Retrospective analysis of telemedicine consultations conducted in pregnant and puerperal women with novel coronavirus infection COVID-19

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Abstract

Objective: To evaluate the incidence of prescribing antibacterial agents (ABA) and the results of microbiological examination in pregnant and puerperal women with COVID-19 by analyzing the electronic records of telemedicine consultations (TMC) in patients from different regions of the Russian Federation.

Materials and methods: A retrospective analysis was done on 2500 pregnant and puerperal women from the database of patients with COVID-19 who received TMC between January and July 2021. The analysis included age, gestational age, medical history, chest computed tomography (chest CT), respiratory support, laboratory test results, frequency of microbiological studies, and ABA administration.

Results: This analysis revealed that 78.8%, 49.6%, and 55.8% of pregnant and puerperal COVID-19 patients were prescribed antibiotics, antifungals, and glucocorticoids, respectively. In microbiological testing, Candida albicans was the most frequently isolated microorganism (30.4 %). The most common gram-positive microorganisms were Staphylococcus spp. (18.8%), and Streptococcus spp. (15.9%), and Acinetobacter spp. among the gram-negative (14,5%). Acinetobacter baumannii accounted for 10.1% of the isolates. Klebsiella pneumoniae accounted for 11.6% of the cases.

Conclusion: The retrospective analysis showed that although microbiological testing was important, it was performed in only 4% of the cases. ABA were used in 78.8% of the cases, and broad-spectrum and reserve drugs were the most common choice. Antifungals were used in 49.6% of patients. Prescribing occurred immediately upon admission to the hospital without confirmation of a bacterial or fungal infection.

About the authors

Natalia E. Shabanova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Author for correspondence.
Email: n_shabanova@oparina4.ru
ORCID iD: 0000-0001-6838-3616

PhD, Associate Professor, Head of the Unit of Clinical Pharmacology, Institute of Microbiology, Antimicrobial Therapy and Epidemiology

Russian Federation, Moscow

Alexey V. Pyregov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: a_pyregov@oparina4.ru

Dr. Med. Sci., Professor, Director of the Institute of Anesthesiology-Resuscitation and Transfusiology

Russian Federation, Moscow

Anastasia V. Nikolaeva

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: a_nikolaeva@oparina4.ru

PhD, Chief Physician

Russian Federation, Moscow

Bayr O. Bembeeva

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: b_bembeeva@oparina4.ru
ORCID iD: 0000-0002-8820-9903

bacteriologist at the Laboratory of Medical Microbiology, Institute of Microbiology, Antimicrobial Therapy and Epidemiology

Russian Federation, Moscow

Alexey V. Skorobogaty

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: a_skorobogatiy@oparina4.ru
ORCID iD: 0000-0003-2137-6421

Junior Researcher at the Unit of Clinical Pharmacology, Institute of Microbiology, Antimicrobial Therapy and Epidemiology

Russian Federation, Moscow

Valery V. Chubarov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: v_chubarov@oparina4.ru

Head of Epidemiological Surveillance Department, Institute of Microbiology, Antimicrobial Therapy and Epidemiology

Russian Federation, Moscow

Pavel A. Denisov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: pa_denisov@oparina4.ru
ORCID iD: 0000-0003-1813-6718

Researcher at the Laboratory of Bioinformatic Analysis, Institute of Microbiology, Antimicrobial Therapy and Epidemiology

Russian Federation, Moscow

Vladimir A. Klimov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: va_klimov@oparina4.ru
ORCID iD: 0000-0002-4699-7614

PhD, Head of the Service for Organization of Medical Care and Information Service

Russian Federation, Moscow

Oleg G. Pekarev

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: o_pekarev@oparina4.ru
ORCID iD: 0000-0001-7122-6830

Dr. Med. Sci., Professor, Deputy Director of the Institute of Obstetrics

Russian Federation, Moscow

Roman V. Polibin

I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University)

Email: n_shabanova@oparina4.ru
ORCID iD: 0000-0003-4146-4787

PhD, Associate Professor, Associate Professor at the Department of Epidemiology and Evidence-Based Medicine

Russian Federation, Moscow

Tatiana V. Priputnevich

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: priput1@gmail.com
ORCID iD: 0000-0002-4126-9730

Dr. Med. Sci., Corresponding Member of the RAS, Director of the Institute of Microbiology, Antimicrobial Therapy and Epidemiology

Russian Federation, Moscow

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2. Figure 1. The ratio of patients, ages and degrees of CT upon admission to inpatient treatment: a - percentage of patients on mechanical ventilation and without mechanical ventilation; b - additional cumulative distribution function (CCDF) of ages in groups with and without mechanical ventilation; c - histogram of the distribution of CT degrees in the group without mechanical ventilation; d - histogram of the distribution of degrees of CT in the group with mechanical ventilation

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3. Figure 2. Prescribing ABP in pregnant women and parents with COVID-19: a - frequency of prescribing ABP in monotherapy and combined (n=2467); b - frequency of use of different groups of antibiotics in pregnant women and puerperas with COVID-19

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4. Figure 3. The results of the microbiological study in pregnant women and puerperas (n=98): a - frequency of material sampling and sterile and non-sterile flaps; b - frequency of detection of pathogens

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