Personalized approach to the management of a patient with COVID-19 with a complicated comorbid background
Infectious Diseases: News, Opinions, Training
; - (1):116-122, 2023.
Article
in Russian
| EMBASE | ID: covidwho-2322413
ABSTRACT
The aim of the work is to form the principles of a personalized approach to the management of patients with COVID-19 with a complicated comorbid background. Material and methods. The article describes a clinical case of successful recovery of an 87-year-old patient from a new coronavirus infection COVID-19, complicated by pneumonia involving 36% of the lung parenchyma area. Along with age, the situation was aggravated by the comorbid status of the patient the presence of chronic lymphocytic leukemia, hypertension, mechanical prostheses of the mitral and aortic valves, postinfarction cardiosclerosis, paroxysmal atrial fibrillation, type 2 diabetes mellitus, stage 4 CKD, anemic syndrome, and subclinical hypothyroidism. Results. The C-reactive protein level at admission was 114.46 mg/L. The patient refused hospitalization. Baricitinib 4 mg, favipiravir according to the scheme, vitamin D 2000 units were prescribed for the previously taken therapy. Already after 3 days, C-reactive protein decreased by 4.6 times, and by the 8th day by 15.5 times and amounted to 7.38 mg/ml. The temperature returned to normal on day 2 from the start of baricitinib. In dynamics, a decrease in creatinine level to 177.0 mumol/l was noted, the glomerular filtration rate increased to 30 ml/min/1.73 m2, which corresponded to stage 3b of CKD (a pronounced decrease in glomerular filtration rate). Conclusion. Despite the age of the patient, many comorbidities, each of which could be fatal, the timely use of baricitinib on an outpatient basis made it possible to stop the progressive course of the disease.Copyright © Eco-Vector, 2023. All rights reserved.
baricitinib; comorbid patient; favipiravir; new coronavirus infection COVID-19; age distribution; aged; anemia; aortic valve prolapse; article; body temperature; case report; chronic kidney failure; chronic lymphatic leukemia; clinical article; clinical outcome; comorbidity; coronavirus disease 2019/dt [Drug Therapy]; coronavirus disease 2019/th [Therapy]; creatinine blood level; disease classification; disease exacerbation; glomerulus filtration rate; heart muscle fibrosis; hospital admission; hospitalization; human; hypertension; lung parenchyma; non insulin dependent diabetes mellitus; paroxysmal atrial fibrillation; personalized medicine; subclinical hypothyroidism; time to treatment; treatment refusal; very elderly; baricitinib/dt [Drug Therapy]; baricitinib/pv [Special Situation for Pharmacovigilance]; C reactive protein/ec [Endogenous Compound]; creatinine/ec [Endogenous Compound]; favipiravir/dt [Drug Therapy]; favipiravir/pv [Special Situation for Pharmacovigilance]; vitamin D; mitral valve prosthesis
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
Russian
Journal:
Infectious Diseases: News, Opinions, Training
Year:
2023
Document Type:
Article
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