Терапевтические возможности реабилитации пациентов, перенесших COVID-19, с остаточными изменениями легочной ткани

Игнатова Г.Л., Антонов В.Н. Терапевтические возможности реабилитации пациентов, перенесших COVID-19, с остаточными изменениями легочной ткани. Consilium Medicum. 2022;24(3):177–181.
DOI: 10.26442/20751753.2022.3.201427

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Ignatova GL, Antonov VN. Therapeutic possibilities of rehabilitation of patients who have undergone COVID-19 with residual changes in the lungs: A review. Consilium Medicum. 2022;24(3):177–181.
DOI: 10.26442/20751753.2022.3.201427

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Аннотация

В статье приводятся данные о механизмах формирования сохранения остаточных изменений поражения легочной ткани у пациентов с новой коронавирусной инфекцией COVID-19. Рассмотрены основные факторы риска, приводящие к формированию повреждения легочной ткани, такие как возраст, тяжесть заболевания, нахождение на искусственной вентиляции легких, курение, хронический алкоголизм. Представлены основные направления поиска антифибротических препаратов. Дано обоснование применения фармацевтического препарата Лонгидаза на основании экспериментальных и клинических исследований. Определены основные проблемы, с которыми сталкиваются врачи в период продолжающейся пандемии COVID-19. Рассмотрены схемы назначения препарата Лонгидаза у пациентов с легочным фиброзом после перенесенной новой коронавирусной инфекции.

Ключевые слова: COVID-19, остаточные изменения легочной ткани, Лонгидаза, бовгиалуронидаза азоксимер

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The article presents data on the mechanisms of formation of preservation of residual changes in lung tissue lesions in patients with a new coronavirus infection COVID-19. The main risk factors leading to the formation of lung tissue damage, such as age, severity of the disease, being on a ventilator, smoking, chronic alcoholism, are considered. The main directions of the search for antifibrotic drugs are presented. The rationale for the use of the pharmaceutical drug Longidaze is given, based on experimental and clinical studies. The main problems faced by doctors during the ongoing COVID-19 pandemic are identified. The schemes of administration of the drug Longidaze in patients with pulmonary fibrosis after a new coronavirus infection are considered.

Keywords: COVID-19, residual changes in lung tissue, Longidaze, bovhyaluronidase azoximer

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Список литературы

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1. (WHO) WHO, Coronavirus disease 2019 (COVID-19) situation report-98 27 April 2020, WHO Bull, 2020.
2. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). Available at: https://coronavirus.jhu.edu/map.html. Accessed: 04.02.2022.
3. Ojo AS, Balogun SA, Williams OT, Ojo OS. Pulmonary Fibrosis in COVID-19 Survivors: Predictive Factors and Risk Reduction Strategies. Pulm Med. 2020;2020:6175964. DOI:10.1155/2020/6175964
4. Zumla A, Hui DS, Azhar EI, et al. Reducing mortality from 2019-nCoV: hostdirected therapies should be an option. Lancet. 2020;395(10224):e35-6.
DOI:10.1016/s0140-6736(20)30305-6
5. Farooq S, Han S, Mohammad SA, Ammar H. Post-COVID-19 pulmonary fibrosis. QJM. 2021;114(9):655-6. DOI:10.1093/qjmed/hcab121
6. Zhang C, Wu Z, Li JW, et al. Discharge may not be the end of treatment: Pay attention to pulmonary fibrosis caused by severe COVID-19. J Med Virol. 2021;93(3):1378-86. DOI:10.1002/jmv.26634
7. Samarelli AV, Tonelli R, Marchioni A, et al. Fibrotic Idiopathic Interstitial Lung Disease: The Molecular and Cellular Key Players. Int J Mol Sci. 2021;22(16):8952. DOI:10.3390/ijms22168952
8. Liu J, Zheng X, Tong Q, et al. Overlapping and discrete aspects of the pathology and pathogenesis of the emerging human pathogenic coronaviruses SARS-CoV, MERS-CoV, and 2019-nCoV. J Med Virol. 2020;92(5):491-4. DOI:10.1002/jmv.25709
9. Rabieian R, Boshtam M, Zareei M, et al. Plasminogen Activator Inhibitor Type-1 as a Regulator of Fibrosis. J Cell Biochem. 2018;119(1):17-27. DOI:10.1002/jcb.26146
10. Guo Y, Yan B, Gui Y, et al. Physiology and role of PCSK9 in vascular disease: Potential impact of localized PCSK9 in vascular wall. J Cell Physiol. 2021;236(4):2333-51. DOI:10.1002/jcp.30025
11. Rousselle P, Montmasson M, Garnier C. Extracellular matrix contribution to skin wound re-epithelialization. Matrix Biol. 2019;75-76:12-26. DOI:10.1016/j.matbio.2018.01.002
12. Silva AC, Lobo JMS. Cytokines and Growth Factors. Adv Biochem Eng Biotechnol. 2020;171:87-113. DOI:10.1007/10_2019_105
13. Konopka KE, Nguyen T, Jentzen JM, et al. Diffuse alveolar damage (DAD) resulting from coronavirus disease 2019 Infection is Morphologically Indistinguishable from Other Causes of DAD. Histopathology. 2020;77(4):570-8. DOI:10.1111/his.14180
14. Sgalla G, Iovene B, Calvello M, et al. Idiopathic pulmonary fibrosis: pathogenesis and management. Respir Res. 2018;19(1):32. DOI:10.1186/s12931-018-0730-2
15. Xu X, Han M, Li T, et al. Effective treatment of severe COVID-19 patients with tocilizumab. ChinaXiv. 2020; published online March 5. DOI:10.12074/202003.00026
16. George PM, Wells AU, Jenkins RG. Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy. Lancet Respir Med. 2020;8(8):807-15.
DOI:10.1016/S2213-2600(20)30225-3
17. Richeldi L, Collard HR, Jones MG. Idiopathic pulmonary fibrosis. Lancet. 2017;389(10082):1941-52. DOI:10.1016/S0140-6736(17)30866-8
18. Hui DSC, Zumla A. Severe Acute Respiratory Syndrome: Historical, Epidemiologic, and Clinical Features. Infect Dis Clin North Am. 2019;33(4):869-89. DOI:10.1016/j.idc.2019.07.001
19. Nikolich-Zugich J, Knox KS, Rios CT, et al. SARS-CoV-2 and COVID-19 in older adults: what we may expect regarding pathogenesis, immune responses, and outcomes. Geroscience. 2020;42(2):505-14. DOI:10.1007/s11357-020-00186-0
20. Temporary guidelines "Prevention, diagnosis and treatment of new coronavirus infection (COVID-19)" version 10. (08.02.2021). Available at: https://minzdrav.gov.ru/ministry/med_covid19. Accessed: 01.02.2022 (in Russian).
21. Grasselli G, Pesenti A, Cecconi M. Critical care utilization for the COVID-19 outbreak in Lombardy, Italy. JAMA. 2020;323(16):1545. DOI:10.1001/jama.2020.4031
22. Vardavas CI, Nikitara K. COVID-19 and smoking: a systematic review of the evidence. Tob Induc Dis. 2020;18:20. DOI:10.18332/tid/119324
23. Chick J. Alcohol and COVID-19. Alcohol Alcohol. 2020;55(4):341-2. DOI:10.1093/alcalc/agaa039
24. Novikova LN, Zakharova AS, Dzadzua DV, et al. Effects of Longidaza in Patients With Idiopathic Pulmonary Fibrosis. Doktor.Ru. 2011;6:50-4 (in Russian).
25. Longidase: an enzyme preparation of complex action. Available at: https://www.longidaza.ru/pneumofibrosis/ Accessrd: 01.02.2022 (in Russian).
26. Nekrasov AV, Ivanova AS, Puchkova NG. Principles of development of Longidase, a pharmacological agent for the treatment of diseases accompanied by connective tissue hyperplasia. XII Russian National Congress "Man and Medicine" (abstracts). 2005; p. 688 (in Russian).
27. Nekrasov AV, Ivanova AS, Puchkova NG. Longidase – a modern approach in the treatment of diseases accompanied by connective tissue hyperplasia. Signatura. 2006;1:43-52 (in Russian).

Авторы

Г.Л. Игнатова*, В.Н. Антонов

ФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава России, Челябинск, Россия
*iglign@mail.ru

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Galina L. Ignatova*, Vladimir N. Antonov

South Ural State Medical University, Chelyabinsk, Russia
*iglign@mail.ru

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