May 6, 2022
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Academician Alexander Chuchalin: with covid, the lung is so disfigured that it is difficult to recognize it

According to Johns Hopkins University, which cited Professor, Academician of the Russian Academy of Sciences Alexander Chuchalin29% of discharged covid patients were re-hospitalized, of which 12% died[1]. The main causes of death in patients in the post-COVID period are pathological changes in the lungs and thromboembolic complications. At the same time, the presence of fibrotic processes in the lung tissue is often the dominant factor.

“The lung is so disfigured that it is difficult to recognize. Imagine, the delicate lung tissue, like a snow cloud, is covered with a dense infiltrate, already caused by fibrotic changes, in an extremely short time. There is a remodeling of the lung tissue, it shrinks,” says Alexander Chuchalin.

According to him, an important marker of acute lung injury and respiratory distress syndrome is an excess of hyaluronic acid in the alveolar space and interstitium. With this picture, a ground glass phenomenon is observed, which, according to McGroder CF, can persist for a long time in 39% of patients.[2].

The academician noted the importance of introducing innovative approaches in the treatment of complications of COVID-19, noting your experience applicableI drug “Longidaza®» nbased on hyaluronidase, which allows you to adjust the metabolism of hyaluronic acid. “To combat prolonged post-covid syndrome, it is necessary to pay attention to combination therapy with the drug Longidaza®»which we actively use in patients in our clinic“, – said Alexander Chuchalin

ProfessorChief Freelance Pulmonologist of the Ministry of Health of the Russian Federation for the Ural Federal District, MD Galina Ignatova drew attention to the fact that with fibrotic changes and an imbalance of hyaluronic acid, the gas exchange in the lungs, oxygen ceases to flow into the capillary bed, the patient may suffer from severe shortness of breath, both in the acute phase of the disease and in the post-covid period.

In 47% of patients, post-COVID symptoms persist for six months after discharge, while in 21% – This general weakness, and 14.5% of patients suffer from shortness of breath[3]. Galina Ignatova shared this information, referring to the data of the Sechenov University. The professor spoke about the results of the Dissolve study, which showed that the use of a stabilized hyaluronidase enzyme has a positive effect on the physical condition of recovered patients and helps them recover faster.

“We used a Russian drug Longidaza®containing enzyme bovhyaluronidase, as part of routine clinical practice. The drug reduces the excess amount of hyaluronic acid, which is able to maintain inflammation and provoke edema in the lungs, increase the viscosity of the secret, ”comments Galina Ignatova.

Anna Petukhova, pulmonologist, head. City Outpatient Consultative Department of Allergology and Immunology of the Central City Clinical Hospital No. 6 of Yekaterinburg confirmedthat shortness of breath is one of the most alarming symptoms in the post-COVID period and, according to the department’s own data, persists in 45% of recovered patients. The “language of shortness of breath” is very diverse, there are more than 20 patterns of its behavior, and the doctor’s task is to correctly assess this symptom in different groups of patients,” Anna Petukhova summed up.

Returning to the data from the Dissolve study, Anna Petukhova clarified that about 3/4 of those patients who took Longidaz» had a steady decrease in dyspnea, while in the control group, about half of the patients did not show positive dynamics.

The expediency of the therapeutic use of “Longidase” spoke and Professor Natalia Teplova, Head of the Department of Clinical Pharmacology, Faculty of Medicine, Pirogov University. She pointed to the systemic effect of the drug, noting that it reduces tissue swelling and improves microcirculation, and also has an antifibrotic effect without damaging normal connective tissue, but causing changes in pathological foci. The most pronounced action Longidases»according to her, it was in the treatment of seriously ill patients.

In the prevention and treatment of fibrosis, Longidaza® has a number of advantages, as it does not cause unwanted immune suppression and does not adversely affect liver function, noted Lyubov Novikova, Candidate of Medical Sciences, Pulmonologist of the highest category, Associate Professor of the Department of Pulmonology, FPO, St. Petersburg State Medical University. Academician I.P. Pavlova.

The fact that recovered patients should not be delayed with control examinations and rehabilitation Vitaly Sereda, pulmonologist, professor, doctor of medical sciences, associate professor of the Military Medical Academy. CM. Kirov, Deputy chief physician for inpatient care International Medical Center SOGAZ». He emphasized that patients who recovered from covid should definitely undergo a study of lung function, observing this indicator in dynamics.

The Dissolve study included 160 post-surgery patients. COVID-19 from 13 medical centers (9 Russian cities). One group went drug rehabilitation Longidaza®»for the other group – carried out dynamic observation without the use of the drug. As a result, after the course accepts patients recovered faster, showing more pronounced improvement of forced vital capacity of the lungs, tolerance to physical exercise, shortness of breath, as well as an indicator of blood oxygen saturation.

[1] Molly Walker, MedPage Today, March 31, 2021

[2] McGroder CF, Zhang D, Choudhury MA, Salvatore MM, D’Souza BM, Hoffman EA, Wei Y, Baldwin MR, Garcia CK. Pulmonary fibrosis 4 months after COVID-19 is associated with disease severity and leukocyte telomere length. rib cage. 2021 Dec;76(12):1242-1245. doi: 10.1136/thoraxjnl-2021-217031. Epub 2021, April 29th. PMID: 33927016; PMCID: PMC8103561.

[3] Moonblit D, Bobkova P, Spiridonova E, et al. Incidence and risk factors for persistent symptoms in adults previously hospitalized for COVID-19. Klin Expert Allergy. 2021; 51(9): 1107-1120.

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