Рецепт. 2021; : 614-624
Многоликость пост-COVID-синдрома и возможности коррекции постинфекционной иммуносупрессии
https://doi.org/10.34883/PI.2021.24.5.001Аннотация
В обзорной статье приводятся определение пост-COVID-синдрома и его классификации. Основные клинические проявления пост-COVID-синдрома включают в себя множество состояний и симптомов, частота проявлений которых варьирует в зависимости от тяжести острой инфекции и периода наблюдения. Наиболее распространенный симптом пост-COVID-синдрома – усталость, встречающаяся с частотой от 17,5% до 72%. По данным Dennis A. и соавт., МРТ выявила поражение хотя бы одного органа в 70% случаев пост-COVID-синдрома через 4 месяца после выздоровления от острой инфекции. Длительное воспаление, иммунная дисрегуляция играют ключевую роль в развитии большинства пост-COVID-проявлений, безусловно, являясь не единственным патофизиологическим механизмом их развития. Если воспалительный ответ слишком подавлен, то пациент, сумев «пережить» первоначальный гипервоспалительный цитокиновый шторм и прогрессирование полиорганной недостаточности, может вступить в стадию затяжной иммуносупрессии, известной как синдром стойкого воспаления, иммуносупрессии и катаболизма, что является одной из предполагаемых причин стойкого пост-COVID-синдрома. Приведена работа, в которой рассматривается возможность применения в лечении инфекции SARS-CoV-2 инозина пранобекса, который зарегистрирован как противовирусный иммуномодулирующий препарат более чем в 70 странах мира.
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Recipe. 2021; : 614-624
Post-COVID Syndrome Variety and Possibilities of Correction of Post-Infectious Immunosuppression
https://doi.org/10.34883/PI.2021.24.5.001Abstract
The review article provides the definition of post-COVID syndrome and its classification. The main clinical manifestations of post-COVID syndrome include many conditions and symptoms, the frequency of which varies depending on the severity of the acute infection and the observation period. The most common symptom of post-COVID syndrome is fatigue, ranging from 17.5% to 72%. According to Dennis A. et al., the MRI revealed damage to at least one organ in 70% of post- COVID cases in 4 months after recovery from acute infection. Prolonged inflammation and immune dysregulation play a key role in the development of the majority of post-COVID manifestations, certainly not being the only pathophysiological mechanism of its development. If the inflammatory response is too suppressed, the patient, having managed to "survive" the initial hyperinflammatory cytokine storm and the progression of multiple organ failure, may enter the stage of protracted immunosuppression known as persistent inflammation, immunosuppression and catabolism syndrome, which is one of the alleged reasons of persistent post-COVID syndrome. The work is presented, in which the possibility of using inosine pranobex, which is registered as an antiviral immunomodulatory drug in more than 70 countries of the world, is considered in the treatment of SARS-CoV-2 infection.
References
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