Options of metabolic support in case of coronaviral infection


DOI: https://dx.doi.org/10.18565/therapy.2020.7.146-155

Vertkin A.L., Shishkova V.N., Sycheva A.S., Kebina A.L., Nosova A.V., Uryanskaya K.A., Gazikova Kh.M., Zavyalov G.V.

1) A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia; 2) Center for speech pathology and neurorehabilitation of Moscow Healthcare Department
The aim of the research is to evaluate Mildronate® medicine as a metabolic corrector in coronaviral pneumonia and chronic heart failure (CHF) patients.
Material and methods. In an open short-term study, 77 people were selected with coronaviral infection-caused pneumonia and heart disease; 59 persons from them received Mildronate® as a metabolic support, 18 similar comorbid patients received only standard therapy. In addition to standard studies, patients had an assessment of the levels of C-reactive protein (CRP), D-dimer, creatinine, lactate dehydrogenase on the first day of hospitalization and at discharge. The duration of hospitalization, the dynamics of symptoms of cardiovascular diseases according to the scale for assessing the clinical status of a patient with CHF scale, the severity of asthenia according to the MFI-20 scale, and the quality of life according to the EQ-5D scale were estimated.
Results. There was fixed a decrease in hospitalization time in the Mildronate® group comparatively to the control group; the difference was statistically significant (p ≤0,01). Laboratory indicators and their dynamics did not have significant differences between the groups, however, in the group receiving Mildronate®, there was a significant (p ≤0,01) decrease in the level of CRP and D-dimer by the time of discharge. The results of the estimation on SHOKS, MFI-20, EQ-5D scales did not show statistically significant differences between patients in the groups during hospitalization, however, after 3 months in the Mildronate® group there was a significant improvement in the quality of life (p ≤0,01), a decrease in clinical manifestations of chronic heart failure on the SHOKS scale (p ≤0,01), as well as manifestations of asthenia (p ≤0,01).
Conclusion. In this work, for the first time, the complex effect of Mildronate® is shown in improving not only the parameters of metabolism, the hemostasis system, clinical manifestations of chronic heart failure, but also reducing the severity of symptoms, the first stage with severe post-infectious asthenia.
Keywords: coronavirus, metabolism, pneumonia, chronic heart failure, meldonium, Mildronate®
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About the Autors

Arkady L. Vertkin, MD, professor, head of the Department of therapy, clinical pharmacology and emergency medical care of A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. E-mail: kafedrakf@mail.ru. ORCID: 0000-0001-8975-8608
Veronika N. Shishkova, PhD, assistant of the Department of polyclinic therapy of A.I. Evdomimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia, senior researcher of the neurorehabilitation Department of Center for speech pathology and neurorehabilitation of Moscow Healthcare Department. Address: 109240, Moscow, 20/1 Nikoloyamskaya Str. Tel.: +7 (495) 637-83-63. E-mail: veronika-1306@mail
Anna V. Nosova, PhD, associate professor of the Department of therapy, clinical pharmacology and emergency medical care of A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. E-mail: nosova21@mail.ru
Anastasia L. Kebina, assistant of the Department of therapy, clinical pharmacology and emergency medical care of A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. E-mail: akebina@list.ru
Alexandra S. Sycheva, assistant of the Department of therapy, clinical pharmacology and emergency medical care of A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. E-mail: docsycheva@gmail.com
Kristina A. Uryanskaya, resident physician of the Department of therapy, clinical pharmacology and emergency medical care of A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. E-mail: kristi.uryanskaya@yandex.ru
Khedi M. Gazikova, assistant of the Department of therapy, clinical pharmacology and emergency medical care of A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya Str. E-mail: xadi.gazikova.94@mail.ru
Zavyalov G.V., student of medical faculty of A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 1274732, Moscow, 20 Delegatskaya Str., building 1.

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