RESUMO
Background: The COVID-19 pandemic is considered as a major challenge of the 21st century medicine around the world. Prolonged post-COVID symptoms of the respiratory system remain a topical issue: dry annoying cough, respiratory failure, and discomfort in the lung projection area. Thus, in COVID-infected patients, the assessment of respiratory system functional state with postcoid respiratory symptoms is undoubtedly important that is the aim of our study. Method(s): To achieve this aim, 56 patients (18 to 65 years of age, 33-females, 23-males) with post-COVID respiratory symptoms who referred to the Scientific Research Institute of Allergology, Asthma and Clinical Immunology (Tskaltubo, Georgia) for further diagnosis and treatment were involved in the study. Result(s): Respiratory status: external respiratory functioning status and spirometry features were assessed using computer spirometry -Spirolab 3. Analysis of the results showed that in the above patients, defects in forced expiratory time (FET < 6 min) were observed. According to the basic parameters of spirometry, the slight changes in FEV1;FVC FEV1/VC (Tiffeneau-Pinelli index) were revealed;Only 6 (10%) patients showed a mild obstruction, 4 of irreversible type and only 2 patients had reversible broncho-obstruction. In addition, mild restriction was determined in only 5 (9%) patients. Restrictive changes were detected in patients with a history of severe course of COVID infection and CT severity scores 12-21. Significant changes were observed in the PEF-peak expiratory flow rate in 35 (61%) patients the PEF index was reliably lower, by 70% or more, compared to the norm. Conclusion(s): Obstruction of medium and small bronchus was also reported in the majority of patients. MEF50%, MEF25% indicators were reliably reduced, undoubtedly indicating the importance of COVID 19 infection in the development and course of respiratory symptoms. The study reaffirmed the need for spirometry in the management and monitoring of COVID infection. Information on changes in spirometry parameters in COVID patients and patients with post-COVID respiratory symptoms is still scarce, however, the study in this area is undoubtedly promising.
RESUMO
Background: Introduction: Coronavirus disease (COVID-19) is a global problem. The COVID-19 pandemic has infected millions of people and the number of patients who have been exposed to postcovid implications are increased. Postcovid changes are more investigated in adults, although information is scarce in pediatric patients. Method(s): The aim of the study was to evaluate the radiological changes of respiratory system in peaditric patients after acute mild and severe covid infections. Research subjects: 259 pediatric patients (age: 10 months -18 years) recovered from Covid-19 and had a negative PCR test were examined. All patients underwent X-ray examinations. Patients were divided into 3 subgroups. Patients (46%) recovered from severe or moderate covid pneumonia and had non-respiratory symptoms upon arrival at the clinic: weakness, mild fatigue, drowsiness. Patients (28%) recovered from covid infection and had respiratory symptoms: cough, shortness of breath during exercise, respiratory failure;Patients (26%) with a fever upon entry to the hospital. The statitical analysis was done using SPSS 12.0 software. Result(s): Patients, whose had (69.9% ) the severe Covid pneumonia and postcovid respiratory symptoms (cough 78.4%), which was the cause of abnormal changes in the cardiovascular system were onserved in 48.6% of patients. Unlike other types of viral infections, the changes continue in the postcovid period. Severe course of the disease does not always mean detection of postcovid syndrome and vice versa. However, in case of mild disease the possibility development of various degrees of polyorgan damage was 26.9%. Conclusion(s): The radiological changes are manifested during 4th week from recovery and may last for a longer period of time, however the radiological changes do not always indicator a severity of the disease.
RESUMO
Background: COVID 19 pandemic, undoubtedly, is a challenge of the 21st century. Due to its urgency, the issue can be considered as a problem of medicine. According to the researchers around the world, a strong correlation between vitamin D deficiency and severity and mortality rate of the disease caused by novel coronavirus (Covid-19) has been established. Method: Based on the above-mentioned, the aim of the study was to determine the correlation between Vitamin D plasma level and serum markers of disease in patients with covid-positive among Georgian population confirmed by the PCR method. Results: 135 COVID positive patients (74 females, 61 males) of mild and moderate severity who applied to the our Institute of Allergy in Tskaltubo, (Georgia) have been involved in the study to monitor Covid markers in the blood. Patients underwent the following examinations/ tests: complete blood count (CBC), C-reactive protein, coagulogram, D-dimer. In parallel, Vitamin D level in the blood was determined. Analysis of the results obtained showed that 113 (84%) of 135 patients involved in the study had severe leukopenia, 13 (9%)-leukocytosis, and only 9 (7%)-white blood cell level within the norm, respectively. It is noteworthy to emphasize that erythrocyte sedimentation rate (ESR) was elevated in 39 (28%) cases and C-reactive protein-in 95 (70%), respectively, while increase in D-dimer level was observed in only 65 (48%) of the patients. Coagulogram analysis revealed a sharp increase in fibrinogen concentration (FB) in 125 (92%) patients. In parallel, vitamin D deficiency was detected in 76 (56%) of Covid-patients in Georgian population, and acute deficiency in 37 (27%), respectively. Vitamin D level was found to be in norm only in 22 (17%) cases. According to the analysis of the results obtained, the greater vitamin D level deficiency, the more pronounced change in other blood Covid markers. Statistical analysis showed a high degree of correlation between vitamin D level and fibrinogen concentration (r = 0.8), C-reactive protein (r = 0.6), D-dimer (r = 0.5) blood levels. It is also worth noting that vitamin D deficiency correlates to a high degree with the severity of Covid infection clinical course. Conclusion: The results obtained allowed make conclusion: Vitamin D deficiency is directly related to the infection course degree, thus explaining the recommendations on necessity to include in disease management.
RESUMO
Background: The Covid-19 pandemic is considered as the biggest challenge not only to modern medicine but to all mankind. The situation is exacerbated by the lack of specific effective medications/ drugs against the virus. Coronavirus disease management is a continuous process of constant updating. Method: Common symptoms of the novel coronavirus include dry and lingering cough, and less common symptoms-a skin rash, respectively. During the course of infection an active involvement of allergic mechanisms type can be observed, leading to the need for including anti-allergic medications in the management of Covid infection. Results: During the course of infection an active involvement of allergic mechanisms of pathogenic type can be observed, leading to the need for including anti-allergic medications in the management of Covid infection. This clinical symptom persisted in the post-covid period. The above-mentioned aroused our interest and the study of post-covid patients experiencing post-covid symptoms such as lingering cough and a prolonged feeling of respiratory failure was conducted. It is noteworthy to emphasize that according to the results of clinical and laboratory studies, no sharp changes in allergic diagnostic parameters in the blood of these patients were revealed. Therefore, the empirical prescription of antiallergic drugs based on symptoms was chosen as a research tactic. 56 patients involved in the study (18 to 65 years of age, 33 women, 23 men) with dry and lingering cough symptoms were prescribed an inhaled form of local glucocorticosteroid-Budesond with generic active substance, leukotriene receptor antagonist, and antihistamines. Follow-up showed that the clinical effect was more pronounced in patients administering montelukast/desloratadine or levocetirizine in combination than in patients who were taking montelukast and/or desloratadine or levocetirizine separately. Monitoring of the patients revealed that 45 (80%) patients receiving above complex treatment had sooth in cough as a symptom, however, the clinical effect was obtained after nearly 10 days of treatment while 11 (20%) patients failed to achieve clinical efficacy with this treatment regimen Conclusion: Research monitoring has confirmed the ancillary effect of antiallergic drugs, however, the issue of Covid infection management still remains open and research in this direction still continues to be active around the world.