ABSTRACT
Post-COVID-19 syndrome is an important challenge for modern medicine, requiring the involvement of different health professionals. This multidisciplinary approach is underpinned by the variety of clinical manifestations and the need for comprehensive rehabilitation of patients, including children and adolescents. The review highlights clinical manifestations of post-COVID-19 syndrome. Currently, a symptom management approach has been established for improving post-COVID-19 conditions. Also, appropriate lifestyle changes, such as adequate rest and sleep hygiene, may be useful. Rehabilitation interventions for post-COVID-19 syndrome may include physiotherapy exercises and various psychotherapy techniques. Since mitochondrial dysfunction, energy supply deficit, oxidative stress, endothelial dysfunction, and immune dysregulation profoundly impact the pathogenesis of post-COVID-19 syndrome, the use of L-carnitine which plays a crucial role in energy production, is considered as a promising method in the management of such patients. L-carnitine may have cardioprotective, anabolic and neuroprotective effects. The authors present a case report of post-COVID-19 condition in their own patient, a 4-year-old boy who survived multisystem inflammatory syndrome. As a result of combination therapy, including L-carnitine, the patient's sense of well-being significantly improved: he had no complaints, the muscle weakness and asthenization became less pronounced, and his spirits rose. The described clinical case illustrated the effectiveness of using L-carnitine in the combined therapy of post-COVID-19 syndrome in children . © 2022, Meditsina-Inform LLC. All rights reserved.
ABSTRACT
Since the beginning of the pandemic, repeated attempts have been made to develop etiotropic therapy for a novel coronavirus infection. Hydroxychloroquine, lopinavir/ritonavir, etc. derivatives were used as antiviral agents, however, they demonstrated a low efficiency and an insufficient safety. In this connection, other groups of drugs with a more effective and safe pharmacological profile are currently being actively used. The aim of the study was to analyze the literature references on the efficacy and safety of antiviral drugs for the COVID-19 treatment.Materials and methods. When searching for the materials for the review article writing, such databases as PubMed, Google Scholar, e-Library were used. The search was carried out on publications for the period from January 2020 to September 2022. The key queries were: COVID-19, etiotropic therapy;immunological drugs;antiviral drugs;interferons.Results. Currently, there are various degrees of effective etiotropic drugs for the treatment of COVID-19 patients. The review has considered a few groups of drugs that are of interest from the point of view of etiotropic therapy: immunological drugs (anticovid plasma, the drugs based on antiviral antibodies, the drugs of recombinant interferons-alpha 2 and-beta 1, as well as interferon inducers, i.e., the drugs based on double-stranded RNA sodium salt, and others);drugs that block the penetration of the virus into the cell (umifenovir);the drugs that disrupt the process of the viral replication (favipiravir, remdesivir, molnupiravir, nirmatrelvir/ritonavir).Conclusion. Synthetic antivirals, in particular favipiravir, molnupiravir, remdesivir, and nirmatrelvir/ritonavir, have the largest evidence base for their efficacy and safety. The search for new effective and safe etiotropic drugs for the treatment of COVID-19, as well as the collection and analysis of post-registration data on the drugs already used in clinical practice, continues.
ABSTRACT
Since the beginning of the pandemic, repeated attempts have been made to develop etiotropic therapy for a novel coronavirus infection. Hydroxychloroquine, lopinavir/ritonavir, etc. derivatives were used as antiviral agents, however, they demonstrated a low efficiency and an insufficient safety. In this connection, other groups of drugs with a more effective and safe pharmacological profile are currently being actively used. The aim of the study was to analyze the literature references on the efficacy and safety of antiviral drugs for the COVID-19 treatment. Materials and methods. When searching for the materials for the review article writing, such databases as PubMed, Google Scholar, e-Library were used. The search was carried out on publications for the period from January 2020 to September 2022. The key queries were: COVID-19, etiotropic therapy;immunological drugs;antiviral drugs;interferons. Results. Currently, there are various degrees of effective etiotropic drugs for the treatment of COVID-19 patients. The review has considered a few groups of drugs that are of interest from the point of view of etiotropic therapy: immunological drugs (anticovid plasma, the drugs based on antiviral antibodies, the drugs of recombinant interferons-alpha2 and -beta1, as well as interferon inducers, i.e., the drugs based on double-stranded RNA sodium salt, and others);drugs that block the penetration of the virus into the cell (umifenovir);the drugs that disrupt the process of the viral replication (favipiravir, remdesivir, molnupiravir, nirmatrelvir/ritonavir). Conclusion. Synthetic antivirals, in particular favipiravir, molnupiravir, remdesivir, and nirmatrelvir/ritonavir, have the largest evidence base for their efficacy and safety. The search for new effective and safe etiotropic drugs for the treatment of COVID-19, as well as the collection and analysis of post-registration data on the drugs already used in clinical practice, continues. Copyright © 2022 Volgograd State Medical University, Pyatigorsk Medical and Pharmaceutical Institute. All rights reserved.