COVID-19: controversial aspects of patients’ curation


DOI: https://dx.doi.org/10.18565/therapy.2020.5.20-24

Zaitzev A.A.

N.N. Burdenko Main military clinical hospital of the Ministry of Defense of the Russian Federation
The publication is devoted to the discussion of topical issues of curation patients with ne COVID-19 coronavirus infection. The aspect of correct understanding the main points of pulmonary damage in COVID-19 case from the viewpoint of a practitioner is considered. Particular attention is paid to antimicrobial therapy indications, consideration of the role of inflammatory response biomarkers in COVID-19 patients. Also the data on the prospects for systemic glucocorticosteroids use in COVID-19 case are represented and recommendations for their use are made.
Keywords: new COVID-19 coronavirus infection, inflammatory response biomarkers, procalcitonin, C-reactive protein, antimicrobial therapy, systemic glucocorticosteroids, methylprednisolone, pulse therapy
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Literature


  1. Bassetti M., Vena A., Giacobbe D.R. The Novel Chinese Coronavirus (2019 nCoV) Infections: challenges for fighting the storm. Eur J Clin Invest. 2020; 50(3): e13209. doi: 10.1111/eci.13209.

  2. Временные методические рекомендации – профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19). Версия 7 (03.06.2020). Министерство здравоохранения Российской Федерации. Электронное издание. Available at: https://static-0.rosminzdrav.ru/system/attachments/attaches/000/050/584/original/03062020_МR_COVID-19_v7.pdf (дата обращения – 19.07.2020). [Temporary guidelines – prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 7 (03.06.2020). Ministry of Healthcare of the Russian Federation. Electronic edition. Available at: https://static-0.rosminzdrav.ru/system/attachments/attaches/000/050/584/original/03062020_МR_COVID-19_v7.pdf (date of access – 19.07.2020) (In Russ.)].

  3. Canada.ca. 2019 novel coronavirus: Symptoms and treatment. The official website of the Government of Canada. Available at: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirusinfection/symptoms.html (date of access – 19.07.2020).

  4. CDC. 2019 Novel Coronavirus. Available at: https://www.cdc.gov/coronavirus/2019-ncov/index.html (date of access – 19.07.2020).

  5. Chen N., Zhou M., Dong X. et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395(10223): 507–13. doi: 10.1016/S0140-6736(20)30211-7.

  6. Huang C., Wang Y., Li X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223): 497–506. doi: 10.1016/S0140-6736(20)30183-5.

  7. Guan W.-J., Ni Z.-Y., Hu Y. et al. Clinical characteristics of 2019 novel coronavirus infection in China. N Engl J Med. 2020; 382(18): 1708–20. doi: 10.1056/NEJMoa2002032.

  8. Zhang J., Zhou L., Yang Y. et al. Therapeutic and triage strategies for 2019 novel coronavirus disease in fever clinics. Lancet Respir Med. 2020; 8(3): e11–e12. doi: 10.1016/S2213-2600(20)30071-0.

  9. COVID-19: обсуждение спорных моментов, касающихся вызванных коронавирусом изменений в легких, и подходов к лечению. Информационное письмо Межрегиональной ассоциации специалистов респираторной медицины (МАСРМ). 2020. Available at: http://www.antibiotic.ru/index.php?article=2959 (дата обращения – 19.07.2020). [COVID-19: discussion of controversial issues caused by coronavirus changes in the lungs, and approaches to treatment. Information letter of the Interregional Association of Respiratory Medicine Specialists. 2020. Available at: http://www.antibiotic.ru/index.php?article=2959 (date of access – 19.07.2020) (In Russ.)].

  10. Российское респираторное общество (РРО), Межрегиональная ассоциация по клинической микробиологии и антимикробной химиотерапии (МАКМАХ). Клинические рекомендации по диагностике, лечению и профилактике тяжелой внебольничной пневмонии у взрослых. М., 2018. Доступ: www.antibiotic.ru. (дата обращения – 10.06.2020). [Russian Respiratory Society, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. Clinical practice guidelines for the diagnosis, treatment and prevention of severe community-acquired pneumonia in adults. М. 2018. Available at: www.antibiotic.ru (date of access – 10.06.2020) (In Russ.)].

  11. Зайцев А.А., Овчинников Ю.В., Кондратьева Т.В. Биологические маркеры воспаления при внебольничной пневмонии. Consilium Medicum. 2014; 11: 36–41. [Zaytsev A.A., Ovchinnikov Yu.V., Kondratieva T.V. Biological markers of inflammation in community-acquired pneumonia. Consilium Medicum. 2014; 11: 36–41 (In Russ.)].

  12. Ingram P.R., Inglis T., Moxon D., Speers D. Procalcitonin and C-reactive protein in severe 2009 H1N1 influenza infection. Intensive Care Med. 2010; 36(3): 528–32. doi: 10.1007/s00134-009-1746-3.

  13. Cuquemelle E., Soulis F., Villers D. et al. Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study. Intensive Care Med. 2011; 37(5): 796–800. doi: 10.1007/s00134-011-2189-1.

  14. Ji-Young R., Hong G., Min Ryu K. Clinical implications of 5 cases of middle east respiratory syndrome coronavirus infection in a South Korean outbreak. Jpn J Infect Dis. 2016; 69(5): 361–66. doi: 10.7883/yoken.JJID.2015.445.

  15. Chen N., Zhou M., Dong X. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395: 507–13. doi: 10.1016/S0140-6736(20)30211-7.

  16. Zhou F., Yu T., Du R. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395: 1054–62. doi: 10.1016/S0140-6736(20)30566-3.

  17. Zhang W., Zhao Y., Zhang F. et al. (2020). The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The experience of clinical immunologists from China. Clin Immunol. 2020; 214: 108393. doi: 10.1016/j.clim.2020.108393.

  18. Du B., Qiu H., Zhan X. et al. [Pharmacotherapeutics for the new coronavirus pneumonia]. Zhonghua Jie He He Hu Xi Za Zhi. 2020; 43(3): 173–76. doi: 10.3760/cma.j.issn.1001-0939.2020.03.005.

  19. Sun P., Lu X., Xu C. et al. Understanding of COVID-19 based on current evidence J Med Virol. 2020; 92(6): 548–51. doi: 10.1002/jmv.25722.

  20. Chan K.W., Wong V.T., Tang S.C.W. COVID-19: an update on the epidemiological, clinical, preventive and therapeutic evidence and guidelines of integrative Chinese-Western medicine for the management of 2019 novel coronavirus disease. Am J Chin Med. 2020; 48(3): 737–62. doi: 10.1142/S0192415X20500378.

  21. EVMS critical care COVID-19 management protocol. Developed and updated by Marik P. 2020. Available at: https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf (date of access – 01.08.2020).

  22. Fadel R., Austin R., Morrison P. et al. Early short course corticosteroids in hospitalized patients with COVID-19. Clin Infect Dis. 2020; ciaa601. doi: 10.1093/cid/ciaa601.

  23. Auyeung T.W., Lee J.S., Lai W. et al. The use of corticosteroid as treatment in SARS was associated with adverse outcomes: a retrospective cohort study. J Infect. 2005; 51(2): 98–102. doi: 10.1016/j.jinf.2004.09.008.

  24. Ho J.C., Ooi G.C., Mok T.Y. et al. High-dose pulse versus nonpulse corticosteroid regimens in severe acute respiratory syndrome. Am J Respir Crit Care Med. 2003; 168(12): 1449–56. doi: 10.1164/rccm.200306-766OC.

  25. Yam L.Y., Lau A.C., Lai F.Y. et al. Corticosteroid treatment of severe acute respiratory syndrome in Hong Kong. J Infect. 2007; 54(1): 28–39. doi: 10.1016/j.jinf.2006.01.005.

  26. Chen R.C., Tang X.P., Tan S.Y. et al. Treatment of severe acute respiratory syndrome with glucosteroids: the Guangzhou experience. Chest. 2006; 129(6): 1441–52. doi: 10.1378/chest.129.6.1441.


About the Autors

Andrey A. Zaitsev, MD, professor, Honored doctor of Russia, the chief pulmonologist of N.N. Burdenko Main military clinical hospital of the Ministry of Defense of the Russian Federation. Address: 105094, Moscow, 3 Gospital`naya Sq. Tel.: +7 (499) 263-10-47. E-mail: a-zaicev@yandex.ru. ORCID: 0000-0002-0934-7313.

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