Методические рекомендации посвящены вопросам практической работы по диагностике и лечению новой коронавирусной инфекции COVID-19. Целью создания данного документа явилась необходимость выработки единого подхода в организации помощи пациентам с новой коронавирусной инфекцией COVID-19 в военных стационарах с позиций практического опыта специалистов госпиталя, требо-ваний национальных рекомендаций. наиболее важные рекомендации касаются вопросов правильного понимания заболевания, алго-ритмов действий врачебного персонала и режимов фармакотерапии пациентов с коронавирусной инфекцией. Ключевые слова: новая коронавирусная инфекция COVID-19, фармакотерапия, алгоритмы работы, клинические рекомендации. Для цитирования: Зайцев А.А., чернов С.А., Стец В.В. и др. Алгоритмы ведения пациентов с новой коронавирусной инфекцией COVID-19 в стационаре. Методические рекомендации. Consilium Medicum. 2020; 22 (11): 91–97. DOI: 10.26442/20751753.2020.11.200520

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The end of the acute period of COVID-19 does not mean complete recovery. Observation of patients in the post-COVID-19 period showed that a significant number of people experience shortness of breath, fatigue, muscle weakness, sleep disorders, cough, palpitations, so the term post-COVID-19 syndrome was coined. The examination to identify the causes of complaints of COVID-19 convalescents should include lung function assessment.The aim of the study was to assess the dynamics of lung function 4 months after hospitalization for COVID-19.Methods. 31 patients (26 males, the median age was 49 years) underwent traditional pulmonary function tests (PFTs) (spirometry, body plethysmography, test of diffusing lung capacity) and impulse oscillometry (IOS). Results. During the 1st visit, the average PFTs and IOS parameters were within the normal range in the whole group, apart from the diffusing lung capacity (DLCO), which was reduced mildly (on the border with moderate) in 77% of patients. During the 2nd visit, which was conducted on average 102 days after the 1st one, 58% of patients demonstrated abnormal lung diffusion capacity. The second assessment revealed a statistically significant increase in the slow and forced vital capacity (VC and FVC), the forced exhalation volume in 1 second (FEV1), total lung capacity (TLC), DLCO, and a decrease in the ratio of FEV1/FVC and the residual lung volume to TLC ratio.Conclusion. Post-COVID-19 patients show a statistically significant improvement of their lung function 4 months after hospital discharge. A systematic follow-up is essential for such patients to detect lung function abnormalities and correct them.

The lack of effective etiotropic methods of treatment and prevention of the new coronavirus infection (COVID-19), which caused the pandemic in 2020, determines the relevance of the review of researches of medicines for etiotropic and pathogenetic therapy. Most patients are diagnosed with pneumonia, the disease is especially difficult in people with concomitant chronic diseases, since COVID-19 leads to their decompensation, which can lead to death. To assess risk factors for mortality, scientists are developing programs to transfer the patient to appropriate treatment in a timely manner. This article analyzes the clinical efficacy of various agents for etiotropic and pathogenetic treatment of a new coronavirus infection based on data from international researches. Etiotropic medicines used at the beginning of the pandemic did not show their effectiveness in reducing the duration of treatment, the development of death, and preventing the transition to the use of mechanical ventilation. There are described researches of vaccines against a new coronavirus infection, developed in the Russian Federation, the USA, Germany and the UK, which showed the greatest efficiency (more than 90%) in preventing COVID-19. The World Health Organization initiated the international clinical research SOLIDARITY, according to which all medicines participating in the trials have little or no effect on overall mortality, the onset of ventilation requirements and the length of hospital stay in hospitalized patients. Now, only systemic glucocorticosteroids have proven effective against severe and critical forms of COVID-19. Thus, effective etiotropic drugs for the treatment of COVID-19 have not been developing, however, an active search for these funds and the development of vaccines to prevent the incidence of coronavirus infection are underway.

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