RESUMO
The article discusses pathogenesis and treatment of COVID-19. The authors presented state-of-the-art insight into hemostatic disorders in patients with COVID-19 and clinical recommendations on prevention of thrombosis and thromboembolism in patients infected with SARS-CoV-2. The article discussed in detail a new hypothesis proposed by Chinese physicians about a new component in the pathogenesis of COVID-19, namely, about the effect of SARS-CoV-2 virus on the hemoglobin beta-chain and the formation of a complex with porphyrin, which results in displacement of the iron ion. Thus, hemoglobin loses the capability for transporting oxygen, which aggravates hypoxia and worsens the prognosis. The article stated rules of hemotransfusion safety in the conditions of COVID-19 pandemic.
Assuntos
Gasometria , Transfusão de Sangue , Infecções por Coronavirus/fisiopatologia , Hemostasia , Pneumonia Viral/fisiopatologia , Betacoronavirus , COVID-19 , Hemoglobinas , Humanos , Hipóxia , Ferro , Pandemias , Porfirinas , SARS-CoV-2RESUMO
This article discusses relevant aspects in the treatment of patients with COVID-19. Up-to-date information about principles for administration of statins, antithrombotics, and antiarrhythmics is presented. The authors addressed in detail specific features of reversing heart rhythm disorders in patients with coronavirus infection and the interaction of antiarrhythmic and antiviral drugs. Recommendations are provided for outpatient and inpatient antithrombotic therapy for patients with COVID-19. Issues of antithrombotic and antiviral drug interaction are discussed.
Assuntos
Anticoagulantes , Cardiologia , Infecções por Coronavirus , Inibidores de Hidroximetilglutaril-CoA Redutases , Pandemias , Pneumonia Viral , Antiarrítmicos/uso terapêutico , Anticoagulantes/uso terapêutico , Betacoronavirus , COVID-19 , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Federação Russa , SARS-CoV-2 , Sociedades Médicas , Tratamento Farmacológico da COVID-19RESUMO
The agreement of experts of the Eurasian Association of Therapists (EAT) discusses pathogenesis and treatment of COVID-19. Modern data on the characteristics of cardiovascular, kidney, respiratory damage in SARS-infected CoV-2 are presented. The tactics of managing patients initially having cardiovascular diseases, diabetes mellitus, chronic obstructive pulmonary disease, bronchial asthma, chronic kidney disease are discussed in detail. The article presents data on drug interaction of drugs.
Assuntos
Asma , COVID-19 , Diabetes Mellitus , Doença Pulmonar Obstrutiva Crônica , Humanos , SARS-CoV-2RESUMO
Endothelium function was assessed from endothelium-dependent vasodilation and plasma endothelin-1 (ET-1) levels in 16 patients with arterial hypertyension (AH) and insulin resistance (IR) and compared with that in 22 patients with AH without IR. IR was diagnosed indirectly from the fasting glucose-to-insulin ratio in venous blood below 6. Additional studies included round-the-clock monitoring arterial pressure, reactive hyperemia test, and immunoreactive ET-1 assay. Major changes revealed in the patients with AH and IR were a smaller-than-normal diameter of the humeral artery, its decreased incremental growth, and elevated plasma ET-1 compared with the AH patients without IR. It is concluded that patients with AH and IR exhibit more pronounced dysfunction of endothelium than patients with AH without metabolic disorders.