First experience of using casirivimab/imdevimab in COVID-19 in the Russian Federation.

The lack of effective etiotropic therapy is a serious challenge in the treatment of patients with COVID-19. The recent emergence of a new class of medications neutralizing monoclonal antibodies against the SARS-CoV-2 spike protein allows to partially solve this problem. This article presents a clinical case of a patient with an increased risk of COVID-19 complications (paroxysmal atrial fibrillation, atherogenic dyslipidemia, impaired carbohydrate tolerance) who was treated with 600 mg casirivimab and 600 mg imdevimab by intravenous infusion. A significant improvement in the patient's well-being was noted within the first 24 hours: normalization of body temperature, stool, reduction of weakness, disappearance of arthralgia and myalgia. After 48 hours, a negative test result for SARS-CoV-2 RNA was obtained, which altogether made it possible to state the recovery. There were no adverse events during and after therapy. The casirivimab and imdevimab monoclonal antibody combination may be considered as a promising etiotropic treatment for COVID-19. Copyright © 2022, Dynasty Publishing House.

First experience of using casirivimab/imdevimab in COVID-19 in the Russian Federation

The lack of effective etiotropic therapy is a serious challenge in the treatment of patients with COVID-19. The recent emergence of a new class of medications neutralizing monoclonal antibodies against the SARS-CoV-2 spike protein allows to partially solve this problem. This article presents a clinical case of a patient with an increased risk of COVID-19 complications (paroxysmal atrial fibrillation, atherogenic dyslipidemia, impaired carbohydrate tolerance) who was treated with 600 mg casirivimab and 600 mg imdevimab by intravenous infusion. A significant improvement in the patient's well-being was noted within the first 24 hours: normalization of body temperature, stool, reduction of weakness, disappearance of arthralgia and myalgia. After 48 hours, a negative test result for SARS-CoV-2 RNA was obtained, which altogether made it possible to state the recovery. There were no adverse events during and after therapy. The casirivimab and imdevimab monoclonal antibody combination may be considered as a promising etiotropic treatment for COVID-19. Copyright © 2022, Dynasty Publishing House.

Abdominal Pain as First Manifestation of New Coronavirus Infection COVID-19

Aim. A clinical case description of abdominal pain as the first manifestation of the new coronavirus infection COVID-19. Key points. A 80-yo patient was admitted to a surgical unit with growing epigastric pain and fever. Acute abdomen was diagnosed negative, chest computed tomography (CT) revealed two-sided ground-glass opacity, discharged. Hospitalised in a severe condition with presumed new coronavirus infection at the Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology, the Sechenov University. COVID-19 agent RNA was detected with PCR. Diagnosis: new coronavirus infection COVID-19, severe degree, community-acquired bilateral polysegmental pneumonia, severe degree, respiratory failure type 1. Therapy with azithromycin, hydroxychloroquine, enoxaparin subcutaneously. Respiratory distress increased on day 7 at the clinic, with 50-75% lesion in chest CT, which required ordering of dexamethasone intravenously, with a subsequent dose reduction and withdrawal, and levofloxacin. Upon the treatment, abdominal pain was eliminated, body temperature normalised and the volume of affected parenchyma decreased. The patient was discharged for outpatient care. Patients with SARS-CoV-2 may have abdominal complaints that may require exclusion of an acute surgical pathology. These circumstances inevitably waste time of assisting patients suffering the new coronavirus infection and worsen the prognosis due to severe pneumonia.Conclusion. A gastroenterological debut of the new coronavirus infection with the main symptoms of abdominal pain has been presented. The currently continued unfavourable epidemiological situation demands diagnosis for SARSCoV-2 and COVID-19-associated pneumonia upon the exclusion of peritoneal symptoms even in absence of respiratory complaints. Цель. Представить клиническое наблюдение новой коронавирусной инфекции COVID-19, первым проявлением которой была боль в животе.Основные положения. 80-летний пациент с нарастающей болью в эпигастрии и лихорадкой госпитализирован в хирургическое отделение, где исключен «острый живот», при компьютерной томографии (КТ) органов грудной клетки выявлены изменения по типу матового стекла двусторонней локализации, выписан. С подозрением на новую коронавирусную инфекцию госпитализирован в тяжелом состоянии в Клинику пропедевтики внутренних болезней, гастроэнтерологии и гепатологии имени В. Х. Василенко Сеченовского Университета. Методом полимеразной цепной реакции (ПЦР) выделена РНК возбудителя COVID-19. Установлен диагноз: новая коронавирусная инфекция COVID-19, тяжелой степени, внебольничная двусторонняя полисегментарная пневмония тяжелой степени, дыхательная недостаточность 1-й степени. Начата терапия азитромицином, гидроксихлорохином, эноксапарином подкожно. На 7-е сутки пребывания в клинике стала нарастать дыхательная недостаточность, при КТ органов грудной клетки прогрессирование - объем поражения составил 50-75 %, что потребовало назначения дексаметазона внутривенно с последующим снижением дозы и отменой, левофлоксацина. На фоне проводимой терапии боль в животе купирована, температура тела нормализовалась, уменьшился объем пораженной паренхимы. Пациент выписан на амбулаторное долечивание. Среди жалоб больных с SARS-CoV-2 - боль в животе, иногда требующая исключения острой хирургической патологии. Эти обстоятельства неизбежно приводят к потере времени оказания помощи пациентам с новой коронавирусной инфекцией и ухудшают прогноз из-за развития тяжелой пневмонии. Заключение. Представлен гастроэнтерологический вариант клинического дебюта новой коронавирусной инфекции, главным симптомом которого была абдоминальная боль. В условиях сохраняющейся неблагоприятной эпидемиологической обстановки после исключения перитонеальных симптомов необходимо обследование на наличие SARS-CoV-2, а также пневмонию при COVID-19 даже при отсутствии респираторных жалоб.

A new understanding of health and a healthy lifestyle: A holistic and existential-humanistic approach

Confronting current challenges, especially the COVID-19 pandemic, and striving to create a hopeful future – an era of life and active longevity – determine an urgent global need to implement the principles of humanity and create a new understanding of health and a healthy lifestyle, correlated with a fundamental respect for the dignity of life. Based on the idea of the relationship between health and a healthy lifestyle through the inherent value of the individual, embodying the intrinsic value of life, basic contradictions were identified: the contradiction between the understanding of health as a state of physical, mental, and social well-being and a healthy lifestyle, which focuses on the physical aspect of health, omitting the spiritual component;the contradiction between the numerous proposed strategies for a healthy lifestyle and the lack of a fundamental goal that expresses its value-semantic result. In the aspect of philosophical-methodological ideas about health and a healthy lifestyle, their essential binding element was defined – the good that embodies the result of the ultimate aspiration of a person. The resolution of the basic contradictions revealed in the analysis of philosophical-methodological ideas about health and a healthy lifestyle made it possible to present new, clearer definitions of health and a healthy lifestyle: health is a good that allows a person to embody the value of life in a specific reality;a healthy lifestyle is an individual way of life, which is based on a person’s respect for the dignity of life and creates a benefit to him/herself and others, gaining the joy of existence. A new concept of a healthy lifestyle was developed, which defined the joy of existence as its fundamental goal, implemented by a person through the creation of good for oneself and others in a system of socio-cultural and natural interaction based on respect for the dignity of life. © 2020 LLC Ecological Help. All rights reserved.