The respiratory exercise significance in the olfaction restoration in the postcovid period

One of the pathognomonic COVID19 signs, occurring in 8598% of patients, is olfactory dysfunction, developing in the absence of pronounced nflammation and edema of the nasal mucosa. A promising medicine direction that helps restore microcirculation, increase blood oxygenation, improve metabolism and regenerate olfactory epithelial cells is the Nadi Shodhana breathing exercise technique. Objective: To assess the possibilities of using the pranayama technique as a method of restorative olfactory treatment in the postcovid period. Materials and methods: 79 persons aged 22 to 68 years with olfactory disturbances occurring at COVID19 and persisting in the postcovid period were examined. As a restorative treatment for olfactory disorders, the patients of the main group were offered a course of Nadi Shodhana breathing xercises, which is an alternate nostril breathing. Breathing training consisted of three such cycles performed three times a day at the same time for 5 days. The possibility of using the pranayama technique was assessed according to the visual analog scale. The control group consisted of 74 patients with olfactory disorders after COVID19 comparable in sex and age with the main group. Results: Olfactory disorders are characteristic of postCOVID patients. Using Nadi Shodhana breathing exercise course can significantly reduce the lfactory dysfunction level in this patient category. It was showen that the pranayama technique is more effective in people under 40 years of age. It was lso established that the olfaction restoration largely depends on the duration of the dysfunction period. Conclusion: The study results make it possible to recommend the using breathing exercises in patients underwent COVID19 to restore olfaction n the postCOVID period. Copyright: © 2018 Zhao Qi et al.

Higher procoagulatory potential but lower DIC score in COVID-19 ARDS patients compared to non-COVID-19 ARDS patients.

BACKGROUND: COVID-19 is a novel viral disease. Severe courses may present as ARDS. Several publications report a high incidence of coagulation abnormalities in these patients. We aimed to compare coagulation and inflammation parameters in patients with ARDS due to SARS-CoV-2 infection versus patients with ARDS due to other causes. METHODS: This retrospective study included intubated patients admitted with the diagnosis of ARDS to the ICU at Munich university hospital. 22 patients had confirmed SARS-CoV2-infection (COVID-19 group), 14 patients had bacterial or other viral pneumonia (control group). Demographic, clinical parameters and laboratory tests including coagulation parameters and thromboelastometry were analysed. RESULTS: No differences were found in gender ratios, BMI, Horovitz quotients and haemoglobin values. The median SOFA score, serum lactate levels, renal function parameters (creatinine, urea) and all inflammation markers (IL-6, PCT, CRP) were lower in the COVID-19 group (all: p < 0.05). INR (p < 0.001) and antithrombin (p < 0.001) were higher in COVID-19 patients. D-dimer levels (p = 0.004) and consecutively the DIC score (p = 0.003) were lower in this group. In ExTEM®, Time-to-Twenty (TT20) was shorter in the COVID-19 group (p = 0.047), these patients also had higher FibTEM® MCF (p = 0.005). Further, these patients presented with elevated antigen and activity levels of von-Willebrand-Factor (VWF). CONCLUSION: COVID-19 patients presented with higher coagulatory potential (shortened global clotting tests, increased viscoelastic and VWF parameters), while DIC scores were lower. An intensified anticoagulation regimen based on an individual risk assessment is advisable to avoid thromboembolic complications.