Postcovid bronchoobstructive syndrome in practice of general practitioner and pulmonologist: large-scale study
https://doi.org/10.18093/0869-0189-2022-32-4-539-547
Abstract
It is hard to make a conclusion about relationship between Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and Bronchoobstructive Syndrome (BOS) in the postcovid period based on the literature.
The aim. To determine the optimal treatment approaches by conducting a comprehensive assessment of clinical, laboratory and functional parameters, taking into account the risk factors for the development of BOS.
Methods. 10,456 patients with Coronavirus Disease-19 (COVID-19) were examined, and 7,459 patients were randomized into 2 groups with a newly diagnosed BOS. Group 1 (n = 3,245) was prescribed beclomethasone/formoterol (BDP/FORM) as Maintenance And Reliever Therapy (MART). Group 2 (n = 4,252) was prescribed budesonide suspension (BUD) and salbutamol solution (SAL). The study assessed severity of COVID-19, presence of atopy and frequency of acute respiratory viral infections (SARS) in the medical history, spirometric parameters, blood eosinophils, Asthma Control Questionnaire-5 (ACQ-5) score, use of pro re nata medications, and adverse events.
Results. Patients who had mild COVID-19 were diagnosed with BOS at weeks 8 – 24 (73.3%), while patients with moderate or severe COVID-19 were diagnosed at week 4 (54.9%). Virus-induced BOS (VI BOS) was diagnosed in 71.8% of the cases. 13% of the patients with BOS in postcovid period were diagnosed with asthma.
Conclusion. The incidence of BOS is significantly higher in patients with atopy and history of frequent SARS who had moderate or severe COVID-19. A fixed combination of extrafine BDP/FORM as MART was superior to nebulized BUD + SALM in the treatment of VI BOS.
Supporting agencies: The authors express their gratitude to the administration and staff of the pulmonological service of the “Novaya bol’nitsa” Clinical Association Limited Liability Companies for their assistance, aid and support in conducting this scientific study.
About the Authors
I. V. Leshchenko
Ural Federal State Medical University, Healthcare Ministry of Russia; Ural Federal Research Institute of Phthisiology and Pulmonology – A Branch of National Medical Research Center for Phthisiology, Pulmonology and Infectious Diseases, Healthcare Ministry of Russia; “Novaya bol’nitsa” Clinical Association Limited Liability Companies
Russian Federation
Competing Interests:
Russian Federation
Igor V. Leshсhenko, Doctor of Medicine, Professor, Department of Phthisiology, Pulmonology and Thoracic Surgery, Ural Federal State Medical University, Healthcare Ministry of Russia; Chief Researcher, Ural Federal Research Institute of Phthisiology and Pulmonology – A Branch of National Medical Research Center for Phthisiology, Pulmonology and Infectious Diseases, Healthcare Ministry of Russia; Scientific Director of the Clinic, “Novaya bol’nitsa” Clinical Association Limited Liability Companies
ul. Repina 3, Ekaterinburg, 620028
ul. 22-go Parts’ezda 50, Ekaterinburg, 620039
ul. Zavodskaya 29, Ekaterinburg, 620109
tel.: (343) 246-44-75
Competing Interests:
The authors declare no conflict of interest.
N. A. Esaulova
Ural Federal State Medical University, Healthcare Ministry of Russia; “Novaya bol’nitsa” Clinical Association Limited Liability Companies
Russian Federation
Competing Interests:
Russian Federation
Natalya A. Esaulova, Candidate or Medicine, Associate Professor, Department of Phthisiology and Pulmonology, Ural Federal State Medical University, Healthcare Ministry of Russia; Head of Pulmonology Department, “Novaya bol’nitsa” Clinical Association Limited Liability Companies
ul. Repina 3, Ekaterinburg, 620028
ul. Zavodskaya 29, Ekaterinburg, 620109
tel.: (343) 242-48-42
Competing Interests:
The authors declare no conflict of interest.
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For citations:
Leshchenko I.V., Esaulova N.A. Postcovid bronchoobstructive syndrome in practice of general practitioner and pulmonologist: large-scale study. PULMONOLOGIYA. 2022;32(4):539-547. (In Russ.) https://doi.org/10.18093/0869-0189-2022-32-4-539-547
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