Abstract:
Summary
Introduction: The COVID-19 pandemic has a major
negative impact on health and socio-economic well-being.
Understanding the characteristics of COVID-19 disease and
identifying the wide range of factors affecting health and
quality of life can be the key to providing viable solutions
to improve the management of patients and their physical
and psycho-emotional rehabilitation. The purpose of the
present study was to evaluate the influence of SARS CoV-2
infection on the health status of adults hospitalized with the
diagnosis of COVID-19 in the Republic of Moldova.
Material and methods: The presented study is a retrospective, cohort, consisting of a sample of 7441 patients
randomly selected, aged 18 y.o. and older, hospitalized in
10 public medical institutions in Chisinau, Moldova. Diagnosis of COVID-19 was confirmed by detection of CoV-2 SARS
RNA. The data in the patients’ medical records were processed and stored according to the unified, pre-established
form, prepared in accordance with the requirements of the
software „Electronic Patient Record COVID-19”. The severity of COVID-19 disease was assessed using two principles:
(1) according to the criteria of the National Clinical Protocol
PCN-371; (2) according to the 7-point graduated scale developed by the WHO Special Committee (V.3.0, 3 March 2020) in
randomized multicenter clinical trials.
Result: Only 30.07% patients mentioned the presence
of a close contact with a COVID-19 positive person. The average age of the patients in the study was 52.83 years. Mild
form was diagnosed in 5.00% of patients, medium - 66.15%,
severe –20.67%, critical-8.18%. The main complaints of patients were fever, fatigue or physical asthenia, cough, and
headache. More than 1/4 of those hospitalized have severe
or critical forms of COVID-19; more than 1/3 - require oxygen therapy, and every 6-th patient needs non-invasive
high-flow oxygen ventilation or mechanical ventilation. Old
age, male sex, chronic comorbidities increase statistically
significantly the probability of patients having an unfavorable prognosis in COVID-19. 7.93% of patients died, according to the age group: every 2-nd patient over 90 years, every 3-rd over 80 years, every 5-th over 70 years, and every
9-th over 60 years died.
Conclusions: (1) The uncertainty of the source of infection lead to delay specific prophylactic public health measures; (2) In COVID-19, in a hospital-type medical management, the emphasis should be placed mainly on patients
over the age of 50; (3) There is no specific clinical manifestation in COVID-19, that would allow to distinguish the
disease from other pathologies; (4) Age over 60 y.o., male
sex, and chronic cardiovascular diseases, diabetes mellitus, chronic kidneys diseases and malignant tumors unfavorable influence the evolution of COVID-19; (5) Antibiotic administration remains at a high level in hospitalized patients
and is often unjustified and unnecessary.
