RESUMO
Aim Prospective assessment of the nature of cardiac injury in patients with post-COVID syndrome according to contrast-enhanced MRI in routine clinical practice.Material and methods 106 previously unvaccinated patients were evaluated. 62 (58.5%) of them were women with complaints that persisted after COVID-19 (median age, 57.5 [49; 64] years). In addition to standard indexes, markers of inflammation and myocardial injury were determined, and cardiac contrast-enhanced MRI was performed in each patient.Results The median time from the onset of COVID-19 to cardiac MRI was 112.5 [75; 151] days. The nature of cardiac injury according to MRI in patients with post-COVID syndrome was complex and included a decrease in left ventricular (LV) and right ventricular ejection fraction, pericardial effusion, and pathological foci of late and early contrast enhancement at various locations. In 29 (27.4%) cases, there was a combination of any two signs of heart injury. In 28 (26.4%) patients with focal myocardial injury during the acute phase of COVID-19, hydroxychloroquine and tocilizumab were administered significantly more frequently, but antiviral drugs were administered less frequently. The presence of focal myocardial injury was associated with pathological LV remodeling.Conclusion According to contrast-enhanced cardiac MRI, at least 27.4% of patients with post-COVID syndrome may have signs of cardiac injury in various combinations, and in 26.4% of cases, foci of myocardial injury accompanied by LV remodeling are detected. The nature of heart injury after COVID-19 depends on the premorbid background, characteristics of the course of the infectious process, and the type of prescribed therapy. An algorithm for evaluating patients with post-COVID syndrome is proposed.
Assuntos
COVID-19 , Traumatismos Cardíacos , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Volume Sistólico , Estudos Prospectivos , COVID-19/complicações , Função Ventricular Direita , Imageamento por Ressonância Magnética , Imagem Cinética por Ressonância Magnética , Função Ventricular EsquerdaRESUMO
AIM: To study antiinfluenza vaccination (AIV) effects on the course of chronic obstructive pulmonary disease (COPD) in metallurgists. MATERIAL AND METHODS: COPD and acute respiratory viral infections (ARVI) morbidity was studied in' metallurgists as well as a 5-year trend in functional tests in a group of 51 patients with moderate AR VI. RESULTS: It is shown that ARVI play a key role in activation of persisting infection in COPD. CONCLUSION: AIV reduces the rate and severity of COPD exacerbations, suppresses the disease progression.
Assuntos
Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Vacinação/métodos , Feminino , Seguimentos , Volume Expiratório Forçado/fisiologia , Humanos , Influenza Humana/complicações , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Prognóstico , Doença Pulmonar Obstrutiva Crônica/complicações , Estudos Retrospectivos , Índice de Gravidade de DoençaRESUMO
A membrane stabilizing effect of endobronchial laser therapy and antioxidative drugs piracetam and solcoseril was studied in 83 patients with chronic bronchitis. Malonic dialdehyde was measured to evaluate effects of this treatment on cellular and humoral immunity, blood coagulation and lipid peroxidation. It was found that the addition of membrane stabilizers to standard therapy of chronic bronchitis lowered malonic dialdehyde concentrations while the addition of the stabilizers and endobronchial laser therapy relieved clinical symptoms earlier, improved parameters of immunity, hemostasis and lipid peroxidation.
