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Objective. To assess the factors influencing mean length of hospitalisation (LOH) and treatment outcomes in patients with coro-navirus disease 2019 (COVID-19) between January 31, 2020 and June 10, 2021. Material and methods. We analyzed the results of specialized medical care in patients with COVID-19. Medical, gender and anam-nestic factors influencing treatment outcomes were chosen for analysis. The follow-up unit was a record with data about a patient with COVID-19. We harvested data from the Federal Register of Persons with COVID-19 developed in accordance with the De-cree of the Government of the Russian Federation dated March 31, 2020 No. 373 "On Approval of Interim Rules for Recording Information in order to Prevent the Spread of a New Coronavirus Infection (COVID-19)>>. Results. A retrospective cohort study of data from the Federal Register of patients with COVID-19 involving more than 3 million patients (40.7% men and 59.3% women) revealed the highest incidence of disease in men aged 60-64, 55-59 and 35-39 years, as well as in women aged 60-64, 55-59 and 50-54 years. There was no significant correlation between age and LOH (linear correlation coefficient (r-Pearson) for men 0.021 (p<0.05), for women 0.0124 (p<0.05)). Weighted mean LOH in all age groups was 14.7 days for men (standard deviation (SD) 5.6 days) and 15.7 days for women (SD 5.2 days). Thirty-seven comorbidities/ complications of the underlying disease worsened prognosis regarding LOH in patients with severe and extremely severe COV-ID-19 compared to course of disease without comorbidities or complications. Analysis of impact of COVID-19 severity on mortality revealed strong direct relationship between these signs (r-Pearson for men 0.830 (p<0.0001), for women 0.799 (p<0.0001). Patients with moderate COVID-19 died 89.4 times more often compared to those with mild infection. Severe patients died 20.5 times more often compared to patients with moderate severity of disease. Risk of mortality from COVID-19 is 11.3% higher in patients with extremely severe infection than in patients with severe disease. Conclusion. Our data on mean LOH differentiated by sex and age, as well as comparison of this indicator with comorbidities and severity of COVID-19, can be used for modeling of hospital workload for a stochastic flow of patients whose parameters are com-parable with data of patients analyzed in this study.Copyright © 2022, Media Sphera Publishing Group. All rights reserved.
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Background. The pandemic of novel coronavirus infection (NCI) COVID-19 is accompanied by a high risk of thrombosis and bleeding. The debate regarding the choice of dose of anticoagulant therapy in severe patients with NCI is ongoing at present. Objective: to assess coagulation parameters and identify risk factors in patients with severe COVID-19. Patients/Methods. Out of 370 patients with NCI COVID-19 treated in Ryazan covid hospitals in 2021, 173 (46.8%) patients with severe coronavirus infection were included in the retrospective study. Risk factors, the frequency of thrombotic complications and bleeding, laboratory parameters of hemostasis and inflammation (general blood analysis, blood biochemistry, coagulogram), dose variants of anticoagulant therapy (preventive, intermediate and therapeutic doses) were accessed. Results. Among 173 patients with severe COVID-19, 98 (56.7%) persons recovered, and 75 (43.3%) patients died. In non-survivors vs. survivors, hypertension was more often observed — in 64 (85.3%) cases (p = 0.043), as well as obesity — in 8 (50.7%) cases (p = 0.024) and type 2 diabetes mellitus — in 34 (45.3%) cases (p = 0.022), therapeutic dosage of anticoagulants was used more often (58.6% of cases). C-reactive protein (CRP) level on admission was significantly higher in non-survivors vs. survivors — 117.3 (185–356) mg/L vs. 90.4 (1.2–301.0) mg/L (p = 0.033) as well as fibrinogen content — 6.3 (1.3–10.0) g/L vs. 3.6 (1.1–12.0) g/L (p = 0.004). In patients with lethal outcome, pulmonary embolism (PE) without a source in the lower extremities was determined more often than in patients with favorable outcome — 10 (13.3%) vs. 0 (0%) cases (p = 0.002). Isolated deep vein thrombosis (DVT) occurred only in patients with favorable outcome. The analysis of hemorrhagic complications revealed that the frequency of major bleeding was higher among non-survivors vs. survivors — 7 (9.3%) vs. 2 (2.04%) cases (p = 0.032). Conclusions. The use of therapeutic doses of anticoagulants did not reduce the mortality rate in severe patients with NCI and was accompanied by PE development with and without a source in the lower extremities in 15 (20%) cases. High levels of CRP, fibrinogen, D-dimer, and low platelet count are predictive laboratory markers of unfavorable outcome in patients with severe NCI. © Kalinin R.E., Suchkov I.A., Agapov A.B., Mzhavanadze N.D., Maksaev D.A., Chobanyan A.A., 2022 © Gemostaz i Reologia LLC, 2022.
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Background. COVID-19 is a widespread, important, and frequently fatal disease, considered a risk factor for the development and progression of other pathologies. One of the most common associated conditions is stroke. Objective: to identify the patterns of occurrence and mechanisms of ischemic stroke (IS) development under novel coronavirus infection COVID-19. Patients/Methods. The prospective study included 80 individuals: 20 COVID-19 patients with subsequent IS development (main group);40 COVID-19 patients without cerebrovascular accident (comparison group);20 healthy volunteers (control group). Concen-trations of fibrinogen, antithrombin III, D-dimer, von Willebrand factor (vWF), C-reactive protein (CRP), matrix metalloproteinase-2 (MMP-2), cytokines (interleukin, IL) — IL-6, IL-8, IL-10, tumor necrosis factor-alpha (tumor necrosis factor-alpha, TNF-α) were accessed in peripheral blood. The study was carried out from November 2020 to February 2021. The primary endpoint of the study was IS development in COVID-19 patients. Results. In 70% patients of the main group a stroke developed by the end of the second week from the infection onset. The main risk factor in 12 (57%) COVID-19 patients with an unfavorable stroke course and subsequent development of multiple organ failure syndrome (MOFS) was a high comorbidity with various forms of circulatory system pathology. All 12 patients with IS and MOFS (100%) showed a statistically significant changes in many clinical and laboratory parameters by the end of the first day after admission to the hospital: they had arterial hypertension (100%), tachycardia (80%), significant increased blood levels of D-dimer (83%), vWF (75%), IL-10 (92%), TNF-α (92%), CRP (100%), MMP-2 (100%). Conclusions. COVID-19 and high comorbidity with various forms of circulatory system pathology are 2 significant risk factors for both the occurrence and adverse course of stroke and its outcomes. Arterial hypertension, increased blood levels of D-dimer, vWF, IL-10, TNF-α, CRP and MMP-2 are the early predictors of acute MOFS development in more than 75% of COVID-19 patients with stroke. © Kabaeva E.N., Litvitskiy P.F., Artyukov O.P., Tushova K.A., Nozdryukhina N.V., Ershov A.V., 2022
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Introduction. Today, two years after the first outbreak of the novel coronavirus infection (NCI) COVID-19, there is still insufficient data to fully assess risks and pattern of the course of this infectious disease in pregnant women. Aim(s): to conduct a comparative analysis of perinatal pregnancy outcomes as well as clinical and laboratory data in COVID-19 patients at the time of delivery and those suffering from the disease during pregnancy. Materials and Methods. A retrospective comparative study was carried out after analyzing pregnancy and childbirth histories in 191 women admitted for delivery in three obstetric medical organizations of Saint Petersburg in the years 2020-2021. Perinatal outcomes of pregnancy as well as clinical and laboratory data in patients suffering from COVID-19 during pregnancy were analyzed: Group 1-57 patients with asymptomatic and mild form of verified COVID-19;Group 2-50 patients with COVID-19 of moderate and severe course;Group 3-52 patients who underwent COVID-19 in the third trimester of pregnancy. Group 4 (control) consisted of 32 women lacking COVID-19. Results. Comparing delivery outcomes in Group 1 vs. Group 2 revealed a significantly higher rate of urgent deliveries - 54 (94.7 %) and 38 (76.0 %) (chi2 = 7.76) respectively, as well as a significantly lower number of premature births - 3 (5.3 %) and 12 (24.0 %) (chi2 = 7.76) respectively. Comparison of Group 1 vs. Group 3 showed significantly fewer natural births - 33 (57.8 %) and 42 (80.8 %) (chi2 = 6.63) respectively, but a greater rate of caesarean section - 24 (42.0 %) and 10 (19.2 %) (chi2 = 6.63). Comparison of Group 1 vs. Group 4 revealed a significantly higher number of women with acute and progressive fetal hypoxia (fetal distress) - 16 (28.1 %) and 2 (6.3 %) (chi2 = 6.05) respectively. These data allow us to state about an impact of the severity of infectious process SARS-CoV-2-caused disease and its timeframe during pregnancy on the timing and method of delivery. No significant data were obtained that might allow to state that the infectious process directly caused increased rate of premature birth in pregnant women with moderate and severe COVID-19. At hospital admission and discharge, patients with mild and asymptomatic COVID-19 were significantly less likely to have neutrophilia - 5 (8.8%) and 42 (84.0%) (chi2 = 61.2;p < 0.001) respectively, increased aspartate aminotransferase - 4 (7.0 %) and 38 (76.0 %) (chi2 = 53.15;p < 0.001), lactate dehydrogenase (LDH) - 0 (0.0 %) and 12 (24.0 %) (chi2 = 15.41;p < 0.001), C-reactive protein (CRP) - 6 (10.5 %) and 49 (98.0 %) (chi2 = 81.58;p < 0.001), creatinine reduction - 0 (0.0 %) and 11 (22.0 %) (chi2 = 13.98;p < 0.001) respectively. In groups with severe, mild and asymptomatic COVID-19, a strong direct correlation was established the CRP level and leukocyte count, between level of serum CRP and alanine aminotransferase;a less noticeable relationship was observed between serum CRP and LDH concentrations, CRP and total protein level. Conclusion. It was shown that no specific effect of SARS-CoV-2 infection was exerted on majority of parameters related to normal course of labor, as well as on condition of neonates born to patients with COVID-19 of varying severity. In patients with COVID-19 at the time of delivery, changes in clinical and laboratory parameters corresponded to the disease severity. Copyright © 2022 Rostovskii Gosudarstvennyi Meditsinskii Universitet. All rights reserved.
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Introduction. Today, two years after the first outbreak of the novel coronavirus infection (NCI) COVID-19, there is still insufficient data to fully assess risks and pattern of the course of this infectious disease in pregnant women. Aim(s): to conduct a comparative analysis of perinatal pregnancy outcomes as well as clinical and laboratory data in COVID-19 patients at the time of delivery and those suffering from the disease during pregnancy. Materials and Methods. A retrospective comparative study was carried out after analyzing pregnancy and childbirth histories in 191 women admitted for delivery in three obstetric medical organizations of Saint Petersburg in the years 2020-2021. Perinatal outcomes of pregnancy as well as clinical and laboratory data in patients suffering from COVID-19 during pregnancy were analyzed: Group 1-57 patients with asymptomatic and mild form of verified COVID-19;Group 2-50 patients with COVID-19 of moderate and severe course;Group 3-52 patients who underwent COVID-19 in the third trimester of pregnancy. Group 4 (control) consisted of 32 women lacking COVID-19. Results. Comparing delivery outcomes in Group 1 vs. Group 2 revealed a significantly higher rate of urgent deliveries - 54 (94.7 %) and 38 (76.0 %) (chi2 = 7.76) respectively, as well as a significantly lower number of premature births - 3 (5.3 %) and 12 (24.0 %) (chi2 = 7.76) respectively. Comparison of Group 1 vs. Group 3 showed significantly fewer natural births - 33 (57.8 %) and 42 (80.8 %) (chi2 = 6.63) respectively, but a greater rate of caesarean section - 24 (42.0 %) and 10 (19.2 %) (chi2 = 6.63). Comparison of Group 1 vs. Group 4 revealed a significantly higher number of women with acute and progressive fetal hypoxia (fetal distress) - 16 (28.1 %) and 2 (6.3 %) (chi2 = 6.05) respectively. These data allow us to state about an impact of the severity of infectious process SARS-CoV-2-caused disease and its timeframe during pregnancy on the timing and method of delivery. No significant data were obtained that might allow to state that the infectious process directly caused increased rate of premature birth in pregnant women with moderate and severe COVID-19. At hospital admission and discharge, patients with mild and asymptomatic COVID-19 were significantly less likely to have neutrophilia - 5 (8.8%) and 42 (84.0%) (chi2 = 61.2;p < 0.001) respectively, increased aspartate aminotransferase - 4 (7.0 %) and 38 (76.0 %) (chi2 = 53.15;p < 0.001), lactate dehydrogenase (LDH) - 0 (0.0 %) and 12 (24.0 %) (chi2 = 15.41;p < 0.001), C-reactive protein (CRP) - 6 (10.5 %) and 49 (98.0 %) (chi2 = 81.58;p < 0.001), creatinine reduction - 0 (0.0 %) and 11 (22.0 %) (chi2 = 13.98;p < 0.001) respectively. In groups with severe, mild and asymptomatic COVID-19, a strong direct correlation was established the CRP level and leukocyte count, between level of serum CRP and alanine aminotransferase;a less noticeable relationship was observed between serum CRP and LDH concentrations, CRP and total protein level. Conclusion. It was shown that no specific effect of SARS-CoV-2 infection was exerted on majority of parameters related to normal course of labor, as well as on condition of neonates born to patients with COVID-19 of varying severity. In patients with COVID-19 at the time of delivery, changes in clinical and laboratory parameters corresponded to the disease severity. Copyright © 2022 Rostovskii Gosudarstvennyi Meditsinskii Universitet. All rights reserved.
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Objective - This article aims to assess parameters of myocardial electrical instability and arrhythmic events in patients after myocardial infarction (MI), with and without ST-segment elevation, comorbid/noncomorbid with a novel coronavirus infection (COVID-19) using a long-term electrocardiographic (ECG) monitoring. Methods - The study included 64 subjects: 25 (39%) patients with MI comorbid with COVID-19 (MI+C group) and 39 (61%) patients with MI noncomorbid with a novel coronavirus infection (MI group). The mean age of patients was 54.3+/-6.8 years. A long-term ECG monitoring for 97.4 (95% CI 77.9-115.2) hours was performed with Astrocard-Telemetry system (Meditek JSC, Russia), starting from the 4th day of MI. Rhythm and conduction disorders, along with ischemic episodes were recorded;an analysis of ventricular late potentials, heart rate turbulence, and QT dispersion was carried out. Results - There were no differences in the frequency of delayed afterdepolarizations in MI and MI+C groups: 15-28% and 18-33% of patients, respectively. An analysis of turbulence parameters did not reveal statistically significant differences between the groups. Such arrhythmic events as frequent supraventricular extrasystole and life-threatening arrhythmias (ventricular extrasystole of grade 4A and higher sensu B. Lown and M. Wolf) were recorded significantly more often in the MI+C group than in the MI group: 48% vs. 20.5% (p=0.021) and 24% vs. 5.1% (p=0.026), respectively. Conclusion - The novel coronavirus infection (COVID-19) exacerbates myocardial electrophysiological heterogeneity in the acute cardiovascular event and is associated with an increase in clinically significant arrhythmic events. Copyright © 2022, Russian Open Medical Journal.
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Based on available publications, the article systematizes information about some forms of lesions of the central nervous system (CNS), their pathogenesis and clinical manifestations in the case of COVID-19. The risk factors, mechanisms of development, diagnostic approach, and the age characteristics of patients with neurological complications of COVID-19 are discussed. The specific mechanisms of the neuroinvasiveness and neurovirulence of the SARS-CoV-2 virus, regardless of the age of patients and the presence of risk factors, lead to systemic damage to the endothelium of small-caliber vessels, generalized thrombovasculitis, and an increased risk of ischemic and hemorrhagic strokes. At the same time, the most vulnerable category is elderly and senile patients with cardiovascular and metabolic disorders (arterial hypertension, obesity, diabetes mellitus), which sharply worsen treatment outcomes. The clinical experience accumulated during the COVID-19 pandemic indicates the development of the following most frequent post-covid neurological complications and consequences in mainly elderly and senile patients: cranial mononeuropathies, chemosensory dysfunction, encephalopathy, insomnia, stroke, acute meningoencephalitis, acute disseminated encephalomyelitis, acute polyneuropathy Guillain-Barre syndrome, and transverse myelitis. The benefits of vaccination against COVID-19 far outweigh the risks of possible post-vaccination neurological complications and consequences, especially in elderly and senile patients.
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Aim of the study – comprehensive assessment of factors harming the newborns of mothers in COVID-19. The definition of perinatal and neonatal outcomes in newborns exposed to SARS-CoV-2. Material and methods. A retrospective study was conducted in the Department of Neonatal Intensive Care (3rd level) of the Regional Clinical Hospital #2. The ward is a separate division of the Perinatal Center (Ministry of Health of the Krasnodar Territory). Ninety-two newborns were included in the study. The gestational age was between the 22nd and 41st weeks of gestation (average 35 weeks). Mothers have confirmed new coronavirus infection or in the group of risk. Results and discussion. Clinical experience received in the health management of newborns has shown that there were different criteria of disadaptation in the early neonatal period. Children have had a high incidence of respiratory disorders and can require respiratory therapy, early hemodynamic failure, and a tendency to hemorrhagic complications. A significant proportion of them had the signs of infectious diseases specific to the perinatal period. Babies from mothers with severe COVID-19 had at high risk of severe perinatal asphyxia. Adverse neonatal outcomes in newborns were associated with severe prematurity or the presence of co-morbidities. Conclusion. The differential diagnostics of the new coronavirus infection in a newborn without the specific clinical manifestations and the violence of adaptation in the early neonatal period will require the development plan of the routing and assistance for the third-level institutions. © 2022 by the Author(s).
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Based on the available publications, the article systematizes information about some forms of lesions of the central nervous system (CNS), their pathogenesis, and clinical manifestations in COVID-19. Risk factors, developmental mechanisms, diagnostic approach, age characteristics of patients with neurological complications of COVID-19 are discussed. The specific mechanisms of the neuroinvasiveness and neurovirulence of the SARS-CoV-2 virus, regardless of the age of patients and the presence of risk factors, lead to systemic damage to the endothelium of small-caliber vessels, generalized thrombovasculitis, and an increased risk of ischemic and hemorrhagic strokes. At the same time, the most vulnerable category is elderly and senile patients with cardiovascular and metabolic disorders (arterial hypertension, obesity, diabetes mellitus), which sharply worsen treatment outcomes. The clinical experience accumulated during the COVID-19 pandemic indicates the development of the following most frequent post-covid neurological complications and consequences in mainly elderly and senile patients: cranial mononeuropathies, chemosensory dysfunction, encephalopathy, insomnia, stroke, acute meningoencephalitis, acute disseminated encephalomyelitis syndrome acute polyneuropathy Guillain-Barré, transverse myelitis. The benefits of vaccination against COVID-19 far outweigh the risks of possible post-vaccination neurological complications and consequences, especially in elderly and senile patients.
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BACKGROUND: The newly identified betacoronavirus SARS-CoV-2 is the causative pathogen of the 2019 coronavirus disease (COVID-19), which has killed more than 4.5 million people. SARS-CoV-2 causes severe respiratory distress syndrome by targeting the lungs and also induces myocardial damage. Shenshao Ningxin Yin (SNY) has been used for more than 700 years to treat influenza. Previous randomized controlled trials (RCTs) have demonstrated that SNY can improve the clinical symptoms of viral myocarditis, reverse arrhythmia, and reduce the level of myocardial damage markers. METHODS: This work uses a rational computational strategy to identify existing drug molecules that target host pathways for the treatment of COVID-19 with myocarditis. Disease and drug targets were input into the STRING database to construct proteinÉprotein interaction networks. The Metascape database was used for GO and KEGG enrichment analysis. RESULTS: SNY signaling modulated the pathways of coronavirus disease, including COVID-19, Ras signaling, viral myocarditis, and TNF signaling pathways. Tumor necrosis factor (TNF), cellular tumor antigen p53 (TP53), mitogen-activated protein kinase 1 (MAPK1), and the signal transducer and activator of transcription 3 (STAT3) were the pivotal targets of SNY. The components of SNY bound well with the pivotal targets, indicating there were potential biological activities. CONCLUSION: Our findings reveal the pharmacological role and molecular mechanism of SNY for the treatment of COVID-19 with myocarditis. We also, for the first time, demonstrate that SNY displays multi-component, multi-target, and multi-pathway characteristics with a complex mechanism of action.
Subject(s)
COVID-19 Drug Treatment , Myocarditis , Drugs, Chinese Herbal , Humans , Molecular Docking Simulation , Myocarditis/drug therapy , SARS-CoV-2ABSTRACT
The article analyzes 46 publications on the use of ICS for COVID-19. Both research results and their discussion by specialists are presented. The expediency of continuing basic therapy, including ICS, has been demonstrated in the event of COVID-19 in patients with bronchial asthma and chronic obstructive pulmonary disease. The risk of local immunosuppressive action of ICS has been compared with the ability to suppress inflammation in the initial period of COVID-19. Analysis of the publications suggests that it is safe to prescribe ICS to patients with COVID-19 as well as it is advisable to use them in the initial stages of this disease. © 2022 New Terra Publishing House. All rights reserved.
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We performed a comparative morphological analysis of placental villi in parturient women with mild and moderate COVID-19 infection. The area and perimeter of terminal villi, their capillaries, and syncytiotrophoblast were assessed on immunohistochemical preparations with antibodies to CD31 using an image analysis system; the parameters of fetal vascular component in the placental villi were also assessed. Changes in the studied parameters differed in parturient women with mild and moderate COVID-19 infection. The observed increase in the total perimeter with a simultaneous decrease in the total capillary area and the degree of vascularization of the placental villi in parturient women with COVID-19 indicates impairment of circulation in the fetal compartment and the development of placental hypoxia, which can be the cause of unfavorable neonatal outcomes.
Subject(s)
COVID-19/pathology , Chorionic Villi/pathology , Pregnancy Complications, Infectious/pathology , SARS-CoV-2/pathogenicity , Trophoblasts/pathology , Adult , COVID-19/virology , Chorionic Villi/blood supply , Chorionic Villi/virology , Female , Fetus , Humans , Immunohistochemistry , Parturition/physiology , Pregnancy , Pregnancy Complications, Infectious/virology , SARS-CoV-2/growth & development , Severity of Illness Index , Trophoblasts/virologyABSTRACT
A comparative morphological study was carried out to analyze the number of syncytial knots and VEGF expression in placental villi in parturient women with COVID-19 categorized by the disease severity. The number of syncytial knots was assessed on specimens stained with hematoxylin and eosin. VEGF expression was determined by immunohistochemical analysis in syncytiotrophoblast and villous endothelial cells. Morphological study of the placenta tissue of parturient women with COVID-19 showed increased numbers of syncytial knots in the villi, indicating the development of preplacental hypoxia. High VEGF expression in syncytiotrophoblast and vascular endotheliocytes reflects a stereotyped response to hypoxia and can underlie the development of a preeclampsia-like syndrome. The number of syncytial knots and VEGF expression in placental villi in parturient women with COVID-19 depended on the disease severity.
Subject(s)
COVID-19/metabolism , COVID-19/pathology , Chorionic Villi/metabolism , Placenta/metabolism , Vascular Endothelial Growth Factor A/metabolism , Female , Humans , Immunohistochemistry , Pregnancy , SARS-CoV-2/pathogenicityABSTRACT
The novel coronavirus infection COVID-19 (SARS-CoV-2) is now known to cause a variety of extrapulmonary complications, including cardiovascular, neurological and dermatological complications, many of which occur or last several weeks after infection. We present a clinical case of a patient who first developed symptoms of ankylosing spondylitis 2 weeks after recovering from COVID-19. The patient was prescribed therapy in accordance with international and Russian recommendations for the management of patients with ankylosing spondylitis with a positive effect in the form of absence arthritis, enthesitis and reducing the inflammatory back pain.
Subject(s)
COVID-19 , Spondylitis, Ankylosing , Humans , Spondylitis, Ankylosing/complications , Spondylitis, Ankylosing/diagnosis , Spondylitis, Ankylosing/drug therapy , SARS-CoV-2 , RussiaABSTRACT
In connection with the spread of the novel coronavirus infection (COVID-19) pandemic and the increase in the development of severe acute respiratory syndrome, works are published around the world that determined the risk factors for complications and poor outcomes in this disease. Among the main comorbidities in COVID-19, scientists distinguish hypertension, diabetes, obesity, etc. Recently, more and more physicians and researchers are concerned about the high frequency of severe and critical complications of COVID-19 in patients with obstructive sleep apnea (OSA). In this review, we present some data on COVID-19 and OSA in the age aspect, show the general pathophysiological pathways leading to increased systemic inflammation and adverse consequences in the comorbid course of these diseases. Special attention is paid to such studies in the pediatric population, but only a few works of foreign scientists were found that did not reveal the essence of the problem under discussion, which requires further research in this area.
Subject(s)
COVID-19 , Hypertension , Sleep Apnea, Obstructive , Child , Comorbidity , Humans , Hypertension/epidemiology , Risk Factors , SARS-CoV-2 , Sleep Apnea, Obstructive/epidemiologyABSTRACT
Összefoglaló. Az új típusú koronavírus-fertozés (COVID-19) nagy terhet ró az egészségügyi ellátórendszerre és a társadalomra. A betegségnek három nagy szakasza van, melyek alapvetoen meghatározzák a kezelést. Az I-IIA fázisban az antivirális, míg a IIB-III. fázisban a gyulladásgátló kezelés áll elotérben, melyhez intenzív terápiás, szupportív kezelés csatlakozik. A jelen ajánlás kizárólag a gyógyszeres kezelésre vonatkozik, és a rendelkezésre álló bizonyítékok alapján foglalja össze a terápiás lehetoségeket. Emellett egy javasolt kezelési algoritmust is tartalmaz. Orv Hetil. 2021; 162(17): 643-651. Summary. The novel coronavirus infection (COVID-19) places a heavy burden on the health care system and our society. There are three major stages in the disease that fundamentally determine treatment approaches. Phases I-IIA require primarily antiviral treatment. In phases IIB-III, anti-inflammatory treatment is needed accompanied by intensive and supportive care. This recommendation applies only to pharmacotherapy and summarizes the therapeutic options based on the available evidence. It also includes a proposed treatment algorithm. Orv Hetil. 2021; 162(17): 643-651.