ХОБЛ -одно из самых распространенных заболеваний дыхательной системы человека, которое ока-зывает влияние не только на рост нетрудоспособности и преждевременной смертности, но и на качество жизни пациентов, вызывая такие хронические респираторные симптомы, как одышка, хронический кашель или выделение мокроты. Хроническая обструктивная болезнь легких (ХОБЛ) приводит к стойкому ограни-чению скорости воздушного потока, связанному с хроническим воспалительным ответом легочной ткани на действие патогенных частиц или газов. В статье обсуждаются результаты исследований по применению опросников, направленных на выявление респираторных симптомов, для ранней диагностики ХОБЛ.Ключевые слова: хроническая обструктивная болезнь легких, опросники, респираторные симптомы. Chronic obstructive pulmonary disease (COPD) is a disease which leads to permanent airflow limitation associated with a chronic inflammatory response of the lung tissue to action particles or gases. COPD is one of the most common diseases of the respiratory system leading not only to the increase of disability and premature death, but also to decrease quality of life of patients, causing chronic respiratory symptoms such as shortness of breath, chronic cough or sputum production. In this article authors discuss the results of trials with using questionnaires used to identify respiratory symptoms for early diagnosis of COPD.Keywords: chronic obstructive pulmonary disease, questionnaires, respiratory symptoms.Введение. Хроническая обструктивная болезнь легких (ХОБЛ) вносит существенный вклад в рост временной нетрудоспособности, увеличение ко-личества случаев инвалидности и преждевремен-ной смертности [1]. Доля ХОБЛ занимает лиди-рующее положение, составляя более 55% в струк-туре заболеваний дыхательной системы [2]. При этом продолжительность жизни больных ХОБЛ в России ниже на 10-15 лет, чем в странах Запад-ной Европы [3].Диагностика ХОБЛ основывается на сборе ана-мнестических данных, данных клинического осмот-ра, а также на результатах исследования венти-ляционной функции легких. Основными клиниче-скими проявлениями ХОБЛ являются наличие хронического кашля, выделения мокроты и/или одышки. Но так как данное заболевание начина-ется, как правило, у лиц старше 40 лет и прогресси-рует медленно и незаметно для пациента, основ-ные симптомы ХОБЛ заставляют обращаться за медицинской помощью уже спустя годы после их появления, когда болезнь приобретает среднетя-желое и тяжелое течение.Проблему своевременной диагностики ХОБЛ в большинстве стран решают врачи первичного звена здравоохранения, к которым обращаются пациенты с жалобами на респираторные симпто-мы, не являющиеся специфичными для это го за-болевания. Вместе с тем распространенность таких респираторных симптомов, как кашель, мокрота и/или одышка, в популяции составляет до 35%. Если исходить из того, что основной диагностиче-ский стандарт ХОБЛ на сегодня -выявление не-обратимой или частично обратимой бронхиальной обструкции при исследовании вентиляционной функции легких, может создаться впечатление, что потребности...

INTRODUCTION: The sudden appearance of a new coronavirus infection in the world has posed difficult challenges for science to determine the main clinical manifestations of this disease, as well as to approve standards for diagnosis, treatment and prevention. Research of the symptoms of mild COVID-19 is continuing. The data obtained in such studies are particularly relevant for primary care physicians. THE AIM: To evaluate the features of the clinical course of COVID-19 among students of the North-Western State Medical University named after I.I. Mechnikov, placed in the observatory, during the first and second waves of rising morbidity. MATERIALS AND METHODS: The study was conducted on the basis of the observatory of the NWSMU named after I.I. Mechnikov in two stages: in the period from 21.04.2020 to 31.08.2020 (the first wave) and from 16.09.2020 to 31.12.2020 (the second wave). Demographic, epidemiological, and clinical-anamnestic data were recorded in all participants of the study. RESULTS: The study involved 309 people: 39.8% men (n = 123) and 58.9% women (n = 182). The average age of the respondents was 21.5 2.6 years. The number of participants in the first and second waves was 113 and 196 people, respectively. The average age of participants with COVID-19 in the first wave was 1.5 years less and was 21.2 2.5 years (р 0.001). There was a significant increase in the frequency of the following symptoms: dry cough, loss of smell, headache, general weakness, increased body temperature to 38.0 С, nasal congestion (р 0.05) in students who were monitored in the second wave of increased incidence of COVID-19 compared to the first. The frequency of symptoms such as chest congestion, lower back pain, and fever above 38.0 С significantly decreased (р 0.05). There was a significant decrease in the incidence of viral pneumonia in patients who were observed during the second wave, compared with the data obtained during the first wave (р 0.001).

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BACKGROUND: The pandemic of a new coronavirus infection, which began in the Chinese city of Wuhan in December 2019, has spread to more than 200 countries and territories. There are a number of studies, the results of which indicate that deaths are mainly registered among the middle-aged and elderly population with chronic non-communicable diseases. Most of these studies are based on the study of cases of COVID-19 with severe course or in hospitalized patients. At the same time, a greater number of patients, including those with chronic non-communicable diseases, carry COVID-19 to a mild degree and remain under the supervision of primary care physicians. AIM: To identify risk factors for the development of severe COVID-19 in patients with chronic non-communicable diseases who sought outpatient care during various periods of increased incidence of new coronavirus infection from March 2020 to February 2022. MATERIALS AND METHODS: The study was carried out on the basis of the Family Medicine Center of North-Western State Medical University named after I.I. Mechnikov, which provides primary health care to the population attached under compulsory health insurance. The design of the study was published earlier. A retrospective cohort study was conducted based on the analysis of outpatient records of patients who sought medical care at the Family Medicine Center during various periods of increased incidence of COVID-19: from 19.03.2020 to 30.06.2020 (group 1), from 1.10.2021 to 30.11.2021 (group 2) and from 18.01.2022 to 28.02.2022 (group 3). RESULTS: 343 patients were included in the study: 137 men (39.9%) and 206 women (60.1%). The number of patients with at least one chronic non-communicable disease was 232 (67.9%). It was found that the severity of COVID-19 is not affected by the presence of one or more chronic non-communicable diseases of mild severity in the patient. At the same time, grade II obesity and grade III hypertension are independent factors that significantly increase the risk of developing severe COVID-19 by 13.4 and 5.4 times, respectively (p 0.05). It should be noted that the combination of these diseases significantly increased the likelihood of developing severe COVID-19 by 11.9 times (p 0.05). CONCLUSIONS: Regardless of the period of morbidity, the clinical manifestations of COVID-19 in patients with chronic non-communicable diseases have their own characteristics: weakness, sweating, dry and wet cough are significantly more common (p 0.05). With each subsequent wave of increase in the incidence of COVID-19 in patients with chronic non-communicable diseases, there is a significant tendency to decrease the frequency of severe and very severe course of the disease, pneumonia and hospitalization, as in patients without chronic non-communicable diseases. It was found that the severity of the COVID-19 course is not affected by the presence of mild chronic non-communicable diseases in the patient. At the same time, grade II and higher obesity or grade III hypertension are independent factors that significantly increase the risk of developing severe COVID-19 by 11.9 and 5.4 times, respectively (p 0.05). The combination of these diseases significantly increased the probability of developing severe COVID-19 by 13.4 times (p 0.05).