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COVID-19: OBSERVATIONS ON STANDARD TREATMENT ALGORITHMS

https://doi.org/10.15789/1563-0625-COO-2265

Abstract

In this article, a retrospective analysis of the medical histories was carried out in order to develop an individualized approach to treating COVID-19. Questions were raised about the advisability of the universal immunosuppressive therapy, the need to prescribe glucocorticosteroids only taking into account the cytokine profile of patients, the relationship of glucocorticosteroid therapy and carbohydrate metabolism disorders, as one of the most common complications of pharmacotherapy COVID-19 in the patients we studied. Unjustified immunosuppression in the stage of active fight against the infectious agent as a factor of chronization of the process and decrease of the body reactivity, as well as neutralization by immunosuppressive therapy of factors of protection of innate non-specific immunity mobilized to fight the causative agent. The importance of taking into account the probability of thrombosis with consideration of coagulogram indices and thrombosis markers (D-dimer, fibrin degradation products) does not exclude the risk of the hemorrhagic complications when prescribing high doses of anticoagulants. Antibacterial therapy for uncomplicated viral infections is neither an etiologic nor a pathogenetic treatment option. In addition, it leads to the emergence of resistant strains of microorganisms as a result of mutational variability and evolutionary adaptations of bacteria, which greatly complicates the choice of an effective antibacterial drug in some cases. Antithrombotic, glucocorticosteroid and antibacterial therapy should be clinically and laboratory justified in each individual case. The article focuses on the safety of prescribing antipodagric agents in the treatment of COVID-19 as anti-inflammatory. The review considers all the above-mentioned aspects of COVID-19 therapy with reference to foreign studies, describes options for the pathophysiological development of infection. We note the need to develop systematic data on coronavirus, changes that the pathogen induces in the body. This will allow the development of innovative and effective therapeutic strategies for the treatment of the new coronavirus infection. 

About the Authors

I. Kh. Borukaeva
Kh. Berbekov Kabardino-Balkarian State University
Russian Federation

PhD, MD (Medicine), Professor, Department of Normal and Pathological Human Physiology, Medical Faculty, 

360017, Kabardino-Balkarian Republic, Nalchik, Shortanov str., 3, apt 100



Z. Kh. Abazova
Kh. Berbekov Kabardino-Balkarian State University

PhD (Medicine), Associate Professor, Department of Normal and Pathological Human Physiology, Medical Faculty, 

Nalchik, Kabardino-Balkarian Republic



F. Kh. Temirzhanova
Kh. Berbekov Kabardino-Balkarian State University

6th year Student, Medical Faculty, 

Nalchik, Kabardino-Balkarian Republic



M. M. Yusupova
Kh. Berbekov Kabardino-Balkarian State University

6th year Student, Medical Faculty, 

Nalchik, Kabardino-Balkarian Republic



References

1. Caring for people with COVID-19. Supporting Australia’s healthcare professionals with continually updated, evidence-based clinical guidelines. Available at: https://covid19evidence.net.au/.

2. Chia E.W., Grainger R., Harper J.L. Colchicine suppresses neutrophil superoxide production in a murine model of gouty arthritis: a rationale for use of low-dose colchicine. Br. J. Pharmacol., 2008, Vol. 153, no. 6, pp. 1288-1295.

3. Clinical management of patients with COVID-19: Second interim guidance. Available at: https:// www.canada.ca/en/public-health/services/diseases/2019-novelcoronavirus-infection/clinical-managementcovid-19.html.

4. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at: https://www.covid19treatmentguidelines.nih.gov/.

5. Gendelman O., Amital H., Bragazzi N.L. Continuous hydroxychloroquine or colchicine therapy does not prevent infection with SARS-CoV-2: Insights from a large healthcare database analysis. Autoimmun. Rev., 2020, Vol. 19, no. 7, pp. 102566-102588.

6. Mohanty A., Tiwari-Pandey R., Pandey N.R. Mitochondria: the in-dispensable players in innate immunity and guardians of the inflammatory response. J. Cell Commun. Signal., 2019, Vol. 13, no. 3, pp. 303-318.

7. 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, Vol. 20, pp. 30566-30569.

8. Zhou P., Yang X., Wang X. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature, 2020, Vol. 579, pp. 270-273.


Supplementary files

Review

For citations:


Borukaeva I.Kh., Abazova Z.Kh., Temirzhanova F.Kh., Yusupova M.M. COVID-19: OBSERVATIONS ON STANDARD TREATMENT ALGORITHMS. Medical Immunology (Russia). 2021;23(4):909-914. https://doi.org/10.15789/1563-0625-COO-2265

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ISSN 1563-0625 (Print)
ISSN 2313-741X (Online)