Organization of medical evacuation of patients with severe COVID-19 and the results of their treatment in a specialized department of anesthesiology-intensive care

Abstract

In order to study the timeliness of medical evacuation of the patients with severe novel coronavirus from the districts of the Sakha Republic (Yakutia), a retrospective analysis of data from the Republic’s Center for Disaster Medicine (RCDM) for 2019-2022 was carried out. To compare the treatment results of patients living in the city of Yakutsk and patients evacuated from the districts of the republic (“city”, “district”), we conducted a prospective observational case-control study of 600 patients with severe COVID-19 in the specialized anesthesiology, resuscitation and intensive care unit (ARICU) of the Sakha Republic Clinical Hospital in 2020-2022. Lethal outcome (n=397) was chosen as the studied criterion. It was found that the study groups had statistically significant differences in age (p=0.002), body mass index (BMI) (p=0.001), saturation (SaO2) of mixed blood upon admission to the ARICU (p=0.003), oxygenation index (p=0.011), and the severity of the condition according to the SOFA (Sequential Organ Failure Assessment) score. The patients evacuated from the districts were characterized by younger age, higher body mass index, and greater damage to lung tissue. City residents were more prone to experience brain failure, acute kidney injury, and the development of multiple organ dysfunction. The mortality rate for the district patients with severe COVID-associated community-acquired pneumonia was 65.8%; for urban patients it made 66.3%, with no statistically significant differences established (p=0.906). Thus, the arrangement of medical evacuation for COVID-19 patients to a specialized institution during the pandemic ensured the availability and timeliness of specialized care provided to them.