COVID-19: lessons we are learning today (as of April 27, 2020)


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Abstract

The whole world is experiencing a pandemic of a new coronavirus infection COVID-19 caused by the SARS-CoV-2 virus. Analysis of the SARS-CoV-2 genome showed significant similarity with the previously identified strain of coronavirus, which caused an outbreak of the so-called atypical viral pneumonia or severe acute respiratory syndrome (SARS) in 2003. All age groups are susceptible to the virus, while elderly patients with concomitant diseases are more susceptible to the severe course of the disease. The main clinical manifestations are fever, cough, and asthenia. In some patients, the condition is characterized by dyspnea and hypoxemia, which can quickly (within a week) progress with the development of acute respiratory distress syndrome, septic shock, metabolic acidosis, coagulation function, and multiple organ dysfunction syndrome. It is recommended to perform computed tomography of the chest for all patients to clarify the diagnosis and monitor the development of the disease. Chest X-ray has insufficient information, and therefore its implementation is impractical. In most cases, changes in the lung tissue are characterized by multiple areas of induration of the lung tissue by the type of «frosted glass», and interstitial changes. There are no data on the convincing effectiveness of any antiviral treatment. Currently, in the framework of etiotropic therapy, lopinavir / ritonavir, chloroquine, hydroxychloroquine, and recombinant interferon beta-1b are used. For the timely detection of signs of severe course and complications, constant monitoring of vital signs and laboratory indicators is necessary. The most significant risk factors for severe progressive course and poor outcome are under investigation. This review presents known epidemiological data, features of diagnosis and clinical course, risk factors for poor outcome, the possibility of etiotropic and pathogenetic treatment and prevention.

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About the authors

Yulia G. Belotserkovskaya

Russian Medical Academy of Continuous Professional Education

Email: belo-yuliya@yandex.ru
Cand. Sci. (Med.), Associate Professor at the Department of Pulmonology 2/1, build. 1, Barrikadnaya str., Moscow 125993, Russian Federation

A. I Sinopalnikov

Russian Medical Academy of Continuous Professional Education

Moscow, Russia

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