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Zhuravleva MV, Chulanov VP, Gagarina JV, Shabalina EA. Pharmacoeconomic evaluation of the tixagevimab and cilgavimab combination using for pre-exposure prophylaxis of COVID-19. TERAPEVT ARKH 2023; 95:66-77. [PMID: 37167117 DOI: 10.26442/00403660.2023.01.202065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 02/26/2023]
Abstract
Aim. To evaluate pharmacoeconomic feasibility using of the tixagevimab and cilgavimab combination for pre-exposure prophylaxis of COVID-19 in immunocompromised patients.
Materials and methods. Cost-effectiveness of tixagevimab and cilgavimab in persons 12 years old who weigh 40 kg and have either a history of allergy that prevents their vaccination against COVID-19 or moderate or immunocompromised was assessed based on PROVENT phase III study results. The quantity of life years or quality-adjusted life years gained was calculated. Direct medical cost associated with prophylaxis of COVID-19, treatment of infected patients and those experiencing long COVID post infection were assessed. Results were compared with wiliness-to-pay threshold, measured as tripled gross domestic product per capita and equal to 2.69 mln RUB in 2022.
Results. Pre-exposure prophylaxis of COVID-19 results in additional 0.0287 life years or 0.0247 quality-adjusted life years. The cost of additional life year gained is equal to 1.12 mln RUB, the cost of additional quality-adjusted life years is 1.30 mln RUB. Both costs of additional life year and cost of quality-adjusted life years appeared to be significantly less compared to wiliness-to-pay threshold.
Conclusion. Pre-exposure prophylaxis of COVID-19 with combination of tixagevimab and cilgavimab is economically feasible and may be recommended for wide use in Russian healthcare system.
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Goma TV, Kalyagin AN, Ryzhkova OV, Soloveva NS. Efficacy of olocizumab in treatment of COVID-19 patients. Acta biomedica scientifica 2022; 7:86-95. [DOI: 10.29413/abs.2022-7.5-2.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background. Production of pro-inflammatory cytokines including interleukin 6 (IL-6) is activated in COVID-19. Using olokizumab which inhibits IL-6 production in treatment of COVID-19 is pathogenetically justified.The aim. To study in real clinical practice the efficacy and safety of using the IL-6inhibitor (olokizumab) in treatment of patients with confirmed COVID-19 pneumonia.Materials and methods. The first group included 41 hospitalized patients with confirmed COVID-19 pneumonia having complex therapy including olokizumab. The control group consisted of 66 patients with confirmed COVID-19 pneumonia who did not have therapy with IL-6 inhibitor. We analyzed clinical (volume of lung involvement, respiratory failure degree, body mass index) and laboratory data (levels of T-troponin, lactate, procalcitonin, natriuretic peptide, C-reactive protein, fibrinogen, D-dimer, ferritin, erythrocyte sedimentation rate, glomerular filtration rate).Results. The groups did not differ in gender, age, body mass index of patients, volume of lung tissue injury, and duration of hospitalization (p > 0.05). Respiratory failure of 2–3rd degree was more common in patients of the first group (χ2 = 6.3; p = 0.010). The initial levels of C-reactive protein (50.9 [34.2; 76.2] and 32.2 [9.9; 69.1] mg/L respectively; p = 0.009) and fibrinogen (6.0 [5.3; 6.7] and 5.2 [4.3; 6.2] g/l respectively; p = 0.005) in patients having therapy including olokizumab were significantly higher than in the control group. The levels of erythrocyte sedimentation rate, fibrinogen and ferritin, D-dimer, detected upon admission of patients to the hospital, didn’t have statistically significant differences. At discharge, the erythrocyte sedimentation rate in patients receiving olokizumab was statistically significantly lower (9.0 [5.5; 14.5] and 13.0 [7.0; 27.0] mm/h; p = 0.018).Conclusions. Using olokizumab in the treatment patient with COVID-19 pneumonia has demonstrated a positive effect on clinical and laboratory parameters (erythrocyte sedimentation rate, fibrinogen level) in patients with pronounced inflammatory changes and respiratory impairment.
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Podzolkov VI, Tarzimanova AI, Bragina AE, Shvedov II, Bykova EE, Ivannikov АA, Khanakyan SS, Almyasheva AM. Effect of spironolactone therapy on the activity of the matrix metalloproteinase system in patients with heart failure after COVID-19. Cardiovasc Ther Prev 2022. [DOI: 10.15829/1728-8800-2022-3431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Aim. To assess the change in the activity of the matrix metalloproteinase (MMP) system after 6-month spironolactone therapy in patients with heart failure (HF) with preserved (HFpEF) and mildly reduced ejection fraction (HFmrEF) after coronavirus disease 2019 (COVID-19).Material and methods. The study included 90 patients treated at the University Clinical Hospital № 4 of the I.M. Sechenov First Moscow State Medical University with a laboratory-confirmed COVID-19. There were following inclusion criteria: age of 18-85 years; the presence of HFpEF and HFmrEF. The patients were randomized into two groups: group I (n=60) — patients with 6-month spironolactone therapy (25 mg/day) in addition to the standard therapy for HF, spironolactone was taken at a dose of 25 mg/day; Group II (comparison group, n=30) — patients who received standard therapy without spironolactone. All patients were determined plasma MMP concentrations.Results. There were no significant differences in the levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) between the groups when included in the study. A repeated investigation revealed a significant decrease in the concentrations of MMP-9 and TIMP-1 only in group I. In patients of group II, there were no significant changes in the plasma concentrations of MMP-9 and TIMP-1. The MMP-9/TIMP-1 ratio during the initial examination of patients did not have significant differences. After 6-months therapy, a significant decrease in the ratio of MMP-9/TIMP-1 was observed only in patients taking spironolactone.Conclusion. The results obtained confirm a significant decrease in MMP system activity after 6-month spironolactone therapy in patients with HFpEF and HFmrEF after COVID-19. The described antifibrotic effects of spironolactone make it possible to recommend the use of this drug in this category of patients to reduce the negative effect of MMPs on cardiovascular system.
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Affiliation(s)
| | | | | | | | - E. E. Bykova
- I.M. Sechenov First Moscow State Medical University
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Petelina TI, Musikhina NA, Garanina VD, Shcherbinina AE, Kalyuzhnaya EN, Sharoyan YA, Kapustina AA, Gapon LI, Yaroslavskaya EI. Characterization of blood biomarkers in prospective follow-up of patients with cardiovascular pathology in combination with type 2 diabetes mellitus after COVID-19 associated pneumonia. Klin Lab Diagn 2022; 67:561-569. [PMID: 36315170 DOI: 10.51620/0869-2084-2022-67-10-561-569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The study of the characteristics and dynamics of laboratory biomarkers in patients with cardiovascular diseases (CVD) with type 2 diabetes mellitus who underwent COVID-19-associated pneumonia is of great clinical importance for preventing the risk of adverse events. IN the study we used data from 65 patients in the present work. Patients were divided into 2 groups: group 1 included patients with CVD: arterial hypertension (AH) in combination with coronary artery disease (CAD) without DM2 (n=45), group 2 included patients with CVD and DM2 (n=20). Patients were examined at baseline in the infectious disease hospital and 3 months after discharge. During laboratory examination of blood biosamples we evaluated parameters of general blood test; biochemical and immunologicai parameters; elastic properties of the vascular wall. The analyzed leukocyte parameters and their index coefficients - increase in NLR ratio (neutrophils/lymphocytes) and decrease in LYM/CRP ratio (lymphocytes/CRP) were more significantly changed in DM2 group. Patients in both groups had a significant excess of baseline max CRP concentrations with decrease in parameters after 3 months, but with persistent excess values in group 2. Three months after discharge patients with DM2 had levels of hs-CRP, IL-1β and TNFa and NT-proBNP, that exceeded both the reference values and those in group 1, which reflected the presence of more pronounced vascular inflammatory potential for possible adverse events in this group of patients in post-COVID period. The method of multiple regression showed that DM2 is an independent risk factor for increased stiffness of the vascular wall. Thus, dynamic control of laboratory parameters has prognostic value in assessing the nature of the course of COVID-19 associated pneumonia in patients with CVD and DM2 developing an algorithm for personalized monitoring of patients in the post-COVID period with the aim of timely prevention of unwanted vascular complications.
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Affiliation(s)
- Tatiana Ivanovna Petelina
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - N A Musikhina
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - V D Garanina
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - A E Shcherbinina
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - E N Kalyuzhnaya
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - Y A Sharoyan
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - A A Kapustina
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - L I Gapon
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - E I Yaroslavskaya
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
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5
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Topolnitskiy EB, Shefer NA, Kapitanova DV, Podgornov VF. [Treatment of post-intensive care tracheal stenosis after previous covid-19 pneumonia]. Khirurgiia (Mosk) 2022:5-10. [PMID: 35477194 DOI: 10.17116/hirurgia20220415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To analyze postoperative outcomes and perioperative management of patients with post-intensive care tracheal stenosis and previous COVID-19 pneumonia. MATERIAL AND METHODS There were 8 patients with post-intensive care tracheal stenosis and previous COVID-19 pneumonia aged 34-61 years between January 2021 and April 2021. Lung damage CT-3 was observed in 2 (25%) patients, CT-4 - in 5 (62.5%) patients. In one case, COVID-19 pneumonia with lung damage CT-2 joined to acute cerebrovascular accident. Post-tracheostomy stenosis was detected in 7 (87.5%) cases, post-intubation stenosis - in 1 patient. Duration of invasive mechanical ventilation ranged from 5 to 130 days. In 75% of cases, tracheal stenosis was localized in the larynx and cervical trachea. Two patients admitted with tracheostomy. In one case, an extended tracheal stenosis was combined with atresia of infraglottic part of the larynx. One patient had tracheal stenosis combined with tracheoesophageal fistula (TEF). Length of tracheal stenosis was 15-45 mm. Tracheomalacia was observed in 4 (50%) patients. All patients had severe concomitant diseases. RESULTS To restore airway patency, we used circular tracheal resection with anastomosis, laryngotracheoplasty and endoscopic methods. Tracheal resection combined with TEF required circular tracheal resection with disconnection of fistula. Adequate breathing through the natural airways was restored in all patients. There was no postoperative mortality. Three patients with baseline tracheal stenosis had favorable postoperative outcomes after circular tracheal resection. Four patients are at the final stage of treatment after laryngotracheoplasty and tracheal stenting. CONCLUSION Patients after invasive mechanical ventilation for COVID-19 pneumonia are at high risk of cicatricial tracheal stenosis and require follow-up. Circular tracheal resection ensures early rehabilitation and favorable functional results. Laryngotracheoplasty is preferred if circular tracheal resection is impossible. This procedure ensures adequate debridement of tracheobronchial tree and respiratory support. Endoscopic measures are an alternative for open surgery, especially for intrathoracic tracheal stenosis and intractable tracheobronchitis.
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Affiliation(s)
- E B Topolnitskiy
- Siberian State Medical University, Tomsk, Russia.,Tomsk Regional Clinical Hospital, Tomsk, Russia
| | - N A Shefer
- Tomsk Regional Clinical Hospital, Tomsk, Russia
| | - D V Kapitanova
- Siberian State Medical University, Tomsk, Russia.,Alperovich Tomsk City Clinical Hospital No. 3, Tomsk, Russia
| | - V F Podgornov
- Alperovich Tomsk City Clinical Hospital No. 3, Tomsk, Russia
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6
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Simanenkov V, Maev I, Tkacheva O, Alekseenko S, Andreev D, Bakulina N, Bakulin I, Bordin D, Vlasov T, Vorobyeva N, Grinevich V, Gubonina I, Drobizhev M, Efremov N, Karateev A, Kotovskaya Y, Kravchuk I, Krivoborodov G, Kulchavenya E, Lila A, Maevskaya M, Nekrasova A, Poluektova E, Popkova T, Sablin O, Solovyeva O, Suvorov A, Tarasova G, Trukhan D, Fedotova A. Epithelial protective therapy in comorbid diseases. Practical Guidelines for Physicians. TERAPEVT ARKH 2022; 94:940-956. [PMID: 36286974 DOI: 10.26442/00403660.2022.08.201523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 04/25/2022] [Indexed: 02/08/2023]
Abstract
In 2021 the first multidisciplinary National Consensus on the pathophysiological and clinical aspects of Increased Epithelial Permeability Syndrome was published. The proposed guidelines are developed on the basis of this Consensus, by the same team of experts. Twenty-eight Practical Guidelines for Physicians statements were adopted by the Expert Council using the "delphic" method. Such main groups of epithelial protective drugs as proton pump inhibitors, bismuth drugs and probiotics are discussed in these Guidelines from the positions of evidence-based medicine. The clinical and pharmacological characteristics of such a universal epithelial protector as rebamipide, acting at the preepithelial, epithelial and subepithelial levels, throughout gastrointestinal tract, are presented in detail.
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Abstract
Numerous studies demonstrate that a new coronavirus infection is associated with an increased risk of thrombosis, which underlies many of the complications of COVID-19. At the same time, many elderly patients with COVID-19 and with concomitant cordial pathology receive antiplatelet therapy to prevent recurrent ischemic events. The aim of this systematic review was to assess the effect of antiplatelet therapy on the risk of thrombotic complications and disease course in SARS-COV-2 infected patients. We carried out the search of the articles published from 2019 to 2021 with the keywords «antiplatelet therapy» and «COVID-19» in the PubMed database. A total of 209 articles were retrieved out of which 16 which were included in the review. According to majority of retrospective studies (7 out of 10 studies, more than 30.000 patients), antiplatelet therapy is associated with a statistically significant and prominent reduction in overall mortality. Several studies showed that antiplatelet therapy positively influences the risks of severe respiratory disorders, need of invasive lung ventilation and decreases the probability of thrombotic events. However the only prospective randomized placebo-controlled study did not show a benefit of antiplatelet therapy in symptomatic patients with mild stable COPD-19. None of the studies reported a negative effect of antiplatelet therapy on the course of a new coronavirus infection. Therefore, to date there is no conclusive evidence based on prospective randomized trials, of a positive effect of antiplatelet therapy on the course of COVID-19. Further research on this issue using the double-blind method is needed. However, there are no reports of significant adverse effects of antiplatelet agents, who have previously been given antiplatelet therapy for secondary prevention.
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Affiliation(s)
- L A Edilgireeva
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - T A Sadulaeva
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - V V Zakharov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - N V Vakhnina
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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8
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Petelina TI, Musikhina NA, Garanina VD, Gorbatenko EA, Shcherbinina AE, Zhmurov DV, Zhmurov VA, Gapon LI, Galeeva NA, Avdeeva KS, Kapustina AA, Yaroslavskaya EI. Prospective analysis of laboratory blood parameters in patients with cardiovascular diseases who underwent COVID-19-associated pneumonia. Klin Lab Diagn 2022; 67:133-139. [PMID: 35320627 DOI: 10.51620/0869-2084-2022-67-3-133-139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The study of the characteristics and dynamics of laboratory biomarkers in patients with cardiovascular diseases (CVD) undergoing COVID-19-associated pneumonia may be of great clinical importance. The study included 116 patients who underwent COVID-19-associated pneumonia. The patients were divided into 2 groups. The first group included 49 patients without CVD, the second group - 67 patients with CVD. A blood sample was performed in all patients at the time of hospitalization and 3 months after discharge from the hospital. The parameters of general blood count, biochemistry, hemostasis, and biomarkers of inflammation were assessed - concentration of C-reactive protein (CRP), highly sensitive CRP (hs-CRP), homocysteine and IL-6. All patients initially underwent computed tomography of the chest organs. We found that ESR, WBC (leukocytes), NLR (neutrophils/lymphocytes ratio), fibrinogen, LDH (lactate dehydrogenase), LYM/CRP ratio (lymphocytes/CRP) were parameters that significantly distinguished patients in the 1st and 2nd groups. Three months after discharge from the hospital in patients of both groups the increased indicators approached the reference values, however, some parameters such as CRP, ESR, WBC, fibrinogen remained at a higher level in group 2 compared to group 1. Correlation analysis revealed the relationship between parameters of inflammation and hemostasis in the 2nd group of patients, which confirms the presence of latent vascular inflammatory potential in this group. It was revealed that such indicators as lymphocytes, neutrophils, APTT and LDH were associated with the initial volume of lung lesion more than 50%. Increase of these parameters by 1 unit contributes to increase in the volume of lung tissue damage by 6.5%, 6.4%, 11%, and 0.6%, respectively. Thus, dynamic control of laboratory parameters has prognostic value in assessing the nature of the course of COVID-19 associated pneumonia in patients with CVD and developing an algorithm for personalized monitoring of patients in the post-COVID period with the aim of timely correction of therapy to prevent unwanted vascular complications.
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Affiliation(s)
- Tatiana Ivanovna Petelina
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - N A Musikhina
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - V D Garanina
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - E A Gorbatenko
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - A E Shcherbinina
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - D V Zhmurov
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences.,Federal State Budgetary Educational Institution of Higher Education "Tyumen State Medical University" of the Ministry of Healthcare of the Russian Federation
| | - V A Zhmurov
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences.,Federal State Budgetary Educational Institution of Higher Education "Tyumen State Medical University" of the Ministry of Healthcare of the Russian Federation
| | - L I Gapon
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - N A Galeeva
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - K S Avdeeva
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
| | - A A Kapustina
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences.,Federal State Budgetary Educational Institution of Higher Education "Tyumen State Medical University" of the Ministry of Healthcare of the Russian Federation
| | - E I Yaroslavskaya
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center of the Russian Academy of Sciences
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Betuganova A, Notov A, Ahkubekova Z, Aramisova R, Kambachokova Z, Shereuzhev T, Aramisov K, Kambachokova A. Features of the course of cardiovascular diseases against the background of COVID-19. CM 2022. [DOI: 10.18137/cardiometry.2022.21.102106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Based on the analysis of 308 electronic medical records of patients with a confirmed diagnosis of a new coronavirus infection COVID-19, the features of the course of cardiovascular diseases at the regional level were studied. It was found that in patients with cardiovascular diseases, the severity of the course and mortality are higher than in patients without cardiac pathology.
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Podzolkov VI, Tarzimanova AI, Bragina AE, Shvedov II, Bykova EE, Ivannikov AA, Vasilyeva LV. Damage to the Cardiovascular System in Patients with SARS-CoV-2 Coronavirus Infection. Part 1: Predictors of the Development of an Unfavorable Prognosis. Racionalʹnaâ farmakoterapiâ v kardiologii 2022. [DOI: 10.20996/1819-6446-2021-11-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim. To evaluate the effect of sinus tachycardia and reduced left ventricular ejection fraction (LVEF) on the prognosis of patients with a verified diagnosis of a new coronavirus infection SARS-CoV-2.Material and methods. The study included 1,637 patients with a verified diagnosis of a new coronavirus infection SARS-CoV-2. The average age of the patients was 58.8±16.1 years. More than half of the patients admitted to the hospital had a history of cardiovascular diseases: hypertension was diagnosed in 915 (56%) patients, coronary artery disease – in 563 (34%), chronic heart failure – in 410 (25%). 294 (17.9%) patients suffered from diabetes mellitus. The unfavorable course of new coronavirus infection was assessed by the fact of being in the intensive care unit (ICU), the use of mechanical ventilation and death.Results. An unfavorable course of coronavirus infection was observed in 160 (9.8%) patients. Statistical analysis revealed that 341 (20.8%) patients with COVID-19 were diagnosed with sinus tachycardia, which required the appointment of pulse-reducing therapy. The occurrence of sinus tachycardia in patients with COVID-19 significantly increased the risk of death (odds ratio [OR] 1.248, confidence interval [CI] 1.038-1.499, p=0.018), increased the likelihood of mechanical ventilation use (OR 1.451, CI 1.168-1.803, p<0.001) and stay in the ICU (OR 1.440, CI 1.166-1.778, p<0.001).In 97 (5.9%) patients during hospital stay during echocardiography, a decrease in LVEF of less than 50% was diagnosed. A decrease in myocardial contractile function in patients with COVID-19 with high reliability increased the risk of death (OR 1.744, CI 1.348-2.256, p<0.001), increased the likelihood of using the mechanical ventilation (OR 1.372, CI 1.047-1.797, p=0.022) and stay in the ICU (OR 1.360, CI 1.077-1.716, p=0.010).Conclusion. The appearance of sinus tachycardia and reduced LVEF are in dependent predictors of the unfavorable course of COVID-19 in relation to factors such as death, the use of mechanical ventilation and the stay of patients in the ICU. Early pharmacological correction of cardiovascular lesions should be one of the goals of the management theese patients.
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Affiliation(s)
- V. I. Podzolkov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. I. Tarzimanova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. E. Bragina
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - I. I. Shvedov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - E. E. Bykova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. A. Ivannikov
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - L. V. Vasilyeva
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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11
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Editorial A. The possibilities of using antiplatelet agents during and after COVID-19 disease. Results of the Expert Council meeting. Cardiovasc Ther Prev 2022. [DOI: 10.15829/1728-8800-2021-3152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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12
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Shefer NA, Topolnitskiy EB, Dambayev GT. [Results and features of surgical treatment of lung cancer after previous COVID-19 pneumonia]. Khirurgiia (Mosk) 2021:15-19. [PMID: 34941204 DOI: 10.17116/hirurgia202112115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the features of preoperative preparation and postoperative outcomes in patients with lung cancer and previous COVID-19 pneumonia. MATERIAL AND METHODS There were 7 patients with non-small cell lung cancer and previous bilateral viral pneumonia between June 2020 and January 2021. In 3 cases, lung cancer was detected in a hospital for COVID-19 patients. Four patients had persistent structural changes in X-ray images. After appropriate preparation, all patients underwent total resection. RESULTS At admission, all patients had severe physical and functional exhaustion associated with prolonged hypoxia and adynamia that required preoperative rehabilitation. Considering high risk of thromboembolic complications, we administered anticoagulation throughout the entire perioperative period and after discharge. Surgical treatment included anatomical resection (extended lobectomy). Postoperative complications occurred in 2 cases and were associated with prolonged air discharge through the pleural drainage tube. CONCLUSION As we study the consequences of the new coronavirus infection COVID-19, it becomes obvious that a new category of patients requiring specific diagnosis and treatment has emerged.
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Affiliation(s)
- N A Shefer
- Tomsk Regional Clinical Hospital, Tomsk, Russia.,Tomsk Regional Oncology Center, Tomsk, Russia
| | - E B Topolnitskiy
- Tomsk Regional Clinical Hospital, Tomsk, Russia.,Tomsk Regional Oncology Center, Tomsk, Russia.,Siberian State Medical University, Tomsk, Russia
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13
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Ardatskaya MD, Butorova LI, Kalashnikova MA, Nugaeva NR, Ovchinnikov YV, Oynotkinova OS, Pavlov AI, Plavnik RG, Sayutina EV, Topchiy TВ, Trunova SN. [Gastroenterological symptoms in COVID-19 patients with mild severity of the disease: opportunities to optimize antidiarrheal therapy]. TERAPEVT ARKH 2021; 93:923-931. [PMID: 36286887 DOI: 10.26442/00403660.2021.08.201020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The novel coronavirus infection COVID-19 can be manifested by damage to the organs of the gastrointestinal tract (GIT). Damage to the gastrointestinal tract by the SARS-CoV-2 virus leads to a violation of the microbial-tissue complex of the mucous membrane of the digestive tract. A common gastroenterological manifestation of COVID-19 is diarrhea. AIM Study of the clinical features of gastroenterological disorders and the possibility of optimizing the treatment of diarrheal syndrome in patients with COVID-19 with a mild form of viral infection. MATERIALS AND METHODS The observation group consisted of 230 patients with mild COVID-19: K-group (n=115) with respiratory symptoms, I group (n=115) with gastrointestinal manifestations in combination and without signs of respiratory damage. In order to compare the effectiveness of treatment of diarrheal syndrome, patients of group I are randomized into 2 subgroups: Ia (n=58) prebiotic treatment (Zacofalk) and Ib (n=57) enterosorbents. RESULTS The development of gastrointestinal symptoms with SARS-CoV-2 infection is significantly more often noted in comorbid patients (67%). Gastrointestinal symptoms were dominated by diarrhea (93.9%) and flatulence (76.5%), in 1/3 of patients they were the first manifestos of infection. It was established that in 98.4% of patients of group I (against 42.6% of the K-group) signs of infectious intoxication were detected. In patients with gastrointestinal lesions, an elongation of the febrile period by 91.5 days was noted, a later (6 days) verification of the viral etiology of the disease. It was found that in patients of group I, the regression of clinical symptoms, the duration of viral disease, the dynamics of antibody formation, the prognosis for the development of IBS-like disorders in the post-infectious period depended on the treatment. In patients taking (Zacofalk), these indicators were significantly better. CONCLUSION In mild cases, to reduce the severity of viral intestinal damage, for effective relief of intestinal symptoms, to reduce the risk of IBS-like symptoms, it is advisable to prescribe (Zacofalk) in an initial dose of 3 tablets per day.
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Affiliation(s)
| | - L I Butorova
- Central State Medical Academy of the President of the Russian Federation
| | - M A Kalashnikova
- Central Clinical Hospital for Rehabilitation Treatment of the President of the Russian Federation
| | | | | | - O S Oynotkinova
- Lomonosov Moscow State University
- Research Institute for Healthcare Organization and Medical Management
| | - A I Pavlov
- Vishnevsky 3rd Central Military Clinical Hospital
| | | | - E V Sayutina
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - T В Topchiy
- Central State Medical Academy of the President of the Russian Federation
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14
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Grinevich VB, Kravchuk YA, Ped VI, Sas EI, Salikova SP, Gubonina IV, Tkachenko EI, Sitkin SI, Lazebnik LB, Golovanova EV, Belousova EA, Makarchuk PA, Eremina EY, Sarsenbaeva AS, Abdulganieva DI, Tarasova LV, Gromova OA, Ratnikov VA, Kozlov KV, Ratnikova AK. Management of patients with digestive diseases during the COVID-19 pandemic. Clinical Practice Guidelines by the Russian scientific medical society of internal medicine (RSMSIM) and the Gastroenterological Scientific Society of Russia (2nd edition). jour 2021:5-82. [DOI: 10.31146/1682-8658-ecg-187-3-5-82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
The presented clinical practice guidelines of the Gastroenterological Scientific Society of Russia (GSSR), diagnostic, and therapeutic approaches for patients with digestive diseases during the COVID-19 pandemic. The guidelines were approved by the XXIII Congress of the GSSR and the 22nd International Slavonic-Baltic Scientifi c Forum “St. Petersburg - Gastro-2020 ON-LINE” (St. Petersburg, June 11, 2020). The presented clinical practice guidelines of the Russian Scientific Medical Society of Internal Medicine (RSMSIM) and the Gastroenterological Scientific Society of Russia (GSSR), diagnostic, and therapeutic approaches for patients with digestive diseases during the COVID-19 pandemic. The recommendations were approved at the XV National Congress of Internal Medicine, XXIII Congress of NOGR on the basis of the 1st edition, adopted at the 22nd International Slavic- Baltic Scientific Forum “St. Petersburg - Gastro-2020 ON-LINE”.
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Affiliation(s)
| | | | - V. I. Ped
- Military Medical Academy named after S. M. Kirov
| | - E. I. Sas
- Military Medical Academy named after S. M. Kirov
| | | | | | | | - S. I. Sitkin
- State Research Institute of Highly Pure Biopreparations of FMBA of Russia; Almazov National Medical Research Centre; North-Western state medical University named after I. I. Mechnikov, Ministry of health of the Russian Federation
| | - L. B. Lazebnik
- Moscow state University of Medicine a. Densitry named after A. I. Yevdokimov of the Ministry of Health of Russia
| | - E. V. Golovanova
- Moscow state University of Medicine a. Densitry named after A. I. Yevdokimov of the Ministry of Health of Russia
| | - E. A. Belousova
- State Budgetary Institution of Moscow Region “Moscow Regional Research Clinical Institute n.a. M. F. Vladimirsky”
| | - P. A. Makarchuk
- State Budgetary Institution of Moscow Region “Moscow Regional Research Clinical Institute n.a. M. F. Vladimirsky”
| | - E. Yu. Eremina
- Federal State Budgetary Educational Institution of Higher Education “National Research Ogarev Mordovia State University”
| | - A. S. Sarsenbaeva
- FSBEI HE SUSMU MOH Russia, st. Vorovskogo, 64, Ural Federal District
| | | | - L. V. Tarasova
- FSBEI of HE “The Chuvash State University n.a. I. N. Ulyanov”; BI of HE “The Surgut State University”
| | - O. A. Gromova
- Federal Research Center “Informatics and Management” of the Russian Academy of Sciences; Federal State Educational Institution of Higher Education Lomonosov Moscow State University
| | - V. A. Ratnikov
- Federal state budgetary institution “North-West District Scientific and Clinical Center named after L. G. Sokolov Federal Medical and Biological Agency“
| | - K. V. Kozlov
- Military Medical Academy named after S. M. Kirov
| | - A. K. Ratnikova
- Military Medical Academy named after S. M. Kirov; Federal state budgetary institution “North-West District Scientific and Clinical Center named after L. G. Sokolov Federal Medical and Biological Agency“
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15
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Mamedov MN, Rodionova YV, Yavelov IS, Smirnova MI, Dudinskaya EN, Potievskaya VI. COVID-19 from the interdisciplinary standpoint. Round table. Cardiovasc Ther Prev 2021. [DOI: 10.15829/1728-8800-2021-2849] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
On February 25, 2021, an expert round table was held, which considered the problem of interdisciplinary discussion of a coronavirus disease 2019 (COVID-19) and the development of joint actions for management of patients with chronic noncommunicable diseases during a pandemic.
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Affiliation(s)
- M. N. Mamedov
- National Medical Research Center for Therapy and Preventive Medicine
| | - Yu. V. Rodionova
- National Medical Research Center for Therapy and Preventive Medicine
| | - I. S. Yavelov
- National Medical Research Center for Therapy and Preventive Medicine
| | - M. I. Smirnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - E. N. Dudinskaya
- Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University
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16
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Podzolkov VI, Tarzimanova AI. The Importance of Antihypertensive and Lipid-Lowering Therapy in the Treatment of Patients with a New Coronavirus Infection COVID-19. Racionalʹnaâ farmakoterapiâ v kardiologii 2021. [DOI: 10.20996/1819-6446-2021-03-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
At the end of 2020, a new term “post-COVID-19 syndrome” appeared in the medical community. The prevalence of this syndrome reaches more than 30% among patients who have had COVID-19, and its duration can vary from 12 weeks to 6 months. One of the most severe consequences of COVID- 19 is the defeat of the cardiovascular system, which has a variety of mechanisms: dysregulation of the renin-angiotensin-aldosterone system; pathological systemic inflammatory response; direct action of the virus on the myocardium with the development of myocarditis; respiratory failure with hypoxia, leading to damage to cardiomyocytes; microvascular damage due to hypoperfusion, increased vascular permeability, angiospasm and the direct damaging effect of the virus on the endothelium of the coronary arteries; thrombotic complications due to the procoagulant and prothrombogenic effect of systemic inflammation. One of the most promising directions in the treatment and prevention of damage to the cardiovascular system in patients with hypertension who have undergone COVID-19 is the appointment of antihypertensive drugs that have the most pronounced organoprotective properties together with statins. The single pill combination of lisinopril, amlodipine and rosuvastatin is an effective drug that allows achieving not only adequate hypotensive and lipid-lowering effects, but also due to its pronounced organoprotective properties, to expect a reduction in cardiovascular risk and complications in patients who have suffered a new coronavirus infection caused by the SARS-CoV-2 virus.
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Affiliation(s)
- V. I. Podzolkov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A. I. Tarzimanova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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