Медицинская иммунология (Oct 2021)
COVID-19: OBSERVATIONS ON STANDARD TREATMENT ALGORITHMS
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.
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