Diseases Department
I. V. Demko
Russian Federation
MD, PhD, professor, Head of the Department of Hospital Therapy and Immunology with Postgraduate Education; Head of the Department of Pulmonary Allergology Center,
pulmonologist, allergist-immunologist
A. V. Evzerikhina
Russian Federation
PhD, deputy chief physician
A. V. Zharkov
Russian Federation
PhD, chief physician
U. K. Kamilova
Uzbekistan
MD, PhD, Professor, Deputy Director of Scientific Work
Z. F. Kim
Russian Federation
PhD, associate professor, deputy chief physician
T. Yu. Kuznetsova
Russian Federation
MD, PhD, associated professor, head of the department of Faculty Therapy, Phthisiology, Infectious Diseases and Epidemiology, deputy director for postgraduate education
N. V. Lareva
Russian Federation
MD, PhD, professor, head of the department of Therapy at the Faculty of Advanced Training and Professional Continuing Education
E. V. Makarova
Russian Federation
MD, PhD, Associate Professor, Head of the Department of Propaedeutics of internal diseases; Senior Researcher
S. V. Malchikova
Russian Federation
MD, PhD, associate professor, ptofessor of the Department of Clinical Therapy
S. V. Nedogoda
Russian Federation
MD, PhD, professor, vice-rector for clinical work and regional health development, head of the Department of Internal Medicine
M. M. Petrova
Russian Federation
MD, PhD, professor, head of the Department of Polyclinic Therapy and Family Medicine with a Course of Postgraduate Education
I. G. Pochinka
Russian Federation
MD, PhD, associate professor at the Department of Enocrinology and Internal Medicine; head of the Department of Cardiology №1
K. V. Protasov
Russian Federation
MD, PhD, professor, deputy director of research
D. N. Protsenko
Russian Federation
PhD, chief physician of The City Clinical Hospital №40; head of the anesthesiology and resuscitation department of the school of continuing medical education
D. Yu. Ruzanau
Belarus
PhD, associate professor, vice-rector for clinical work, professor at the Department of Phthisiology and Pulmonology
S. A. Sayganov
Russian Federation
MD, PhD, rector, professor, head of the Department of Hospital Therapy and Cardiology
A. Sh. Sarybaev
Kyrgyzstan
MD, PhD, professor, Head of the National Center of Cardiology and Internal Medicine named after prof. M. Mirrakhimov
N. M. Selezneva
Russian Federation
PhD, associate professor at the Department of Hospital Therapy
A. B. Sugraliev
Kazakhstan
PhD, associate professor, head of the Department of Internal Diseases with a Course of Propaedeutics
I. V. Fomin
Russian Federation
MD, PhD, associate professor, head of the department of hospital therapy
O. V. Khlynova
Russian Federation
MD, PhD, Professor, corresponding member of the Russian Academy of Sciences, Head of the Department of Hospital Therapy
O. Yu. Chizhova
Russian Federation
MD, PhD, professor at the department of Propedeutics of Internal Diseases, Gastroenterology and Dietology named after S.M. Ryss
I. I. Shaposhnik
Russian Federation
MD, PhD, professor, head of the department of the propaedeutics of internal diseases
D. A. Shchukarev
Russian Federation
head of department of infectious deseases
A. K. Abdrahmanova
Kazakhstan
PhD, head of the Department of Infectious Diseases, chief physician
S. A. Avetisian
Armenia
clinical resident at cardiology department
H. G. Avoyan
Armenia
cardiologist
K. K. Azarian
Armenia
cardiologist
G. T. Aimakhanova
Kazakhstan
PhD, Associate Professor at the Department of Internal Diseases with a course of propaedeutics
D. A. Ayipova
Kyrgyzstan
head of the department of nephrology
A. Ch. Akunov
Kyrgyzstan
PhD, head of the Department of urgent cardiology and reanmation-2
M. K. Alieva
Russian Federation
therapist
A. V. Aparkina
Russian Federation
PhD, assistant at the Department of Hospital Therapy, Medical Faculty
O. R. Aruslanova
Russian Federation
PhD, cardiovascular surgeon
E. Yu. Ashina
Russian Federation
assistant at the Department of Propedeutics of Internal Diseases
O. Yu. Badina
Russian Federation
Head of the Infectious Diseases Department
O. Yu. Barisheva
Russian Federation
MD, PhD, associated professor, professor of department of hospital therapy
T. I. Batluk
Russian Federation
PhD, Medical adviser; Assistant Lecturer, Department of Internal Medicine Propaedeutics, Pediatric Faculty
A. S. Batchayeva
Russian Federation
clinical laboratory diagnostician
R. A. Bashkinov
Russian Federation
Medical adviser; postgraduate student of the department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E. E. Eichwald 2019-2022
A. M. Bitieva
Russian Federation
cardiologist
I. U. Bikhteyev
Russian Federation
student
N. A. Borodulina
Russian Federation
cardiologist
M. V. Bragin
Russian Federation
student
A. M. Budu
Moldova, Republic of
head at the Department of Therapy
G. A. Bykova
Russian Federation
PhD, associate professor at the Department of Hospital Care, pulmonologist
K. R. Vagapova
Russian Federation
endocrinologist
D. D. Varlamova
Russian Federation
2-year student
N. N. Vezikova
Russian Federation
Professor, MD, PhD, head of department of hospital therapy
E. A. Verbitskaya
Russian Federation
therapist
O. E. Vilkova
Russian Federation
PhD, Senior Lecturer at the Department of Clinical Medicine
E. A. Vinnikova
Russian Federation
attending physician
V. V. Vustina
Russian Federation
PhD, cardiologist
E. A. Gаlova
Russian Federation
PhD, deputy director for science of the University clinic
V. V. Genkel
Russian Federation
PhD, associated professor at the Department of Propedeutics of Internal Medicine
E. I. Gorshenina
Russian Federation
PhD, associate professor at the Department of Hospital Care
E. V. Grigorieva
Russian Federation
PhD, associate professor at the Department of Hospital Therapy, Medical Faculty
E. Yu. Gubareva
Russian Federation
PhD, assistant of the Department of Faculty Therapy, physician at Functional Diagnostics Department
G. M. Dabylova
Kazakhstan
assistant of the Department of Internal Diseases with the Course of Propaedeutics
I. A. Demchenko
Russian Federation
laboratory assistant at the Department of Faculty Therapy, intern doctor
O. Yu. Dolgikh
Russian Federation
PhD, chief physician
M. Y. Duyshobayev
Kyrgyzstan
physician at the department of urgent cardiology and reanmation-2
D. S. Evdokimov
Russian Federation
postgraduate student at the Department of Faculty Therapy 2020-2023 Place of employment: Senior Laboratory Assistant, Department of Faculty Therapy
K. E. Egorova
Russian Federation
Gastroenterologist of nephrology department
A. N. Ermilova
Russian Federation
senior medical advisor, psychiatrist
A. E. Zheldybayeva
Kazakhstan
assistant of the Department of Internal Diseases with the course of propaedeutics
N. V. Zarechnova
Russian Federation
deputy chief physician at Clinical Hospital №2
Yu. D. Zimina
Russian Federation
therapist
S. Yu. Ivanova
Russian Federation
deputy chief physician
E. Yu. Ivanchenko
Russian Federation
PhD, associate professor at the department of therapy and cardiology
M. V. Ilina
Russian Federation
therapist
M. V. Kazakovtseva
Russian Federation
PhD, associate professor of the Department of Clinical Therapy
E. V. Kazymova
Russian Federation
deputy chief physician
Yu. S. Kalinina
Russian Federation
assistant at the Department of Нospital Therapy and Immunology with Postgraduate Education Course
N. A. Kamardina
Russian Federation
cardiologist
A. M. Karachenova
Russian Federation
therapist, pulmonologist
I. A. Karetnikov
Russian Federation
deputy chief phisician
N. A. Karoli
Russian Federation
MD, PhD, professor at the Department of Hospital Therapy, Medical Faculty
M. K. Karsiev
Russian Federation
attending physician
D. S. Кaskaeva
Russian Federation
PhD, associate professor of the Department of Outpatient Therapy and Family Medicine with a Course of Postgraduate Education
K. F. Kasymova
Russian Federation
resident of Department of Нospital Therapy and Immunology with Postgraduate Education Course
Zh. B. Kerimbekova
Kyrgyzstan
junior researcher at the department of mountain medicine and pulmonary hypertension
A. Sh. Kerimova
Russian Federation
assistant of a chief physician
E. S. Kim
Russian Federation
administrator
N. V. Kiseleva
Russian Federation
therapist
D. A. Klimenko
Russian Federation
laboratory assistant at the Department of Faculty Therapy, intern doctor
A. V. Klimova
Russian Federation
general practitioner; postgraduate student at the Department of the Internal Medicine
O. V. Kovalishena
Russian Federation
MD, PhD, head of the Department of Epidemiology, Microbiology and Evidence-Based Medicine, director of the Research Institute of Preventive Medicine of the University Clinic
E. V. Kolmakova
Russian Federation
PhD, associate professor at the Department of Internal Diseases, Clinical Pharmacology and Nephrology
T. P. Kolchinskaya
Russian Federation
deputy chief physician on outpatient therapy
M. I. Kolyadich
Russian Federation
PhD, associate professor of the Department of Propedeutics of Internal Medicine; deputy chief physician
O. V. Kondriakova
Russian Federation
6-year student
M. P. Konoval
Russian Federation
therapist
D. Yu. Konstantinov
Russian Federation
MD, PhD, associate professor, head of the Department of Infectious Diseases
E. A. Konstantinova
Russian Federation
PhD, associate professor at the Department of Infectious Diseases
V. A. Kordukova
Russian Federation
resident in pulmonology
E. V. Koroleva
Russian Federation
physician of the department of cardiology №2
A. Yu. Kraposhina
Russian Federation
PhD, associate professor at the Department of Hospital Therapy and Immunology with Postgraduate Education; pulmonologist
T. V. Kriukova
Russian Federation
project manager
A. S. Kuznetsova
Russian Federation
PhD, associate professor of the Department of Clinical Therapy
T. Yu. Kuzmina
Russian Federation
PhD, associate professor at the Depatment of Infecction Diseases and Epidemiology
K. V. Kuzmichev
Russian Federation
resident
Ch. K. Kulchoroeva
Kyrgyzstan
junior researcher
T. V. Kuprina
Russian Federation
postgraduated student
I. M. Kouranova
Russian Federation
deputy chief phhysician
L. V. Kurenkova
Russian Federation
attending physician
N. Yu. Kurchugina
Russian Federation
4-year student
N. A. Kushubakova
Kyrgyzstan
junior researcher
V. I. Levankova
Russian Federation
deputy chief physician for therapy
N. A. Lyubavina
Russian Federation
PhD, associated professor
N. A. Magdeyeva
Russian Federation
PhD, associate professor at the Department of Hospital Therapy, Medical Faculty
K. V. Mazalov
Russian Federation
head of the Department of Cardiology
V. I. Majseenko
Belarus
assistant lecturer at the Department of Phthisiopulmonology with the course of the Faculty of Professional Development and Retraining
A. S. Makarova
Russian Federation
postgraduate student of the department of cardiology and functional diagnostics
A. M. Maripov
Kyrgyzstan
head of Department of Pulmonary Hypertension and High altitude medicine of NCCIM, leading researcher
A. A. Marusina
Russian Federation
therapist
E. S. Melnikov
Russian Federation
medical advisor; postgraduate student of the department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E. E. Eichwald 2020-2023
N. B. Moiseenko
Russian Federation
student
F. N. Muradova
Russian Federation
postgraduate student of the Department of Therapy and Cardiology
R. G. Muradyan
Russian Federation
general practitioner
Sh. N. Musaelian
Armenia
clinical resident at cardiology department
A. O. Myshak
Russian Federation
data analyst
E. S. Nekaeva
Russian Federation
Head of the Department of the Reception and Consultation, therapist at the Privolzhsky Research Medical University
N. M. Nikitina
Russian Federation
MD, PhD, professor at the Department of Hospital Therapy, Medical Faculty
B. B. Ogurlieva
Russian Federation
research assistant; сardiologist
A. A. Odegova
Russian Federation
PhD, asistant of the Department of Clinical Therapy
Yu. M. Omarova
Russian Federation
postgraduate student of the Department of Therapy and Cardiology
N. A. Omurzakova
Kyrgyzstan
MD, PhD, deputy director
Sh. O. Ospanova
Kazakhstan
assistant at the Department of Internal Diseases with the Course of Propaedeutics
E. V. Pahomova
Russian Federation
phthisiatrician of the Department of Pulmonary Tuberculosis for Adults
L. D. Petrov
Moldova, Republic of
director
S. S. Plastinina
Russian Federation
PhD, assistant professor at the Internal Medicine Department
V. A. Pogrebetskaya
Russian Federation
deputy chief physician
D. V. Polyakov
Russian Federation
PhD, associate professor of the department of internal medicine
D. S. Polyakov
Russian Federation
PhD, assistant professor at the Department of Therapy and Cardiology
E. V. Ponomarenko
Russian Federation
cardiologist
L. L. Popova
Russian Federation
MD, PhD, professor at the Department of Infectious Diseases
N. A. Prokofeva
Russian Federation
PhD, head of the department of therapy №2
I. A. Pudova
Russian Federation
assistant at the Department of Faculty and Polyclinic Therapy; chief physician
N. A. Rakov
Russian Federation
attending physician
A. N. Rakhimov
Uzbekistan
junior researcher
N. A. Rozanova
Russian Federation
nurse
S. Serikbolkyzy
Kazakhstan
assistant of the Department of Internal Diseases with the Course of Propaedeutics
A. A. Simonov
Russian Federation
therapist
V. V. Skachkova
Russian Federation
attending physician
D. V. Soloveva
Russian Federation
resident
I. A. Soloveva
Russian Federation
MD, PhD, associate professor; pulmonologist, allergologist-immunologist
I. M. Sukhomlinova
Russian Federation
therapist
A. G. Sushilova
Russian Federation
resident
D. R. Tagayeva
Uzbekistan
junior researcher
Yu. V. Titojkina
Russian Federation
resident
E. P. Tikhonova
Russian Federation
MD, PhD, professor, head of the Department of Infectious Diseases and Epidemiology with a Course of Postgraduate Education
D. S. Tokmin
Russian Federation
head of analytics
A. A. Tolmacheva
Russian Federation
postgraduate student, assistant of the department of Faculty Therapy n.a. Zalesskiy G.D., therapist
M. S. Torgunakova
Russian Federation
resident of Department of Нospital Therapy and Immunology with Postgraduate Education Course
K. V. Trenogina
Russian Federation
PhD, cardiologist
N. A. Trostianetckaia
Russian Federation
PhD, cardiologist
D. A. Trofimov
Russian Federation
student, nurse (Department of Cardiology №4)
M. A. Trubnikova
Russian Federation
medical advisor; nephrologist
A. A. Tulichev
Russian Federation
PhD, assistant of Department of Internal Medicine Propedeutics; head of the Emergency Room
A. T. Tursunova
Kazakhstan
assistant of the Department of Internal Diseases with the Course of Propaedeutics
N. D. Ulanova
Russian Federation
resident
O. V. Fatenkov
Russian Federation
MD, PhD, assistant professor, director, head of the Department of Faculty Therapy, cheef freelance therapist of the Ministry of Healthcare of Samara Region
O. V. Fedorishina
Russian Federation
PhD, associate professor at the department of cardiology and functional diagnostics
T. S. Fil
Russian Federation
PhD, head of the department of gastroenterology, therapist
I. Yu. Fomina
Russian Federation
PhD, associate professor at the Department of Faculty and Outpatient Therapy; chief physician
I. S. Fominova
Russian Federation
neurologist
I. A. Frolova
Russian Federation
cardiologist
S. M. Tsvinger
Russian Federation
PhD, rheumatologist, associate professor at the department of ambulatory care with courses of medical rehabilitation
V. V. Tsoma
Russian Federation
PhD, associate professor, Department of Internal Medicine, Institute of Continuing Medical Education, head of Additional Professional Education Department, chief freelance pulmonologist of the Health Committee of the Volgograd Region
M. B. Cholponbaeva
Kyrgyzstan
junior researcher
T. I. Chudinovskikh
Russian Federation
PhD, assistant of the Department of Hospital Therapy
O. A. Shevchenko
Russian Federation
general practitioner
T. V. Sheshina
Russian Federation
assistant at the department of clinical medicine
E. A. Shishkina
Russian Federation
MD, PhD, associate professor at the Hopspital Therapy and Cardiology Department
K. Yu. Shishkov
Russian Federation
6-year student
S. Yu. Sherbakov
Russian Federation
resident in anaesthesiology and resuscitation
E. A. Yausheva
Russian Federation
endocrinologist
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