Сoronavirus infection COVID-19 and features of its treatment in a patient with cardiovascular pathology. Clinical case

Patients with cardiovascular disease represent a particularly vulnerable population in a pandemic of the coronavirus infection COVID-19. They are more at risk of infection, a severe course of the disease, as well as a higher mortality rate compared to a healthy population. Currently, there are no randomized clinical trials to determine the most effective approaches to treatment in this category of patients. The presented clinical example demonstrates the possibilities of using various groups of drugs recommended for the treatment of COVID-19, and the high efficiency of treatment with an interleukin-6 receptor inhibitor (IL-6) in a patient with severe new coronavirus infection and the presence of concomitant cardiovascular pathology. © 2020, Media Sphera Publishing Group. All rights reserved.

["Guiding lights" for the diagnosis of chronic thromboembolic pulmonary hypertension in the flow of patients with pulmonary embolism].

On December 13, 2021, an expert council was held to determine the position of experts of different specialties regarding the reasons for the low level of diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) in real clinical practice in a pandemic of a new coronavirus infection and possible ways to improve detection in patients with pulmonary embolism (PE) ) in history. The reasons for the low level of diagnosis of CTEPH are the insufficient level of knowledge of specialists, especially primary care physicians; lack of clear regulatory documents and expert centers for the management of this category of patients. Primary diagnosis of CTEPH in a pandemic can be strengthened through the widespread use of telemedicine for consultations of primary care physicians with specialists from expert centers; to maximize the role of echocardiography and computed tomography (CT) as differential diagnostic tools for dyspnea, in particular in patients with COVID-19. To increase the detection rate of CTEPH, diagnostic vigilance is required in patients with risk factors and episodes of venous thromboembolism. To improve the screening of CTEPH, it is necessary to create an algorithm for monitoring patients who have had PE; provide educational activities, including through the media; create materials for patients with accessible information. The regulatory documents should designate the circle of responsible specialists who will be engaged in long-term monitoring of patients with PE. Educational programs are needed for primary care physicians, cardiologists, and other physicians who come into the field of view of patients with CTEPH; introduction of a program to create expert centers for monitoring and managing patients with the possibility of performing ventilation-perfusion lung scintigraphy, cardiopulmonary stress test, CT, right heart catheterization. It seems important to build cooperation with the Ministry of Health of Russia in order to create special protocols, procedures for managing patients with PE and CTEPH.

Features of the course and approaches to the treatment of coronavirus infection COVID- 19 patients with cardiovascular diseases

Patients with cardiovascular disease represent a particularly vulnerable population in a pandemic of the coronavirus infection COVID -19. They are more at risk of infection, a severe course of the disease, as well as a higher mortality rate compared to a healthy population. Currently, there are no randomized clinical trials to determine the most effective approaches to treatment in this category of patients. The presented clinical example demonstrates the possibilities of using various groups of drugs recommended for the treatment of COVID-19, and the high efficiency of treatment with an interleukin-6 receptor inhibitor (IL-6) in a patient with severe new coronavirus infection and the presence of concomitant cardiovascular pathology. Пациенты с наличием сердечно-сосудистых заболеваний (ССЗ) представляют особую уязвимую группу населения в условиях пандемии коронавирусной инфекции COVID -19. Они наиболее подвержены риску заражения, тяжелому течению заболевания, а также более высокой летальности по сравнению со здоровой популяцией. В настоящее время отсутствуют рандомизированные клинические исследования, позволяющие определить наиболее эффективные подходы к лечению у данной категории больных. Представленный клинический пример демонстрирует возможности применения различных групп препаратов, рекомендованных для лечения COVID-19 и высокую эффективность терапии ингибитором рецептора интерлейкина - 6 (ИЛ-6) у пациента с тяжелым течением новой коронавирусной инфекции и наличием сопутствующей сердечно-сосудистой патологии.