International Journal of Medical Sciences And Clinical Research
62
https://theusajournals.com/index.php/ijmscr
VOLUME
Vol.05 Issue01 2025
PAGE NO.
62-68
10.37547/ijmscr/Volume05Issue01-09
Indicators of clinical and laboratory findings in patients
who was suffered from Covid in Uzbekistan.
(Retrospective and Prospective Analysis)
Nabiyeva Dildora Abdumalikovna
D.m.s., Professor of the Department of Faculty and Hospital Therapy and Prof. pathology No. 1 of Tashkent Medical Academy,
Uzbekistan
Makhfuza Rustamovna Bekchanova
Teacher in Kimyo International University in Tashkent, 156/Shota Rustaveli street, Tashkent, Uzbekistan
Received:
24 October 2024;
Accepted:
26 December 2024;
Published:
28 January 2025
Abstract:
A comparative analysis of clinical, anamnestic and laboratory parameters of patients with COVID-19 was
carried out using the method of retrospective and prospective examination. It was found that during treatment
with antiviral drugs, a quarter of patients had changes of cytolysis markers. It was also shown that patients with
comorbidity were more common in a prospective study.
Keywords:
Covid-19, retrospective study, prospective analysis, comorbidity.
Introduction:
Despite the fact that almost 3 years have
passed since the beginning of the Covid-19 pandemic,
the whole world is experiencing uncertainty. The
current crisis caused by Covid-19 is taking place in
unprecedented conditions for society. Freedom of
human transit between countries in this globalized
world [1 , 2 , 3 , 4], that is, the coronavirus of this
environment or each of its new variants, such as Delta
or Omicron, causes infection.
Depending on the countries of the world, six waves of
Covid-19 can be counted, which left thousands of
infected and deceased people as a trace after
themselves [7].
And in Uzbekistan, the first confirmed case was
detected on March 15, 2020 in a citizen of Uzbekistan
who returned from France, and the first case was
officially announced [11, 9].
Nevertheless, on April 22, 2020, it was said that 1,692
people were infected with Covid-19 in our country.
Based on data from the Worldometers portal, our
country has one of the lowest rates in the world in
terms of the number of cases detected in a million
inhabitants (51)
–
while the entire world rate was (330),
and in terms of the number of deaths from this
dangerous infection per million inhabitants (7 people)
–
0.2%, and the entire world rate was -22.9% [12].
In early June 2020, an intensive increase in morbidity
was reported, with the death toll ranging from 3 to 7
per day, with the maximum number of new cases
reported on 4 August (981 patients) [8].
The most common clinical symptom of Covid
—
19 is
fever, mainly subfebrile (up to 37.5 °C); respiratory
symptoms: cough; in severe cases-symptoms of
hangover and intoxication: fatigue and general
weakness, headache, dyspepsia and diarrhea. Most
common in severe cases-pneumonia and hypoxia [8,
10]. Having studied the above, we considered it
permissible to study the history, complaints, clinical-
laboratory changes of patients with Covid-19 in
Uzbekistan.
METHODS
Our investigation is to study patients with coronovirus
in Uzbekistan in 2020 (July-August) and 2021 (July)
using a retrospective and prospective research
method.
International Journal of Medical Sciences And Clinical Research
63
https://theusajournals.com/index.php/ijmscr
International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
We have been using the retrospective research
method, examined the medical histories of 182
patients who were treated at the Tashkent Medical
Academy, and clinical - anamnestic studies of 110
patients at the Republican special Zangiota hospital
through the prospective research method. We
analyzed the results obtained statistically.
RESULTS AND DISCUSSION
we have taught the average age and gender
characteristics of patients who have selected in both
research methods. We analyzed the results by
comparing them.
Table 1
Age and gender characteristics of patients with Covid-19
Indications
Prospective method
Retrospective method
abc
%
abc
%
Male
62
56,36
96
52,7
Female
48
43,64
86
47,3
Average age
43,27
1,42
53,93
0,99
Duration
of
hospital
treatment
12,40
0,41
8,96
0,23
We can see from the table that the gender ratio in the
groups is the same, and male predominance was
observed.
The average age corresponds to the middle-aged (45-
60 years) in the retrospective group, and to the young
(25- 44 years) in our prospective group. The day of
hospital treatment was longer in patients in the
prospective group, 12 days.
We divided the patients in the research groups
according to the classification of the World Health
Organization by age (Fig. 1)
Figure 1. Age distribution of patients in retrospective and prospective study methods.
During the analysis, it became clear that in the
retrospective research method, the predominance of
middle-aged patients with 82 cases was observed,
while in the prospective study, young patients with 56
cases made up a larger percentage. The least damage
corresponds to elderly patients of both groups. We
studied the comorbid conditions of patients in the
study groups (Fig. 2)
International Journal of Medical Sciences And Clinical Research
64
https://theusajournals.com/index.php/ijmscr
International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
retrospective prospective
Figure 2. The occurrence of comorbid conditions in
patients in a retrospective and prospective research
method.
In the retrospective analysis group, cardiovascular
disease and diabetes are more common among
patients.
According to World statistics, this is the most common
pathology in patients of this age. Patients of the
prospective group had a higher incidence of
cardiovascular disease and obstructive pulmonary
disease, and had a higher incidence of digestive system
diseases compared to them. Many diagnoses of this
pathology in young patients are associated with
improper nutrition. Since our patients were sick in two
periods, we analyzed their complaints. only by
promising research method, it was possible to observe
the dynamics of patients (Fig.3).
Figure 3. Occurrence of complaints in patients with Covid-19 (prospective and retrospective)
During the study of the main complaints of patients
under study, it became known that the most common
weakness (93.6%) and decreased appetite (75.5%)
were found. Loss of taste and sense of smell was
observed in 48.2%. Nausea, on the other hand, was
observed in 30.9% of patients, and 7.3% of patients
complained of vomiting. Diarrhea-in 9.1% of patients,
those in the same ratio said that they suffered from
pain in the muscles, by 7 days it can be seen from the
diagram that these complaints increased the sensation.
When we studied the results of the clinical-anamnestic
analysis, we studied the amounts of saturation in the
blood of patients. In accordance with it, we received
the following results (Figure 4).
International Journal of Medical Sciences And Clinical Research
65
https://theusajournals.com/index.php/ijmscr
International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
(*-88.2% differences are statistically significant P<0.05 )
Figure 4. Severity levels of COVID-19, distribution by incidence of SpO2.
From the diagram it turned out that in a large part of
the sick, the amount of oxygen in the blood is less than
95%, only 11.8% and in 28.6% it became known to us
that it is lower than 90%.
The study studied the results of the general blood analysis of our patients in dynamics (Table 2).
№
Indicators
Reference
results
Retrospective
Prospective
before
treatment
4 days
7 days
1
Hemoglobin
120-160 г/л
165,63±4,02
209,39±3,06
185,63±3,02*
142,91±3,3**^
2
Leukocyte
3-9 10
6
/ ul
8,4±1,35
5,57±0,24
8,29±0,35*
10,10±0,52**
3
Platelet
180-320
10
3
/ ul
195,37±6,5
221,37±6,25
289,07±10,43*
283,87±7,94**
4
Erythrocyte
sedimentation
rate
4-10 мм/ч
15,7±1,6
18,37±1,23
16,16±1,25
13,47±1,28*
*- before treatment and 4 days, **- before treatment and 7 days, ^- results compared to 4 days and 7
days are reliable ( p <0.05)
Looking at the table and analyzing it, we observed an
increase in ESR in patients in the retrospective study
groups. This indicates that the inflammatory process is
increasing in the div. The rest of the general blood
parameters are normal.
An increase in hemoglobin was observed among
patients in the prospective group, which showed an
average of 209.39±3.06 g/l, indicating hypoxia or blood
clotting.
The average number of leukocytes at the beginning of
theexamination was 10.10±0.52 106 / ul, ESR increased
by 18.37±1.23 mm/s, which indicates inflammation.
The average value of thrombocytes increased
dynamically, but within the normal range, this
condition indicates blood clotting.
In our patients, it was not possible to study the
biochemical analysis of the patients in the
retrospective analysis, we only studied the results of
the prospective study and saw their changes during the
treatment period.
International Journal of Medical Sciences And Clinical Research
66
https://theusajournals.com/index.php/ijmscr
International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
Table 3
Characteristics of biochemical indicators in patients with Covid-19 (n=110)
.
№
indicators
Reference
results
before treatment
4 days
7 days
1
ALT (n=110)
<40 U/l
43,4±3,02
102,78±7,35*
115,98±11,64**
2
АSТ (n=110)
<35 U/l
37,57±2,62
65,79±4,57*
64,77±7,4**
3
Bilirubin (n=110)
3,4-20,5
mmol/l
9,93±0,4
10,39±0,65*
10,01±0,41**
4
Albumin (n=110)
35-55 g|l
37,02±0,22
35,98±0,32*
35,83±0,29**
5
СРО (n=110)
0-6 mg|l
41,93±4,63
16,74±2,95
7,54±1,01
6
Glucose (n=110)
3,2-6,1 mmol/l
5,34±0,19
5,39±0,25*
4,92±0,09**^
7
Creatinine (n=46)
44-115 mmol/l
92,65±2,45
88±0,93*
100,6±1,41**
8
Urea (n=110)
2,5-8,3 mmol/l
5,95±0,19
6,16±0,19
6,46±0,22
9
Total protein (n=110)
66-85 g|l
75,72±0,36
73,96±0,51*
73,69±0,4**
10
Calcium (n=43)
2-2,6 mmol/l
2,1±0,01
2,14±0,01*
2,14±0,01**
11
Cholesterol (n=17)
<5,2 mmol/l
3,18±0,09
3,31±0,23
2,99±0,08
12
Triglyceride (n=17)
<2,28 mmol/l
2,35±0,07
3,45±0,64
2,18±0,1**
13
Amylase (n=17)
0-220 U/l
137,95±2,83
130,65±1,97
143,9±3,74**
14
GGT (n=17)
9-61 U/l
47,8±3,41
75,8±5,34
79,8±5,18
15
LDH (n=17)
225-450 U/l
245,05±5,65
283,48±4,11*
295,5±5,71**
16
IF (n=13)
38-126 U/l
159,29±6,91
139,65±2,64
152,7±5,73*
*- before treatment and 4 days, **- before treatment and 7 days, ^- results compared to 4 days and 7 days are
reliable ( p <0.05)
Table 3, in the blood biochemical analysis, only liver
enzymes (ALT, AST) were found to be elevated, and the
daily ratio of ALT increased by 267.2% and AST by
172.3%, but bilirubin did not exceed the normal range
even though it increased to 100.8%.
Indicators of hepatotoxic damage of the liver increased
up to 120% of LDH, Alkaline phosphatase up to 109%
within normal limits, GGT up to 166%. This indicator
was checked in only 17 people. Perhaps if 110 people
were examined, these figures would show different
results.
We observed that amylase increased to 104.3%, Urea
to 108%, Creatinine to 109% around the norm. The
inflammatory marker SRO decreased from 41.93 mg/l
to 7.54 mg/l. Lipid parameters increased to a maximum
of 111%, Triglyceride increased to 115% and decreased
again. Such a situation shows the effectiveness of
treatment procedures carried out in patients.
According to foreign scientists [13], hypercoagulation is
observed in patients infected with coronavirus, which
motivated us to examine the blood coagulation system
of our patients (Table 4).
T
able 4
Results of coagulogram indicators in patients with Covid-19 (n=110)
№
indicators
Reference
result
Before treatment
5 days
7 days
1
Prothrombin time
(PTT)
12-15 sec
13,13±0,12
13,18±0,11
13,53±0,15**
2
PTI
70-110%
95,59±1,15
95,71±0,79*
89,62±2,06**^
International Journal of Medical Sciences And Clinical Research
67
https://theusajournals.com/index.php/ijmscr
International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
3
international
normalized ratio
(INR)
0,8-1,2
1,26±0,23
1,31±0,23
1,07±0,01
4
APTT (activated
partial
thromboplastin time)
21-35 sec
23,56±0,27
24,11±0,31
23,67±0,34
5
ferritin
( n=32)
0,3-0,7
4,19±0,09
3,55±0,1*
7,34±0,78**^
*- before treatment and 4 days, **- before treatment and 7 days, ^- after 4 days and 7 days, the results
are reliable (p<0.05).
As can be seen in the table, prothrombin time (PTT),
prothrombin index (pti), International normative
relations (INR), partial activation of thromboplastin
time (APTT) are within the norm limit, but in dynamics
there has been a decrease in time relative to time on
arrival at the hospital. Balkim is one of the effects of
these anticoagulants. As a supplement, a ferritin ratio
was tested in 25 patients and an increase occurred,
indicating inflammation or liver damage during
coronovirus. So, in the results of laboratory analysis of
patients with the method of prospective examination,
we observed an increase in hemoglobin and platelets,
but not out of the norm, and an increase in ESR. In a
blood biochemical analysis,we saw an increase in
indicators that indicate toxic liver damage (AlT, AST, IF,
GGTP and LDH).
CONCLUSION
1. In July-August 2020, middle-aged people were
infected with coronavirus more often, and in June 2021
- young people, while the lowest incidence was
detected in elderly patients. In two methods of
analysis, male proportions prevailed.
2. Among the concomitant pathologies, diseases of the
cardiovascular system were in the lead, but in the
prospective group, pathologies associated with
digestion were more pronounced compared to the
retrospective study method.
3. With a prospective method of investigation, a
biochemical blood test revealed signs characteristic of
Reactive liver damage.
4. When we analyzed the blood clotting system,
indicators indicating blood clotting prevailed.
REFERENCES
Green M.S., Zeniman J., Cohen D., Wither I., Baliser R.D.
/Risk Assessment and Risk Communication
Strategies for Bioterrorism Preparedness //Springer
Science & Business Media; Dordrecht, The
Netherlands: 2007
Conrow E. H., Polmann L. D. / Effective risk
management: some keys to success, second edition.
Understanding.
2004;
6:44.
doi:
10.1002/inst.20046244.
De las Heras-Pedrosa K., Sanchez-Nunez P., Pelaez H.I.
/ Sentiment analysis and understanding of
emotions during the COVID-19 pandemic in Spain and
its impact on digital ecosystems. // Intern. J.
Environment. Res. Healthcare. 2020; 17:5542. doi:
10.3390/ijerph17155542.
Iglesias-Sanchez P.P., Witt G.F.V., Cabrera F.E.,
Hambrino-Maldonado C. / Contagion of the senses
during the COVID-19 pandemic crisis: a case of
lockdown in Spain. // International J. Environment.
Res.
Healthcare.
2020;
17:5918.
doi:
10.3390/ijerph17165918.
Pavlic J., Tomasic T., Kozhuh I. / The impact of new
technologies on the effectiveness of product
placement: a preliminary study from the perspective of
interactive marketing. //J. Res. To interact.
Mark. 2021: 10.1108/JRIM-02-2021-0041.
Popova A.Yu. et al. / Experience of international
cooperation in organizing anti-epidemic measures by
healthcare institutions in the context of the covid-19
pandemic in the Republic of Uzbekistan, DOI:
10.21055/0370-1069-2021-3-122-128
European Commission. Coronavirus: Commission
presents EU vaccine strategy. 2020. [(accessed 24
January
2022)].
https://ec.europa.eu/commission/presscorner/detail/
en/ip_20_1103
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al.
/Clinical Characteristics of Coronavirus
Disease 2019 in China. // N Engl J Med. 2020. [Epub
ahead of print]
https://doi.org/10.1056/NEJMoa2002032
Sobirova G.N., Bafoyeva Z.O. Determination and
Analysis of Changes in the Hepatobiliary System in
Patients with Covid-19 // American Journal of Medicina
and Medical Sciences.- 2021.-11(2).- P.145-
147.
Sobirova G. N., Bafoeva Z.O., Usmankhodzhayeva A. A.
Сlinical and biochemical parameters of
patients with Сovid
-19 with impaired liver function
before and after treatment.// Тошкент тиббиёт
International Journal of Medical Sciences And Clinical Research
68
https://theusajournals.com/index.php/ijmscr
International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
академияси, Ёш олимлар журнали.
-
Тошкент.
-
2023.-
№1(06).
-
Б. 105
-112
Uzbekistan confirms first coronavirus case
—
govt.
Available at:
https://www.reuters.com/article/health-coronavirus-
uzbekistan-idUSL8N2B802F (accessed
16.01.2022).
Jasim SA, Mahdi RS, Bokov DO, Najm MAA, Sobirova
GN, Bafoyeva ZO, Taifi A, Alkadir OKA,
Mustafa YF, Mirzaei R, Karampoor S./The deciphering
of the immune cells and marker signature in
COVID-19 pathogenesis: An update //J Med Virol . 2022
Jul 14;10.1002/jmv.28000. doi:
10.1002/jmv.28000. Epub ahead of print. PMID:
35835586; PMCID: PMC9350195. С.1
-21
Chan, J.F., Kok, K.H., Zhu, Z., Chu, H., To, K.K., et al.
(2020) Genomic Characterization of the 2019
Novel Human-Pathogenic Coronavirus Isolated from a
Patient with Atypical Pneumonia after Visiting
Wuhan. Emerging Microbes & Infections, 9, 221-236.
https://doi.org/10.1080/22221751.2020.1719902
