Comorbidity is an important problem of modern medicine, the study of which is a priority for public health. According to the literature, the prevalence of comorbidity reaches a third of the population in some countries, while there is a tendency for an increase in the number of such patients in all age groups. In the context of the COVID-19 pandemic, the presence of comorbidity in patients is a significant risk factor affecting the course and prognosis of a new coronavirus infection; at the same time, it is comorbid patients who belong to the most vulnerable group. The review presents data indicating a significant impact of comorbid pathologies on an increase in the number of complications and mortality; the most common combinations of diseases in patients with a new coronavirus infection were analyzed. There is an increase in the prevalence of comorbidity in all age groups, which dictates the need to develop an integrated interdisciplinary approach for such patients. The vast majority of clinical guidelines for the treatment of comorbidities in COVID-19 are mainly focused on individual diseases, which limits the use of these algorithms in comorbid patients. Due to the high risk of contracting a viral infection, as well as the frequent development of complications and mortality in comorbid patients, preventive measures should be focused simultaneously on two tasks: measures aimed at preventing infection with COVID-19 and compensating for comorbid pathology. In the case of SARS-CoV-2 infection, careful monitoring of such patients, most often in a hospital setting, is necessary in order to prevent complications and adverse outcomes.
The whole world has been living in the conditions of the COVID-19 pandemic caused by the SARS-CoV-2 virus for more than 2 years. Despite the unprecedented measures aimed at finding new means of prevention and treatment, the development and implementation of vaccines, COVID-19 continues to be a significant medical and social problem. This is due to the peculiarity of SARS-CoV-2 to constant changes in the virus as a result of mutations and the formation of new strains. It affects the effectiveness of vaccination and treatment, necessitating preventive measures, primarily aimed at maintaining the normal functioning of the immune system that protects the host from various pathogens, including viruses. An important role in the state of the immune system is played by some micronutrients, which include zinc, selenium, iron and copper. Zinc and selenium have pronounced immunoregulatory, antioxidant and antiviral properties, iron is necessary for the growth and development of some cells of the immune system, and copper, in addition to its antiviral effect, reduces the risk of secondary infection in viral diseases. At the same time, according to the literature, more than 2 billion people in the world suffer from micronutrient deficiencies. In addition, there is often a combined deficiency of minerals, which necessitates its diagnosis and correction. Most of the studies we analyzed emphasize the importance of using micronutrients in people at risk, as well as in patients at the very beginning of the disease, in order to strengthen the immune system in the condition of a laboratory-confirmed deficiency.
An electronic search for publications on the features of the course of COVID-19 in patients with the most common chronic noncommunicable diseases (arterial hypertension, diabetes mellitus and obesity) was carried out using the Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health, CyberLeninka databases, RSCI, as well as journals peer-reviewed by the Higher Attestation Commission. The review analyzed the effect of comorbidity on the prognosis of a new coronavirus infection (complication rate, severity of the course, mortality). It has been shown that previous noncommunicable diseases are a significant risk factor for adverse outcomes in patients with COVID-19, and if the effect of arterial hypertension is not confirmed by all authors, then type 2 diabetes mellitus, as well as any degree of obesity, are important prognostic signs of an unfavorable course of the new coronavirus infections. Thus, in the context of the COVID-19 pandemic, patients suffering from chronic noncommunicable diseases need more careful monitoring and preventive measures aimed not only at preventing infection with the new coronavirus, but also at slowing the progression of these pathologies and their complications.
Despite the development and implementation of vaccines in various countries of the world, COVID-19 remains a significant medical and social problem. This is directly related to the characteristic feature of SARS-CoV-2 to form new strains, which reduces the effectiveness of vaccination. In connection with the foregoing, the priority in the prevention of COVID-19 is to improve and maintain the normal functioning of the human immune system. Recently, more and more scientists have noted the significant role of micronutrients in ensuring immune function. However, most research focuses on micronutrients such as zinc, selenium, iron and copper, while it is known that the balance of micronutrients depends on all its constituents. Consequently, any change in the content of one mineral substance can affect the level of others, leading to an imbalance of trace elements in the body. The aim of this work was to analyze literature data on less studied microelements in the context of the COVID-19 pandemic, both essential and toxic, that can affect the state of the immune system and, as a result, the incidence and risk of complications and adverse outcomes in COVID-19. An analysis of the literature on the effect of manganese, chromium, iodine, cadmium, mercury, lead, arsenic and lithium on human antiviral protection, including in the case of a disease caused by SARS-CoV-2, showed that the determination of the microelement status, taking into account the above microelements and, with necessary, the appointment of preparations containing minerals is promising for the purpose of prevention and as an additional therapy for COVID-19.
Due to the progressive increase in the incidence of endocrine pathology in the world, the issues of prevention and treatment of this group of diseases become topical. Diseases of the endocrine system are often accompanied by the development of comorbidities and complications, which negatively affects the quality of life and survival of patients. Currently, the features of the trace element status in patients with various diseases are actively studied. Numerous modern studies are devoted to the question of the influence of the balance of trace elements on the etiology and pathogenesis of diabetes mellitus, obesity and some thyroid diseases, including autoimmune ones. The role of iodine, selenium, iron, zinc and copper in the development and progression of these diseases has been established, but the results of these studies are sometimes contradictory. This review presents the data obtained by national and foreign researchers on the role of trace elements in the development of endocrine pathology, gives a brief description of the most significant mineral substances, as well as the effect of their imbalance on the structure and function of the organs of the endocrine system. The need for further study of this issue is discussed, taking into account concomitant diseases, as well as the mutual influences of mineral substances on each other, which can lead to a change in the concentration of trace elements in the body.
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