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Experience in managing a patient with a complicated course of SARS-COV-2 infection: early pulmonary rehabilitation and prevention of pulmonary fibrosis (clinical case)

Over the past two decades the world community has been shocked by the three largest coronavirus pandemics, each of which, despite the similarity of clinical symptoms in many aspects, has its own differences. This fact significantly complicates the diagnosis and treatment of new virus strains, which leads to a forced delay in early diagnosis and treatment of the disease, as well as the impossibility of suppressing the epidemic at the initial stages of its development. The article presents the clinical case of a complicated course of a new coronavirus infection – COVID-19 from the practice of a pulmonologist. There is data on the tactics of managing the patient until the visit to the pulmonologist. Minor changes are observed only in the auscultatory picture among physical data. Certain changes in laboratory and instrumental parameters are noted during the treatment of the patient. An important role in the diagnosis of the disease was played by the methods of enzyme immunoassay and polymerase chain reaction, as well as spiral computed tomography (SCT) of the chest, which made it possible to detect lesions, diagnose excessive consolidation (formation of pneumofibrosis) and its regression in dynamics against the background of active treatment. Spirometry made it possible to assess lung function over time. In the treatment were used drugs with anticoagulant and anti-fibrotic activity (new oral anticoagulants – apixaban (Eliquis®), a polyenzyme drug – Wobenzym® and enzyme – bovgialuronidase azoxymer (Longidaza®)), together with a set of antioxidant vitamins and minerals, and there was an improvement in lung function. The scientific community is carrying out a large-scale work to find new approaches in the treatment of coronavirus infection (COVID-19), however, the majority of the developed diagnostic and treatment methods are currently under study, while an ordinary doctor needs to prescribe a suitable therapy for a patient here and now.

DOI: 10.18413/2687-0940-2020-43-3-365-372
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