On the possibility of using succinate in hypoxia developing in covid-19

Aim. To provide a rationale for the feasibility of using the succinate-containing drugs to treat hypoxia associated with COVID-19 based on the analysis of experimental and clinical studies. Materials and methods. 84 Russian and international literature sources concerning the pathogenesis of COVID-19 and the pathogenetic role of succinate in the management of COVID-19 associated hypoxia, oxida-tive stress and diaphragmatic dysfunction were analyzed. The literature search was performed using Pubmed and ELIBRARY.ru databases. Results. The literature analysis showed that tissue hypoxia, triggering the pathomorphological cascade of events and resulting in multiple organ failure is a central element of COVID-19 pathogenesis. Experimental and clinical studies show the positive impact of tissue hypoxia correction using succinate in both adult patients and children with various conditions associated with acute respiratory failure. Conclusion. The literature data provide a rationale for using succinate-containing drugs in the treatment of severe COVID-19.

One hundred questionnaires from repurposed hospitals: With what forces and means did we fight the «second wave» of covid-19?

In November-December 2020, the Federation of Anesthesiologists and Reanimatologists has conducted a survey of intensive care units (ICU) in 100 hospitals re-profiled for the treatment of COVID-19. There were regional (n=44), city (n=31), district (n=13), inter-district (n=8) and federal (n=4) hospitals from 27 constituent entities of the Russian Federation. Capacity of 59 hospitals was less than 300 beds, 23 hospitals — over 500 beds, 18 hospitals — 300—500 beds. The number of ICU beds exceeded 10% of repurposed beds in 35 hospitals, 5—10% of ICU beds — in 51 hospitals, less than 5% — in 14 hospitals. There were 6—12 patients per one physician in 68 ICUs, less than 6 patients — in 12 ICUs, over 12 patients — in 20 ICUs. Also, there were 3-6 patients per a nurse in 69 ICUs, less than 3 patients — in 2 ICUs, over 6 patients — in 29 ICUs. Over 70% of the repurposed beds were provided with a networked oxygen supply in 61 hospitals, 50—70% — in 25 hospitals, less than 50% — in 14 hospitals. Oxygen flow rate over 10 l/min was provided in 70 hospitals, 5—10 l/min — in 28 hospitals, less than 5 l/min — in 2 hospitals. Over 80% of ICU beds are equipped with ventilators in 78 hospitals, 50—80% — in 15 hospitals, less than 50% — in 7 hospitals. Less than 5% of ventilators have been out of order throughout the pandemic in 62 ICUs, 5—10% — in 20 departments, over 10% — in 18 ICUs. High-flow oxygen therapy was not available in 48 ICUs, ultrasound — in 10 ICUs. ECMO was available only in 17 ICUs. If we consider the pandemic as a model of health system response to non-standard global challenges, these data are essential for critical analysis despite small sample size. © 2021, Media Sphera Publishing Group. All rights reserved.

Is there a connection between iron exchange and COVID-19?

The review analyzes possible epidemiological and molecular mechanisms responsible for hyperinflammation in patients with the severe course of COVID-19. Results: it highlights the similarities between this condition and hyperferritinemic syndrome which allows considering pathogenesis of COVID-19 with the direct involvement of iron metabolism. In the case of COVID-19 infection of moderate severity and especially in its severe forms, it is indicated to use of iron chelators and other methods of free iron elimination. © 2020 Messenger of Anesthesiology and Resuscitation. All rights reserved.