pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2021-31-3-355-363pulmo-2372Research ArticleКЛИНИЧЕСКАЯ ФАРМАКОЛОГИЯCLINICAL PHARMACOLOGYО перспективах применения тиамина, пиридоксина и цианокобаламина в комплексной терапии и реабилитации пациентов с COVID-19On the prospects for the use of thiamine, pyridoxine, and cyanocobalamin in the complex therapy and rehabilitation of patients with COVID-19https://orcid.org/0000-0002-7663-710XГромоваО. А.GromovaO. A.

Громова Ольга Алексеевна – д. м. н., профессор, ведущий научный сотрудник Института фармакоинформатики при Федеральном исследовательском центре «Информатика и управление» Российской академии наук; ведущий научный сотрудник отдела интеллектуальных систем Центра технологий хранения и анализа больших данных на базе Федерального государственного бюджетного образовательного учреждения высшего образования «Московский государственный университет имени М.В.Ломоносова». SPIN: 6317-9833, Author ID: 94901, Author ID: 7003589812, WOS ID: J-4946-2017

119333, Москва, ул. Вавилова, 44, корп. 2119234, Москва, Ленинские горы, 1тел.: (916) 108-09-03

Olga A. Gromova, Doctor of Medicine, Professor, Leading Researcher, Institute of Pharmacoinformatics, Federal Research Center “Informatics and Control”, Russian Academy of Sciences; Leading Researcher, Department of Intelligent Systems, Center for storing and analyzing big data, National Center for Digital Economy, Moscow State University M.V.Lomonosov. SPIN: 6317-9833, Author ID: 94901, Author ID: 7003589812, WOS ID: J-4946-2017

ul. Vavilova 44, build. 2, Moscow, 119333Leninskie Gory 1, Moscow, 119991tel.: (916) 108-09-03

unesco.gromova@gmail.comhttps://orcid.org/0000-0002-2659-7998ТоршинИ. Ю.TorshinI. Yu.

Торшин Иван Юрьевич – к. ф.-м. н., к. х. н., старший научный сотрудник отдела интеллектуальных систем Института фармакоинформатики при Федеральном исследовательском центре «Информатика и управление» Российской академии наук; научный руководитель Центра технологий хранения и анализа больших данных на базе Федерального государственного бюджетного образовательного учреждения высшего образования «Московский государственный университет имени М.В.Ломоносова». Author ID: 7003300274, SPIN-код: 1375-1114, Author ID: 54104, WOS ID: C-7683-2018

119333, Москва, ул. Вавилова, 44, корп. 2119234, Москва, Ленинские горы, 1тел.: (499) 135-24-89

Ivan Yu. Torshin, Candidate of Physics & Mathematics, Candidate of Chemistry, Senior Researcher, Department of Intellectual Systems, Institute of Pharmacoinformatics, Federal Research Center “Informatics and Control”, Russian Academy of Sciences, Academic Advisor, Center for storing and analyzing big data, National Center for Digital Economy, Moscow State University M.V.Lomonosov. Author ID: 7003300274, SPIN: 1375-1114, Author ID: 54104, WOS ID: C-7683-2018

ul. Vavilova 44, build. 2, Moscow, 119333Leninskie Gory 1, Moscow, 119991tel.: (499) 135-24-89

tiy135@yahoo.comhttps://orcid.org/0000-0002-5070-5450ЧучалинА. Г.ChuchalinA. G.

Чучалин Александр Григорьевич – д. м. н., профессор, академик Российской академии наук, заведующий кафедрой госпитальной терапии педиатрического факультета

117997, Москва, ул. Островитянова, 1тел.: (499) 780-08-50

Alexander G. Chuchalin, Doctor of Medicine, Professor, Academician of Russian Academy of Sciences, Head of Department of Hospital Internal Medicine, Pediatric Faculty

ul. Ostrovityanova 1, Moscow, 117997tel.: (499) 780-08-50

pulmomoskva@mail.ruИнститут фармакоинформатики при Федеральном исследовательском центре «Информатика и управление» Российской академии наук; Центр технологий хранения и анализа больших данных на базе Федерального государственного бюджетного образовательного учреждения высшего образования «Московский государственный университет имени М.В. Ломоносова»РоссияInstitute of Pharmacoinformatics, Federal Research Center “Informatics and Control”, Russian Academy of Sciences; Center for storing and analyzing big data, National Center for Digital Economy, Moscow State University M.V. LomonosovRussian FederationФедеральное государственное автономное образовательное учреждение высшего образования «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Министерства здравоохранения Российской ФедерацииРоссияPirogov Russian National Research Medical University (Pirogov Medical University)Russian Federation202110062021313355363Copyright © Громова О.А., Торшин И.Ю., Чучалин А.Г., 20212021Громова О.А., Торшин И.Ю., Чучалин А.Г.Gromova O.A., Torshin I.Y., Chuchalin A.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/2372

Важность постоянной поддержки систем врожденного противовирусного иммунитета обусловлена в т. ч. новой коронавирусной инфекцией COVID-19. Целью исследования явился систематический анализ публикаций, посвященных исследованиям применения витаминов группы В для поддержки иммунитета и реабилитации пациентов с COVID-19. Материалы и методы. Выполнен интеллектуальный анализ сверхбольших данных (big data) при помощи специальных вычислительных методов анализа «больших данных» биомедицинских публикаций, основанных на топологической теории сентимент-анализа медицинских текстов, индексируемых базами данных PubMed / MEDLINE. Результаты. Низкая обеспеченность витаминами группы В способствует формированию у пациента хронических коморбидных патологий и существенно отягощает клиническое течение COVID-19. Важность повышения обеспеченности витаминами группы В при COVID-19 обусловлена поддержанием энергетического и кислородного метаболизма, прямыми противовирусными эффектами витаминов (снижение репликации SARS-CoV-2), компенсацией хронических коморбидных патологий (тромбоэмболия, нарушения функции печени и почек, сахарный диабет (СД), полинейропатии)), отягощающих течение COVID-19; снижением гипергомоцистеинемии и хронического асептического воспаления; ингибированием карбоангидраз, при котором улучшается кислородный обмен в легких; увеличением клиренса лактата крови и профилактикой сепсиса. Заключение. Посредством улучшения миелинизации обонятельных сенсорных нейронов витамин В12 способствует преодолению аносмии, которая встречается у 80 % пациентов с COVID-19. Короткие курсы (до 2–3 нед.) высокодозной парентеральной терапии тиамином, пиридоксином и цианокобаламином могут быть использованы в комплексе терапевтических мероприятий для улучшения клинических исходов у пациентов с COVID-19, особенно пожилых, лиц с полигиповитаминозом, СД, гипергомоцистеинемией, тромбофилией и высоким риском развития сепсиса. Пероральная терапия тиамином, пиридоксином и цианокобаламином рациональна в рамках проведения реабилитационных мероприятий у лиц, уже перенесших COVID-19 и столкнувшихся с его последствиями в виде клинических признаков недостатка витаминов группы В.

The new coronavirus infection COVID-19 has highlighted the importance of ongoing support for innate antiviral immunity systems. The aim. Conduct a systematic review of publications on the research of the use of B vitamins to support immunity and rehabilitation of patients with COVID-19. Methods. Intelligent analysis of so-called Big Data and special computational methods for analyzing Big Data of biomedical publications, based on the topological theory of sentiment analysis of medical texts from PubMed/MEDLINE. Results. Low levels of B vitamins contribute to chronic comorbidities and aggravate the clinical course of COVID-19 significantly. Increasing the supply of B vitamins in COVID-19 patients is essential for the maintenance of energy and oxygen metabolism; the direct antiviral effects of vitamins (reduction of SARS-CoV-2 replication); compensation of chronic comorbidities (thromboembolism, impaired liver and kidney functions, diabetes mellitus, polyneuropathy), which aggravate the course of COVID-19; reducing hyperhomocysteinemia and chronic aseptic inflammation; inhibiting carbonic anhydrases to improve oxygen metabolism in the lungs, and increasing the clearance of lactate from the blood and preventing sepsis. Conclusion. By improving myelination of the olfactory sensory neurons, vitamin B12 can help overcome anosmia, which occurs in 80% of COVID-19 patients. Short courses (up to 2 – 3 weeks) of high-dose parenteral therapy with thiamine, pyridoxine, and cyanocobalamin can be used as a part of a complex of therapeutic measures to improve clinical outcomes in patients with COVID-19, especially in elderly patients with polyhypovitaminosis, diabetes mellitus, hyperhomocysteinemia, thrombophilia, and high risk of sepsis. Oral therapy with thiamine, pyridoxine, and cyanocobalamin is justified as a part of rehabilitation measures after COVID-19 in patients who have faced its consequences in the form of clinical signs of vitamin B vitamin deficiency.

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