Clinical outcomes of patients with COVID-19 admitted for respiratory support to the intensive care units in Russia

Глыбочко, П. В.; Fоmin, Victоr; Moiseev, Sergey; Авдеев, С. Н.; Yavorovskiy, Andrey; Brovko, Michail; Umbetova, Karina; Aliev, V.; Буланова, Е Л; Бондаренко, И. З.; Волкова, Ольга Сергіївна; Gaynitdinova, V. V.; Gneusheva, T. Yu.; Дубровин, К В; Капустина, Валентина; Kraeva, V. V.; Merzhoeva, Zamira M.; Нуралиева, Г. С.; Новиков, П. В.; Nogtev, Pavel; Panasyuk, V.; Политов, М Е; Popov, Aron Frederik; Popova, Elizaveta V.; Raspopina, N. A.; Royuk, Valery V.; Sorokin, Yuriy; Trushenko, Natalia V.; Khalikova, E.Yu.; Tsareva, Natalya; Чикина, С. Ю.; Chichkova, N.; Akulkina, Larisa; Beketov, Vladimir; Bulanov, Nikolay; Ermolova, L.; Зыкова, А А; Kitbalyan, Aram; Moiseev, A.; Потапов, П. П.; Smirnova, Irina G.; Tao, E.; Sholomova, Victoria; Shchepalina, A.; Yakovleva, Alexandra V.

doi:10.32756/0869-5490-2020-3-25-36

Cited by 12 publications

(7 citation statements)

References 33 publications

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“…No deaths were observed in the study population receiving AZB. Considering the rates of mortality reported for similar populations of patients with COVID-19 in Russia at the time of this study, 30 estimates suggest that, with 23 patients admitted needing respiratory support, we should have expected at least five deaths in the study population. Furthermore, there was a relatively high incidence of comorbidity in our patient group (19/32 patients had co-morbidities including diabetes and other types of ‘weighted’ co-morbidities).…”

Section: Discussionmentioning

confidence: 83%

The effect of azoximer bromide (Polyoxidonium®) in patients hospitalized with coronavirus disease (COVID-19): an open-label, multicentre, interventional clinical study

Efimov¹,

Matsiyeuskaya²,

Boytsova³

et al. 2021

DIC

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A clinical need for aetiotropic coronavirus disease (COVID-19) treatments is required. The immune modulator azoximer bromide (AZB; Polyoxidonium®) is indicated in Russia for use against acute viral infections and during remission. In this study, adults hospitalized with COVID-19 ( n =32) received AZB and standard of care in an open-label, multicentre, interventional study. All patients were symptomatic; 22 had severe disease (National Early Warning Score ≥5) and required mechanical ventilation or oxygen saturation (SpO 2 ) and 19 patients had co-morbidities. Patients received AZB 12 mg intravenously once daily for 3 days, then intramuscularly every other day (approximately ten injections) until discharge. The primary endpoint was the patient’s clinical status (7-point Ordinal Scale; OS) on day 15 versus that at baseline. The mean duration of hospitalization was 20 days. All patients were alive and discharged with normal SpO 2 with no secondary infections or delayed mortality reported by the end-of-study visit (on day 28–72). A decrease in the mean OS and National Early Warning Score values was observed following treatment with AZB. A decrease in OS score was marked in patients identified as severe. Both sets of patients achieved similar scores, which can be classified as an improvement by day 9–10; SpO 2 levels trended to normalization over time. By day 11–12, all patients had a normal body temperature. Serum C-reactive protein levels decreased in patients with severe and mild disease. Most patients had signs of pneumonia at baseline ( n =27), with the majority recovering by days 10–12. No major toxicities were observed. AZB was safe and well tolerated when administered in addition to standard of care treatment for COVID-19. Further randomized, placebo-controlled studies are needed to elucidate any potential therapeutic effect in COVID-19.

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Section: Discussionmentioning

confidence: 83%

The effect of azoximer bromide (Polyoxidonium®) in patients hospitalized with coronavirus disease (COVID-19): an open-label, multicentre, interventional clinical study

Efimov¹,

Matsiyeuskaya²,

Boytsova³

et al. 2021

DIC

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“…Летальность среди пациентов, находившихся на кислородотерапии, составила 10,1% и увеличивалась при переводе на неинвазивную (36,8%) или инвазивную (76,5%) вентиляцию легких. Риск смерти увеличивался с возрастом, при наличии ИБС, ожирения, СД 2 типа, и в возрастных группах старше 50 лет у мужчин он был достоверно выше, чем у женщин [9]. Изменения в легких после тяжелого заболевания могут сохраняться длительное время и обусловливать симптомы ПКС.…”

Section: патогенез и клиническая картина Covid-19 и пксunclassified

Postcovid syndrome: risk factors, pathogenesis, diagnosis and treatment of patients with respiratory damage after COVID-19 (overview)

Bilichenko¹

2022

Russian Medical Inquiry

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In COVID-19 of moderate to severe degree, there are significant inflammatory changes in the lungs and other organs involved in the pathological process with corresponding symptoms and functional disorders lasting longer than 12 weeks. They are designated as postcovid syndrome (PCS) and require further treatment. The article presents the pathogenetic mechanism of PCS, in which organ damage has the systemic nature. Special attention is paid to the changes in the organs of the respiratory system (atelectasis in the alveoli within the lungs, remodeling of the bronchial epithelium, hyaluronan deposition in the lumen of alveoli, bronchi and perialveolar interstitial with the formation of connective tissue), which in the long term lead to fibrous changes, especially in patients with severe COVID-19 and concomitant respiratory diseases. This, in turn, makes oxygen and carbon dioxide to pass through the alveoli wall with difficulties, decreases exercise tolerance and life quality, and increases mortality in elderly patients. The article also outlines the main directions of pathogenetically conditioned therapy of patients with respiratory disorder in the outpatient settings, providing a decrease in rehabilitation period and improving the patients condition. KEYWORDS: postcovid syndrome, alveolar epithelium, atelectasis, comorbidity, rehabilitation. FOR CITATION: Bilichenko T.N. Postcovid syndrome: risk factors, pathogenesis, diagnosis and treatment of patients with respiratory damage after COVID-19 (overview). Russian Medical Inquiry. 2022;6(7):367–375 (in Russ.). DOI: 10.32364/2587-6821-2022-6-7-367-375.

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“…и др.) [1][2][3][4][5]. В практику внедрены методы терапии кислородом (в т. ч. в домашних условиях), гелием, оксидом азота, неинвазивной вентиляции легких, что позволило существенно увеличить выживаемость пациентов с тяжелыми БОД.…”

Section: результаты и обсуждениеunclassified

“…В условиях пандемии новой коронавирусной инфекции (НКИ) перед сотрудниками ФГБУ «НИИ пульмонологии» ФМБА поставлены задачи разработки и внедрения инновационных методов диагностики, лечения пациентов с COVID-19, программ реабилитации после перенесенной инфекции с использованием научно-практического потенциала в полном объеме. При этом изучены клиникоэпидемиологические характеристики инфекции COVID-19, разработаны методические рекомендации по диагностике и ведению пациентов, исследованы и внедрены в практику новые методы диагностики, лечения и реабилитации пациентов после перенесенной инфекции [5,8,15,16,[29][30][31][32][33][34][35][36][37][38]. Установлено, что НКИ поражает людей любого возраста, а риск заболевания и тяжелого течения COVID-19 имеет прямую связь с возрастом и наличием хронических болезней [29].…”

Section: результаты и обсуждениеunclassified

“…В борьбе за выживание пациентов с COVID-19 большое значение придается кислородотерапии и респираторной поддержке на дореанимационном этапе, а также неинвазивной вентиляции легких [33,34]. Основными факторами риска смерти больных с COVID-19, переведенных в отделение реанимации и интенсивной терапии для респираторной поддержки, явиляются, прежде всего, тяжесть острого респираторного дистресс-синдрома, необходимость в инвазивной вентиляции легких, пожилой возраст, мужской пол, а также наличие ишемической болезни сердца, ожирения и сахарного диабета 2-го типа [5]. Отмечено, что у пациентов с тя-желым течением COVID-19 при назначении ингаляционного сурфактанта до перевода на искусственную вентиляцию легких сдерживалось прогрессирование дыхательной недостаточности, удалось предотвратить использование инвазивной вентиляции легких и повысить выживаемость пациентов [35].…”

Section: результаты и обсуждениеunclassified

See 1 more Smart Citation

The achievements of pulmonology and the main directions of further improvement of medical care in the Russian Federation

Биличенко

Shutov

2021

Pulʹmonologiâ (Mosk.)

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The development of pulmonology in Russia is linked with the creative activity of the Scientific Research Institute of Pulmonology of the Federal Medico-Biological Agency (Research Institute of Pulmonology of the FMBA) and its scientific school.The aim of the analytical review was to assess the role and contribution of the research team of the Research Institute of Pulmonology in improving the quality of medical care to the population of Russia.Methods. The data of medical statistics of the Ministry of Health of the Russian Federation on morbidity and mortality of the population due to respiratory diseases (RD) from 2004 - 2018 are analyzed. The publications on scientific research conducted with the participation of employees of the Research Institute of Pulmonology for the period from 2005 to 2020 were studied.Results. Over the past 30 years in Russia, with the participation of the staff of the Research Institute of Pulmonology, the state task of creating a system for organizing medical care for the population with RD has been successfully solved. The study and implementation of modern innovative approaches in the diagnosis, treatment and prevention of RD, the training of primary care physicians allowed to improve the quality of medical care to patients to the level of world standards. For the period from 2004 - 2018 the mortality of the population from RD 35.6% decrease was registered. During the pandemic of a new coronavirus infection, the use of pulmonology achievements in clinical practice contributed to a decrease in the frequency of deaths in people with COVID-19.Conclusion. Currently, the Research Institute of Pulmonology of the FMBA of Russia retains a leading position in the country in the field of fundamental scientific research, innovative methods of diagnosis and treatment of RD, educational activities and training of specialists in the field of pulmonology.

show abstract

Clinical outcomes of patients with COVID-19 admitted for respiratory support to the intensive care units in Russia

Cited by 12 publications

References 33 publications

The effect of azoximer bromide (Polyoxidonium®) in patients hospitalized with coronavirus disease (COVID-19): an open-label, multicentre, interventional clinical study

The effect of azoximer bromide (Polyoxidonium®) in patients hospitalized with coronavirus disease (COVID-19): an open-label, multicentre, interventional clinical study

Postcovid syndrome: risk factors, pathogenesis, diagnosis and treatment of patients with respiratory damage after COVID-19 (overview)

The achievements of pulmonology and the main directions of further improvement of medical care in the Russian Federation

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