The Pavlov University experience in medical assistance for patients with the novel coronavirus infection: first results and lessons
https://doi.org/10.21292/2078-5658-2021-18-2-7-16
Abstract
The constant mutation of the virus and the complicated epidemiological situation in other countries keep the probability of a third wave of the pandemic in the Russian Federation fairly high. It is important to summarize the gained experience as fast as possible to use it appropriately once it is needed.
The objective: to analyze the specific parameters of care for critically ill patients with the novel coronavirus infection in Pavlov Multidisciplinary Medical Center.
Subjects and methods. This is a result-based report on the work performed by the Infection Center, which was deployed twice in Pavlov Multidisciplinary Medical Center (from 28.04.2020 to 03.08.2020 and from 01.11.2020 to 15.03.2021). Totally, 3,830 patients with SARS-CoV-2 were managed (1,680 patients during the first deployment and 2,150 patients during the second one). In the preparatory period, the operation of the emergency department based on the inpatient emergency medical department (EMD) had been simulated to clarify its staff structure and the procedure for admission, examination, and treatment of patients. Here we compare the organizational approaches during the first and second waves of the pandemic and present the characteristics of the demographic data of the treated patients, the incidence of certain complications, and outcomes.
Results. The overall lethality in the Center made 6.2%. Despite the experience gained in the first wave, the results of treatment during the second wave (autumn-winter) did not improve (5.7% died in the first wave and 6.7% in the second one). Lethality in ICU and EMD was 40.0% and 49.6%, in ICU only – 38.5% and 46.9% respectively. A moderate lethality increase in ICU was due to the concentration of critically ill and most critically ill patients. There were 51.4% of patients with comorbidities and 53.5% were above 65 years of age. Refinement and differentiation of tasks performed by departments, simulation of the operation of the Center before opening made it possible to increase the throughput of the medical unit avoiding rush during admission and deterioration the quality of treatment.
Conclusion. Certain aspects of the organization of medical care affect the performance of a multidisciplinary medical institution transformed into an infectious diseases hospital. The experience gained under such circumstances can be useful in other emergencies with a large number of victims and patients.
About the Authors
S. F. Bagnenko,
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Sergey F. Bagnenko, Academician of RAS, Professor, Director of Surgery
and Emergency Medicine Research Institute, Rector
6-8, Lva Tolstogo St., St. Petersburg, 197022
Yu. S. Polushin
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
ry S. Polushin, Academician of RAS, Professor, Head of Anesthesiology and Intensive Care Department, Head of Research Clinical Center of Anesthesiology and Intensive Care
6-8, Lva Tolstogo St., St. Petersburg, 197022
I. V. Shlyk
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Irina V. Shlyk, Doctor of Medical Sciences, Professor of Anesthesiology and Intensive Care Department, Deputy Head of Research Clinical Center of Anesthesiology and Intensive Care, Deputy Head Physician of Coronavirus
Infection Treatment Center
6-8, Lva Tolstogo St., St. Petersburg, 197022
V. M. Teplov
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Vadim M. Teplov, Candidate of Medical Sciences, Head of Emergency Care Department, Head Physician of Coronavirus Infection Treatment Center
6-8, Lva Tolstogo St., St. Petersburg, 197022
E. A. Karpova
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Elena A. Karpova, Candidate of Medical Sciences, Head Physician of Multidisciplinary Medical Center
6-8, Lva Tolstogo St., St. Petersburg, 197022
E G. Gavrilova
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Elena G. Gavrilova, Candidate of Medical Sciences, Associate Professor of Anesthesiology and Intensive Care Department, Head of Intensive Care Unit no. 2 of Research Clinical Center of Anesthesiology and Intensive Care, Head of Intensive Care Unit of Coronavirus Infection Treatment Center
6-8, Lva Tolstogo St., St. Petersburg, 197022
A. A. Afanasyev
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Aleksey A. Afanasyev, Candidate of Medical Sciences, Assistant of Anesthesiology and Intensive Care Department, Head of Intensive Care Unit no. 1 of Research Clinical Center of Anesthesiology and Intensive Care, Head of Intensive Care Unit of Coronavirus Infection Treatment Center
6-8, Lva Tolstogo St., St. Petersburg, 197022
A. A. Khryapa
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Aleksandr A. Khryapa, Candidate of Medical Sciences, Assistant of Anesthesiology and Intensive Care Department, Head of Anesthesiology and Intensive Care Department no. 2 of Research Clinical Center of Anesthesiology and Intensive Care, Head of Anesthesiology and Intensive Care Unit of Coronavirus Infection Treatment Center
\6-8, Lva Tolstogo St., St. Petersburg, 197022
I. V. Bovkun
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Igor V. Bovkun, Head of Intensive Care Unit no. 4 for Emergency
Detoxification of Research Clinical Center of Anesthesiology and Intensive Care,
Head of Intensive Care Unit for Emergency Detoxication of Coronavirus Infection Treatment Center
6-8, Lva Tolstogo St., St. Petersburg, 197022
L. M. Kalmanson
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Lev M. Kalmanson, Assistant of Anesthesiology and Intensive Care Department,
Head of Intensive Care Unit no. 5 of Research Clinical Center of Anesthesiology
and Intensive Care, Head of Intensive Care Unit of Coronavirus Infection Treatment Center
6-8, Lva Tolstogo St., St. Petersburg, 197022
D. A. Malinina
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Darya A. Malinina, Post Graduate Student of Anesthesiology and Intensive Care
Department, Head of Intensive Care Unit of Coronavirus Infection Treatment Center
6-8, Lva Tolstogo St., St. Petersburg, 197022
R. D. Skvortsova
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Ruf D. Skvortsova, Head of Respiratory Therapy Department of Interstitial and Orphan Diseases Research Institute, Functional Diagnostics Specialist
of Functional Diagnostics Department no. 2 of Clinical Research Center,
Physician of Coronavirus Infection Treatment Center
6-8, Lva Tolstogo St., St. Petersburg, 197022
E. A. Korobenkov
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Evgeniy A. Korobenkov, Head of Information and Technical Support Department
6-8, Lva Tolstogo St., St. Petersburg, 197022
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Review
For citations:
Bagnenko, S.F., Polushin Yu.S., Shlyk I.V., Teplov V.M., Karpova E.A., Gavrilova E.G., Afanasyev A.A., Khryapa A.A., Bovkun I.V., Kalmanson L.M., Malinina D.A., Skvortsova R.D., Korobenkov E.A. The Pavlov University experience in medical assistance for patients with the novel coronavirus infection: first results and lessons. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2021;18(2):7-16. (In Russ.) https://doi.org/10.21292/2078-5658-2021-18-2-7-16
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