COVID-19: The efficacy and safety of anticoagulant, glucocorticosteroid therapy and metabolic
Infectious Diseases: News, Opinions, Training
; 11(1):47-56, 2022.
Article
in Russian
| EMBASE | ID: covidwho-2326016
ABSTRACT
Objective:
assessment of the efficacy and safety of the use of anticoagulant, glucocorticosteroid, metabolic therapy in patients with COVID-19 at the inpatient stage of treatment. Material and methods. In February 2021, a prospective, randomized, single-center, continuous comparative study was organized on the basis of the Gomel City Clinical Hospital No. 3, which included 827 patients with moderate and severe clinical course of COVID-19. Results. Stratification of the risks of an unfavorable outcome in patients with moderate and severe clinical course of COVID-19 made it possible to optimize treatment, with the selection of optimal doses of anticoagulant and glucocorticosteroid therapy, which led to an increase in patient survival. A high level of blood lactate reflects the degree of damage to the lung tissue, the severity of the course of the disease and requires an increase in the dose of anticoagulant therapy. The use of thiotriazoline effectively reduces the level of lactate, which makes it possible to restore the energy balance of the cell. Conclusion. The use of therapeutic (intermediate) doses of anticoagulant and optimal glucorticosteroid therapy in patients at high risk of poor outcomes with moderate and severe clinical course of COVID-19, can increase the survival rate from 82.1 to 96.8%, p<0.0001. The appointment of anticoagulant therapy was complicated by "minor" bleeding in 2.13% in the main group, in 2.11% in the control group, p>0.05, and the use of glucocorticosteroids was complicated by newly diagnosed diabetes mellitus (2.13% in the main group, 1.81% in the control group, p>0.05), which allows us to consider the therapy used is safe. The use of the metabolic, antioxidant agent thiotriazoline in patients with an LDH level of more than 800 U/L and with a high risk of an unfavorable outcome led to a decrease in LDH within five days of treatment by 447.9 U/L in the main group compared with the control group by 124.0 U/L (p=0.0001), which was accompanied by an improvement in the general condition, increased physical activity, and an earlier start of rehabilitation.Copyright © 2022 by the authors.
anticoagulant therapy; covid-19; glucocorticosteroid therapy; pneumonia; stratification of the risk of an unfavorable prognosis; survival; thiotriazoline; article; bleeding; clinical article; clinical outcome; controlled study; coronavirus disease 2019/dt [Drug Therapy]; diabetes mellitus; disease course; disease severity; drug efficacy; drug safety; drug use; energy balance; human; lactate blood level; lactate dehydrogenase blood level; lung parenchyma; physical activity; priority journal; prospective study; randomized controlled trial; tissue injury; anticoagulant agent/dt [Drug Therapy]; antioxidant/dt [Drug Therapy]; glucocorticoid/dt [Drug Therapy]; lactate dehydrogenase/ec [Endogenous Compound]; lactic acid/ec [Endogenous Compound]
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Language:
Russian
Journal:
Infectious Diseases: News, Opinions, Training
Year:
2022
Document Type:
Article
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