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Savushkina OI, Astanin PA, Nekludova GV, Avdeev SN, Zaytsev AA. [The possibilities of impulse oscillometry in the diagnosis of the lung function disorders after COVID-19]. TERAPEVT ARKH 2023; 95:924-929. [PMID: 38158947 DOI: 10.26442/00403660.2023.11.202474] [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] [Received: 11/23/2023] [Accepted: 11/23/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Impulse oscillometry (IOS) is an effort independent method of studying lung mechanics. AIM To study the diagnostic significance of IOS in assessing lung mechanics after COVID-19. MATERIALS AND METHODS Spirometry, body plethysmography, diffusion test (DLco), IOS parameters were analyzed in 315 patients (the median age 48 years), the median period from the beginning of COVID-19 to the study was 50 days. Statistical analysis included descriptive statistics, correlation analysis and one-dimensional logistic regression analysis with an assessment of odds ratios. RESULTS In general group, spirometry and body plethysmography parameters were in normal values, while DLCO was reduced in 61% of patients. Parameters of IOS were analyzed in the general group and between the groups, depending on the value of DLco and total lung capacity (TLC): normal or reduced. In general group, reactance area (AX), hererogeneity of resistance Rrs5-Rrs20, resistance at 5 Hz (Rrs5), reactance at 5 Hz (ΔXrs5) were increased in 29.8%, 17.8%, 6%, 4.8% of patients, respectively, and were statistically significantly higher in the group with reduced TLC, whereas in the group with reduced DLco AX, Rrs5-Rrs20 were statistically significantly higher. Logistic regression analysis showed that patients with Rrs5-Rrs20>0.07 kPa×sec/l or AX>0.32 kPa/l had a 1.99-fold and 2.24-fold increased risk for decrease DLco, respectively, while the risk of decrease in TLC was 2.25-fold (p=0.012) and 3.16-fold (p<0.001) higher, respectively. CONCLUSION IOS allow to detect both dysfunction of small airways (if AX or Rrs5-Rrs20 are increased) and the risk of restrictive pattern and lung diffusion impairment after COVID-19.
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Affiliation(s)
- O I Savushkina
- Burdenko Main Military Clinical Hospital
- Federal Pulmonology Research Institute
| | - P A Astanin
- Pirogov Russian National Research Medical University
- Izmerov Research Institute of Occupational Health
| | - G V Nekludova
- Federal Pulmonology Research Institute
- Sechenov First Moscow State Medical University (Sechenov University)
| | - S N Avdeev
- Federal Pulmonology Research Institute
- Sechenov First Moscow State Medical University (Sechenov University)
| | - A A Zaytsev
- Burdenko Main Military Clinical Hospital
- BIOTECH University
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Trushenko NV, Suvorova OA, Nekludova GV, Levina IA, Chikina SY, Nikolenko AM, Tsareva NA, Volkov AV, Yaroshetskiy AI, Merzhoeva ZM, Nuralieva GS, Avdeev SN. Predictors of Pulmonary Hypertension and Right Ventricular Dysfunction in Patients with Hypersensitivity Pneumonitis. Life (Basel) 2023; 13:1348. [PMID: 37374130 PMCID: PMC10302253 DOI: 10.3390/life13061348] [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] [Received: 04/20/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) that occurs in susceptible individuals in response to various inhaled antigens. The fibrotic phenotype of HP is characterized by disease progression and can lead to pulmonary hypertension (PH). The aim of this study was to estimate the prevalence of PH and to identify predictors of PH in patients with chronic HP. METHODS We conducted an observational longitudinal study that included 85 patients with an established diagnosis of HP. Clinical examination, quality of life questionnaires, high-resolution computed tomography (HRCT) of the chest, arterial blood gases analyses, six-minute walking test (6-MWT), pulmonary function tests, and echocardiography were performed. RESULTS Patients were divided into groups with fibrotic (71.8%) and nonfibrotic phenotype (28.2%). PH was detected in 41 (48.2%) patients. Patients with PH had the predominant fibrotic phenotype of HP, were older, more symptomatic, and had a higher FVC/DLco ratio. The most significant predictors of PH were CT signs of fibrosis, finger clubbing, FVC/DLco, decreased distance, and SpO2 at the end of 6-MWT, as well as the presence of cardiovascular diseases. CONCLUSIONS PH is a common condition in patients with chronic HP, especially with the fibrotic phenotype. Early detection of the PH predictors is necessary for the timely diagnosis of this complication of HP.
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Affiliation(s)
- Natalia V. Trushenko
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia; (O.A.S.); (G.V.N.); (I.A.L.); (S.Y.C.); (A.M.N.); (N.A.T.); (A.V.V.); (A.I.Y.); (Z.M.M.); (G.S.N.); (S.N.A.)
- Pulmonology Scientific Research Institute, Federal Medical and Biological Agency of Russian Federation, Orekhovyy Boulevard 28, 115682 Moscow, Russia
| | - Olga A. Suvorova
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia; (O.A.S.); (G.V.N.); (I.A.L.); (S.Y.C.); (A.M.N.); (N.A.T.); (A.V.V.); (A.I.Y.); (Z.M.M.); (G.S.N.); (S.N.A.)
| | - Galina V. Nekludova
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia; (O.A.S.); (G.V.N.); (I.A.L.); (S.Y.C.); (A.M.N.); (N.A.T.); (A.V.V.); (A.I.Y.); (Z.M.M.); (G.S.N.); (S.N.A.)
- Pulmonology Scientific Research Institute, Federal Medical and Biological Agency of Russian Federation, Orekhovyy Boulevard 28, 115682 Moscow, Russia
| | - Iuliia A. Levina
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia; (O.A.S.); (G.V.N.); (I.A.L.); (S.Y.C.); (A.M.N.); (N.A.T.); (A.V.V.); (A.I.Y.); (Z.M.M.); (G.S.N.); (S.N.A.)
| | - Svetlana Y. Chikina
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia; (O.A.S.); (G.V.N.); (I.A.L.); (S.Y.C.); (A.M.N.); (N.A.T.); (A.V.V.); (A.I.Y.); (Z.M.M.); (G.S.N.); (S.N.A.)
| | - Alexandra M. Nikolenko
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia; (O.A.S.); (G.V.N.); (I.A.L.); (S.Y.C.); (A.M.N.); (N.A.T.); (A.V.V.); (A.I.Y.); (Z.M.M.); (G.S.N.); (S.N.A.)
| | - Natalia A. Tsareva
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia; (O.A.S.); (G.V.N.); (I.A.L.); (S.Y.C.); (A.M.N.); (N.A.T.); (A.V.V.); (A.I.Y.); (Z.M.M.); (G.S.N.); (S.N.A.)
- Pulmonology Scientific Research Institute, Federal Medical and Biological Agency of Russian Federation, Orekhovyy Boulevard 28, 115682 Moscow, Russia
| | - Alexandr V. Volkov
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia; (O.A.S.); (G.V.N.); (I.A.L.); (S.Y.C.); (A.M.N.); (N.A.T.); (A.V.V.); (A.I.Y.); (Z.M.M.); (G.S.N.); (S.N.A.)
- Federal State Budgetary Scientific Institution, V. A. Nasonova Research Institute of Rheumatology, Kashirskoye Highway 34A, 115522 Moscow, Russia
| | - Andrey I. Yaroshetskiy
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia; (O.A.S.); (G.V.N.); (I.A.L.); (S.Y.C.); (A.M.N.); (N.A.T.); (A.V.V.); (A.I.Y.); (Z.M.M.); (G.S.N.); (S.N.A.)
| | - Zamira M. Merzhoeva
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia; (O.A.S.); (G.V.N.); (I.A.L.); (S.Y.C.); (A.M.N.); (N.A.T.); (A.V.V.); (A.I.Y.); (Z.M.M.); (G.S.N.); (S.N.A.)
- Pulmonology Scientific Research Institute, Federal Medical and Biological Agency of Russian Federation, Orekhovyy Boulevard 28, 115682 Moscow, Russia
| | - Galiya S. Nuralieva
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia; (O.A.S.); (G.V.N.); (I.A.L.); (S.Y.C.); (A.M.N.); (N.A.T.); (A.V.V.); (A.I.Y.); (Z.M.M.); (G.S.N.); (S.N.A.)
- Pulmonology Scientific Research Institute, Federal Medical and Biological Agency of Russian Federation, Orekhovyy Boulevard 28, 115682 Moscow, Russia
| | - Sergey N. Avdeev
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia; (O.A.S.); (G.V.N.); (I.A.L.); (S.Y.C.); (A.M.N.); (N.A.T.); (A.V.V.); (A.I.Y.); (Z.M.M.); (G.S.N.); (S.N.A.)
- Pulmonology Scientific Research Institute, Federal Medical and Biological Agency of Russian Federation, Orekhovyy Boulevard 28, 115682 Moscow, Russia
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Trushenko NV, Suvorova OA, Pershina ES, Nekludova GV, Chikina SY, Levina IA, Chernyaev AL, Samsonova MV, Tyurin IE, Mustafina MK, Yaroshetskiy AI, Nadtochiy NB, Merzhoeva ZM, Proshkina AA, Avdeev SN. Predictors of Progression and Mortality in Patients with Chronic Hypersensitivity Pneumonitis: Retrospective Analysis of Registry of Fibrosing Interstitial Lung Diseases. Life (Basel) 2023; 13:life13020467. [PMID: 36836825 PMCID: PMC9965638 DOI: 10.3390/life13020467] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/28/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) resulting from an immune-mediated response in susceptible and sensitized individuals to a large variety of inhaled antigens. Chronic HP with a fibrotic phenotype is characterized by disease progression and a dismal prognosis. The aim of this study was to identify predictors of progression and mortality in patients with chronic HP in real clinical practice. MATERIALS AND METHODS This retrospective, multicenter, observational study used data from a registry of 1355 patients with fibrosing ILDs. The study included 292 patients diagnosed with chronic HP based on the conclusion of a multidisciplinary discussion (MDD). RESULTS The patients were divided into groups with progressive (92 (30.3%) patients) and nonprogressive pulmonary fibrosis (200 (69.7%) patients). The most significant predictors of adverse outcomes were a DLco < 50% predicted, an SpO2 at the end of a six-minute walk test (6-MWT) < 85%, and a GAP score ≥ 4 points. CONCLUSION Pulmonary fibrosis and a progressive fibrotic phenotype are common in patients with chronic HP. Early detection of the predictors of an adverse prognosis of chronic HP is necessary for the timely initiation of antifibrotic therapy.
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Affiliation(s)
- Natalia V. Trushenko
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia
- Pulmonology Scientific Research Institute, Federal Medical and Biological Agency of Russian Federation, Orekhovyy Boulevard 28, 115682 Moscow, Russia
- Correspondence: (N.V.T.); (O.A.S.)
| | - Olga A. Suvorova
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia
- Correspondence: (N.V.T.); (O.A.S.)
| | - Ekaterina S. Pershina
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia
- Pirogov City Clinical Hospital No. 1, Moscow Healthcare Department, Leninsky Avenue 8, 117049 Moscow, Russia
| | - Galina V. Nekludova
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia
- Pulmonology Scientific Research Institute, Federal Medical and Biological Agency of Russian Federation, Orekhovyy Boulevard 28, 115682 Moscow, Russia
| | - Svetlana Yu. Chikina
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia
| | - Iuliia A. Levina
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia
| | - Andrey L. Chernyaev
- Pulmonology Scientific Research Institute, Federal Medical and Biological Agency of Russian Federation, Orekhovyy Boulevard 28, 115682 Moscow, Russia
- Morphology Department, Pirogov Federal Russian National Research Medical University, Healthcare Ministry of Russia, Ostrovityanova St. 1, 117997 Moscow, Russia
- Federal Research Institute of Human Morphology, Tsyurupy St. 3, 117418 Moscow, Russia
| | - Maria V. Samsonova
- Pulmonology Scientific Research Institute, Federal Medical and Biological Agency of Russian Federation, Orekhovyy Boulevard 28, 115682 Moscow, Russia
- Moscow Clinical Scientific Center, Enthusiasts Highway 84/1, 111123 Moscow, Russia
| | - Igor E. Tyurin
- Russian Federal Academy of Continued Medical Education, Healthcare Ministry of Russia, Barrikadnaya St. 2/1, Build. 1, 123995 Moscow, Russia
| | - Malika Kh. Mustafina
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia
- Pulmonology Scientific Research Institute, Federal Medical and Biological Agency of Russian Federation, Orekhovyy Boulevard 28, 115682 Moscow, Russia
| | - Andrey I. Yaroshetskiy
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia
- Morphology Department, Pirogov Federal Russian National Research Medical University, Healthcare Ministry of Russia, Ostrovityanova St. 1, 117997 Moscow, Russia
| | - Nikita B. Nadtochiy
- Chelyabinsk Regional Clinical Hospital, Vorovskogo St. 70, 454076 Chelyabinsk, Russia
- Radiology Department, South-Ural State Medical University, Healthcare Ministry of Russia, Vorovskogo St. 64, 454092 Chelyabinsk, Russia
| | - Zamira M. Merzhoeva
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia
- Pulmonology Scientific Research Institute, Federal Medical and Biological Agency of Russian Federation, Orekhovyy Boulevard 28, 115682 Moscow, Russia
| | - Anna A. Proshkina
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia
| | - Sergey N. Avdeev
- Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya St. 8, Build. 2, 119991 Moscow, Russia
- Pulmonology Scientific Research Institute, Federal Medical and Biological Agency of Russian Federation, Orekhovyy Boulevard 28, 115682 Moscow, Russia
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Proshkina AA, Tsareva NA, Nekludova GV, Avdeev SN. [Triple combination therapy with macitentan, riociguat, and selexipag in a patient with idiopathic pulmonary arterial hypertension (functional class III)]. Kardiologiia 2021; 61:104-107. [PMID: 34763645 DOI: 10.18087/cardio.2021.10.n1789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
The article presents a clinical case of successful triple combination therapy in a female patient with functional class III idiopathic pulmonary arterial hypertension. Supplementing the previous macitentan and riociguat treatment with selexipag reduced the severity of clinical manifestations of pulmonary hypertension. Also, the treatment efficacy was demonstrated by improvement of laboratory and instrumental indexes. Time-related changes were evaluated at 3 months after initiation of the selexipag treatment.
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Affiliation(s)
- A A Proshkina
- Sechenov Moscow State Medical University, Moscow, Russia
| | - N A Tsareva
- Sechenov Moscow State Medical University, Moscow, Russia
| | - G V Nekludova
- Sechenov Moscow State Medical University, Moscow, Russia
| | - S N Avdeev
- Sechenov Moscow State Medical University, Moscow, Russia
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Tsareva NA, Avdeev SN, Kosanovic D, Schermuly RT, Trushenko NV, Nekludova GV. Inhaled iloprost improves gas exchange in patients with COVID-19 and acute respiratory distress syndrome. Crit Care 2021; 25:258. [PMID: 34289888 PMCID: PMC8294235 DOI: 10.1186/s13054-021-03690-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/10/2021] [Indexed: 01/08/2023]
Affiliation(s)
- Natalia A Tsareva
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya Street 8, Moscow, Russia, 119991
| | - Sergey N Avdeev
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya Street 8, Moscow, Russia, 119991.
| | - Djuro Kosanovic
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya Street 8, Moscow, Russia, 119991
| | - Ralph Theo Schermuly
- Department of Internal Medicine, Justus-Liebig University Giessen, Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Natalia V Trushenko
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya Street 8, Moscow, Russia, 119991
| | - Galina V Nekludova
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Healthcare Ministry of Russia, Trubetskaya Street 8, Moscow, Russia, 119991
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Avdeev SN, Trushenko NV, Tsareva NA, Yaroshetskiy AI, Merzhoeva ZM, Nuralieva GS, Nekludova GV, Chikina SY, Gneusheva TY, Suvorova OA, Shmidt AE. Anti-IL-17 monoclonal antibodies in hospitalized patients with severe COVID-19: A pilot study. Cytokine 2021; 146:155627. [PMID: 34237556 PMCID: PMC8253694 DOI: 10.1016/j.cyto.2021.155627] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/30/2021] [Accepted: 06/12/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND One of the main pathophysiological mechanisms underlying the severe course of COVID-19 is the hyper-inflammatory syndrome associated with progressive damage of lung tissue and multi-organ dysfunction. IL-17 has been suggested to be involved in hyper-inflammatory syndrome. OBJECTIVE To evaluate the efficacy and safety of the IL-17 inhibitor netakimab in patients with severe COVID-19. STUDY DESIGN In our retrospective case-control study we evaluated the efficacy of netakimab in hospitalized patients with severe COVID-19 outside the intensive care unit (ICU). Patients in the experimental group were treated with standard of care therapy and netakimab at a dose of 120 mg subcutaneously. RESULTS 171 patients with severe COVID-19 were enrolled in our study, and 88 of them received netakimab. On the 3 day of therapy, body temperature, SpO2/FiO2, NEWS2 score, and CRP improved significantly in the netakimab group compared to the control group. Other clinical outcomes such as transfer to ICU (11.4% vs 9.6%), need for mechanical ventilation (10.2% vs 9.6%), 28-day mortality (10.2% vs 8.4%), did not differ between the groups. CONCLUSION In hospitalized patients with severe COVID-19, anti-IL-17 therapy might mitigate the inflammatory response and improve oxygenation, but do not affect the need for mechanical ventilation and mortality.
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Affiliation(s)
- Sergey N Avdeev
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
| | - Natalia V Trushenko
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Natalia A Tsareva
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Andrey I Yaroshetskiy
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Zamira M Merzhoeva
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Galia S Nuralieva
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Galina V Nekludova
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Svetlana Yu Chikina
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Tatiana Yu Gneusheva
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Olga A Suvorova
- International School 'Medicine of the Future', I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anna E Shmidt
- International School 'Medicine of the Future', I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Nekludova GV, Avdeev SN, Tsareva NA, Trushenko NV, Ataman K. Using TAPSE (tricuspid annular plane systolic excursion) as a predictor of poor prognosis of COVID-19: is it enough? Int J Infect Dis 2021; 107:164. [PMID: 33895408 PMCID: PMC8061623 DOI: 10.1016/j.ijid.2021.04.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/15/2021] [Indexed: 01/08/2023] Open
Affiliation(s)
- Galina V Nekludova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Sergey N Avdeev
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
| | - Natalia A Tsareva
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Natalia V Trushenko
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Kirill Ataman
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Avdeev SN, Nekludova GV, Trushenko NV, Yaroshetskiy AI, Nuralieva GS. Can lung ultrasound predict histologic pattern of lung injury in critically ill patients with COVID‑19? Intensive Care Med 2021; 47:629-630. [PMID: 33630096 PMCID: PMC7905427 DOI: 10.1007/s00134-021-06372-8] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Sergey N Avdeev
- Pulmonology Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2, Trubetskaya Str., 119991, Moscow, Russia.
| | - Galina V Nekludova
- Pulmonology Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2, Trubetskaya Str., 119991, Moscow, Russia
| | - Natalia V Trushenko
- Pulmonology Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2, Trubetskaya Str., 119991, Moscow, Russia
| | - Andrey I Yaroshetskiy
- Pulmonology Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2, Trubetskaya Str., 119991, Moscow, Russia
| | - Galia S Nuralieva
- Pulmonology Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2, Trubetskaya Str., 119991, Moscow, Russia
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Avdeev SN, Nekludova GV, Trushenko NV, Tsareva NA, Yaroshetskiy AI, Kosanovic D. Lung ultrasound can predict response to the prone position in awake non-intubated patients with COVID‑19 associated acute respiratory distress syndrome. Crit Care 2021; 25:35. [PMID: 33494771 PMCID: PMC7829618 DOI: 10.1186/s13054-021-03472-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/13/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Sergey N Avdeev
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
| | - Galina V Nekludova
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Natalia V Trushenko
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Natalia A Tsareva
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Andrey I Yaroshetskiy
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Djuro Kosanovic
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Kosanovic D, Yaroshetskiy AI, Tsareva NA, Merzhoeva ZM, Trushenko NV, Nekludova GV, Schermuly RT, Avdeev SN. Recombinant tissue plasminogen activator treatment for COVID-19 associated ARDS and acute cor pulmonale. Int J Infect Dis 2021; 104:108-110. [PMID: 33352323 PMCID: PMC7833717 DOI: 10.1016/j.ijid.2020.12.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 02/06/2023] Open
Abstract
Existing literature highlights the fact that patients with COVID-19 exhibit alterations in the coagulation process and are associated with respiratory and cardiovascular diseases, including acute respiratory distress syndrome and acute cor pulmonale. In this report, we describe the effects of systemic thrombolysis on acute cor pulmonale in a patient suffering from COVID-19. We demonstrated that systemic thrombolysis successfully improved the hemodynamics of our patient and resulted in a prominent reduction in hypercapnia, alveolar dead space, and ventilatory ratio.
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Affiliation(s)
- Djuro Kosanovic
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Andrey I Yaroshetskiy
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Natalia A Tsareva
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Zamira M Merzhoeva
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Natalia V Trushenko
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Galina V Nekludova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Ralph Theo Schermuly
- Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Sergey N Avdeev
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
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Avdeev SN, Nekludova GV, Tsareva NA, Yaroshetskiy AI, Merzhoeva ZM, Nuralieva GS, Trushenko NV. Pain, Swelling and Blue Discoloration of Right Hand in a COVID-19 Patient. Ann Emerg Med 2021; 77:650-657. [PMID: 34030779 PMCID: PMC7836820 DOI: 10.1016/j.annemergmed.2021.01.001] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Sergey N Avdeev
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Galina V Nekludova
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Natalia A Tsareva
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Andrey I Yaroshetskiy
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Zamira M Merzhoeva
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Galia S Nuralieva
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Natalia V Trushenko
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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12
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Avdeev SN, Yaroshetskiy AI, Tsareva NA, Merzhoeva ZM, Trushenko NV, Nekludova GV, Chikina SY. Noninvasive ventilation for acute hypoxemic respiratory failure in patients with COVID-19. Am J Emerg Med 2020; 39:154-157. [PMID: 33067061 PMCID: PMC7527350 DOI: 10.1016/j.ajem.2020.09.075] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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] [Received: 08/28/2020] [Revised: 09/21/2020] [Accepted: 09/26/2020] [Indexed: 01/08/2023] Open
Abstract
Aim Noninvasive ventilation (NIV) is known to reduce intubation in patients with acute hypoxemic respiratory failure (AHRF). We aimed to assess the outcomes of NIV application in COVID-19 patients with AHRF. Materials & methods In this retrospective cohort study, patients with confirmed diagnosis of COVID-19 and AHRF receiving NIV in general wards were recruited from two university-affiliated hospitals. Demographic, clinical, and laboratory data were recorded at admission. The failure of NIV was defined as intubation or death during the hospital stay. Results Between April 8 and June 10, 2020, 61 patients were enrolled into the final cohort. NIV was successful in 44 out of 61 patients (72.1%), 17 patients who failed NIV therapy were intubated, and among them 15 died. Overall mortality rate was 24.6%. Patients who failed NIV were older, and had higher respiratory rate, PaCO2, D-dimer levels before NIV and higher minute ventilation and ventilatory ratio on the 1-st day of NIV. No healthcare workers were infected with SARS-CoV-2 during the study period. Conclusions NIV is feasible in patients with COVID-19 and AHRF outside the intensive care unit, and it can be considered as a valuable option for the management of AHRF in these patients.
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Affiliation(s)
- Sergey N Avdeev
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
| | - Andrey I Yaroshetskiy
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Natalia A Tsareva
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Zamira M Merzhoeva
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Natalia V Trushenko
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Galina V Nekludova
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Svetlana Yu Chikina
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Abstract
The ultrasound method is a non-invasive and safe diagnostic method. Ultrasound examination (ultrasound) of the diaphragm allows you to conduct a direct study of its structure and function. Using stationary and portable ultrasound scanners, the study of the diaphragm can be carried out in specialized laboratories, in outpatient departments, in various departments of the clinic, including in intensive care units, in patients in different clinical conditions. Ultrasound of the diaphragm can be implemented on devices of different technical levels. Despite the fact that at present the diaphragm ultrasound method is not standardized, nevertheless, it provides clinically important information for solving various clinical studies, including when conducting dynamic observation.
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Affiliation(s)
- G V Nekludova
- Pulmonology Scientific Research Institute under Federal Medical and Biological Agency of Russsian Federation, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - S N Avdeev
- Pulmonology Scientific Research Institute under Federal Medical and Biological Agency of Russsian Federation, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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