pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2021-31-5-663-670pulmo-2886Research ArticleОБЗОРЫREVIEWБронхиальная астма и COVID-19: обзор рекомендаций по ведению пациентов с бронхиальной астмой во время пандемии COVID-19Asthma and COVID-19: Аn overview of the guidelines for the management of asthma patients during the COVID-19 pandemichttps://orcid.org/0000-0003-4894-0918ОсиповаВ. В.OsipovaVeronika V.

Осипова Вероника Вячеславовна – к. м. н., старший научный сотрудник отдела клинических исследований

115682, Москва, Ореховый бульвар, 28

тел.: (495) 395-63-93

Veronika V. Osipova, Candidate of Medicine, Senior Researcher, Clinical Research Department

Orekhovyy bul’var 28, Moscow, 115682

tel.: (495) 395-63-93

pulmofin@mail.ruhttps://orcid.org/0000-0002-0284-7438ОсиповаГ. Л.OsipovaGalina L.

Осипова Галина Леонидовна – д. м. н., профессор образовательного центра, заведующая отделом клинических исследований

115682, Москва, Ореховый бульвар, 28

тел.: (495) 395-63-93

Galina L. Osipova, Doctor of Medicine, Professor, Educational Center, Head of the Clinical Research Department

Orekhovyy bul’var 28, Moscow, 115682

tel.: (495) 395-63-93;

pulmofin@mail.ruhttps://orcid.org/0000-0003-1904-1497ЗаряноваЕ. А.ZaryanovaElena A.

Зарянова Елена Алексеевна – к. м. н., научный сотрудник отдела клинических исследований

115682, Москва, Ореховый бульвар, 28

тел.: (495) 395-63-93

Elena A. Zaryanova, Candidate of Medicine, Researcher, Clinical Research Department

Orekhovyy bul’var 28, Moscow, 115682

tel.: (495) 395-63-93

pulmofin@mail.ruhttps://orcid.org/0000-0001-6172-2312ТереховД. В.TerekhovDmitry V.

Терехов Дмитрий Валентинович – к. м. н., научный сотрудник отдела клинических исследований

115682, Москва, Ореховый бульвар, 28

тел.: (495) 395-63-93

Dmitry V.Terekhov, Candidate of Medicine, Researcher, Clinical Research Department

Orekhovyy bul’var 28, Moscow, 115682

tel.: (495) 395-63-93

pulmofin@mail.ruФедеральное государственное бюджетное учреждение «Научно-исследовательский институт пульмонологии» Федерального медико-биологического агентстваРоссияFederal Pulmonology Research Institute, Federal Medical and Biological AgencyRussian Federation202120102021315663670Copyright © Осипова В.В., Осипова Г.Л., Зарянова Е.А., Терехов Д.В., 20212021Осипова В.В., Осипова Г.Л., Зарянова Е.А., Терехов Д.В.Osipova V.V., Osipova G.L., Zaryanova E.A., Terekhov D.V.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/2886

При появлении нового заболевания COVID-19 (COronaVIrus Disease–2019), вызванного коронавирусом SARS-CoV-2, значительно изменилась привычная схема взаимодействия врача и пациента. По данным крупных исследований выявлен ряд факторов риска развития тяжелого течения заболевания COVID-19 – пожилой возраст, гипертония, сахарный диабет, сердечно-сосудистые заболевания, хроническая обструктивня болезнь легких. Однако бронхиальная астма (БА) и респираторная аллергия не идентифицированы как существенные факторы риска тяжелого течения заболевания, а выявление этих факторов дает важную информацию о патогенезе COVID-19, подходах к базисной, таргетной и аллерген-специфической терапии (АСИТ) в условиях пандемии при различных фенотипах и эндотипах БА.

Целью обзора явилось обобщение имеющихся в настоящее время знаний о SARS‐CoV‐2, Т2-эндотипе БА, эозинофильном воспалении. Представлены данные исследований по изучению особенностей течения COVID-19 у пациентов с БА, основные рекомендации Глобальной инициативы по БА (Global Initiative for Asthma – GINA, 2021) и Министерства здравоохранения Российской Федерации. Показано, что ориентирование на эндотипы и фенотипы БА способствует выбору оптимальной тактики ведения пациентов с COVID-19 и БА. Рассмотрено влияние дисбаланса иммунной системы, провоспалительных цитокинов, эффекторных клеток у больных БА на развитие и прогрессирование COVID-19. Приведены рекомендации по ведению пациентов препаратами базисной, таргетной терапии, АСИТ в условиях пандемии.

Заключение. Текущие рекомендации по лечению БА, основанные на результатах последних исследований, в контексте c COVID-19 углубляют понимание особенностей течения коорновирусной болезни у пациентов с различными фенотипами и эндотипами БА и подходов к традиционным методам ее лечения согласно клиническим рекомендациям в условиях пандемии.

The emergence of a new disease COVID-19 (coronavirus disease 2019), caused by the coronavirus named SARS-CoV-2, has significantly changed the usual interaction pattern between a doctor and a patient. Previous large studies have identified risk factors for a severe course of COVID-19, including old age, hypertension, diabetes, cardiovascular diseases, and chronic obstructive pulmonary disease. However, asthma and respiratory allergy have not been identified as risk factors for the severe disease. These factors give clues to the pathogenesis of COVID-19, approaches to the controller medications, target therapy, allergen-specific immunotherapy (ASIT) in patients with various phenotypes and endotypes of asthma during the pandemic.

The purpose of this review is to summarize the currently available knowledge about SARS-CoV-2, T2-endotype of asthma, eosinophilic inflammation. The article provides an overview of the data from studies of COVID-19 patients with asthma, the main recommendations of the Global Initiative for Asthma (2021) and the Ministry of Health of the Russian Federation. It shows that targeting the endotypes and phenotypes of asthma can influence the management of COVID-19 patients with asthma. The influence of the imbalance of the immune system, pro-inflammatory cytokines, and effector cells in patients with asthma on the development and progression of COVID-19 is considered. Recommendations are given for the controller medications, targeted therapy, allergen-specific immunotherapy during the pandemic.

Conclusion. The current recommendations for asthma treatment, based on the latest research of COVID-19, deepen our understanding of the course of COVID-19 in patients with different phenotypes and endotypes of asthma, approaches to traditional methods of treating asthma according to clinical guidelines during the pandemic.

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