SARS-CoV-2 is a novel coronavirus that has been identified as the cause of the 2019 coronavirus infection (COVID-19), which originated at Wuhan city of PRC in late 2019 and widespread worldwide. As the number of patients recovering from COVID-19 continue to grow, it’s very important to understand what health issues they may keep experiencing. COVID-19 is now recognized as an infectious disease that can cause multiple organ diseases of various localization. It is against this background that a new term was introduced: post-acute post-COVID-19 syndrome characterized by several persistent symptoms inherent in the acute phase of the disease, as well as the occurrence of delayed and (or) long-term complications beyond 4 weeks from the onset of the disease. The work reflected in this article revealed a portrait of a patient with post-COVID-19 syndrome, the most common complications of this period, as well as the mechanisms of their development and the resulting metabolic, cellular, tissue disorders leading to the tissue and organ dysfunctions. A comprehensive biochemical and immunological screening was carried out using the example of three clinical cases to identify the most significant disorders in these patients and to correlate with their clinical status over time. In point of fact, such patients were diagnosed with vascular dysfunction factors (development of endothelial dysfunction), metabolic dysfunction factors (metabolic acidosis, mitochondrial dysfunction, carbohydrate metabolism disorder, insulin resistance, altered branched-chain and aromatic amino acid metabolism), neurological disorder factors (neurotoxicity of the resulting metabolites), immunological disorder factors (decreased efficiency of detoxification systems, secondary immunodeficiency, risk of secondary bacterial infection).
Surgical treatment outcomes on 87 patients aged 60-83 years operated on for degenerative-dystrophic diseases of lumbosacral spine have been presented. Depending on the stage of pathologic process and compressive factor direction, different types of decompressive stabilizing surgical interventions were performed in compliance with the elaborated tactics of surgical treatment. Evaluation of the results showed significant decrease in pain sensations (by Visual Analog Scale) and increase in the indices of daily activity (by Oswestry Disability Index) both in early (under 3 months) and late (up to 36 months) postoperative periods, that led to significant improvement of the life quality in elderly patients. The achieved results confirmed the efficacy of the elaborated differentiated approach to surgical treatment of that group of patients.
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