The pandemic of a new coronavirus infection in the Kabardino-Balkarian Republic. Regional experience

M.S. Shogenova^1,2, S.Kh. Khutueva¹, I.B. Tlupova¹, M.A. Akkieva¹, L.S. Shogenova²

¹Center of Allergology of the Ministry of Health of the KBR, Nalchik

²Kabardino-Balkarian State University named after H.M. Berbekov, Nalchik

Aim: to analyze various clinical indicators in patients with a new coronavirus infection and determine the main disease markers.

Patients and Methods: 55 case histories of patients diagnosed with new coronavirus infection (COVID-19) were analyzed. There were 5 groups: group 1 — mild course; group 2 —moderate course with lung damage up to 25% (according to CT); group 3 — moderate course with lung damage 25–50% (according to CT); group 4 — severe course; group 5 — extremely severe course. The examination included clinical and biochemical studies, coagulogram, determination of SARS-CoV-2 RNA by polymerase chain reaction (PCR), as well as IgM and IgG antibodies to the SARS-CoV-2 betacoronavirus nucleocapsid protein by enzyme immunoassay.

Results: it was found that in the COVID-19 clinical picture, the manifestations of gastroenterocolitis (13 patients, 23.6%) and cutaneous eruption (3 patients, 5.5%), along with intoxication syndrome, were significant. In patients depending on the severity of detected eritropeniya (3,51±0,1×10¹²/L in group 5), leukopenia (2,93±0,1×10⁹/L in group 5) and elevated ESR (46,14±2.0 mm/h in group 5), which has significant differences versus the groups 3 and 4. Acute-phase proteins — C-reactive protein (CRP), D-dimer, ferritin — had statistically significant differences (p<0.01) and increased in groups depending on the COVID-19 course, for instance, CRP increased more than 15 times. A direct correlation was established (r=0.68, p<0.01) between CRP level and COVID-19 course. A direct correlation was recorded between an increase in the level of CRP, interleukin-6 (IL-6) and COVID-19 course (r=0.56, p<0.05), which suggests that CRP and IL-6 are markers of COVID-19 severity.

Conclusion: thus, the study identified clinical COVID-19 masks —intestinal (23.6% of patients) and cutaneous (5.5% of patients). At the disease onset before the pneumonia occurrence, the PCR diagnosis of COVID-19 is more informative, which confirms the presence of 100% positive results of a PCR smear on SARS-CoV-2 RNA in group 1 and 100% negative results of a PCR smear on SARS-CoV-2 RNA in group 5.

Keywords: new coronavirus infection, COVID-19, D-dimer, ferritin, saturation, lung damage rate, clinical masks.

For citation: Shogenova M.S., Khutueva S.Kh., Tlupova I.B. et al. The pandemic of a new coronavirus infection in the Kabardino-Balkarian Republic. Regional experience. RMJ. 2021;6:9–13 (in Russ.).