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Pavlenko TA, Lebedeva AY, Protsenko DN. Bridging therapy according to new clinical guidelines: A review. Consilium Medicum 2022. [DOI: 10.26442/20751753.2022.10.201912] [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: 12/23/2022] Open
Abstract
In modern world it is really important to know how to manage patients taking anticoagulant or antiplatelet therapy. There is an increasing number of patients, who have gone through PCI or any other cardiac intervention and who also need another surgery which cannot be postponed till the end of dual antiplatelet therapy. The number of patients who take oral anticoagulant has also increased last years. Algorithms of perioperative bridging therapy and antiplatelet therapy discontinuation can help to decrease both ischemic and hemorrhagic complications. Multidisciplinary risk assessment remains a critical component of perioperative care.
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Prudinnik DS, Sinauridze EI, Shakhidzhanov SS, Bovt EA, Protsenko DN, Rumyantsev AG, Ataullakhanov FI. Filterability of Erythrocytes in Patients with COVID-19. Biomolecules 2022; 12:biom12060782. [PMID: 35740907 PMCID: PMC9220947 DOI: 10.3390/biom12060782] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/27/2022] [Accepted: 06/01/2022] [Indexed: 12/02/2022] Open
Abstract
For the first time, the influence of COVID-19 on blood microrheology was studied. For this, the method of filtering erythrocytes through filters with pores of 3.5 μm was used. Filterability was shown to significantly decrease with the increasing severity of the patient’s condition, as well as with a decrease in the ratio of hemoglobin oxygen saturation to the oxygen fraction in the inhaled air (SpO2/FiO2). The filterability of ≤ 0.65, or its fast decrease during treatment, were indicators of a poor prognosis. Filterability increased significantly with an increase in erythrocyte count, hematocrit and blood concentrations of hemoglobin, albumin, and total protein. The effect of these parameters on the erythrocyte filterability is directly opposite to their effect on blood macrorheology, where they all increase blood viscosity, worsening the erythrocyte deformability. The erythrocyte filterability decreased with increasing oxygen supply rate, especially in patients on mechanical ventilation, apparently not due to the oxygen supplied, but to the deterioration of the patients’ condition. Filterability significantly correlates with the C-reactive protein, which indicates that inflammation affects the blood microrheology in the capillaries. Thus, the filterability of erythrocytes is a good tool for studying the severity of the patient’s condition and his prognosis in COVID-19.
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Affiliation(s)
- Dmitry S. Prudinnik
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of Russian Federation, Samory Mashela Str., 1, GSP-7, 117198 Moscow, Russia; (D.S.P.); (S.S.S.); (E.A.B.); (A.G.R.)
- Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Srednyaya Kalitnikovskaya Str., 30, 109029 Moscow, Russia
| | - Elena I. Sinauridze
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of Russian Federation, Samory Mashela Str., 1, GSP-7, 117198 Moscow, Russia; (D.S.P.); (S.S.S.); (E.A.B.); (A.G.R.)
- Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Srednyaya Kalitnikovskaya Str., 30, 109029 Moscow, Russia
- Correspondence: (E.I.S.); (F.I.A.)
| | - Soslan S. Shakhidzhanov
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of Russian Federation, Samory Mashela Str., 1, GSP-7, 117198 Moscow, Russia; (D.S.P.); (S.S.S.); (E.A.B.); (A.G.R.)
- Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Srednyaya Kalitnikovskaya Str., 30, 109029 Moscow, Russia
| | - Elizaveta A. Bovt
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of Russian Federation, Samory Mashela Str., 1, GSP-7, 117198 Moscow, Russia; (D.S.P.); (S.S.S.); (E.A.B.); (A.G.R.)
- Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Srednyaya Kalitnikovskaya Str., 30, 109029 Moscow, Russia
| | - Denis N. Protsenko
- City Clinical Hospital No. 40 Moscow Health Department, Kasatkin Str., 7, 129301 Moscow, Russia;
- Department of Anaesthesia and Critical Care, Pirogov Russian National Research Medical University, Ostrovityanov Str., 1, 117997 Moscow, Russia
| | - Alexander G. Rumyantsev
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of Russian Federation, Samory Mashela Str., 1, GSP-7, 117198 Moscow, Russia; (D.S.P.); (S.S.S.); (E.A.B.); (A.G.R.)
| | - Fazoil I. Ataullakhanov
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of Russian Federation, Samory Mashela Str., 1, GSP-7, 117198 Moscow, Russia; (D.S.P.); (S.S.S.); (E.A.B.); (A.G.R.)
- Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of Sciences, Srednyaya Kalitnikovskaya Str., 30, 109029 Moscow, Russia
- Department of Biophysics, Physics Faculty, Lomonosov Moscow State University, Leninskie Gory, 1, Build. 2, GSP-1, 119991 Moscow, Russia
- Moscow Institute of Physics and Technology, National Research University, Institutskiy Per., 9, 141701 Dolgoprudny, Russia
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, PA 19104, USA
- Correspondence: (E.I.S.); (F.I.A.)
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Arutyunov GP, Tarlovskaya EI, Arutyunov AG, Belenkov YN, Konradi AO, Lopatin YM, Rebrov AP, Tereshchenko SN, Chesnikova AI, Hayrapetyan HG, Babin AP, Bakulin IG, Bakulina NV, Balykova LA, Blagonravova AS, Boldina MV, Vaisberg AR, Galyavich AS, Gomonova VV, Grigorieva NY, Gubareva IV, Demko IV, Evzerikhina AV, Zharkov AV, Kamilova UK, Kim ZF, Kuznetsova TY, Lareva NV, Makarova EV, Malchikova SV, Nedogoda SV, Petrova MM, Pochinka IG, Protasov KV, Protsenko DN, Ruzanau DY, Sayganov SA, Sarybaev AS, Selezneva NM, Sugraliev AB, Fomin IV, Khlynova OV, Chizhova OY, Shaposhnik II, Sh'ukarev DA, Abdrahmanova АK, Avetisian SA, Avoyan HG, Azarian KK, Aimakhanova GT, Ayipova DA, Akunov AC, Alieva MK, Aparkina AV, Aruslanova OR, Ashina EY, Badina OY, Barisheva OY, Batchayeva AS, Bitieva AM, Bikhteyev IU, Borodulina NA, Bragin MV, Budu AM, Bykova GM, Vagapova KR, Varlamova DD, Vezikova NN, Verbitskaya EA, Vilkova OE, Vinnikova EA, Vustina VV, Galova EA, Genkel VV, Gorshenina EI, Gostishev RV, Grigorieva EV, Gubareva EY, Dabylova GM, Demchenko AI, Dolgikh OY, Duyshobayev MY, Evdokimov DS, Egorova KE, Ermilova AN, Zheldybayeva AE, Zarechnova NV, Zimina YD, Ivanova SY, Ivanchenko EY, Ilina MV, Kazakovtseva MV, Kazymova EV, Kalinina YS, Kamardina NA, Karachenova AM, Karetnikov IA, Karoli NA, Karsiev MK, Кaskaeva DS, Kasymova KF, Kerimbekova ZB, Kerimova AS, Kim ES, Kiseleva NV, Klimenko DA, Klimova AV, Kovalishena OV, Kolmakova EV, Kolchinskaya TP, Kolyadich MI, Kondriakova OV, Konoval MP, Konstantinov DY, Konstantinova EA, Kordukova VA, Koroleva EV, Kraposhina AY, Kriukova TV, Kuznetsova AS, Kuzmina TY, Kuzmichev KV, Kulchoroevna CK, Kuprina TV, Kouranova IM, Kurenkova LV, Kurchugina NY, Kushubakova NA, Levankova VI, Lyubavina NA, Magdeyeva NA, Mazalov KV, Majseenko VI, Makarova AS, Maripov AM, Marusina AA, Melnikov ES, Moiseenko NB, Muradova FN, Muradyan RG, Musaelian SN, Myshak AO, Nekaeva ES, Nikitina NM, Ogurlieva BB, Odegova AA, Omarova YV, Omurzakova NA, Ospanova SO, Pahomova EV, Petrov LD, Plastinina SS, Pogrebetskaya VA, Polyakov DS, Ponomarenko EV, Popova LL, Prokofeva NA, Pudova IA, Rakov NA, Rahimov AN, Rozanova NA, Serikbolkyzy S, Simonov AA, Skachkova VV, Soloveva DV, Soloveva IA, Subbotin AK, Sukhomlinova IM, Sushilova AG, Tagayeva DR, Titojkina YV, Tikhonova EP, Tokmin DS, Tolmacheva AA, Torgunakova MS, Trenogina KV, Trostianetckaia NA, Trofimov DA, Tulichev AA, Tursunova AT, Ulanova ND, Fatenkov OV, Fedorishina OV, Fil TS, Fomina IY, Fominova IS, Frolova IA, Tsvinger SM, Tsoma VV, Cholponbaeva MB, Chudinovskikh TI, Shevchenko OA, Sheshina TV, Shishkina EA, Shishkov KY, Sherbakov SY, Yausheva EA. ACTIV SARS-CoV-2 registry (Analysis of Chronic Non-infectious Diseases Dynamics After COVID-19 Infection in Adult Patients). Assessment of impact of combined original comorbid diseases in patients with COVID-19 on the prognosis. TERAPEVT ARKH 2022; 94:32-47. [DOI: 10.26442/00403660.2022.01.201320] [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: 06/17/2021] [Indexed: 12/23/2022]
Abstract
Aim. Study the impact of various combinations of comorbid original diseases in patients infected with COVID-19 later on the disease progression and outcomes of the new coronavirus infection.
Materials and methods. The ACTIV registry was created on the Eurasian Association of Therapists initiative. 5,808 patients have been included in the registry: men and women with COVID-19 treated at hospital or at home. ClinicalTrials.gov ID NCT04492384.
Results. Most patients with COVID-19 have original comorbid diseases (oCDs). Polymorbidity assessed by way of simple counting of oCDs is an independent factor in negative outcomes of COVID-19. Search for most frequent combinations of 2, 3 and 4 oCDs has revealed absolute domination of cardiovascular diseases (all possible variants). The most unfavorable combination of 2 oCDs includes atrial hypertension (AH) and chronic heart failure (CHF). The most unfavorable combination of 3 oCDs includes AH, coronary heart disease (CHD) and CHF; the worst combination of 4 oCDs includes AH, CHD, CHF and diabetes mellitus. Such combinations increased the risk of lethal outcomes 3.963, 4.082 and 4.215 times respectively.
Conclusion. Polymorbidity determined by way of simple counting of diseases may be estimated as a factor in the lethal outcome risk in the acute phase of COVID-19 in real practice. Most frequent combinations of 2, 3 and 4 diseases in patients with COVID-19 primarily include cardiovascular diseases (AH, CHD and CHF), diabetes mellitus and obesity. Combinations of such diseases increase the COVID-19 lethal outcome risk.
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Rodionov VE, Avdalyan AM, Konovalov DM, Boriskin NV, Tyurin IN, Protsenko DN, Zayratyants OV, Filipenko ML, Oskorbin IP, Koryukov MA. [Features of the cell composition of inflammatory infiltrate in different phases of diffuse alveolar lung damage with COVID-19]. Arkh Patol 2022; 84:5-13. [PMID: 35639838 DOI: 10.17116/patol2022840315] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Acute respiratory distress syndrome (ARDS) with COVID-19 has a worse prognosis than ARDS with other diseases. Mortality from ARDS with COVID-19 is 26.0 - 61.5%, and due to other causes - 35.3-37.2%. OBJECTIVE To find of the correlation between polymorphonuclear leukocytes (PMNs), lymphocytes, and macrophages in the cellular composition of the inflammatory infiltrate at different stages and phases of diffuse alveolar damage (DAD) with COVID-19, analyzing the autopsy material. MATERIAL AND METHODS The lung tissue of 25 patients who died from ARDS with COVID-19 without a secondary bacterial or mycotic infection, another thanatologically significant pathology of the lungs, was studied. To study the cellular composition of the inflammatory infiltrate and the dynamics of its changes a double immunohistochemical analysis of the expression of antibodies to CD15, CD3, and CD68 was used. RESULTS The inflammatory infiltrate and intraalveolar exudate in the exudative phase of DAD was represented by 56.8% of PMNs (CD15-positive cells; hereinafter - the average value of the percentage of positive cells to the total number of cells of the inflammatory infiltrate), 6.9% - lymphocytes (CD3-positive cells) and 19.5% macrophages (CD68-positive cells). In the early stage of the proliferative phase: 14.1% PMNs, 38.7% lymphocytes and 13.5% macrophages. In the late stage of the proliferative phase: 11.3% PMNs, 14.5% lymphocytes and 39.3% macrophages. CONCLUSIONS In the exudative phase of DAD a statistically significant predominance of PMN was revealed, which could determine the main volume of lung damage and the severity of ARDS with COVID-19. In the early stage of the proliferative phase of DAD, a statistically significant change in the composition of the inflammatory infiltrate was revealed to compare with the exudative phase: a significant decrease in the content of PMNs relative to the total number of cells in the inflammatory infiltrate; an increase in the number of lymphocytes, which is probably associated with the start of organization and repair processes. In the late stage of the proliferative phase of DAD, compared with its early stage, was revealed a statistically significant increase in the number of macrophages in ratio.
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Affiliation(s)
- V E Rodionov
- Moscow Multidisciplinary Clinical Center «Komnunarka» of Moscow Healthcare department, Moscow, Russia
- Peoples' Friendship University of Russia, Moscow, Russia
| | - A M Avdalyan
- Moscow Multidisciplinary Clinical Center «Komnunarka» of Moscow Healthcare department, Moscow, Russia
- A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of Russia, Moscow, Russia
| | - D M Konovalov
- Moscow Multidisciplinary Clinical Center «Komnunarka» of Moscow Healthcare department, Moscow, Russia
- Dmitry Rogachev National Medical Research Center Of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
- Russian Medical Academy of Continuious Professional Education, Moscow, Russia
| | - N V Boriskin
- Moscow Multidisciplinary Clinical Center «Komnunarka» of Moscow Healthcare department, Moscow, Russia
| | - I N Tyurin
- Moscow Multidisciplinary Clinical Center «Komnunarka» of Moscow Healthcare department, Moscow, Russia
| | - D N Protsenko
- Moscow Multidisciplinary Clinical Center «Komnunarka» of Moscow Healthcare department, Moscow, Russia
- N.I. Pirogov Russian National Research Medical University, Moscow, Russia
| | - O V Zayratyants
- A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of Russia, Moscow, Russia
- Acad. A.P. Avtsyn Research Institute of Human Morphology, Moscow, Russia
| | - M L Filipenko
- Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia
| | - I P Oskorbin
- Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia
| | - M A Koryukov
- Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia
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Lomakin NV, Bakirov BA, Protsenko DN, Mazurov VI, Musaev GH, Moiseeva OM, Pasechnik ES, Popov VV, Smolyarchuk EA, Gordeev IG, Gilyarov MY, Fomina DS, Seleznev AI, Linkova YN, Dokukina EA, Eremeeva AV, Pukhtinskaia PS, Morozova MA, Zinkina-Orikhan AV, Lutckii AA. The efficacy and safety of levilimab in severely ill COVID-19 patients not requiring mechanical ventilation: results of a multicenter randomized double-blind placebo-controlled phase III CORONA clinical study. Inflamm Res 2021; 70:1233-1246. [PMID: 34586459 PMCID: PMC8479713 DOI: 10.1007/s00011-021-01507-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE AND DESIGN The aim of this double-blind, placebo-controlled, phase III CORONA clinical trial was to evaluate the efficacy and safety of IL-6 receptor inhibitor levilimab (LVL) in subjects with severe COVID-19. SUBJECTS The study included 217 patients. The eligible were men and non-pregnant women aged 18 years or older, hospitalized for severe COVID-19 pneumonia. TREATMENT 206 subjects were randomized (1:1) to receive single subcutaneous administration of LVL 324 mg or placebo, both in combination with standard of care (SOC). 204 patients received allocated therapy. After the LVL/placebo administration in case of deterioration of symptoms, the investigator could perform a single open-label LVL 324 mg administration as the rescue therapy. METHODS The primary efficacy endpoint was the proportion of patients with sustained clinical improvement on the 7-category ordinal scale on Day 14. All efficacy data obtained after rescue therapy administration were considered missing. For primary efficacy analysis, all subjects with missing data were considered non-responders. RESULTS 63.1% and 42.7% of patients in the LVL and in the placebo groups, respectively, achieved sustained clinical improvement on Day 14 (P = .0017). The frequency of adverse drug reactions was comparable between the groups. CONCLUSION In patients with radiologically confirmed SARS-CoV-2 pneumonia, requiring or not oxygen therapy (but not ventilation) with no signs of other active infection administration of LVL + SOC results in an increase of sustained clinical improvement rate. TRAIL REGISTRATION The trial is registered at the US National Institutes of Health (ClinicalTrials.gov; NCT04397562).
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Affiliation(s)
- Nikita V Lomakin
- Federal State Budgetary Institution Central Clinical Hospital of the Management Affair of President Russian Federation (FSBI CCH), Moscow, Russian Federation
| | - Bulat A Bakirov
- Federal State Budgetary Educational Institution of Higher Education "Bashkir State Medical University of the Ministry of Healthcare of the Russian Federation" (FSBEI HE BSMU of the Ministry of Health of Russia), Ufa, Russian Federation
| | - Denis N Protsenko
- State Budgetary Healthcare Institution of the City of Moscow Municipal Clinical Hospital No. 40 of the Moscow Healthcare Department (SBHI MCH No. 40 MHD), Moscow, Russian Federation
| | - Vadim I Mazurov
- Federal State Budgetary Educational Institution of Higher Education "I.I. Mechnikov North-Western State Medical University", Ministry of Healthcare of the Russian Federation (FSBEI HE I.I. Mechnikov NWSMU, Ministry of Health of Russia), St. Petersburg, Russian Federation
| | - Gaziyavdibir H Musaev
- State Budgetary Institution of the Republic of Dagestan "Republican Clinical Hospital" (SBU RD RCH), Makhachkala, Russian Federation
| | - Olga M Moiseeva
- Federal State Budgetary Institution "Almazov National Medical Research Center", Ministry of Health of the Russian Federation (Almazov National Medical Research Center), St. Petersburg, Russian Federation
| | - Elena S Pasechnik
- State Budgetary Healthcare Institution «Kaluga Regional Clinical Hospital» (SBHI KR KRCH), Kaluga, Russian Federation
| | - Vladimir V Popov
- Private Healthcare Institution N.A. Semashko Clinical Hospital «RZD-Medicine» (PHI N.A. Semashko Railroad Clinical Hospital), (Formerly Known As Non-State Healthcare Institution N.A. Semashko Railroad Clinical Hospital at the Lyublino Station of the JSC Russian Railways), Institute of Continues Medical Education Moscow State University of Food Production, Moscow, Russian Federation
| | - Elena A Smolyarchuk
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), [FSAEI HE I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University)], Moscow, Russian Federation
| | - Ivan G Gordeev
- Moscow State Budgetary Healthcare Institution O.M. Filatov Municipal Clinical Hospital No. 15 of the Moscow Healthcare Department) (SBHI MCH No. 15 MHD) (formerly known as the State Healthcare Institution of Moscow O.M. Filatov Municipal Clinical Hospital No. 15 of the Moscow Healthcare Department), Moscow, Russian Federation
| | - Mikhail Yu Gilyarov
- State Budgetary Healthcare Institution of the City of Moscow N.I. Pirogov Municipal Clinical Hospital No. 1 of the Moscow Healthcare Department (N.I. Pirogov MCH No. 1), Moscow, Russian Federation
| | - Darya S Fomina
- State Budgetary Healthcare Institution of the City of Moscow Municipal Clinical Hospital No. 52 of the Moscow Healthcare Department (SBHI MCH No. 52 MHD), Moscow, Russian Federation
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University, FSAEI HE I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University), Moscow, Russian Federation
| | | | - Yulia N Linkova
- JSC BIOCAD, Ul. Italianskaya 17, St-Petersburg, Russia, 191186
| | | | - Anna V Eremeeva
- JSC BIOCAD, Ul. Italianskaya 17, St-Petersburg, Russia, 191186
| | | | | | | | - Anton A Lutckii
- JSC BIOCAD, Ul. Italianskaya 17, St-Petersburg, Russia, 191186
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Tarlovskaya EI, Arutyunov AG, Konradi AO, Lopatin YM, Rebrov AP, Tereshchenko SN, Chesnikova AI, Hayrapetyan HG, Babin AP, Bakulin IG, Bakulina NV, Balykova LA, Blagonravova AS, Boldina MV, Vaisberg AR, Galyavich AS, Gomonova VV, Grigorieva NY, Gubareva IV, Demko IV, Evzerikhina AV, Zharkov AV, Kamilova UK, Kim ZF, Kuznetsova TY, Lareva NV, Makarova EV, Malchikova SV, Nedogoda SV, Petrova MM, Pochinka IG, Protasov KV, Protsenko DN, Ruzanau DY, Sayganov SA, Sarybaev AS, Selezneva NM, Sugraliev AB, Fomin IV, Khlynova OV, Chizhova OY, Shaposhnik II, Shсukarev DA, Abdrahmanova AK, Avetisian SA, Avoyan HG, Azarian KK, Aimakhanova GT, Ayipova DA, Akunov AC, Alieva MK, Aparkina AV, Aruslanova OR, Ashina EY, Badina OY, Barisheva OY, Batchayeva AS, Bitieva AM, Bikhteyev IU, Borodulina NA, Bragin MV, Budu AM, Burygina LA, Bykova GA, Vagapova KR, Varlamova DD, Vezikova NN, Verbitskaya EA, Vilkova OE, Vinnikova EA, Vustina VV, Gаlova EA, Genkel VV, Gorshenina EI, Gostishev RV, Grigorieva EV, Gubareva EY, Dabylova GM, Demchenko AI, Dolgikh OY, Duyshobayev MY, Evdokimov DS, Egorova KE, Ermilova AN, Zheldybayeva AE, Zarechnova NV, Zimina YD, Ivanova SY, Ivanchenko EY, Ilina MV, Kazakovtseva MV, Kazymova EV, Kalinina YS, Kamardina NA, Karachenova AM, Karetnikov IA, Karoli NA, Karpov OV, Karsiev MK, Кaskaeva DS, Kasymova KF, Kerimbekova ZB, Kerimova AS, Kim ES, Kiseleva NV, Klimenko DA, Klimova AV, Kovalishena OV, Kolmakova EV, Kolchinskaya TP, Kolyadich MI, Kondriakova OV, Konoval MP, Konstantinov DY, Konstantinova EA, Kordukova VA, Koroleva EV, Kraposhina AY, Kriukova TV, Kuznetsova AS, Kuzmina TY, Kuzmichev KV, Kulchoroeva CK, Kuprina TV, Kouranova IM, Kurenkova LV, Kurchugina NY, Kushubakova NA, Levankova VI, Levin MЕ, Lyubavina NA, Magdeyeva NA, Mazalov KV, Majseenko VI, Makarova AS, Maripov AM, Marusina AA, Melnikov ES, Moiseenko NB, Muradova FN, Muradyan RG, Myshak AO, Nikitina NM, Ogurlieva BB, Odegova AA, Omarova YM, Omurzakova NA, Ospanova SO, Pahomova EV, Petrov LD, Plastinina SS, Pogrebetskaya VA, Polyakov DS, Ponomarenko EV, Popova LL, Prokofeva NA, Pudova IA, Rakov NA, Rakhimov AN, Rozanova NA, Serikbolkyzy S, Simonov AA, Skachkova VV, Soloveva DV, Soloveva IA, Sokhova FM, Subbotin AK, Sukhomlinova IM, Sushilova AG, Tagayeva DR, Titojkina YV, Tikhonova EP, Tokmin DS, Tolmacheva AA, Torgunakova MS, Trenogina KV, Trostianetckaia NA, Trofimov DA, Tulichev AA, Tursunova AT, Ulanova ND, Fatenkov OV, Fedorishina OV, Fil TS, Fomina IY, Fominova IS, Frolova IA, Tsvinger SM, Tsoma VV, Cholponbaeva MB, Chudinovskikh TI, Shevchenko OA, Sheshina TV, Shishkina EA, Shishkov KY, Sherbakov SY, Yausheva EA, Musaelian SN, Belenkov YN, Arutyunov GP. Analysis of influence of background therapy for comorbidities in the period before infection on the risk of the lethal COVID outcome. Data from the international ACTIV SARS-CoV-2 registry («Analysis of chronic non-infectious diseases dynamics after COVID-19 infection in adult patients SARS-CoV-2»). ACTA ACUST UNITED AC 2021; 61:20-32. [PMID: 34713782 DOI: 10.18087/cardio.2021.9.n1680] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 05/28/2021] [Indexed: 11/18/2022]
Abstract
Aim To study the effect of regular drug therapy for cardiovascular and other diseases preceding the COVID-19 infection on severity and outcome of COVID-19 based on data of the ACTIVE (Analysis of dynamics of Comorbidities in paTIents who surVived SARS-CoV-2 infEction) registry.Material and methods The ACTIVE registry was created at the initiative of the Eurasian Association of Therapists. The registry includes 5 808 male and female patients diagnosed with COVID-19 treated in a hospital or at home with a due protection of patients' privacy (data of nasal and throat smears; antibody titer; typical CT imaging features). The register territory included 7 countries: the Russian Federation, the Republic of Armenia, the Republic of Belarus, the Republic of Kazakhstan, the Kyrgyz Republic, the Republic of Moldova, and the Republic of Uzbekistan. The registry design: a closed, multicenter registry with two nonoverlapping arms (outpatient arm and in-patient arm). The registry scheduled 6 visits, 3 in-person visits during the acute period and 3 virtual visits (telephone calls) at 3, 6, and 12 mos. Patient enrollment started on June 29, 2020 and was completed on October 29, 2020. The registry completion is scheduled for October 29, 2022. The registry ID: ClinicalTrials.gov: NCT04492384. In this fragment of the study of registry data, the work group analyzed the effect of therapy for comorbidities at baseline on severity and outcomes of the novel coronavirus infection. The study population included only the patients who took their medicines on a regular basis while the comparison population consisted of noncompliant patients (irregular drug intake or not taking drugs at all despite indications for the treatment).Results The analysis of the ACTIVE registry database included 5808 patients. The vast majority of patients with COVID-19 had comorbidities with prevalence of cardiovascular diseases. Medicines used for the treatment of COVID-19 comorbidities influenced the course of the infectious disease in different ways. A lower risk of fatal outcome was associated with the statin treatment in patients with ischemic heart disease (IHD); with angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor antagonists and with beta-blockers in patients with IHD, arterial hypertension, chronic heart failure (CHF), and atrial fibrillation; with oral anticoagulants (OAC), primarily direct OAC, clopidogrel/prasugrel/ticagrelor in patients with IHD; with oral antihyperglycemic therapy in patients with type 2 diabetes mellitus (DM); and with long-acting insulins in patients with type 1 DM. A higher risk of fatal outcome was associated with the spironolactone treatment in patients with CHF and with inhaled corticosteroids (iCS) in patients with chronic obstructive pulmonary disease (COPD).Conclusion In the epoch of COVID-19 pandemic, a lower risk of severe course of the coronavirus infection was observed for patients with chronic noninfectious comorbidities highly compliant with the base treatment of the comorbidity.
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Affiliation(s)
- E I Tarlovskaya
- Eurasian Association of Therapists, Moscow; Privolzhsky Research Medical University, Nizhny Novgorod
| | - A G Arutyunov
- Eurasian Association of Therapists, Moscow; N. I. Pirogov Russian National Research Medical University, Moscow
| | - A O Konradi
- V. A. Almazov National Medical Research Center, St. Peterburg
| | | | - A P Rebrov
- V. I. Razumovsky Saratov State Medical University, Saratov
| | | | | | - H G Hayrapetyan
- Erebouni Medical Center, Cardiology and Cardiac Surgery Clinic, Erevan
| | - A P Babin
- Nikolae Testemitanu Sate University of Medicine and Pharmacy, Kishinev
| | - I G Bakulin
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - N V Bakulina
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - L A Balykova
- N. P. Ogarev National Research Mordovia State University, Saransk
| | | | - M V Boldina
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - A R Vaisberg
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - A S Galyavich
- Interregional Clinical Diagnostic Center, Kazan; Kazan State Medical University, Kazan
| | - V V Gomonova
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - N Yu Grigorieva
- N. I. Lobachevsky National Research State University of Nizhny Novgorod, Nizhny Novgorod
| | | | - I V Demko
- Krasnoyarsk Regional Clinical Hospital, Krasnoyarsk
| | | | | | - U K Kamilova
- National Specialized Science and Practice Medical Center for Therapy and Medical Rehabilitation, Tashkent
| | - Z F Kim
- Kazan Municipal Clinical Hospital №7, Kazan
| | | | | | - E V Makarova
- Privolzhsky Research Medical University, Nizhny Novgorod
| | | | | | - M M Petrova
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - I G Pochinka
- Privolzhsky Research Medical University, Nizhny Novgorod; Municipal Clinical Hospital #13 of the Nizhny Novgorod Avtozavodsky District, Nizhny Novgorod
| | - K V Protasov
- Irkutsk State Medical Academy of Postgraduate Education, Branch of the Russian Medical Academy of Continuing Professional Education, Irkutsk
| | | | | | - S A Sayganov
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - A S Sarybaev
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | - N M Selezneva
- N. P. Ogarev National Research Mordovia State University, Saransk
| | - A B Sugraliev
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | - I V Fomin
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - O V Khlynova
- Akademician E. A. Vagner Perm State Medical University, Perm
| | - O Yu Chizhova
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | | | | | - A K Abdrahmanova
- Kazakh Medical University of Continuous Education, Alma-Ata; I. Zhekenova Municipal Clinical Hospital for Infectious Diseases, Alma-Ata
| | - S A Avetisian
- Erebouni Medical Center, Cardiology and Cardiac Surgery Clinic, Erevan
| | - H G Avoyan
- Erebouni Medical Center, Cardiology and Cardiac Surgery Clinic, Erevan
| | - K K Azarian
- Erebouni Medical Center, Cardiology and Cardiac Surgery Clinic, Erevan
| | - G T Aimakhanova
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | - D A Ayipova
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | - A Ch Akunov
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | - M K Alieva
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - A V Aparkina
- V. I. Razumovsky Saratov State Medical University, Saratov
| | | | - E Yu Ashina
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - O Yu Badina
- Privolzhsky District Medical Center, Nizhny Novgorod
| | | | - A S Batchayeva
- N. I. Pirogov Russian National Research Medical University, Moscow
| | - A M Bitieva
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - I U Bikhteyev
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | | | - M V Bragin
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - A M Budu
- Municipal Clinical Hospital №1, Kishinev
| | - L A Burygina
- P. B. Gannushkin Psychiatric Clinical Hospital №4, Moscow
| | - G A Bykova
- Akademician E. A. Vagner Perm State Medical University, Perm
| | - K R Vagapova
- Polyclinic №1 at the Administrative Department of the President of the Russian Federation, Moscow
| | | | | | - E A Verbitskaya
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - O E Vilkova
- N. I. Lobachevsky National Research State University of Nizhny Novgorod, Nizhny Novgorod
| | - E A Vinnikova
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | | | - E A Gаlova
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - V V Genkel
- South Ural State Medical University, Chelyabinsk
| | - E I Gorshenina
- N. P. Ogarev National Research Mordovia State University, Saransk
| | | | - E V Grigorieva
- V. I. Razumovsky Saratov State Medical University, Saratov
| | | | - G M Dabylova
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | | | | | - M Y Duyshobayev
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | - D S Evdokimov
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - K E Egorova
- V. A Baranov Karelia Republic Hospital, Petrozavodsk
| | - A N Ermilova
- Eurasian Association of Therapists, Moscow; V. P. Serbsky National Medical Research Center of Psychiatry and Narcology, Moscow
| | | | | | - Yu D Zimina
- Municipal Clinical Hospital №25, Novosibirsk
| | | | | | - M V Ilina
- Kirovsk Inter-District Hospital, outpatient department, Kirovsk
| | | | - E V Kazymova
- Clinical Hospital at the Samara Station "Russian Railways Medicine", Samara
| | - Yu S Kalinina
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - N A Kamardina
- Privolzhsky District Medical Center, Nizhny Novgorod
| | | | - I A Karetnikov
- Irkutsk Regional Clinical Hospital, recipient of the "Badge of Honor" award, Irkutsk
| | - N A Karoli
- V. I. Razumovsky Saratov State Medical University, Saratov
| | - O V Karpov
- P. B. Gannushkin Psychiatric Clinical Hospital #4, Moscow
| | - M Kh Karsiev
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - D S Кaskaeva
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - K F Kasymova
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - Zh B Kerimbekova
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | | | - E S Kim
- Kazan State Medical University, Kazan; Kazan Municipal Clinical Hospital №7, Kazan
| | - N V Kiseleva
- Privolzhsky Research Medical University, Nizhny Novgorod
| | | | - A V Klimova
- N. I. Pirogov Russian National Research Medical University, Moscow; Municipal Polyclinic №134, Moscow
| | | | - E V Kolmakova
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | | | - M I Kolyadich
- South Ural State Medical University, Chelyabinsk; Chelyabinsk Municipal Clinical Hospital №1, Chelyabinsk
| | | | - M P Konoval
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | | | | | - V A Kordukova
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - E V Koroleva
- Municipal Clinical Hospital №5 of the Nizhny Novgorod Nizhegorodsky District, Nizhny Novgorod
| | - A Yu Kraposhina
- Krasnoyarsk Regional Clinical Hospital, Krasnoyarsk; Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | | | | | - T Yu Kuzmina
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - K V Kuzmichev
- Municipal Clinical Hospital №13 of the Nizhny Novgorod Avtozavodsky District, Nizhny Novgorod
| | - Ch K Kulchoroeva
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | | | | | | | | | - N A Kushubakova
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | | | - M Е Levin
- P. B. Gannushkin Psychiatric Clinical Hospital №4, Moscow
| | - N A Lyubavina
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - N A Magdeyeva
- V. I. Razumovsky Saratov State Medical University, Saratov
| | - K V Mazalov
- Privolzhsky District Medical Center, Nizhny Novgorod
| | | | - A S Makarova
- Irkutsk State Medical Academy of Postgraduate Education, Branch of the Russian Medical Academy of Continuing Professional Education, Irkutsk
| | - A M Maripov
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | - A A Marusina
- Kirovsk Inter-District Hospital, outpatient department, Kirovsk
| | - E S Melnikov
- Eurasian Association of Therapists, Moscow; I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - N B Moiseenko
- N. I. Lobachevsky National Research State University of Nizhny Novgorod, Nizhny Novgorod
| | - F N Muradova
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - R G Muradyan
- Global Medical System Clinics and Hospitals, Moscow
| | | | - N M Nikitina
- V. I. Razumovsky Saratov State Medical University, Saratov
| | - B B Ogurlieva
- N. I. Pirogov Russian National Research Medical University, Moscow; Municipal Clinical Hospital №4, Moscow
| | | | - Yu M Omarova
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - N A Omurzakova
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | - Sh O Ospanova
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | - E V Pahomova
- GBUZ RK "Republican tuberculosis dispensary", Petrozavodsk
| | | | - S S Plastinina
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - V A Pogrebetskaya
- Municipal Clinical Hospital №38 of the Nizhny Novgorod Nizhegorodsky District, Nizhny Novgorod
| | - D S Polyakov
- Privolzhsky Research Medical University, Nizhny Novgorod
| | | | | | - N A Prokofeva
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - I A Pudova
- Privolzhsky Research Medical University, Nizhny Novgorod; Municipal Polyclinic №4 of the Nizhny Novgorod Kanavinsky District, Nizhny Novgorod
| | - N A Rakov
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - A N Rakhimov
- 21 National Specialized Science and Practice Medical Center for Therapy and Medical Rehabilitation, Tashkent
| | | | - S Serikbolkyzy
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | - A A Simonov
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | | | - D V Soloveva
- Privolzhsky Research Medical University, Nizhny Novgorod
| | - I A Soloveva
- Krasnoyarsk Regional Clinical Hospital, Krasnoyarsk; Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | - F M Sokhova
- P. B. Gannushkin Psychiatric Clinical Hospital №4, Moscow
| | - A K Subbotin
- Privolzhsky District Medical Center, Nizhny Novgorod
| | | | - A G Sushilova
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - D R Tagayeva
- National Specialized Science and Practice Medical Center for Therapy and Medical Rehabilitation, Tashkent
| | - Yu V Titojkina
- N. P. Ogarev National Research Mordovia State University, Saransk
| | - E P Tikhonova
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | | | - A A Tolmacheva
- Novosibirsk State Medical University, Novosibirsk; Clinical Consultative and Diagnostic Polyclinic №27, Novosibirsk
| | - M S Torgunakova
- Prof. V. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
| | | | | | - D A Trofimov
- Kazan State Medical University, Kazan; Kazan Municipal Clinical Hospital №7, Kazan
| | - A A Tulichev
- Privolzhsky Research Medical University, Nizhny Novgorod; Municipal Clinical Hospital №3, Nizhny Novgorod
| | - A T Tursunova
- S. D. Asfendiyarov Kazakh National Medical University, Alma-Ata
| | - N D Ulanova
- Municipal Clinical Hospital #13 of the Nizhny Novgorod Avtozavodsky District, Nizhny Novgorod
| | | | - O V Fedorishina
- Irkutsk State Medical Academy of Postgraduate Education, Branch of the Russian Medical Academy of Continuing Professional Education, Irkutsk
| | - T S Fil
- I. I. Mechnikov North-Western State Medical University, St. Petersburg
| | - I Yu Fomina
- Privolzhsky Research Medical University, Nizhny Novgorod; Municipal Polyclinic #1, Nizhny Novgorod
| | - I S Fominova
- N. P. Ogarev National Research Mordovia State University, Saransk
| | - I A Frolova
- Privolzhsky District Medical Center, Nizhny Novgorod
| | | | - V V Tsoma
- Volgograd State Medical University, Volgograd
| | - M B Cholponbaeva
- M. M. Mirrakhimov National Center of Cardiology and Therapy, Bishkek
| | | | | | - T V Sheshina
- N. I. Lobachevsky National Research State University of Nizhny Novgorod, Nizhny Novgorod
| | - E A Shishkina
- Akademician E. A. Vagner Perm State Medical University, Perm
| | | | - S Yu Sherbakov
- Kazan State Medical Academy, Branch of the Russian Medical Academy of Continuing Professional Education, Kazan
| | - E A Yausheva
- N. P. Ogarev National Research Mordovia State University, Saransk
| | | | - Yu N Belenkov
- The First Moscow state medical University I. M. Sechenov
| | - G P Arutyunov
- Eurasian Association of Therapists, Moscow; N. I. Pirogov Russian National Research Medical University, Moscow
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7
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Shchetinin AM, Tsyganova EV, Protsenko DN, Botikov AG, Gushchin V. A Case of Moderately Severe COVID-19 in a Healthcare Worker in Russia: Virus Isolation and Full Genome Sequencing. Cureus 2021; 13:e13733. [PMID: 33842111 PMCID: PMC8021000 DOI: 10.7759/cureus.13733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is probably the most studied one in history from both clinical and molecular-epidemiological perspectives. Nonetheless, data on the correlation between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral genotypes and COVID-19 symptoms caused by them are still scarce. In this report, we present a moderately severe COVID-19 case in a healthcare worker in Moscow, Russia, supplemented with the data on its causative agent's phenotype regarding in vitro and full-genome characterization. The 44-year-old male healthcare worker who had frequent professional contacts with COVID-19 patients was hospitalized with a viral pneumonia diagnosis and soon started to exhibit fever, dry paroxysmal cough, loss of smell, and typical ground-glass opacities found in both lungs on chest CT scans. The COVID-19 diagnosis was verified by real-time quantitative polymerase chain reaction (qRT-PCR), immunochromatography, and immunochemiluminescent assays. The patient was treated with hydroxychloroquine, azithromycin, paracetamol, and enoxaparin, leading to his recovery after two weeks from the disease onset. The virus was successfully isolated from the nasopharyngeal swab sample taken on the fifth day of the disease onset using the Vero E6 cell line and exhibited a pronounced cytopathic effect (CPE) with a viral titer reaching 106 TCID50/ml in the cell culture medium. The full genome sequence of the viral isolate was obtained and 8 nucleotide and 5 amino acid mutations compared to the Wuhan-Hu-1 reference genome were identified. Viral isolate belonged to GR / 20B / B.1.1 genetic lineage (GISAID, Nextstrain, Pangolin nomenclatures, respectively) - the most prevalent genotype found in Russia to date.
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Affiliation(s)
- Alexey M Shchetinin
- Pathogenic Microorganisms Variability Laboratory, N.F. Gamaleya National Research Centre for Epidemiology and Microbiology, Ministry of Health of the Russian Federation, Moscow, RUS
| | - Elena V Tsyganova
- Department of Clinical Science, Moscow City Centre for AIDS Prevention and Treatment, Moscow, RUS
| | - Denis N Protsenko
- Anesthesiology, Moscow City Clinical Hospital № 40, Moscow, RUS.,Anesthesiology and Reanimatology, Pirogov Medical University, Moscow, RUS
| | - Andrey G Botikov
- Russian State Collection of Viruses, N.F. Gamaleya National Research Centre for Epidemiology and Microbiology, Ministry of Health of the Russian Federation, Moscow, RUS
| | - Vladimir Gushchin
- Pathogenic Microorganisms Variability Laboratory, N.F. Gamaleya National Research Centre for Epidemiology and Microbiology, Ministry of Health of the Russian Federation, Moscow, RUS
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8
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Arutyunov GP, Tarlovskaya EI, Arutyunov AG, Belenkov YN, Konradi AO, Lopatin YM, Tereshchenko SN, Rebrov AP, Chesnikova AI, Fomin IV, Grigorieva NU, Boldina VM, Vaisberg AR, Blagonravova AS, Makarova EV, Shaposhnik II, Kuznetsova TY, Malchikova SV, Protsenko DN, Evzerikhina AV, Petrova MM, Demko IV, Saphonov DV, Hayrapetyan HG, Galyavich AS, Kim ZF, Sugraliev AB, Nedogoda SV, Tsoma VV, Sayganov SA, Gomonova VV, Gubareva IV, Sarybaev AS, Ruzanau DY, Majseenko VI, Babin AP, Kamilova UK, Koroleva EV, Vilkova OE, Fomina IY, Pudova IA, Soloveva DV, Doshchannikov DA, Kiseleva NV, Zelyaeva NV, Kouranova IM, Pogrebetskaya VA, Muradova FN, Badina OY, Kovalishena OV, Gаlova AE, Plastinina SS, Grigorovich MS, Lyubavina NA, Vezikova NN, Levankova VI, Ivanova SY, Ermilova AN, Muradyan RG, Gostishev RV, Tikhonova EP, Kuzmina TY, Soloveva IA, Kraposhina AY, Kolyadich MI, Kolchinskaya TP, Genkel VV, Kuznetsova AS, Kazakovtseva MV, Odegova AA, Chudinovskikh TI, Baramzina SV, Rozanova NA, Kerimova AS, Krivosheina NA, Chukhlova SY, Levchenko AA, Avoyan HG, Azarian KK, Musaelian SN, Avetisian SA, Levin ME, Karpov OV, Sokhova FM, Burygina LA, Sheshina TV, Tiurin AA, Dolgikh OY, Kazymova EV, Konstantinov DY, Chumakova OA, Kondriakova OV, Shishkov KY, Fil ST, Prokofeva NA, Konoval MP, Simonov AA, Bitieva AM, Trostianetckaia NA, Cholponbaeva MB, Kerimbekova ZB, Duyshobayev MY, Akunov AC, Kushubakova NA, Melnikov ES, Kim ES, Sherbakov SY, Trofimov DA, Evdokimov DS, Ayipova DA, Duvanov IA, Abdrahmanova AK, Aimakhanova GT, Ospanova SO, Gaukhar MD, Tursunova AT, Kaskaeva DS, Tulichev AA, Ashina EY, Kordukova VA, Barisheva OY, Egorova KE, Varlamova DD, Kuprina TV, Pahomova EV, Kurchugina NY, Frolova IA, Mazalov KV, Subbotin AK, Kamardina NA, Zarechnova NV, Mamutova EM, Smirnova LA, Klimova AV, Shakhgildyan LD, Tokmin DS, Tupitsin DI, Kriukova TV, Polyakov DS, Karoli NA, Grigorieva EV, Magdeyeva NA, Aparkina AV, Nikitina NM, Petrov LD, Budu AM, Rasulova ZD, Tagayeva DR, Fatenkov OV, Gubareva EY, Demchenko AI, Klimenko DA, Omarova YV, Serikbolkyzy S, Zheldybayeva AE. [International register "Analysis of Chronic Non-infectious Diseases Dynamics After COVID-19 Infection in Adult Patients (ACTIV SARS-CoV-2)"]. Kardiologiia 2021; 60:30-34. [PMID: 33487147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/11/2021] [Indexed: 06/12/2023]
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9
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Potekaev NN, Zhukova OV, Protsenko DN, Demina OM, Khlystova EA, Bogin V. Clinical characteristics of dermatologic manifestations of COVID-19 infection: case series of 15 patients, review of literature, and proposed etiological classification. Int J Dermatol 2020; 59:1000-1009. [PMID: 32621287 PMCID: PMC7361279 DOI: 10.1111/ijd.15030] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/18/2020] [Accepted: 06/04/2020] [Indexed: 01/08/2023]
Affiliation(s)
| | | | | | - Olga M. Demina
- Pirogov Russian National Research Medical UniversityMoscowRussia
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10
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Bagdasarov VV, Bagdasarova EA, Protsenko DN, Ketskalo MV, Tavadov AV. [Extracorporeal membrane oxygenation in severe combined trauma complicated by fat embolism]. Khirurgiia (Mosk) 2018:76-80. [PMID: 30531742 DOI: 10.17116/hirurgia201810176] [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
It is presented the victim with severe combined injury complicated by fat embolism and acute respiratory failure. Veno-venous extracorporeal membrane oxygenation was successfully used to provide adequate extracorporeal gas exchange in refractory respiratory failure.
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Affiliation(s)
| | | | | | | | - A V Tavadov
- Yudin State Clinical Hospital, Moscow, Russia
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11
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Protsenko DN, Boytsov PV, Chentsov VB, Nistratov SL, Kudlyakov ON, Solov'ev VV, Banova ZI, Shkuratova NV, Rezenov NA, Gel'fand BR. OPTIMUM LEVEL OF POSITIVE END-EXPIRATORY PRESSURE IN ACUTE RESPIRATORY DISTRESS SYNDROME CAUSED BY INFLUENZA A(H1NI)PDM09: BALANCE BETWEEN MAXIMAL END-EXPIRATORY VOLUME AND MINIMAL ALVEOLAR OVERDISTENSION. Anesteziol Reanimatol 2016; 61:425-432. [PMID: 29894610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
THE AIM to determine optimum level ofpositive end-expiratory pressure (PEEP) according to balance between maxi- mal end-expiratory lung volume (EEL V)(more than predicted) and minimal decrease in exhaled carbon dioxide volume (VCO) and then to develop the algorithm of gas exchange correction based on prognostic values of EEL K; alveolar recruitability, PA/FiO2, static compliance (C,,,) and VCO2. MATERIALS AND METHODS 27 mechanically ventilatedpatients with acute respiratory distress syndrome (ARDS) caused by influenza A (HINJ)pdm09 in Moscow Municipal Clinics ICU's from January to March 2016 were included in the trial. At the beginning of the study patients had the following characteristic: duration offlu symptoms 5 (3-10) days, p.0/FiO2 120 (70-50) mmHg. SOFA 7 (5-9), body mass index 30.1 (26.4-33.8) kg/m², static compliance of respiratory system 35 (30-40) ml/mbar: Under sedation and paralysis we measured EELV, C VCO and end-tidal carbon dioxide concentration (EtCO) (for CO₂ measurements we fixed short-term values after 2 min after PEEP level change) at PEEP 8, 11,13,15,18, 20 mbar consequently, and incase of good recruitability, at 22 and 24 mbar. After analyses of obtained data we determined PEEP value in which increase in EELV was maximal (more than predicted) and depression of VCO₂ was less than 20%, change in mean blood pressure and heart rate were both less than 20% (measured at PEEP 8 mbar). After that we set thus determined level of PEEP and didn't change it for 5 days. RESULTS Comparision of predicted and measured EELV revealed two typical points of alveloar recruiment: the first at PEEP 11-15 mbar, the second at PEEP 20-22 mbar. EELV measured at PEEP 18 mbar appeared to be higher than predicted at PEEP 8 mbar by 400 ml (approx.), which was the sign of alveolar recruitment-1536 (1020-1845) ml vs 1955 (1360-2320) ml, p=0,001, Friedman test). we didn't found significant changes of VCO₂ when increased PEEP in the range from 8 to 15 mbar (p>0.05, Friedman test). PEEP increase from 15 to 18 mbar and more lead to decrease in VCO₂ (from 212 (171-256) ml/min to 200 (153-227) ml/min, p<0,0001, Friedman test, which was the sign of overdistension. Next decrease of VCO₂ was observed at PEEP increase from 22 to 24 mbar (from 203 (174-251 ml/min) to 185 (182-257) ml/min, p=0.0025, Friedman test). Adjusted PEEP value according to balance between recruitment and overdistension was higher than the one initially set (16(15-18) mbar vs 12(7-15) mbar, p <0.0001). We observed increase of SpO₂ from 93 (87-96) to 97(95-100)% (p<0.0001 followed by decrease in inspiratory oxygen fraction from 60(40-80) to 50(40-60)%(p<0.0001). Low EELV VCO₂ and VCO₂/EtCO₂ at PEEP 8 mbar has low predictive value for death (AUROC 0,547, 0706 and 0.596, respectively).Absolute EELV value at PEEP 18 and 20 mbar were poor predictors of mortality (AUROC 0.61 and 0.65 respectively) Alveolar recruit ability was measured by subtraction of EELV at PEEP 20 and at PEEP II mbar - value below 575 ml was a good predictor of death (sensitivity 75%, specificity 88%, AUROC 0.81). Lowering of VCO₂ at PEEP 20 mbar to less than 207 ml/min was a marker of alveolar overdistension and associated with poor prognosis (sensitivity 83%, specificity 88%, AUROC 0,89). C has poor predictive value at PEEP 8 and 20 mbar (AUROC 0,58 and 0,74 respectively. CONCLUSION PEEP adjustment in ARDS due to influenza A (H1N1) pdm09 in accordance with balance between recruitment and overdistension (based on EELV and VCO measurements) can improve gas exchange, probably, not leading to right ventricular failure. This value of "balanced" PEEP is in the range between 15 and 18 mbar: Low lung recruitabiilty is associated with poor prognosis. Measurements of EELV and VCO₂ at PEEP 8 and 20 mbar can be used to make a decision on whether to keep "high" PEEP level or switch to extracorporeal membrane oxygenation in patient with ARDS due to influenza A (N1H1).
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Suvorov SG, Lekmanov AU, Yaroshetskiy AI, Protsenko DN, Gelfand BR. [RUSSIAN NATIONAL EPIDEMIOLOGICAL STUDY "RUVENT": THE USE OF ARTIFICIAL LUNG VENTILATION IN THE INTENSIVE THERAPY IN CHILDREN]. Anesteziol Reanimatol 2015; 60:27-32. [PMID: 26148358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
UNLABELLED Purpose of this part of the "RuVent" research is to study the real use of the various modes and parameters of prolonged respiratory support in children in Russia. MATERIALS AND METHODS The study included 104 children from 29 ICUs (28 in Russian Federation, 1 in Ukraine) under the age of 15 years with ALV duration more than 12 hours in the period from February 7 to 11, 2011. The collection of information performed through online forms. RESULTS Total lethality was 20.7% (18 of 87 patients). The main reasons for prolonged respiratory support in children were the pathology of the respiratory system: acute respiratory distress syndrome (21.2%), community-acquired pneumonia (9.5%), sepsis (8.2%), and congenital disorders of the central nervous system (8.2%) and cardiac arrest (8.2%). According to the study "RuVent" doctors mostly prefer managed modes of respiratory support (SIMV 41.3%, A/C 28.8%, BIPAP 12.5%). Frequency of non-invasive respiratory support use amounted to 1%. Real respiratory volume based on ideal body weight calculation, averaged for boys 9.2 (7.3; 11.2) ml/kg (n = 54), for girls--8.7 (7.1; 10.1) m/kg (n = 38). PEEP median amounted to 4 mbar Tracheostomy was performed in 12 children out of 104 (11.5%), predominantly classic (n = 11), puncture dilated tracheostomy was performed in 1 child. The median of the tracheostomy installation in children was 24.5 days. The duration of respiratory support in children was 11 days (5; 25) (n = 43). The incidence of ventilator-associated pneumonia in children was 27.9% (12 of 43 cases). CONCLUSIONS The results of the Russian national epidemiological study of the use of mechanical ventilation in the Intensive care unit ("RuVent") showed comparable data with real international clinical practice. The researchers noted significant differences during prolonged mechanical ventilation in children compared with adult patients.
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Gel'fand BR, Kirienko AI, Protsenko DN, Ignatenko OV, Gel'fand EB. ["Evidance"--Russian national epidemiological study]. Anesteziol Reanimatol 2014; 59:33-36. [PMID: 25842938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
UNLABELLED The article deals with results of epidemiological study of 2516 ICU patients received prophylaxis of a deep vein thrombosis (DVT) and venous thromboembolic complications (VTEC). RESULTS The frequency of renal failure was 19.8%. Mortality rate in patients with acute renal failure (ARF) was 34% and in patients without ARF 17%. CONCLUSIONS An analysis of drugs for prophylaxis of DVT and VTEC which were used in patients with ARF showed that the prophylaxis was performed without a taking in account a significance of such complication.
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Iaroshetskiĭ AI, Protsenko DN, Rezepov NA, Gel'fand BR. [Positive end-expiratory pressure adjustment in parenchimal respiratory failure: static pressure-volume loop or transpulmonary pressure?]. Anesteziol Reanimatol 2014; 59:53-59. [PMID: 25549487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The aim of the study was compare the prognostic value, efficacy and safety ofpositive end-expiratory pressure (PEEP) adjustment in conformity with lower inflection point of static "pressure-volume" loop (LIP) or end-expiratory esophageal pressure (EEEP) in parenchymal respiratory failure. METHODS We included in the study 56 patients (39 males) at age 47 +/- 17.8 years with parenchymal respiratory failure (PaO2/FiO2 < 250 mmHg, bilateral infiltrates on chest X-ray or lung CT scan, no signs of left ventricular failure), who were mecAanically ventilated for less than 48 hours. All patients were sedated and paralyzed. We measured intra- Sabdominal pressure, PaO2/FiO2, PaCO2, alveolar dead space (Vdalv), plotted static "pressure-volume" loop by low flow technique in range of 0 to 40 mbar, recording LIP Then we placed nasogastric tube with balloon for esophageal pressure measurement and measured esophageal pressure at PEEP range from 8 to 20 mbar (with 2 mbar steps) and recorded plateau pressure (Pplat), transpulmonary plateau pressure (Ptp plat), transpulmonary pressure at PEEP level (Ptp PEEP), static compliance of respiratory system (Cstat), lung compliance (Clung), chest wall compliance (Ccw) at every step. Also by volumetric capnography technique we measured end-tidal carbon dioxide concentration (EtCO2), minute volume of exhaled carbon dioxide (VCO2) volume of exhaled carbon dioxide by single breath (VtCO2) and calculate VC2/EtCO2 as a surrogate marker of pulmnonary perfusion. After that we set PEEP at EEEP level (at zero end-expirato- my ranspulmonary pressure) and recorded changes of PaO2/FiO2 and Vdalv. RESULTS LIP value was 5 (6-10) mbar and it was less than empirically set PEEP in most of patients before enrollment and had no prognostic value for PEEP setting. EEEP level was 14 (12-18.25) mbar and it was higher than LIP in 96.4% patients. Distribution of EEEP values was close to normal unlike LIP Chest wall compliance was less than normal (100 ml/mbar) in 46% of patients. EEEP has correlation with body mass index (rho 0.554, p=0.002). We did not find any correlation between intra-abdominal pres- sure (IAP) and EEEP (p=0.376) or IAP and LIP (p=0.464). PEEP levels higher than 14 mbar led to significant decrease in Cstat and Clung (p<0.001). We observed significant decrease in VCO at PEEP levels more than 16 mbar, i.e., more than EEEP median. PEEP levels more than 16 mbar decreased VCO2/EtCO2, (decreased pulmonary perfusion) from 7.47 (6.54-8.7) at PEEP 14 mbar to 7.32 (6.35-8.76) at PEEP 20 mbar (p=0.004). PEEP setting at EEEP level increased PaO/FiO2 from 205 (154-235) to 280 (208-358) mmHg (p<0.001), did hot change Vdalv (p=0.093) and decreased Cstat and Clung in the most of patients (64.3%). CONCLUSION L1P was lower than empirically set PEEP in most patients and did not help to optimize gas exchange. PEEP setting at EEEP level in patients with parenchimal respiratory failure increases PaO/FiO, (reflects opening of collapsed alveoli), decreases volume of expired carbon dioxide and decreases lung compliance (reflects overdistenion of opened alveoli). VCO2/EtCO2 ratio decreases (decreased pulmonary perfusion) at PEEP levels more than 16 mbar, which was more than EEEP.
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Yaroshetskiy AI, Protsenko DN, Larin ES, Gelfand BR. [Significance of static pressure-volume loop for differential diagnostics and optimization of respiratory support in parenchimal respiratory failure]. Anesteziol Reanimatol 2014:21-26. [PMID: 25055488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE OF THE STUDY To determine significance of static pressure-volume loop (PV loop) for differential diagnostics of parenchymal respiratory failure, setting of positive end-expiratory pressure (PEEP) and recruit ability of the lung. MATERIALS AND METHODS 76 patients (52 males) with parenchymal respiratory failure were included in the study (oxygenation index (PaO2/ FiO2) < 250 torr infiltrates on chest X-ray or CT-scan of the lungs, no data on left ventricular failure). We plot static PV loop by low flow technique in range of 0 to 40 mbar, fixing lower inflection point (LIP), linear compliance (Clin), upper inflection point (UIP), expiratory inflection point (EIP), compliance of linear deflation limb (C defl), hysteresis (Hyst) and volume of PEEP-induced recruitment of the lung (V(peep)). Then we plot another static PV loop with sustained inflation of 40 mbar for 30 seconds, fixing changes in lung volume at 40 mbar. After 10 minutes of sustained inflation we measured changes of oxygenation index. For 69 patient we performed lung CT-scan and defined diffuse (acute respiratory distress syndrome) or local lung injury (pneumonia, atelectasis). RESULTS LIP value can differentiate diffuse and local lung injury. LIP more than 10 mbar corresponds to diffuse lung injury on CT scan (sensitivity 76%, specificity 85%, AUROC 0.81). LIP cannot predict PEEP-induced alveolar recruitment and changes of PaO2/FiO2 after sustained inflation maneuver (p > 0.05). Empirically set PEEP (by maximum PaO2/FiO2) was much higher than LIP (p < 0.0001), but LIP correlates with empirically set PEEP in diffuse lung injury (rho = 0.642, p = 0.003). Clin cannot differentiate diffuse from local lung injury (p > 0.05), but predicts PEEP-induced alveolar recruitment during static PV loop plotting (rho = 0.493, p < 0.0001). We did not find any statistically significant values of UIP and EIP for differential diagnosis, setting of PEEP or recruit ability of the lung. Hysteresis value (defined as volume difference at 20 mbar between deflation and inflation limbs) cannot predict influence of PEEP setting and sustained inflation maneuver on PaO2/FiO2 changes and recruit ability of the lung (p > 0.05). After static PV loop plotting combined with sustained inflation maneuver recruited volume of the lungs was 350 (250-450) ml. We didn't find significant differences between recruit ability of the diffuse and locally injured lungs (p > 0.05). Recruitment volume has no correlations with all points and segments of static PV loop. CONCLUSIONS Static PV loop has limited prognostic value for differential diagnostics of diffuse or local lung injury and brings potential harm for setting PEEP according to LIP. LIP more than 10 mbar can predict diffuse lung injury. Clin can predict volume of PEEP-induced recruitment. In diffuse lung injury LIP correlates with empirically set PEEP.
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Iaroshetskiĭ AI, Protsenko DN, Ignatenko OV, Larin ES, Novoselova EV, Sulimova II, Gel'fand BR. [Significance of static pressure-volume loop and lung computed tomography for differential diagnostics of parenchymal respiratory insufficiency]. Anesteziol Reanimatol 2013:20-24. [PMID: 24624853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
UNLABELLED Purpose of the study was to determine a significance of static pressure-volume loop and lung computed tomography for differential diagnostics of parenchymal lung failure developing during mechanical ventilation. MATERIALS AND METHODS 75 patients (42 males and 33 females) with acute lung failure due to parenchymal lung injury during mechanical ventilation were included in to the research. Criteria of including into the research were age over 15, ARDS symptoms absence before respiratory support beginning and modified American-European Consensus Conference ARDS criteria presence during mechanical ventilation (AECC ARDS criteria, 1994--PaO2/FiO2 < 250 mmHg). Lung computed tomography (CT), static compliance and plateau measurement were performed in all patients. Static pressure-volume loop was plotted in 23 patients. RESULTS diffuse alveolar damage was diagnosed by CT in 24.3% of patients and "wet sponge" symptom in 10.7% of patients. Dorsal atelectasis (77.3%) and ventilator-associated pneumonia (VAP) (82.7%) were diagnosed in most of patients with AECC ARDS criteria. Sensitivity and specificity of PaO2/FiO2 ratio were too low for diagnostics of ARDS (AUROC 0.67) Patients with diffuse alveolar damage had plateau pressure 25 mbar (95% CI 22-32), while patients with local lung injury (VAP or atelectasis) had significantly lower plateau pressure--20 mbar (95% CI 18-22) (p = 0.014). Elevation of plateau pressure over 30 mbar predicted diffuse alveolar damage with specificity of 100%. Lower inflection point values on the static pressure-volume loop was higher in patients with diffuse alveolar damage than in patients with local lung injury--12 mbar (95% CI 7-17) vs. 6 mbar (95% CI 5-10), (p = 0.042, n = 23). Effective (linear) compliance had poor prognostic value for differential diagnostics of acute respiratory failure due to parenchimal lung injury (p = 0.023). CONCLUSION Lung CT plays leading role in differential diagnostics of parenchymal lung failure developing during mechanical ventilation. In the luck of CT scan elevation of plateau pressure over 30 mbar and values of lower inflection point on the static pressure-volume loop over 12 mbar can predict ARDS.
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Protsenko DN, Yaroshetskiy AI, Suvorov SG, Lekmanov AU, Gelfand BR. Mechanical ventilation in intensive and critical care units of Russia: RuVent national epidemiologic study. Crit Care 2012. [PMCID: PMC3363532 DOI: 10.1186/cc10721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Protsenko DN, Iaroshetskiĭ AI, Suvorov SG, Lekmanov AU, Gel'fand BR. [Application of artificial lung respiration in intensive care units in Russia: national epidemiological research "RuVent"]. Anesteziol Reanimatol 2012:64-72. [PMID: 22834293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED The purpose of the research is to study the real use of the various modes and parameters of prolonged respiratory support in Russia. MATERIALS AND METHODS The study included all patients from ICU with no limitation by sex and age with ALV duration more than 12 hours in the period from February 7 to 11. 2011. 470 patients, including 104 children under the age of 15 years, from 101 ICU in Russian Federation, 2 ICU in the Republic of Belarus and 1 ICU in Ukraine (total 104 centres). The collection of information performed through online forms. RESULTS Total lethality was 35.1% (139 from 396 patients), in case of the ARDS development - 44.9%. The frequency of ARDS development - 18.7%. According to the study "Ru Vent" doctors mostly prefer managed modes of respiratory support (SIMV 45.1%, A/C 20.2%, BiPAP 12.6%) which can partly be explained by a large proportion ofpatients with Central nervous system pathology, included in the study (39.8%). Frequency of non-invasive respiratory support use amounted to 1.1%. Real respiratory volume based on ideal body weight calculation, averaged for men 8.13 (6.84-9.33) ml/kg, for women - 9.1 (7.6-10.9) ml/kg, which is above the "ideal" respiratory volume 6 ml/kg in 1.35 times (1.14-1.56) for men (n=251) and in 1.51 times (1.27 - 1.81) for women (r=161). PEEP median amounted to 5 mbar, in case ofARDS development - 6 mbar. CONCLUSION The results of the Russian national epidemiological research of ALV use in ICU ("RuVent) showed comparable data with real international clinical practice. The used tidal volumes are slightly overestated, and the values ofthe PEEP are understated in comparison with the national and international recommendations.
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Iaroshetskiĭ AI, Protsenko DN, Gel'fand BR. [Role of an anesthesiologist-resuscitation specialist in organ donation for transplantation]. Anesteziol Reanimatol 2010:4-8. [PMID: 20737699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
There is an annual reduction in the number of donors worldwide. An anesthesiologist-resuscitation specialist is a key figure in the whole system of organ donation. The so-called transplantation, i.e., the organization of the whole process of interaction between a healthy care facility, a local organ donation center, and ancillary laboratory and diagnostic services is one of his/her primary roles in organ donation. The organizational, legal, and ethic issues of organ donation for transplantation are discussed from the viewpoint of an anesthesiologist-resuscitation specialist. There is a parallel between the treatment of a patient with multiple organ dysfunction and the management of a donor with brain death.
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Evdokimov AA, Malyshev NA, Protsenko DN, Belevskiĭ AS, Iaroshetskiĭ AI, Murav'ev OB, Boĭtsov PV, Gel'fand BR. [Experience in treating severe viral respiratory infection caused by influenza A (H1N1)]. Anesteziol Reanimatol 2010:22-25. [PMID: 20734842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The authors present their experience in treating 142 patients with severe viral respiratory infection caused by influenza A (H1N1), describe its clinical picture, and identify major syndromes observed in the treatment of these patients at an intensive care unit. A rapid development of acute respiratory distress syndrome, significant hypoxemia and hypercapnia with the low efficiency of various therapeutic measures and hence progressive organ dysfunction determine the essence of the severe course of the disease. Uniform guidelines for intensive care in this patient population are presented.
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Iakovlev SV, Protsenko DN, Shakhova TV, Suvorova MP, Ramishvili VS, Ignatenko OV, Iaroshetskiĭ AI, Romanovskiĭ II, Eremina LV. [Antibiotic resistance in hospital: do we control the situation?]. Antibiot Khimioter 2010; 55:50-58. [PMID: 20583558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Iarochkin VS, Bagdasarov VV, Bagdasarova EA, Protsenko DN, Bagdasarov VV. [Postinfusion complications by acute blood loss]. Khirurgiia (Mosk) 2010:41-48. [PMID: 20724978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Highs and lows of infusion therapy for the treatment of the acute blood loss were studied experimentally and in clinic. Colloid and crystalloid solutions, being hemodilutants, do not transport oxygen, causing, therefore, several complications in recipient's organism. Dilutional anemic and lead to heart insufficiency, which, by-turn, cause the so called dilutional circulatory hypoxia.
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Protsenko DN, Leĭderman IN, Grigor'ev EV, Kokarev EA, Levit AL, Gel'fand BR. [Evaluation of the effectiveness and safety of synthetic colloid solutions in the treatment of severe abdominal sepsis: a randomized comparative study]. Anesteziol Reanimatol 2009:9-13. [PMID: 19938709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Infusion therapy, surgical debridement of an infection focus, and antimicrobial therapy are basic treatments for severe sepsis. At the same time there are no uniform guidelines on how to choose fluids for infusion therapy. The results of individual studies serve as the basis for refusing the use of synthetic colloid agents in the therapy of severe sepsis. The presented multicenter, randomized comparative study has evaluated different synthetic colloid solutions in early targeted therapy for severe sepsis. Evidence is provided for the identical effectiveness of the compared solutions in correcting hypovolemia and stabilizing hemodynamics in patients with severe sepsis and septic shock.
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Gel'fand BR, Protsenko DN, Ignatenko OV, Iaroshetskiĭ AI. [Acute lung injury caused by transfusion of blood components]. Anesteziol Reanimatol 2007:36-38. [PMID: 17933042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Protsenko DN, Ignatenko OV, Iaroshetskiĭ AI, Gel'fand BR. [Alveolar mobilization maneuver (recruitment): solved and unsolved problems]. Anesteziol Reanimatol 2006:42-7. [PMID: 17288265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Acute respiratory distress syndrome (ARDS) is a common complication in patients with critical condition. Studies of pathophysiological changes in the lung in this condition give rise to new methods of respiratory therapy, one of which is alveolar mobilization maneuver (recruitment). This procedure considerably improves oxygenation in patients with ARDS, but at the same time, there is a risk of developing various complications (barotraumas, lowered cardiac output). Further studies of the efficiency of this method and development of well-defined clinical guidelines that will be able to answer the most important questions: "who", "when", and "how" the alveolar recruiting maneuver should perform are currently under way.
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Iaroshetskiĭ AI, Protsenko DN, Ignatenko OV, Gel'fand BR. [Prediction of fatal outcome in severe injury]. Anesteziol Reanimatol 2006:58-64. [PMID: 17288269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The paper reflects the results of a study to predict a fatal outcome in severe injury, by evaluating the condition by the APACHE II, SAPS II, MODS, SOFA, and Glasgow coma scale. Particular emphasis is laid on the assessment of the quality of an obtained prediction, by using the currently available tools--the resolving power of a prognostic model (area under the characteristic curve), choice of the prognostive value (division point), and calibration of the model. It was ascertained that the APACHE II and SAPS II scales could not significantly predict a fatal outcome in severe injury. Based on the scores obtained by the SOFA, MODS, and Glasgow coma scales, the authors developed prognostic indices that provide a high significance in predicting the fatal outcome in severe injury both within the first 24 hours and over time. The independent predictor of a fatal outcome (hypernatriemia) in severe injury was identified.
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Gel'fand BR, Protsenko DN, Gel'fand EB, Shipilova OS, Popov TV. [Abdominal sepsis: intensive care strategy]. Anesteziol Reanimatol 2006:4-9. [PMID: 17288256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Sepsis is one of the most urgent problems of modern surgery as a steady tendency for the number of patients and mortality rates to increase. Sepsis is the syndrome of a systemic inflammatory response to the invasion of microorganisms. Abdominal sepsis (AS) is inherently a systemic inflammatory response to a focal of infection in the abdomen or retroperitoneal space. Implementation of an individual program for intensive care and anesthetic support is also the same important component of the program for AS treatment as surgery. Intensive care for AS is based on the objective evaluation of the patients' condition, which makes it possible not only to determine the severity of the disease and the degree of organ dysfunction, but also to choose the most adequate intensive care program in terms of a specific clinical situation. The reasonable use of currently available intensive care means and methods substantially reduce mortality rates in patients with AS.
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Mamontova OA, Protsenko DN, Eliutin DV, Kirienko PN, Gel'fand BR. [Exogenous activated protein C in severe sepsis]. Anesteziol Reanimatol 2005:42-5. [PMID: 16076046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Exogenous activated protein C combines a marked anti-inflammatory effect on the vascular endothelium and anticoagulative and profibrinolytic activities. The total results of this action are better multiple organ microcirculation and, as a result, elimination and even prevention of irreversible changes in the vitally important organs. The many-sidedness and potency of this effect make the agent essential for intensive therapy of severe sepsis of various etiology. The Russian cooperative study of the efficacy of the exogenous activated protein C--drotrecogine alpha (activated)--has shown that its inclusion into therapy for sepsis with multiple organ dysfunction and septic shock results in longer estimated survival. With this, the best results are observed when therapy is initiated within 48 hours since the development of multiple organ deficiency.
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Iakovlev SV, Romashov OM, Protsenko DN. [Cefepime in the treatment of hospital-acquired pneumonia]. Antibiot Khimioter 2003; 48:38-43. [PMID: 14628578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Affiliation(s)
- S V Iakovlev
- I.M. Sechenov Moscow Medical Academy, Municipal Clinical Hospital No. 7, Moscow
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