RESUMO
According to domestic and foreign studies, diabetes mellitus (DM) is a significant risk factor for infection with the SARS-CoV-2 vi-rus, a severe course of the disease, and an adverse outcome. Trend analysis of epidemiological and clinical characteristics of DM patients living in the Samara region in the initial period of the spread of the new coronavirus infection can help to assess the effectiveness of medical care for DM patients in a challenging epidemiological setting and to determine the directions for its improvement. Objective. To assess the trends in the prevalence, incidence, and mortality of DM patients living in the Samara region and to iden-tify the changes in the structure of vascular complications and the status of glycemic control from 2018 to 2020. Material and methods. The study of the medical and epidemiological DM indicators was performed according to the design of a continuous retrospective observational study covering the period from 2018 to 2020;the object was the adult population of the Samara region. Results. The total number of DM patients in the Samara region in 2020 was 118,623 people (3.73% of the population), of which type 1 diabetes was detected in 5.2% (6118 people) and type 2 diabetes in 94.2% (111,700 people). The trends of the prevalence of type 1 DM were 186.3->192.4/100,000 population, type 2 DM 3132.5->3153.1/100,000 population;the dynamics of primary morbidity with type 1 diabetes mellitus 8.8->6.2/100,000 population, with type 2 DM 259.1->196.4/100,000 population;mortality with type 1 diabetes mellitus 3.2->4.2/100,000 population, with type 2 diabetes mellitus 120.7->174.5/100,000 population. The most common causes of death were cardiovascular diseases: 30.3% in type 1 DM, 39.7% in type 2 DM;there is a trend towards increasing in death <<from DM>> without indicating the immediate cause of death for both types of DM;<<from COVID-19>> 3.8% with type 1 DM and 3.7% with type 2 DM. The incidence of vascular complications in type 1 and type 2 DM was 31.4% and 11.5% for reti-nopathy, and 21.4 and 11.5% for nephropathy, respectively. Trends in the proportion of patients with HbA1c <7%: 28.1%->51.1% in type 1 DM, 15.7%->62.4% in type 2 DM;with HbA1c >=9.0%: 25.4%->12.1% in type 1 DM, 39.8%->7.1% in type 2 DM. Conclusion. The study demonstrates the importance of a comparative sequential assessment of the epidemiological characteristics of diabetes mellitus and the clinical status of patients living in the Samara region in challenging epidemiological settings to assess the prospects for optimizing follow-up.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.
RESUMO
Currently, work in any medical organization carries a risk of coronavirus infection, and, first of all, this applies to medical organizations dealing with the treatment of patients infected with coronavirus. Medical workers are a group at increased risk of infection with the SARS-CoV-2 virus in the provision of medical care in modern conditions, which determines their incidence of COVID-19 [1–3]. The aim of the study is to explore the prevalence of cases of COVID-19 infection in medical workers providing medical care on an outpatient basis. The analysis of the incidence of COVID-19 medical workers in one of the large medical organizations of the Samara region during the period of the pandemic was carried out. The medical staff of the medical organization includes 207 doctors. There are 11 subdivisions in the structure of the medical and prophylactic institution. Research methods: content analysis of the modern regulatory framework (2020-2021), statistical, expert. For the period from May 2020 to March 2021 71 cases of infection of medical workers on an outpatient basis with SARS-CoV-2 were identified, of which 32 doctors (45%) and 39 people (55%) nurses. Based on the results of the expert assessment, the insurance nature of the infection case was established in 50 people (70%). Among the medical and nursing categories of medical workers, the largest number of cases was made by doctors and nurses of primary contact — specialists of the district service: general practitioners (40%), pediatricians (32%), doctors — obstetricians-gynecologists (12%), nurses adults (76%) and children (20%) polyclinic departments. A third of health workers received inpatient treatment for severe COVID-19, an average of 60 days. Medical workers are a risk group of COVID-19 who need support measures, since the possibility of occupational infection has been sufficiently proven, and the risk probably depends on the work performed and the conditions of direct contact of medical personnel, which requires further study in the current persisting epidemic conditions. © 2021, Izmerov Research Institute of Occupational Medicine. All rights reserved.