Abstract

Aim. To assess the behavioral risk factors and the clinical course of cardiovascular diseases (CVDs) and other noncommunicable diseases (NCDs) during quarantine in various regions of Russia.Material and methods. This multicenter cohort cross-sectional study included 205 men and women from 6 Russian cities. Further, 4 of them (Saransk, Nizhny Novgorod, Penza, Ulyanovsk) were combined into one group — the Volga region. The study included men and women aged 30-69 years with one or more NCDs (hypertension, coronary artery disease with or without myocardial infarction, type 2 diabetes, chronic obstructive pulmonary disease/asthma and cancer in patients receiving chemotherapy and/or radiation therapy) who were self-isolated during coronavirus disease 2019 (COVID-19) pandemic. For all patients, a questionnaire was used, which included socio-demographic parameters, behavioral risk factors, status of the underlying disease, incidence of COVID-19 and its complications. Self-assessment of the state of health was carried out using the European Quality of Life Questionnaire.Results. In every third Muscovite, the intensity of physical activity decreased, and in the groups of patients from Omsk and the Volga region, it was 45% and 43%, respectively. An increase in meal frequency and an impairment of eating habits in Moscow and Omsk was noted in 18,2% and 18,7% of participants, while in Volga region subjects, these parameters were 2 times higher (42,4%). At the same time, no significant changes of alcohol consumption and smoking was revealed in the cohorts. Hypertensive crises during a pandemic were noted in all three subgroups, but more of them were recorded in the Volga region — in every third patient (p< 0,05 compared to Moscow), in the Omsk group — in every fourth patient, and among Muscovites — no more than 5%. Clinical deterioration in patients with angina was noted in 15% of cases, while the smallest number was noted in Omsk subjects (5,3%), three times less than in other subgroups. Changes in intensity and regimen of hypoglycemic therapy were noted in patients from Omsk, while 30% of them (p< 0,05 compared with the Volga region) increased the doses of medications taken. Chronic obstructive pulmonary disease was registered in the group with the largest number of Volga region patients — 14,1% (p< 0,05 compared to Omsk), while 17% of patients in this group increased the dose of drugs. Any cancer was recorded in 13,6% of Muscovites, while in the other two groups — about 5%. The largest number of patients from the Volga region noted a health decline over the past year (30,8%), while every fifth patient from Omsk (19,6%) and 13,6% of Muscovites reported health changes.Conclusion. During quarantine and self-isolation, changes in dietary habits and physical activity decline were noted among patients with NCDs, while alcohol consumption and smoking remained practically unchanged. The change in clinical status was characterized by an increase in hypertensive crisis incidence, an increase in doses of antihypertensive and hypoglycemic medication. Depending on the region, the health decline was noted by 13-31% of patients with NCDs.

Highlights

  • АД — артериальное давление, индекса массы тела (ИМТ) — индекс массы тела, СД — сахарный диабет, ССЗ — сердечно-сосудистые заболевания, факторов риска (ФР) — факторы риска, хронических неинфекционных заболеваний (ХНИЗ) — хронические неинфекционные заболевания, ХОБЛ — хроническая обструктивная болезнь легких, COVID-19 — новая коронавирусная инфекция

  • During quarantine and self-isolation, changes in dietary habits and physical activity decline were noted among patients with noncommunicable diseases (NCDs), while alcohol consumption and smoking remained practically unchanged

  • The health decline was noted by 13-31% of patients with NCDs

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Summary

Conclusion

During quarantine and self-isolation, changes in dietary habits and physical activity decline were noted among patients with NCDs, while alcohol consumption and smoking remained practically unchanged. В качестве одной из основных мер для профилактики заболеваемости COVID-19, рекомендовала ограничения в виде карантина и самоизоляции населения, что сопровождалось изменением объема медицинской помощи пациентам с ХНИЗ. В 2020г в зарубежной литературе появились первые публикации о последствиях ограничительных мер на оказание плановой и экстренной медицинской помощи для пациентов с хроническими заболеваниями [7]. Целью настоящего исследования была оценка особенностей поведенческих ФР и динамики клинического течения ССЗ и других ХНИЗ во время карантина в различных регионах России. Результаты и обсуждение Настоящее исследование было посвящено изу­ чению изменения поведенческих ФР и клинического состояния пациентов с ХНИЗ в трех российских городах и регионах во время карантина и самоизоляции. По данным международного исследования с участием 202 врачей из 47 стран во время пандемии рутинная медицинская помощь пациентам с хроническими заболеваниями была перемещена в виртуальное пространство [5]. Лет Пол (муж/жен) Статус работы до пандемии Работал Образование Высшее Статус работы во время карантина Обычный режим Удаленная Временно не работал Потерял работу Семейный статус Женат (замужем) Разведен(а) Вдовец (вдова) Никогда не был женат (замужем)

Динамика поведенческих ФР в когорте лиц с ХНИЗ
Findings
Оценка клинического состояния пациентов с ХНИЗ во время карантина
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