Impact of covid-19 pandemic on gastroenterology: Chronic gastroenterological diseases, iatrogenesis and endoscopy.

The current article describes the course and treatment of chronic gastrointestinal diseases during the COVID-19 pandemic. We analyzed articles about iatrogenic harm to the gastrointestinal tract by etiological and pathogenetic therapy of the COVID-19. National and international recommendations for gastrointestinal endoscopy for infected and uninfected patients are analyzed.Copyright © A.M. SHCHIKOTA, I.V. POGONCHENKOVA, E.A. TUROVA, M.A. RASSULOVA, M.S. FILIPPOV.

Gastrointestinal tract, liver, and pancreas affected by covid-19.

We reviewed literature about the effects of novel coronavirus disease COVID-19 on the digestive system. The review ses the pathogenesis, the natural history, and the frequency of gastrointestinal and hepatobiliary complications in patientCOVID-19. We briefly overviewed therapy for intestinal, liver, and pancreatic damage by COVID-19.Copyright © 2021, Media Sphera Publishing Group. All rights reserved.

Analysis of the dynamics and structure of morbidity of athletes of the national teams of Moscow based on the results of medical examination

Objective: The aim of the study was to analyze the structure and dynamics of morbidity of athletes, members of sports teams of the city of Moscow based on the results of an indepth medical examination in the period 2017-2021. Materials and methods: The data of the medical examination of athletes, which took place at the Moscow scientific and Practical Center for Medical Rehabilitation, restorative and sports medicine, including instrumental, functional and laboratory studies from 2017 to 2021, were analyzed. In 2017, 15176 athletes were examined, in 2018 and 2019, 11200, in 2020, 10080 people and in 2021-11922 athletes. Results: The results of the study showed an increase in the proportion of amenorrhea within the triad of athletes, an increase in general therapeutic morbidity, diseases of the gastrointestinal tract, among which the proportion of secondary hyperbilirubinemia in 2021 increased 3 times compared to 2020, which, in our opinion, is also due to the impact of the pandemic and quarantine restrictions. The high prevalence of ophthalmological morbidity of athletes and changes in the cardiovascular system is shown. During 2017-2021, a change in the structure of cardiac morbidity was revealed in the form of an increase in the proportion of cardiac arrhythmias and hypertensive response to stress. An increase in the endocrine morbidity of athletes in 2021 was revealed due to an increase in the proportion of hypothyroidism and more frequent detection of hyperthyroidism, possibly related to the COVID19 pandemic, which requires further research. There was also an increase in diseases of the skin and genitourinary system in athletes. Psychological problems of athletes increased during the observation period from 2017 to 2021. There was no significant dynamics of surgical and traumatological diseases, otolaryngological pathologу. Conclusion: The results of the study indicate the importance of regular fullfledged examination of athletes, identification of various functional disorders and diseases for their timely prevention and treatment in order to preserve the health of athletes and improve athletic performance. © 2022 by the Author(s).

[Capacity of vibroacoustic therapy for correction of respiratory manifestations of post COVID-19 syndrome]. / Vozmozhnosti vibroakusticheskoi terapii v korrektsii respiratornykh proyavlenii postkovidnogo sindroma.

The search for therapeutic strategies for the correction of post COVID-19 syndrome is an urgent task of medicine. One of the frequent manifestations of post COVID-19 syndrome is the prolonged persistence of respiratory syndromes - dyspnea and cough. Vibroacoustic therapy is promising methods in the complex effect on broncho-pulmonary symptoms of COVID-19. OBJECTIVE: To study the effect of vibroacoustic pulmonary therapy implemented through the BARK VibroLUNG apparatus on the clinical and instrumental parameters of patients undergoing COVID-19 with residual respiratory symptoms. MATHERIAL AND METHODS: The effect of vibroacoustic therapy (5-day course of 2 sessions) on dyspnea and cough and respiratory function in 60 patients aged 18 to 75 years who underwent COVID-19 of varying severity for more than 12 weeks before the start of the study, with the presence of distant respiratory symptoms, was investigated. Patients were divided into two equal and age-matched groups - without (1st) and with (2nd) chronic bronchopulmonary pathology. RESULTS: Analysis of comorbidity of patients with respiratory phenotype of post COVID-19 syndrome showed frequent presence of concomitant cardiovascular pathology (76.7%). The predominant patient complaint was dyspnea (93.3% in both groups): 29 patients (96.7%) in the non-lung group, and 27 patients (90%) in the chronic lung group. The mean mMRC dyspnea score for all patients was 1.1±0.49 points (1.2±0.5 points in the first group and 1.0±0.45 points in the second group). Cough was observed less often - in 18 patients of both groups (30%), mainly in the second group. During the course of vibroacoustic therapy in the 1st group, the number of patients with dyspnea decreased from 96.7 to 30%, in the 2nd group - from 90 to 10%, the total mean mMRC dyspnea score decreased to 0.2±0.4 (Δ 82%), and a complete regression of cough syndrome was achieved in both groups. Also, an increase in forced expiratory volume in 1st second and peak expiratory flow indicators was revealed both in the general group of patients and in the group of patients without chronic lung pathology. CONCLUSION: The results obtained during the study of the use of vibroacoustic therapy in patients with respiratory manifestations of post-COVID syndrome, including the presence of chronic bronchopulmonary pathology, allow us to conclude on the effective correction of dyspnea and cough during treatment. Vibroacoustic therapy is a promising non-drug method of exposure to bronchopulmonary manifestations of post-COVID syndrome in patients during rehabilitation.

Use of Karmolis® DROPS in Comprehensive Rehabilitation after COVID-19

Aim. To evaluate the efficacy and safety of the use of KARMOLIS® DROPS in the rehabilitation of patients after COVID-19 infection. Material and methods. The study included and completed observation of 40 medical staff aged 20 to 60 years who had suffered from COVID-19 in a moderate to severe form. The follow-up period was 21 days. The study participants were divided into two groups. The main group (20 people) received KARMOLIS® DROPS. The control group (20 people) treatment was carried out without the use of KARMOLIS® DROPS. The effectiveness was evaluated according to a set of clinical and functional indicators. Results and discussion. Against the background of taking KARMOLIS® DROPS, reliable positive dynamics of the subjective assessment of shortness of breath (MRC scale) and the subjective assessment of sleep quality (Vane A.M. scale) were recorded in the main group. Subjective efficacy of the studied KARMOLIS ® DROPS was noted by almost all patients who underwent treatment, which is probably due to improved sleep and well-being by reducing autonomic reactions. Taking into account the data obtained during the study, KARMOLIS® DROPS can be used in the recovery process after COVID-19 as a component of comprehensive rehabilitation. Conclusion. The safety of using the herbal medicine KARMOLIS® DROPS was confirmed by the absence of adverse events and cases of decompensation of concomitant diseases during the study. Patients' emotionally positive perception of the drug ensured its high compliance. © 2022 Rostovskii Gosudarstvennyi Meditsinskii Universitet. All rights reserved.

[COVID-19-associated diarrhea].

In addition to the typical clinical picture of respiratory symptoms and intoxication, the SARS-CoV-2 virus is also characterized by a gastroenterotropic effect. Diarrhea is one of the most common gastroenterological symptoms of COVID-19 and is detected, according to the various authors, in 2-49.5% of cases, including children. The presence of diarrhea aggravates the patient's clinical condition, limits the possibility of carrying out the necessary diagnostic manipulations, and complicates the selection of therapy. The article provides an overview of the scientific literature on the formation of diarrheal syndrome in patients with COVID-19. Objective. Analysis of scientific publications studying the pathogenesis, incidence, clinical features, aspects of diagnosis and therapy of diarrhea in patients with COVID-19. Material and methods. A search was made for scientific publications on the electronic resources PubMed, Google Scholar and eLIBRARY.ru. Results. The pathogenesis of diarrhea in a new coronavirus infection is complex and includes, among other things, the effect of the virus on the angiotensin-converting enzyme 2 receptors, inducing an inflammatory process in the gastrointestinal tract mucosa, neurotropic effect on the autonomic regulation of intestinal motor activity, disturbance of the colon microbiota, liver and pancreas damage. Another important pathogenetic aspect of diarrhea in COVID-19 is iatrogenic one, i.e. a side effect of drugs used in the treatment of a new coronavirus infection and its complications, and the activation of opportunistic clostridial intestinal flora against the background of antibiotic therapy. The variety of pathogenetic mechanisms of diarrheal syndrome formation allows us to speak of "COVID-associated diarrhea" as an independent clinical phenomenon characteristic for the new coronavirus infection. Mandatory diagnostic algorithm of a patient with COVID-19 and diarrhea is the fecal analysis test for toxins Cl. difficile, while the possibility of endoscopic examinations during the pandemic is limited. Compliance with the hygiene measures, diet correction and nutritional support, rational antibiotic therapy of COVID-19 complications, careful use of antiperistaltic antidiarrheal drugs, nonspecific therapy (antiviral, rehydration, adsorbents) are considered as the main therapeutic approaches for diarrheal syndrome against the background of COVID-19. The administration of probiotics and antibacterials should be considered in case of confirmed clostridial co-infection. Conclusion. Diarrhea is a frequent clinical manifestation of COVID-19 and can affect the course of the disease. The complex genesis of diarrheal syndrome requires further study of therapeutic strategies and nutritional support for patients after COVID-19.

[Hyperbaric oxygenation in outpatient rehabilitation of COVID-19 convalescents]. / Primenenie giperbaricheskoi oksigenatsii v ambulatornoi reabilitatsii patsientov, perenesshikh COVID-19.

Searching for drug and non-drug modalities for the rehabilitation of patients with the post-COVID syndrome is an urgent public health challenge during the COVID-19 pandemic. Hyperbaric oxygenation is a promising method as a part of complex rehabilitation after COVID-19 due to its antihypoxic, anti-inflammatory, antioxidant and anticoagulant effects. OBJECTIVE: To study the effect of hyperbaric oxygenation as a part of comprehensive outpatient rehabilitation on clinical and functional parameters in COVID-19 convalescents. MATERIAL AND METHODS: The effect of hyperbaric oxygenation on clinical and functional parameters of 45 COVID-19 convalescents was studied: 22 males and 23 females aged 40-60 years. Patients were divided into three groups of 15 subjects each, depending on the CT stage of COVID-associated pneumonia (CT-0, CT-1, and CT-2-3). RESULTS: Patients in group 3 (CT-2-3) were on average in the older age group, had a higher body weight and a higher percentage of fat mass according to bioimpedance measurements, compared to the other groups. Most clinical-functional and laboratory parameters in this group were within normal or subnormal ranges. In addition, high cholesterol levels (total cholesterol 6.5±1.2 mmol/L) and subnormal levels of C-reactive protein (9.3 mg/L) were noted in group 3 patients. After comprehensive rehabilitation, an increase in the distance walked in the 6-minute walking test with a significant trend in the CT-0 (467.9±37.7→531.5±44.3 m; p<0.01) and CT-1 (533.9±74.3→570.1±57.8 m; p<0.05) groups was observed. A significant decrease in norepinephrine level in the group of COVID-19 convalescents with CT-2-3 (Δ 13%), and a decrease in glutathione peroxidase in all three groups (6465.0±1637.3→5101.0±1353.3, 6587.8±1919.3→5418.1±1289.7, 7699.5±1747.9→6620.1±1702.1 units/L in groups 1, 2 and 3, respectively; p<0.05) were recorded. CONCLUSION: The use of hyperbaric oxygenation in comprehensive outpatient rehabilitation of COVID-19 convalescents was associated with benefits, given the improvement of functional parameters, laboratory signs of limiting low-grade inflammation, sympathoadrenal activity, and oxidative stress.

Impact of covid-19 pandemic on gastroenterology: Chronic gastroenterological diseases, iatrogenesis and endoscopy

The current article describes the course and treatment of chronic gastrointestinal diseases during the COVID-19 pandemic. We analyzed articles about iatrogenic harm to the gastrointestinal tract by etiological and pathogenetic therapy of the COVID-19. National and international recommendations for gastrointestinal endoscopy for infected and uninfected patients are analyzed. © A.M. SHCHIKOTA, I.V. POGONCHENKOVA, E.A. TUROVA, M.A. RASSULOVA, M.S. FILIPPOV.

Gastrointestinal tract, liver, and pancreas affected by covid-19

We reviewed literature about the effects of novel coronavirus disease COVID-19 on the digestive system. The review ses the pathogenesis, the natural history, and the frequency of gastrointestinal and hepatobiliary complications in patientCOVID-19. We briefly overviewed therapy for intestinal, liver, and pancreatic damage by COVID-19. © 2021, Media Sphera Publishing Group. All rights reserved.

Cardiological Rehabilitation and COVID-19 Pandemic: Literature Review

Objective of the Review: To review literature data on the need for cardiological rehabilitation of COVID-19 survivors and the features of rehabilitation of patients with cardiovascular pathologies during pandemic. Key Points. SARS-CoV-2 virus uses several cardiotropic mechanisms and can damage the myocardium. The COVID-19 pandemic can result in an increase in the number of patients with acute and chronic cardiological pathologies who require rehabilitation. Traditional cardiological rehabilitation has a limited range of measures during a pandemic;the majority of experts recommend rehabilitation at home and using telemedicine. Conclusion. COVID-19 survivors can need cardiological rehabilitation. Remote management is a key trend in cardiological rehabilitation during a pandemic. Цель обзора: анализ литературных данных о потребности в кардиореабилитации у больных, перенесших COVID-19, и особенностях реабилитации пациентов с сердечно-сосудистой патологией в период пандемии. Основные положения. Вирус SARS-CoV-2 имеет несколько механизмов кардиотропного действия и может вызывать повреждение миокарда. В результате пандемии COVID-19 возможно увеличение числа пациентов с острой и хронической кардиологической патологией, нуждающихся в реабилитации. Возможности традиционной кардиологической реабилитации в условиях пандемии ограничены;большинство экспертов рекомендуют реабилитацию в домашних условиях и использование телемедицинских технологий. Заключение. Пациенты, перенесшие COVID-19, потенциально нуждаются в проведении кардиореабилитации. Применение дистанционных методов является основным вектором развития кардиологической реабилитации в период пандемии.

Chronic obstructive lung disease and COVID-19: Topical issues

The problem of comorbidity of new coronaviral infection (COVID-19) and chronic obstructive pulmonary disease (COPD) is acute, considering similarity of clinical manifestations, diagnostic difficulties, the potential severe disease course. Patients with COPD represent a vulnerable group of infected SARS-CoV-2, with a complicated disease course and frequent adverse outcome. Features of the spread of the virus limit treatment and diagnosis for patients with COPD, making it difficult to provide medical care during the pandemic. The negative results of some clinical studies of antiviral drugs for patients with COVID-19 indicate the need for a search for new drugs;for this reason, analysis of the anti-inflammatory effect on the lungs in infection COVID-19 of drugs of basic COPD therapy is promising. © 2020 Medical Education. All rights reserved.