Analysis of the toxicological situation in Moscow in the first three months of the COVID-19 pandemic

Introduction. On March 11, 2020, WHO announced the global COVID-19 pandemic. According to literature data, the spread of coronavirus infection COVID-19 affected the structure of acute chemical poisoning.

The aim. Assessment of the impact of the COVID-19 pandemic and restrictive measures on the peculiarities of seeking advice and the structure of acute chemical poisoning in Moscow. 

Material and methods. The data of the registration forms “Card of recording of a consultation of a patient with acute poisoning of chemical etiology” in the period from March 30 to June 30, 2020 and 2019 were studied. The analysis indicators of a hospitalization of patients in the department of acute poisoning and somatopsychiatric disorders of N.V. Sklifosovsky, the Research Institute of Emergency Medicine.

Results. It was found that in the analyzed period of 2020 compared to 2019, the proportion of injured people of working age decreased by 11.2%, while it increased at the age of 0-17 years by 3.2 times. An increase in the number of consultations for individuals by 2.1 times was noted. There was an increase in the number of complaints about poisoning with antibiotics, drugs from the T45 group (anticoagulants, vitamins, etc.), T37 (antiviral, anti-microbial, etc.) by 1.7-2 times. 

In March-June 2020, there was an increase in the number of complaints about the toxic effects of alcohol (T51), an increase in hospitalized patients with acute alcohol poisoning by 4 times, and with combined alcohol poisoning – by 2.7 times. The number of complaints about poisoning with detergents and disinfectants in the first three months of the pandemic increased by 2.7 times.

Conclusion. The pandemic and the introduction of restrictive measures for COVID-19 have affected the toxicological situation in Moscow, which must be taken into account when determining the guidelines for organizational measures for the provision of medical care for acute chemical poisoning during the COVID-19 pandemic.

1. Ostrovskiy D.I., Ivanova T.I. Influence of the new coronovirus COVID-19 infection on human mental health (literature review). Omskiy psikhiatricheskiy zhurnal. 2020; (2-S1): 4-10. https://doi.org/10.24411/2412-8805-2020-10201 (In Russian)

2. Ofitsial’nyy sayt Mera Moskvy. Dokumenty. Available at: https://www.mos.ru/city/projects/covid-19/documents/ [Accessed: January 25, 2021]. (In Russian)

3. Lubenitskaya A.N., Ivanova T.I. The world will never become the same – pandemic of the new millennium (review of literature). Omskiy psikhiatricheskiy zhurnal. 2020; (2-S1): 16-22. https://doi.org/10.24411/2412-8805-2020-10203 (In Russian)

4. Chang A., Schnall A.H., Law R., Bronstein A.C., Marraffa J.M., Spiller H.A., et al. Cleaning and Disinfectant Chemical Exposures and Temporal Associations with COVID-19 – National Poison Data System, United States, January 1, 2020–March 31, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(16): 496-8. https://doi.org/10.15585/mmwr.mm6916e1

5. Sefidbakht S., Lotfi M., Jalli R., Moghadami M., Sabetian G., Iranpour P. Methanol toxicity outbreak: when fear of COVID-19 goes viral. Emerg Med J. 2020; 37(7): 416. https://doi.org/10.1136/emermed-2020-209886

6. Pollard M.S., Tucker J.S., Green H.D. Jr. Changes in Adult Alcohol Use and Consequences During the COVID-19 Pandemic in the US. JAMA Netw Open. 2020; 3(9): e2022942. https://doi.org/10.1001/jamanetworkopen.2020.22942)

7. Belova M.V., Il’yashenko K.K., Simonova A.Yu., et al. Struktura ostryh ekzotoksikozov v pervye tri mesyaca pandemii COVID-19 (po dannym otdeleniya ostryh otravlenij GBUZ «NII skoroj pomoshchi im. N.V. Sklifosovskogo DZM»). Neotlozhnaya medicinskaya pomoshch’. 2021; 10(1): 27-32. (In Russian)

8. Luzhnikov E.A. Medical toxicology: National guidelines [Meditsinskaya toksikologiya: natsional’noe rukovodstvo]. Moscow: GEOTAR-Media; 2012. (In Russian)

9. Khoffman R., Nel’son L., Khauland M.E., L’yuin N., Flomenbaum N., Goldfrank L. Emergency medical care for poisoning: translated from English [Ekstrennaya meditsinskaya pomoshch’ pri otravleniyakh: per. s angl.] Moscow: Praktika; 2010. (In Russian)

10. Baeza S., Watkins S.A., Borron S. COVID-19 Crisis Collaboration: The poison Center and Health Department in time of Pandemic. Clin Toxicol. 2020; 58(11: Abstracts North American Congress of Clinical Toxicology (NACCT) - 2020). Abstr #30.

11. Beuhler M., Beuhler P., Dulaney A., Steverson A., Taylor R., Rembert R. The Inception, Execution and Sunsetting of a Poison Center based COVID-19 Information Line. Clin Toxicol. 2020; 58(11: Abstracts North American Congress of Clinical Toxicology (NACCT) - 2020). Abstr #35.

12. Calello D., Ruck B., Meaden C., Nelson L. The Poison Center as Pandemic Response: Establishment and Characteristics of a COVID-19 Hotline through the New Jersey Poison Cent. Clin Toxicol. 2020; 58(11): Abstracts North American Congress of Clinical Toxicology (NACCT) - 2020). Abstr #52.

13. Chen R., Roper L., Krueger J. Trend of toxic alcohol ingestions in the setting of the COVID-19 global pandemic. Clin Toxicol. 2020; 58(11: Abstracts North American Congress of Clinical Toxicology (NACCT) - 2020). Abstr #58.

14. Ferruzzi M., Celentano A., Sesano F., Milanesi G., Assisi F., Bissoli M., et al. Desinfectant and hand sanitizer product exposures in Italy: a «side effect» of the COVID-19 Pandemic. Clin Toxicol. 2020; 58(11: Abstracts North American Congress of Clinical Toxicology (NACCT) - 2020). Abstr #57.

15. Cohle S.D., Thompson W., Eisenga B.H., Cottingham S.L. Unexpected death due to chloramine toxicity in a woman with a brain tumor. Forensic Sci Int. 2001; 124(2–3): 137–9. https://doi.org/10.1016/s0379-0738(01)00592-8

16. Bracco D., Dubois M.J., Bouali R. Intoxication by bleach ingestion. Can J Anaesth. 2005; 52(1): 118–9. https://doi.org/10.1007/BF03018599

17. National Research Council. Acute Exposure Guideline Levels for Selected Airborne Chemicals: Volume 4. Washington (DC): National Academies Press; 2004. https://doi.org/10.17226/10902

18. Medina-Ramón M., Zock J.P., Kogevinas M., Sunyer J., Torralba Y., Borrell A., et al. Asthma, chronic bronchitis, and exposure to irritant agents in occupational domestic cleaning: a nested case-control study. Occup Environ Med. 2005; 62(9): 598–606. https://doi.org/10.1136/oem.2004.017640

19. Babić Ž., Turk R., Macan J. Toxicological aspects of increased use of surface and hand disinfectants in Croatia during the COVID-19 pandemic: a preliminary report. Arh Hig Rada Toksikol. 2020; 71(3): 261-4. https://doi.org/10.2478/aiht-2020-71-3470