Having analyzed the latest recommendations of the World Health Organization, the new data from the scientific literature, and current treatment guidelines, the latest epidemiological data of identified different cases of this infection according to epidemiological and clinical criteria were presented. The main pathogenetic signs, risk factors, including inter-individual differences, which can be represented by the host's genetic profile, are highlighted. The main clinical signs and their distribution, classification according to the severity of the disease, features of the course and treatment of pneumonia in human coronavirus infections are shown, including indications for antibacterial therapy and the main criteria of oxygen support. The basic WHO laboratory recommendations for patients with acute respiratory infection who have been in contact with patients having a confirmed or probable case are defined. The main hardware methods of diagnosis, modern approaches in the therapy in the absence of specific antiviral agents are presented. The lack of definitive specific treatment for this disease and the future development of such a pandemic remains unpredictable that indicates the need for strict adherence to classic public health recommendations, the importance of vaccination. The outbreak of COVID-19 in this century once again had emphasized the constant threat of infectious diseases spread by pathogenic viruses among humanity and this requires effective global cooperation and a high level of preparedness.
The article provides a description of a complex clinical case of cardiorenal syndrome type II in a patient having rheumatoid arthritis and a high degree of activity. The aim of this work is to highlight the problem of multiple organ damage in severe autoimmune diseases, as well as to share the experience of diagnostic and therapeutic approaches in such situations. Under a long-term articular syndrome, the patient subacutely develops new threatening symptoms: signs of inflammatory cardiomyopathy, heart failure, nephropathy, acute renal failure. But thanks to intensive anti-inflammatory therapy, we managed to significantly mitigate the activity of myocarditis, restore myocardial, and as a result, renal function. The success of active anti-inflammatory treatment confirmed our diagnostic hypothesis of cardiorenal syndrome. Several clinical landmarks have become key points for us. First, we detected that myocarditis with myocardial dysfunction and nephropathy with renal failure occurred almost simultaneously. Since the patient was under observation for a long time, until recently, we knew for sure that there were no pathological changes in the function of the heart and kidneys. Then, we detected the subacute onset of cardiac and renal symptoms. Finally, NSAID-induced amyloidosis or nephropathy cannot clearly explain the active course of inflammatory cardiomyopathy. Therefore, based on the characteristics of this clinical situation, we made an assumption of cardiorenal syndrome, most likely type II. All subtypes have similar clinical signs, but their origin largely depends on the underlying disease, history, and features of specific kidney and myocardial damage. Kidney hypoperfusion in our case did not lead to severe irreversible changes in nephrons, which ensured the restoration of renal function. But a prolonged and deep episode of hypoperfusion may be partially or completely irreversible, due to ischemic necrosis of the epithelium of the nephron tubules. Thus, we have shown a complex clinical case of an extra-articular lesion in the form of a cardiorenal syndrome, as well as an algorithm of our actions regarding diagnosis and treatment. Relatively early diagnosis of cardiorenal syndrome obviously enables to achieve good treatment results in a relatively short period of time.
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