Features of providing addiction medical care during the pandemic COVID-19

Abstract

Patients with substance use disorders represent a vulnerable population who are at risk of getting coronavirus due to several factors related to their clinical, psychological, and psycho-social characteristics. The goal of this study was to examine the features of a medical condition in patients with alcohol use disorder who are admitted to the addiction hospital and to describe the specific issues of the addiction care RF region during a pandemic.Material and methods. The online survey has been distributed to 55 addiction psychiatrists from the third-level medical organizations of 4th federal districts (including Northwestern, South, Volga, and North Caucasian) from June 09 to June 20, 2020. The survey consists of 17 items (13 questions were focused on the features of progress and clinical signs of alcohol dependence in hospitalized, in-patient individuals during April-May, 2020; 4 questions were focused on the organizational issues of addiction care in the RF regions during the COVID-19 pandemic).Results. Based on the expert`s assessment, the number of admissions at inpatient and outpatient clinical settings was reduced during the pandemic. In addition, the intensity of alcohol withdrawal among patients who were hospitalized during April-May, 2020 were significantly more severe compared to patients who were hospitalized during February-March, 2020 (Pearson’s chi-squared test). Moreover, alcohol withdrawal was more severe and was associated with alcohol withdrawal delirium (4,7%) or seizures (4,7%) in 9,4% of cases among patients with COVID positive status, which exceeds the data of epidemiological studies. The intensity of alcohol withdrawal delirium among patients with COVID positive status was more severe compared to those who had COVID negative status. During April-June, 2020, the few addiction clinics were temporally closed due to quarantine but a majority of clinics were not (n = 14 (25,5%) vs. n = 41 (74,5%)).Conclusion. During the COVID-19 pandemic, the state of patients hospitalized for treatment of alcohol dependence may be considered more severe, compared to the period February-April 2020.