On April 16, an online consultation was held with the participation of a delegation of doctors from China on a professional working visit to Karaganda. Two clinical cases of COVID-19 are presented to Chinese colleagues. 

The first case  was presented by the attending physician of the infectious diseases hospital. The patient is in a moderate state with diagnosed bilateral pneumonia and  weakened morbid background, as she suffers from chronic diseases, including bronchial asthma. Complicating patient management is the presence of a multivalent drug allergy. Nevertheless, with the help of carefully and strictly verified therapy, careful selection of drugs, complex antiviral treatment, doctors managed to achieve positive results, and the patient is currently on the mend. Indicators of lung function are improving, it can do now without respiratory support. The temperature returned to normal. Although it’s still too early to talk about cure, there is a positive trend, as noted by colleagues from China, recognizing the correct tactics of Karaganda doctors. 

The second clinical case was presented by a resuscitator. The condition of an elderly patient is consistently severe. Our Chinese colleagues noted the particular difficulty of treating this patient, because the coronavirus infection occurred against the background of a severe somatic status of the patient. He suffered a myocardial infarction, coronary artery bypass grafting, ischemic stroke in the past, and by the time coronavirus pneumonia developed, he suffered from residual effects of cerebrovascular accident: he could not move on his own, as he was paralyzed. Along with this, the patient is diagnosed with a pathology of the gastrointestinal tract. In addition, upon admission to the infectious diseases hospital, he was operated on for acute urinary retention, in connection with which a cystostomy was established. 

Chinese experts noted the particular complexity of this case, emphasizing that specific treatment should be accompanied by close attention to the problems of affected internal organs, especially the heart, kidneys, and biliary tract. It was noted by our guests that, despite the severity of the concomitant pathology, the persisting viral load, the doctors managed to stabilize the electrolyte balance, acid-base balance in the patient. 

 The Chinese doctors were impressed by the community of doctors in Karaganda in solving problematic issues of treatment. They advised that more attention be paid to the treatment of chronic pathology in patients with COVID-19, which, in their opinion, may become the main condition for success in the fight against complications of coronavirus disease.
Thanking each other warmly for constructive cooperation, the participants completed an on-line consultation. Moderator of the meeting B.N. Kosherova noted that the advice and recommendations of colleagues from China will certainly be taken into account in the further tactics of treating patients. The Chinese side expressed a desire to continue the discussion of complex cases in a different format.