COVID-19: selected clinical aspects through the prism of practical experience


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Abstract

Since the first report in December 2019 of a new coronavirus infection, dubbed COVID-19, the new human coronavirus strain SARS-CoV-2 has spread worldwide, reaching pandemic proportions. Much remains to be studied, and the challenges for the near future include improvement of our understanding of the epidemiology, pathophysiology, and clinical features of this new infectious disease. There are many questions regarding the interaction of the virus and the human body. Until now, the effectiveness of any of the antiviral drugs has not been proven. This article highlights some aspects of the pathogenesis and clinical course of COVID-19, as well as the possibilities for optimizing therapy associated with these aspects. The multifaceted, sometimes excessive and uncontrollable response from the immune system determines an extremely variable spectrum of clinical manifestations of COVID-19, which ranges from asymptomatic to fatal bilateral pneumonia and multiple organ failure. «Cytokine storm» appears to be one of the most serious and potentially life-threatening events associated with the most severe clinical course of COVID-19, including the development of acute respiratory distress syndrome. Antiinflammatory therapy, including anti-interleukin-6 receptor antibodies, and timely and adequate respiratory support have no doubt proven to be effective in the treatment of these difficult patients. Chronic respiratory diseases such as bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) can dramatically affect the fate of a patient infected with SARS-CoV2. Therefore, preventive measures to prevent nfection and the continuation of basic therapy for asthma and COPD, including inhaled glucocorticosteroids, are strongly recommended to reduce the risk of exacerbation of chronic disease, on the one hand, and improve the outcomes of COVID-19, on the other.

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About the authors

Yu. G Belotserkovskaya

Russian Medical Academy of Continuous Professional Education

Email: belo-yuliya@yandex.ru
Cand. Sci. (Med.), Associate Professor at the Department of Pulmonology 2/1, build. 1, Barrikadnaya str., Moscow 125993, Russian Federation

S. S Lebedev

Russian Medical Academy of Continuous Professional Education

Moscow, Russia

D. V Vakatov

S.P. Botkin City Clinical Hospital

Moscow, Russia

I. A Demina

S.P. Botkin City Clinical Hospital

Moscow, Russia

O. N Sakara

S.P. Botkin City Clinical Hospital

Moscow, Russia

A. G Romanovskikh

Russian Medical Academy of Continuous Professional Education

Moscow, Russia

I. P Smirnov

Russian Medical Academy of Continuous Professional Education

Moscow, Russia

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