The features of the course of covid-19 in patients with respiratory allergic diseases

This literature review provides actual information about the features of the course of COVID-19 in patients with respiratory allergy. The main reviewed topics were respiratory tract damage, the use of antihistamines, stabilizers of mast cell membranes and inhaled corticosteroids in patients with bronchial asthma and allergic rhinitis during the COVID-19 pandemic. The review reflects the clinical recommendations of the international professional community such as GINA (Global Initiative for Asthma). © 2021 Ministry of Health. All rights reserved.

Post-Acute Respiratory Distress Syndrome Pulmonary Fibrosis and Pulmonary Artery Hypertension in Patients Affected by Severe COVID19

Rationale:Many patientswith COVID19 who develop acute respiratory distress syndrome (ARDS) survive the acute phase of the illness ,a substantial proportion die as a result of progressive pulmonary fibrosis.The evaluation of corellation between pulmonary fibrosis after ARDS and development of pulmonary hypertension(PH) in COVID19 patients is very interesting in term on management of pulmonary fibrosis for further prevention of PH.Objective:The aim of this study was to determine the impact of pulmonary fibrosis on development of pulmonary hypertension in COVID19 patients and possibility of use of antifibrotic drugs in such patients.Methods and measurements:It was randomized and controlled study which is included 68 survivors patients with pulmonary fibrosis after ARDS in outpatient settings of Medical University ,Baku city.In all patients have invastigated the 6 minute walk distance(6MWD) ,exersice desaturation,echocariography with further measurement of the pulmonary artery pressure by using RHC,CT scan of the lungs,and pulmonary lung functions(spirometry and DLco).Results:In 41 of 68 (60%)survivors was developed PH and the degree of pulmonary hypertension severity was depneding on the extention of fibrotic and interstitial changes in lung assessing by lung CT scan.In all patients with PH (median range was 40.25+-12.86 mmHg) the 6MWD was significantly less compared to non-PH patients(220+-54m vs 390+-62m;p<0.001);exersice desaturation was significantly lower in patient with PH (10+-4% vs 6+-2 %;p<0.001);lung function although was lower (FVC :43.8+-12.5 vs 60.1+-8.7;p<0.004);diffusing capacity of the lung was markedly lower(DLco:38.54+-10.44 vs 58.65+-11.82;p<0.001).Antifibrotic drug Pifenidone was used to in 14 patients swith pulmonary fibrosis and PH.After three moinths treatment with this drug there was significantly improvement of 6MWD(=0.01),lung function(<0.001),exersice desaturation(=0.01),extention of CT changes(=0.006), and pulmonary artery pressure(=0.004).Conclusion: Pulmonary fibrosis and related to its PH is common in survivors patients with COVID19 complicated with ARDS .After dicharge from hospitals all such patients have to assess regularly for presence of pulmonary hypertension and the level of PH will depends on the severity of extetion of the lung fibrosis. Antifibrotic drug pirfenidone is useful in terms of reducing extention of lung fibrosis ,improving lung function and decreasing pulmonary artery pressure.