geriatrРоссийский журнал гериатрической медициныRussian Journal of Geriatric Medicine2686-86362686-8709Сайт издателя10.37586/2686-8636-1-2022-43-47geriatr-242Research ArticleОБЗОРЫREVIEWSПостковидый синдром: иллюзия или реальность?Postcovid syndrome: illusion or reality?https://orcid.org/0000-0003-0048-268XЕруслановаК. А.EruslanovaK. A.

 младший научный сотрудник лаборатории сердечно-сосудистого старения, Российский геронтологический научно-клинический центр

+7(499)187-78-09

 Москва 

 junior research fellow, Laboratory of Vascular Ageing

+7(499)187-78-09 

 Moscow 

Eruslanova_KA@rgnkc.ruhttps://orcid.org/0000-0002-5313-2715РозановА. В.RozanovA. V.

 канд. мед. наук, помощник директора по региональному развитию и федеральным проектам, Российский  геронтологический научно-клинический центр телефон: +7(985)991-75-47 

 Москва 

 MD, PhD, Assistant Director for Regional Development and Federal Projects

+7(985)991-75-47 

 Moscow 

rozanov_av@rgnkc.ruhttps://orcid.org/0000-0002-1628-5093КотовскаяЮ. В.KotovskayaYu. V.

 д-р мед. наук, профессор, заместитель директора по научной работе, Российский геронтологический научно-клинический центр

телефон: +7(499)187-78-09

 Москва 

MD, PhD, professor, Deputy Director

+7(499)187-78-09 

 Moscow 

kotovskaya_yv@rgnkc.ruhttps://orcid.org/0000-0002-4193-688XТкачеваО. Н.TkachevaO. N.

 д-р мед. наук, профессор, директор Российского геронтологического научно-клинического центрателефон: +7(499)187-64-67

 Москва 

 MD, PhD, professor, Director

+7(499)187-64-67 

 Moscow 

tkacheva@rgnkc.ruФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава РоссииРоссияPirogov National Research Medical University, Russian Gerontology Research and Clinical CentreRussian Federation202224052022014347Copyright © Ерусланова К.А., Розанов А.В., Котовская Ю.В., Ткачева О.Н., 20222022Ерусланова К.А., Розанов А.В., Котовская Ю.В., Ткачева О.Н.Eruslanova K.A., Rozanov A.V., Kotovskaya Y.V., Tkacheva O.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.geriatr-news.com/jour/article/view/242

Новая коронавирусная инфекция была впервые описана в 2019 году в Ухане, Китайская Народная Республика. С первых месяцев распространения инфекции по всему миру стали появляться данные о том, что у пациентов после выздоровления сохраняются различные симптомы. Длительность, интенсивность и вариабельность симптомов у пациентов различны и зачастую не ассоциированы с тяжестью самого острого заболевания. В последнее время понятие постковидного синдрома (post-COVID или long-COVID в англоязычной литературе) приобретает все более четкие критерии диагностики. Сохраняющиеся стойкие симптомы и/или появление отсроченных осложнений через 4 недели и более с момента появления симптомов острого заболевания принято называть постковидным синдромом. В данном обзоре представлена информация о постковидном синдроме, его патофизиологии и специфических поражениях органов. Будут рассмотрены актуальные данные по междисциплинарному ведению пациентов, перенесших новую коронавирусную инфекцию, и предложен алгоритм для диагностики.

A novel coronavirus infection was described in 2019 in Wuhan, China. From the first months of the spread of the infection around the world, evidence began to appear that patients after recovery had various symptoms. Duration, intensity, and variability of symptoms varies among patients and are often not associated with the severity of the most acute illness. Recently the concept of post-COVID syndrome (post-COVID or long-COVID in the English-language literature) has acquired increasingly clear diagnostic criteria. Persistent symptoms and / or the appearance of delayed complications after 4 weeks or more from the onset of symptoms of an acute illness are commonly called post-COVID syndrome. This review provides information on post-COVID syndrome, its pathophysiology and specific organ lesions. Relevant data on the interdisciplinary management of patients who have undergone a new coronavirus infection will be considered and an algorithm for identifying the diagnosis will be proposed.

новая коронавирусная инфекциядыхательная недостаточностьпочечная недостаточностьмиокардитnew coronavirus infectionrespiratory failurerenal failuremyocarditisReferencesWorld Health Organization. Weekly epidemiological update on COVID-19. https://www.who.int/publications/m/item/weekly-epidemiological-update-oncovid-19—28-december-2021World Health Organization. Weekly epidemiological update on COVID-19. https://www.who.int/publications/m/item/weekly-epidemiological-update-oncovid-19—28-december-2021Tolksdorf K., Buda S., Schuler E., Wieler L.H., Haas W. Eine höhere Letalität und lange Beatmungsdauer unterscheiden COVID-19 von schwer verlaufenden Atemwegsinfektionen in Grippewellen. Epidemiol Bull 2020; 41: 3–10.Tolksdorf K., Buda S., Schuler E., Wieler L.H., Haas W. Eine höhere Letalität und lange Beatmungsdauer unterscheiden COVID-19 von schwer verlaufenden Atemwegsinfektionen in Grippewellen. Epidemiol Bull 2020; 41: 3–10.Ellul M.A., Benjamin L., Singh B., Lant S., Michael B.D., Easton A., et al. Neurological associations of COVID-19. Lancet Neurol 2020; 19: 767–783.Ellul M.A., Benjamin L., Singh B., Lant S., Michael B.D., Easton A., et al. Neurological associations of COVID-19. Lancet Neurol 2020; 19: 767–783.Huang C., Huang L., Wang Y., Li X., Ren L., Gu X., et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021; 397: 220–232.Huang C., Huang L., Wang Y., Li X., Ren L., Gu X., et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021; 397: 220–232.Chopra V., Flanders S.A. & O’Malley M. Sixty-day outcomes among patients hospitalized with COVID-19. Ann. Intern. Med. https://doi.org/10.7326/M20–5661 (2020)Chopra V., Flanders S.A. & O’Malley M. Sixty-day outcomes among patients hospitalized with COVID-19. Ann. Intern. Med. https://doi.org/10.7326/M20–5661 (2020)Carvalho-Schneider C. et al. Follow-up of adults with noncritical COVID-19 two months after symptom onset. Clin. Microbiol. Infect. 27; 258–263 (2021).Carvalho-Schneider C. et al. Follow-up of adults with noncritical COVID-19 two months after symptom onset. Clin. Microbiol. Infect. 27; 258–263 (2021).Arnold D.T. et al. Patient outcomes after hospitalization with COVID-19 and implications for follow-up: results from a prospective UK cohort. Thorax https://doi.org/10.1136/thoraxjnl-2020–216086 (2020)Arnold D.T. et al. Patient outcomes after hospitalization with COVID-19 and implications for follow-up: results from a prospective UK cohort. Thorax https://doi.org/10.1136/thoraxjnl-2020–216086 (2020)Moreno-Pérez O. et al. Post-acute COVID-19 syndrome. Incidence and risk factors: a Mediterranean cohort study. J. Infect. https://doi.org/10.1016/j.jinf.2021.01.004 (2021)Moreno-Pérez O. et al. Post-acute COVID-19 syndrome. Incidence and risk factors: a Mediterranean cohort study. J. Infect. https://doi.org/10.1016/j.jinf.2021.01.004 (2021)Halpin S.J. et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: a cross-sectional evaluation. J. Med. Virol. 93; 1013–1022 (2021). 10. Jacobs L.G. et al. Persistence of symptoms and quality of life at 35 days after hospitalization for COVID-19 infection. PLoS ONE 15, e0243882 (2020).Halpin S.J. et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: a cross-sectional evaluation. J. Med. Virol. 93; 1013–1022 (2021). 10. Jacobs L.G. et al. Persistence of symptoms and quality of life at 35 days after hospitalization for COVID-19 infection. PLoS ONE 15, e0243882 (2020).Petersen E.L., Goßling A., Adam G., et al. Multi-organ assessment in mainly non-hospitalized individuals after SARSCoV-2 infection: The Hamburg City Health Study COVID programme [published online ahead of print, 2022 Jan 6]. Eur Heart J. 2022;ehab914. DOI: 10.1093/eurheartj/ehab914Petersen E.L., Goßling A., Adam G., et al. Multi-organ assessment in mainly non-hospitalized individuals after SARSCoV-2 infection: The Hamburg City Health Study COVID programme [published online ahead of print, 2022 Jan 6]. Eur Heart J. 2022;ehab914. DOI: 10.1093/eurheartj/ehab914Nalbandian A., Sehgal K., Gupta A., et al. Post-acute COVID-19 syndrome. Nat Med. 2021; 27(4): 601–615. DOI: 10.1038/s41591–021–01283-zNalbandian A., Sehgal K., Gupta A., et al. Post-acute COVID-19 syndrome. Nat Med. 2021; 27(4): 601–615. DOI: 10.1038/s41591–021–01283-zInoue S. et al. Post-intensive care syndrome: its pathophysiology, prevention, and future directions. Acute Med. Surg. 6; 233–246 (2019).Inoue S. et al. Post-intensive care syndrome: its pathophysiology, prevention, and future directions. Acute Med. Surg. 6; 233–246 (2019).SYNTHESIS. LONG COVID: PATHOPHYSIOLOGY — EPIDEMIOLOGY AND PATIENT NEEDS. Belgian Health Care Knoweldge Center. 2021.SYNTHESIS. LONG COVID: PATHOPHYSIOLOGY — EPIDEMIOLOGY AND PATIENT NEEDS. Belgian Health Care Knoweldge Center. 2021.George P.M., Wells A.U., Jenkins R.G. Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy. Lancet Respir Med. 2020; 8(8): 807–815. DOI: 10.1016/S2213–2600(20)30225–3.George P.M., Wells A.U., Jenkins R.G. Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy. Lancet Respir Med. 2020; 8(8): 807–815. DOI: 10.1016/S2213–2600(20)30225–3.Acat M., Yildiz Gulhan P., Oner S., Turan M.K. Comparison of pirfenidone and corticosteroid treatments at the COVID-19 pneumonia with the guide of artificial intelligence supported thoracic computed tomography. Int J Clin Pract. 2021; 75(12): e14961. DOI: 10.1111/ijcp.14961.Acat M., Yildiz Gulhan P., Oner S., Turan M.K. Comparison of pirfenidone and corticosteroid treatments at the COVID-19 pneumonia with the guide of artificial intelligence supported thoracic computed tomography. Int J Clin Pract. 2021; 75(12): e14961. DOI: 10.1111/ijcp.14961.Puntmann V.O. et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19). JAMA Cardiol. 5, 1265–1273 (2020).Puntmann V.O. et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19). JAMA Cardiol. 5, 1265–1273 (2020).Rajpal S. et al. Cardiovascular magnetic resonance findings in competitive athletes recovering from COVID-19 infection. JAMA Cardiol. 6; 116–118 (2021).Rajpal S. et al. Cardiovascular magnetic resonance findings in competitive athletes recovering from COVID-19 infection. JAMA Cardiol. 6; 116–118 (2021).Ramacciotti E., Barile Agati L., Calderaro D., et al. Rivaroxaban versus no anticoagulation for post-discharge thromboprophylaxis after hospitalisation for COVID-19 (MICHELLE): an open-label, multicentre, randomised, controlled trial. Lancet. 2022; 399(10319): 50–59. DOI: 10.1016/S0140–6736(21)02392–8.Ramacciotti E., Barile Agati L., Calderaro D., et al. Rivaroxaban versus no anticoagulation for post-discharge thromboprophylaxis after hospitalisation for COVID-19 (MICHELLE): an open-label, multicentre, randomised, controlled trial. Lancet. 2022; 399(10319): 50–59. DOI: 10.1016/S0140–6736(21)02392–8.Berger J.S., Kornblith L.Z., Gong M.N., et al. Effect of P2Y12 Inhibitors on Survival Free of Organ Support Among Non–Critically Ill Hospitalized Patients With COVID-19: A Randomized Clinical Trial. JAMA. 2022; 327(3): 227–236. DOI: 10.1001/jama.2021.23605.Berger J.S., Kornblith L.Z., Gong M.N., et al. Effect of P2Y12 Inhibitors on Survival Free of Organ Support Among Non–Critically Ill Hospitalized Patients With COVID-19: A Randomized Clinical Trial. JAMA. 2022; 327(3): 227–236. DOI: 10.1001/jama.2021.23605.Cummings M.J. et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet 395; 1763–1770 (2020).Cummings M.J. et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet 395; 1763–1770 (2020).Stevens J.S. et al. High rate of renal recovery in survivors of COVID-19 associated acute renal failure requiring renal replacement therapy. PLoS ONE 15, e0244131 (2020).Stevens J.S. et al. High rate of renal recovery in survivors of COVID-19 associated acute renal failure requiring renal replacement therapy. PLoS ONE 15, e0244131 (2020).

The authors declare that there are no conflicts of interest present.