Analysis of morbidity and mortality in patients with comorbid pathology during increased incidence of respiratory infection

Objective. To study morbidity and mortality in patients with comorbid pathologies during the period of increased incidence of respiratory infections.

Materials and methods. This study used data of a selective retrospective analysis of morbidity related to acute respiratory viral infections (ARVI). The main materials used in the epidemiological analysis were statistical data on morbidity and mortality rates for the period 2021-2023, including the outbreak of COVID-19 among patients assigned to provide medical care at the Gomel City Clinical Polyclinic No. 5 named after S.V. Golukhova. The study included 320 individuals. 2 groups were created — main and control ones. The study groups were comparable with respect to gender and age. Patients’ management was conducted from the onset of initial symptoms of ARVI till complete recovery or hospitalization. Pathogen determination in affected patients was performed using the polymerase chain reaction method at the Gomel Regional Center of Hygiene, Epidemiology and Public Health.

Results. The obtained results may have a crucial significance for predicting morbidity and mortality in patients with comorbid pathology at the level of outpatient clinics. It is necessary to carry out a quantitative assessment of the probability of complications and a fatal outcome when establishing cases of ARVI in patients with a burdened comorbid background.

Conclusion. ARVIs in patients with comorbid chronic somatic pathology are a high-risk situation. The study showed that, in general, the incidence of ARVI among the healthy population is 67.6% lower than in the main group (people with a history of diabetes and hypertension). The features of the pathogenetic effect of ARVI on patients with a burdened comorbid background contribute to an increased risk of complications and probability of death. The mortality rate among these patients is 28 cases per 160 studied, which is significantly higher than the control group. Taking into account standardization, the mortality rate in the main group will be 18.42%.

Thus, a multidisciplinary approach is needed to manage comorbid patients and predict an unfavorable clinical outcome during the period of an increase in the incidence of respiratory infections at the outpatient stage.

1. Pearce DC, McCaw JM, McVernon J, Mathews JD. Influenza as a trigger for cardiovascular disease: an investigation of serotype, subtype and geographic location. Environ Res. 2017;156:688-696. DOI: https://doi.org/10.1016/j.envres.2017.04.024

2. Han J, Mou Y, Yan D, Zhang YT, Jiang TA, Zhang YY, et al. Transient cardiac injury during H7N9 infection. Eur J Clin Invest. 2015;45(2):117-125. DOI: https://doi.org/10.1111/eci.12386

3. Sitnikov IG, Fazylov VKh, Silina EV. Treatment of influenza and other acute respiratory viral infections in patients with diabetes mellitus. Therapeutic Archive. 2019;91(10):39-47. (In Russ.). DOI: https://doi.org/10.26442/00403660.2019.10.000333

4. Silina EV, Sitnikov IG, Fazylov VC, Yeganyan GA. Treatment of ARVI and influenza in patients with arterial hypertension. Therapeutic Archive. 2019;91(9):53-61. (In Russ.). DOI: https://doi.org/10.26442/00403660.2019.09.000332

5. Chulakova NA, Potapov АF, Chulakov КV, Ivanova АА. The Impact of Comorbidities on the Treatment Outcome in Patients with Severe Covid-19 Associated Pneumonia. Russian Sklifosovsky Journal of Emergency Medical Care. 2025;14(1):81-88. (in Russ.). DOI: https://doi.org/10.23934/2223-9022-2025-14-1-81-88

6. Drapkina OM, Kontsevaya AV, Kalinina AM, Avdeev SN, Agaltsov MV, Alekseeva L. I. Comorbidity of patients with noncommunicable diseases in general practice. Eurasian guidelines. Cardiovascular Therapy and Prevention. 2024;23(3):3996. (In Russ.). DOI: https://doi.org/10.15829/1728-8800-2024-3996

7. Ishmurzin GP, Serebryakova OA, Syuzev KN, Dolganova DA, Gainullina AKh. Cardiovascular complications of respiratory viral infections. The Siberian Journal of Clinical and Experimental Medicine. 2022;37(4):31-37. (In Russ.). DOI: https://doi.org/10.29001/2073-8552-2022-37-4-31-37

8. Gracheva SA, Klefortova II, Shamкhalova MSh. Prevalence of combined atherosclerotic vascular lesions in patients with diabetes mellitus. Diabetes mellitus. 2012;15(1):49-55. (In Russ.). DOI: https://doi.org/10.14341/2072-0351-5979

9. Grоjibovski AM. Confidence intervals for frequencies and percentages [date of access 2025 April 06]. Available from: https://cyberleninka.ru/article/n/doveritelnye-intervaly-dlya-chastot-i-doley

10. Pavlovich TP, Cherevko AN, Labzo SS, Girko IN, Kunitskaya SV, Khalyamina II. Assessment of Risks and Chances in Medical Research: Methodological Guidelines. Minsk: BSMU, 2021. 20 p. (In Russ.).