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Stop COVID Cohort: An Observational Study of 3480 Patients Admitted to the Sechenov University Hospital Network in Moscow City for Suspected Coronavirus Disease 2019 (COVID-19) Infection

Collaborators.

• Sechenov StopCOVID Research Team : Anna Berbenyuk ,  Polina Bobkova ,  Semyon Bordyugov ,  Aleksandra Borisenko ,  Ekaterina Bugaiskaya ,  Olesya Druzhkova ,  Dmitry Eliseev ,  Yasmin El-Taravi ,  Natalia Gorbova ,  Elizaveta Gribaleva ,  Rina Grigoryan ,  Shabnam Ibragimova ,  Khadizhat Kabieva ,  Alena Khrapkova ,  Natalia Kogut ,  Karina Kovygina ,  Margaret Kvaratskheliya ,  Maria Lobova ,  Anna Lunicheva ,  Anastasia Maystrenko ,  Daria Nikolaeva ,  Anna Pavlenko ,  Olga Perekosova ,  Olga Romanova ,  Olga Sokova ,  Veronika Solovieva ,  Olga Spasskaya ,  Ekaterina Spiridonova ,  Olga Sukhodolskaya ,  Shakir Suleimanov ,  Nailya Urmantaeva ,  Olga Usalka ,  Margarita Zaikina ,  Anastasia Zorina ,  Nadezhda Khitrina

Affiliations

• 1 Department of Pediatrics and Pediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 2 Inflammation, Repair, and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom.
• 3 Soloviev Research and Clinical Center for Neuropsychiatry, Moscow, Russia.
• 4 School of Physics, Astronomy, and Mathematics, University of Hertfordshire, Hatfield, United Kingdom.
• 5 Biobank, Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 6 Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 7 Chemistry Department, Lomonosov Moscow State University, Moscow, Russia.
• 8 Department of Polymers and Composites, N. N. Semenov Institute of Chemical Physics, Moscow, Russia.
• 9 Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy.
• 10 Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke University Magdeburg, Magdeburg, Germany.
• 11 Institute for Urology and Reproductive Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 12 Department of Intensive Care, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 13 Clinic of Pulmonology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 14 Department of Internal Medicine No. 1, Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 15 Department of Forensic Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 16 Department of Statistics, University of Oxford, Oxford, United Kingdom.
• 17 Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
• 18 Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
• 19 Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom.
• 20 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• PMID: 33035307
• PMCID: PMC7665333
• DOI: 10.1093/cid/ciaa1535

Background: The epidemiology, clinical course, and outcomes of patients with coronavirus disease 2019 (COVID-19) in the Russian population are unknown. Information on the differences between laboratory-confirmed and clinically diagnosed COVID-19 in real-life settings is lacking.

Methods: We extracted data from the medical records of adult patients who were consecutively admitted for suspected COVID-19 infection in Moscow between 8 April and 28 May 2020.

Results: Of the 4261 patients hospitalized for suspected COVID-19, outcomes were available for 3480 patients (median age, 56 years; interquartile range, 45-66). The most common comorbidities were hypertension, obesity, chronic cardiovascular disease, and diabetes. Half of the patients (n = 1728) had a positive reverse transcriptase-polymerase chain reaction (RT-PCR), while 1748 had a negative RT-PCR but had clinical symptoms and characteristic computed tomography signs suggestive of COVID-19. No significant differences in frequency of symptoms, laboratory test results, and risk factors for in-hospital mortality were found between those exclusively clinically diagnosed or with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR. In a multivariable logistic regression model the following were associated with in-hospital mortality: older age (per 1-year increase; odds ratio, 1.05; 95% confidence interval, 1.03-1.06), male sex (1.71; 1.24-2.37), chronic kidney disease (2.99; 1.89-4.64), diabetes (2.1; 1.46-2.99), chronic cardiovascular disease (1.78; 1.24-2.57), and dementia (2.73; 1.34-5.47).

Conclusions: Age, male sex, and chronic comorbidities were risk factors for in-hospital mortality. The combination of clinical features was sufficient to diagnose COVID-19 infection, indicating that laboratory testing is not critical in real-life clinical practice.

Keywords: COVID-19; Russia; SARS-CoV-2; cohort; mortality risk factors.

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

Publication types

• Observational Study
• Research Support, Non-U.S. Gov't
• Hospitalization
• Middle Aged

Grants and funding

• 20-04-60063/Russian Foundation for Basic Research

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• Covid-19: Moscow re...

Covid-19: Moscow re-enters lockdown as cases surge in Russia

Read our latest coverage of the coronavirus pandemic.

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Moscow is imposing Russia’s first major lockdown in over a year as the country seeks to short circuit an autumn surge that has seen cases and deaths climb relentlessly for six weeks.

Moscow’s mayor will close businesses, schools, kindergartens, and all shops except groceries and pharmacies for 11 days from 28 October. Bars and restaurants will allow takeout only. Museums and galleries may operate at half capacity, admitting only people with digital vaccine certificates. Unvaccinated people aged over 60 will not be permitted to leave home.

Moscow’s coronavirus situation is “developing according to the worst case scenario,” the city’s mayor, Sergei Sobyanin, wrote in a blog.

Throughout Russia workers will receive a week off starting on 30 October, President Vladimir Putin announced. The measure comes as new cases continue to soar, and Russia’s official daily death toll—a figure widely believed to be a serious underestimate—has exceeded 1000 on each of the past six days.

With under a third of Russians fully vaccinated, the Kremlin has begun to voice new exasperation at the prevalence of vaccine scepticism in the country. Mortality is high because of the “unacceptably low level of vaccination,” said a Kremlin spokesman last week. “All facilities have been provided to citizens to save their lives by getting inoculated,” said Dmitry Peskov, who was himself admitted to hospital with covid in May.

Persuading people

Putin this week said that he could not understand why some friends of his had not been vaccinated. “I ask, ‘Have you been vaccinated?’ ‘No.’ ‘Why?’ ‘Oh, I don’t know, I’ll wait.’ It’s strange,” he said. “People with a good education, with academic degrees. I just don’t get what’s going on.”

Critics argue that the Kremlin is a victim of its own success in playing down the pandemic’s impact on Russia, leading many citizens to believe that they have no need of vaccination. Russian media have praised Russian vaccines but also sometimes focused on negative or misleading stories about western vaccines, which may have bred a broader vaccine scepticism. Putin himself was vaccinated only in March, and he chose not to admit cameras.

At a foreign policy forum on 21 October Putin again urged Russians to get vaccinated. “There are just two options for everyone—to get sick or to receive a vaccine,” he said. “There is no way to walk between the raindrops.”

But he rejected vaccine mandates. “I believe we mustn’t force it but persuade people and prove to them that vaccination is better than illness,” he said. “We must try to increase people’s trust in the government’s actions. We need to be more convincing and prove it by example.”

Miscounting the cost

But the mistrust begins with the government’s figures on cases and deaths, which show numerous statistical anomalies at the local level and an inexplicably lighter toll than in nearby countries such as Poland and Romania, which are more thoroughly vaccinated.

From the pandemic’s outset, deaths from covid in Moscow reported by the government agency Rospotrebnadzor were far outstripped by the excess deaths counted in the city’s morgue based reporting system. Official deaths from covid are registered by panels that often attribute the cause of death to some other health condition, even with a positive coronavirus test. But Rospotrebnadzor’s covid death figures are dwarfed by a spike in all cause excess deaths since the pandemic arrived, in figures compiled by Russia’s official statistics agency, Rosstat. 1

Alexei Raksha, a demographer who quit Rosstat last year after criticising official covid statistics, this month used the agency’s data to calculate that Russia had lost 997 000 people in the 12 months from October 2020 to September 2021. 2 The Moscow Times , also working with data obtained from Rosstat, found this month that excess deaths during the pandemic in Russia numbered 660 000. 3 Russia’s official death toll stands at 228 453.

This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

• ↵ Raksha A. Population estimates. 9 Oct 2021. https://www.facebook.com/rickky.spirewanderer/posts/4457670520967557
• ↵ Russia’s coronavirus excess death toll hits 660K. Moscow Times 2021 Oct 8. https://www.themoscowtimes.com/2021/10/08/russias-coronavirus-excess-death-toll-hits-660k-a75254