Management of osteoarthritis in the context of COVID-19

Abstract

Regular revision of the management of osteoarthritis by world associations has been performing both to the epidemiologicalfeatures of the spread of the disease in 80% of the after-50-years-old population, and to the comorbidities. The groupof this age has the highest risk of susceptibility and severe course of COVID–19. Objective. To reveal the features of the step-bystep algorithm for the treatment of patients with osteoarthritis in the conditions of the COVID-19 pandemic. Methods. The study is based on the analysis of the published data on the peculiarities of non-pharmacological and pharmacological means according to the step-by-step algorithm for the treatment of patients with osteoarthritis. 227 published scientific sources, from which 54 editions with a reliable evidence base were selected. Results. The treatment of patients with osteoarthritis in the conditions of a pandemic requires correction, due to the use of drugs with certain pharmacokinetic and pharmacodynamic properties that can atypically or negatively affect the systems of the body. Each of the four steps of the treatment algorithms for patients with osteoarthritis was analyzed, taking into account the pathophysiological features of the course of chronic joint disease and acute viral damage to the respiratory system. It was noted that despite the high variability of treatment methods for patients with osteoarthritis, decisions regarding the therapeutic tactic should be made taking into consideration the individual characteristics of the body and comorbidities. It was emphasized that the final decision regarding the prescription of corticosteroids and non-steroidal anti-inflammatory drugs must be properly argumented. The correction of the treatment measures set at each step of the algorithm is proposed. It would prevent the aggravation of the chronic impression of the joints in the adverse situation of the COVID-19 pandemic. Conclusions. A profound search in the scientific published sources for evidence concerning the specifics of the effect of non-pharmacological and pharmacological means of treatment for patients with osteoarthritis will allow to use their effects effectively using step-by-step algorithm especially during the dangerous pandemic situation.