Методические рекомендации посвящены вопросам практической работы по диагностике и лечению новой коронавирусной инфекции COVID-19. Целью создания данного документа явилась необходимость выработки единого подхода в организации помощи пациентам с новой коронавирусной инфекцией COVID-19 в военных стационарах с позиций практического опыта специалистов госпиталя, требо-ваний национальных рекомендаций. наиболее важные рекомендации касаются вопросов правильного понимания заболевания, алго-ритмов действий врачебного персонала и режимов фармакотерапии пациентов с коронавирусной инфекцией. Ключевые слова: новая коронавирусная инфекция COVID-19, фармакотерапия, алгоритмы работы, клинические рекомендации. Для цитирования: Зайцев А.А., чернов С.А., Стец В.В. и др. Алгоритмы ведения пациентов с новой коронавирусной инфекцией COVID-19 в стационаре. Методические рекомендации. Consilium Medicum. 2020; 22 (11): 91–97. DOI: 10.26442/20751753.2020.11.200520
The end of the acute period of COVID-19 does not mean complete recovery. Observation of patients in the post-COVID-19 period showed that a significant number of people experience shortness of breath, fatigue, muscle weakness, sleep disorders, cough, palpitations, so the term post-COVID-19 syndrome was coined. The examination to identify the causes of complaints of COVID-19 convalescents should include lung function assessment.The aim of the study was to assess the dynamics of lung function 4 months after hospitalization for COVID-19.Methods. 31 patients (26 males, the median age was 49 years) underwent traditional pulmonary function tests (PFTs) (spirometry, body plethysmography, test of diffusing lung capacity) and impulse oscillometry (IOS). Results. During the 1st visit, the average PFTs and IOS parameters were within the normal range in the whole group, apart from the diffusing lung capacity (DLCO), which was reduced mildly (on the border with moderate) in 77% of patients. During the 2nd visit, which was conducted on average 102 days after the 1st one, 58% of patients demonstrated abnormal lung diffusion capacity. The second assessment revealed a statistically significant increase in the slow and forced vital capacity (VC and FVC), the forced exhalation volume in 1 second (FEV1), total lung capacity (TLC), DLCO, and a decrease in the ratio of FEV1/FVC and the residual lung volume to TLC ratio.Conclusion. Post-COVID-19 patients show a statistically significant improvement of their lung function 4 months after hospital discharge. A systematic follow-up is essential for such patients to detect lung function abnormalities and correct them.
The forests of the boreal and mid-latitude zones of the Northern Hemisphere are the largest source of reactive volatile organic compounds (VOCs), which have an important impact on the processes occurring in the atmospheric boundary layer. However, the composition of biogenic emissions from them remains incompletely characterized, as evidenced by the significant excess OH radical concentrations predicted by models in comparison with those observed under the forest canopy. The missing OH sink in the models may be related to the fact that they do not take into account the emission of highly reactive VOCs by vegetation on the forest floor. In this work, we report the results of laboratory determinations of the composition of VOCs emitted by representatives of different groups of plants that form the living soil cover (LSC) in the forests of the boreal and mid-latitude zones: bryophytes, small shrubs, herbaceous plants, and ferns. In the chromatograms of volatile emissions of all 11 studied plant species, 254 compounds with carbon atoms ranging in number from two to 20 were registered. All plants were characterized by the emission of terpenes, accounting for 112 compounds, and the second largest group (35 substances) was formed by carbonyl compounds. Both groups of compounds are characterized by high reactivity and are easily included in the processes of gas-phase oxidation with the participation of radicals HO, NO3 and ozone. These data indicate the importance of a thorough study of the so far disregarded source of VOCs, that is, the LSC in forests.
Objective. To evaluate the efficacy and safety of Ergoferon in children and adults with acute respiratory viral infections (ARVIs). Material and methods. We have analyzed the results of 10 randomized controlled trials involving 1732 patients. The outcome measures included duration of fever, disease severity, frequency of deteriorations, number of adverse events (AEs), and assessment of drug interaction. We have conducted statistical analysis of pooled data and meta-analysis using logistic regression. Results. Patients receiving Ergoferon were 1.5 times more likely to have shorter period of fever than those receiving placebo (ОR = 1.499, р = 0.0002). Patients in the Ergoferon group had milder ARVI and influenza than patients in the placebo group (according to the AUC analysis: 32.83 ± 18.12 vs 36.94 ± 19.08 units in the placebo group, p = 0.0083). The frequency of deterioration in the Ergoferon group was 7 times lower than that in the placebo group (0.6% vs 4.4% of cases). Treatment safety was confirmed by fewer patients having AEs in the experimental group (0.6% vs 10.8%, p = 0.0006.) and no drug interactions. Conclusion. Our findings suggest that Ergoferon significantly reduced duration of fever in patients with ARVI and influenza compared to placebo. Ergoferon alleviated the disease and reduced the incidence of bacterial complications. Moreover, this drug demonstrated good tolerability and compatibility with other drugs. Key words: ARVI, influenza, meta-analysis, ARVI treatment, influenza treatment, Ergoferon
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