Opportunities of the therapist in prevention and at the rehabilitation stage after new coronaviral infection (COVID-19) in comorbid patients with arterial hypertension

Dmitry I. Trukhan , Evgeny L. Davydov , Natalia A. Chusova , Innokenty S. Chusov

For citation:

Abstract

Comorbid patients are the most vulnerable group for the novel coronavirus infection (COVID-19), spread by the SARS-CoV-2 virus, which has a particularly high risk of adverse outcomes. The problem of managing comorbid patients in a pandemic requires an integrated approach aimed both at optimal management of comorbid conditions in patients who are in self-isolation and forced limitation of visits to medical institutions, and at the management of comorbid conditions in patients with COVID-19. Acquired since March 2020, when WHO announced the COVID-19 pandemic, global clinical experience in managing patients with a new coronavirus infection highlights a number of other pressing issues, especially for comorbid patients. These include issues of specific and nonspecific prophylaxis, as well as the supervision of comorbid patients in the rehabilitation period, especially in the framework of the post-COVID syndrome. This review addresses the issues of specific and non-specific prophylaxis of COVID-19, and also discusses the possibilities of indapamide and nitrendipine for the treatment of comorbid patients with arterial hypertension during a pandemic, and in patients with postcoid syndrome at the re-abiding stage.

Key words: comorbidity, arterial hypertension, treatment, indapamide, nitrendipine, new coronavirus infection (COVID-19), prevention, rehabilitation, postcoid syndrome, nutraceuticals.

References

1. Grinevich V. B., Gubonina I. V., Doshchitsin V. L. et. al. Management of patients with comorbidity during novel coronavirus (COVID-19) pandemic. National Consensus Statement 2020. Cardiovascular Therapy and Prevention. 2020; 19 (4): 2630. DOI: 10.15829/1728-88002020-2630 (in Russian).

2. Trukhan D.I., Tarasova L.V. Osobennosti kliniki i lecheniia ostrykh respiratornykh virusnykh infektsii v praktike vracha-terapevta. Vrach. 2014; 8: 44–7. https://www.elibrary.ru/item.asp?id= 21905156 (in Russian).

3. Lytkina I.N., Malyshev N.A. Profilaktika i lechenie grippa i ostrykh respiratornykh virusnykh infektsii sredi epidemiologicheski znachimykh grupp naseleniia. Klinicheskaia infektologiia i parazitologiia. 2015; 2 (13): 117–24. https://www.elibrary.ru/ item.asp?id=23849863 (in Russian).

4. Vremennye metodicheskie rekomendatsii "Poriadok provedeniia vaktsinatsii vzroslogo naseleniia protiv COVID-19'. https://minzdrav.gov.ru/news/2021/07/02/16927-utverzhdeny-vremennye-metodicheskie-rekomendatsii-poryadok-provedeniya-vaktsinatsii-vzroslogo-naseleniya-protiv-covid-19 (in Russian).

5. Trukhan D.I. Kompleksnaia terapiia vospalitel'nykh zabolevanii dykhatel'nykh putei na etape okazaniia pervichnoi mediko-sanitarnoi pomoshchi. Bolezni organov dykhaniia. Prilozhenie k zhurnalu Consilium Medicum. 2015; 1: 44–50. www.elibrary.ru/item.asp?id= 24311085 (in Russian).

6. Trukhan D.I, Mazurov A.L, Rechapova L.A. Ostrye respiratornye virusnye infektsii: aktual'nye voprosy diagnostiki, profilaktiki i lecheniia v praktike terapevta. Terapevticheskii arkhiv. 2016; 11: 76–82. DOI: 10.17116/terarkh2016881176-82 (in Russian).

7. Trukhan D.I., Bagisheva N.V., Mordyk A.V., Nebesnaia E.Iu. Aminodigidroftalazindion natriia v profilaktike, lechenii i reabilitatsii patsientov s zabolevaniiami organov dykhaniia. Consilium Medicum. 2021; 23 (3): 296–303. DOI: 10.26442/20751753.2021.3.200839 (in Russian).

8. Galmés S, Serra F, Palou A. Current State of Evidence: Influence of Nutritional and Nutrigenetic Factors on Immunity in the COVID-19 Pandemic Framework. Nutrients 2020; 12 (9): 2738. DOI: 10.3390/nu12092738

9. Cámara M, Sánchez-Mata MC, Fernández-Ruiz V et al. A Review of the Role of Micronutrients and Bioactive Compounds on Immune System Supporting to Fight against the COVID-19 Disease. Foods 2021; 10 (5): 1088. DOI: 10.3390/foods10051088

10. de Faria Coelho-Ravagnani C, Corgosinho FC, Sanches FFZ et al. Dietary recommendations during the COVID-19 pandemic. Nutr Rev 2021; 79 (4): 382–93. DOI: 10.1093/nutrit/nuaa067

11. Tsink, selen i vitamin D. Kak zashchishchat'sia ot COVID-19? Koronavirus COVID-19: Ofitsial'naia informatsiia o koronaviruse v Rossii na portale – stopkoronavirus.rf. https://xn--80aesfpebagmfblc0a. xn--p1ai/news/20201024-1315.html (in Russian).

12. Wells JM. Immunomodulatory mechanisms of lactobacilli. Microb Cell Fact 2011; 10 (Suppl 1): S17. DOI: 10.1186/1475-2859-10-

S1-S17

13. Trukhan D.I., Viktorova I.A. Korrektsiia narushenii kishechnogo mikrobiotsenoza v aspekte profilaktiki respiratornykh infektsii dykhatel'nykh putei: vozmozhnosti Lactobacillus rhamnosus GG. Gastroenterologiia. Khirurgiia. Intensivnaia terapiia. Consilium Medicum. 2018; 2: 39–44. DOI: 10.26442/26583739.2018.2.180103 (in Russian).

14. Ostrye respiratornye virusnye infektsii v ambulatornoi praktike vracha-pediatra. Posobie dlia vrachei pod red. N.A. Korovinoi. Moscow, 2004. https://elibrary.ru/item.asp?id=29782362 (in Russian).

15. Surkov A.N. Vozmozhnosti korrektsii i profilaktiki narushenii mikrobiotsenoza kishechnika u chasto boleiushchikh detei. Voprosy sovremennoi pediatrii. 2013; 2: 59–65. https://elibrary.ru/item. asp?id=19006300 (in Russian).

16. Trukhan D.I., Mazurov A.L., Rechapova L.A. Ostrye respiratornye virusnye infektsii: aktual'nye voprosy diagnostiki, profilaktiki i lecheniia v praktike terapevta. Terapevticheskii arkhiv. 2016; 11: 76–82. DOI: 10.17116/terarkh2016881176-82 (in Russian).

17. Trukhan D.I., Goloshubina V.V. Ostrye respiratornye virusnye infektsii v praktike vracha pervogo kontakta: aktual'nye aspekty kliniki, lecheniia i profilaktiki. Spravochnik poliklinicheskogo vracha. 2016; 05: 6–11. https://elibrary.ru/item.asp?id=29074224 (in Russian).

18. Grinevich V.B., Kravchuk Yu.A., Tkachenko E.I. et al. Features of management of patients with gastroenterological pathology in the conditions of the COVID-19 pandemic. Experimental and Clinical Gastroenterology. 2020; 176 (4): 3–18. DOI: 10.31146/1682-8658-ecg-176-4-3-18 (in Russian).

19. Tkacheva O.N., Kotovskaya Yu.V., Aleksanyan L.A. et al. Novel coronavirus infection SARS-CoV-2 in elderly and senile patients: prevention, diagnosis and treatment. Expert Position Paper of the Russian Association of Gerontology and Geriatrics. Cardiovascular Therapy and Prevention. 2020; 19 (3): 2601. DOI: 10.15829/1728-8800-2020-2601 (in Russian).

20. Oganov R.G., Simanenkov V.I., Bakulin I.G. et al. Comorbidities in clinical practice. Algorithms for diagnostics and treatment. Cardiovascular Therapy and Prevention. 2019; 18 (1): 5–66. DOI: 10.15829/1728-8800-2019-1-5-66 (in Russian).

21. Staessen JA, Fagard R, Thijs L et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Lancet 1997; 350 (9080): 757–64. DOI: 10.1016/s0140-6736(97)05381-6

22. Forette F, Seux ML, Staessen JA et al . Systolic Hypertension in Europe Investigators. The prevention of dementia with antihypertensive treatment: new evidence from the Systolic Hypertension in Europe (Syst-Eur) study. Arch Intern Med 2002; 162 (18): 2046–52. DOI: 10.1001/archinte.162.18.2046

23. Burnier M, Bakris G, Williams B. Redefining diuretics use in hypertension: why select a thiazide-like diuretic? J Hypertension 2019; 37: 1574–86. DOI: 10.1097/HJH.0000000000002088

24. Trukhan D.I., Davydov E.L., Drokina O.V. Rational pharmacotherapy of arterial hypertension in real clinical practice through the prism of drug safety and multimorbidity. Therapy. 2021; 2: 141–152. DOI: 10.18565/therapy.2021.2.141-152 (in Russian).

25. Trukhan D.I., Filimonov S.N. Treatment of arterial hypertension I–II stages in patients with risk of cardiovascular complications above moderate in real clinical practice: possibilities of indapamide in a combined therapy. Therapy. 2021; 5: 173–83. DOI: 10.18565/therapy.2021.5.173-183 (in Russian).

26. Williams B, Mancia G, Spiering W et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018; 39 (33): 3021–104. DOI: 10.1093/eurheartj/ehy339

27. Klinicheskie rekomendatsii Arterial'naia gipertenziia u vzroslykh. RKO. 2020. https://scardio.ru/content/Guidelines/Clinic_rek_AG_ 2020.pdf (in Russian).

28. Pavlova T.V. Rol' diuretikov v lechenii AG. Spravochnik poliklinicheskogo vracha. 2013; 7–8: 37–41. https://elibrary.ru/item.asp?id= 22149450 (in Russian).

29. Trukhan D.I., Viktorova I.A. Diuretiki v lechenii arterial'noi gipertonii: vybor preparata s pozitsii ratsional'noi farmakoterapii i farmakoekonomicheskoi effektivnosti. Spravochnik poliklinicheskogo vracha. 2011; 8: 31–4. https://elibrary.ru/item.asp?id=23604653 (in Russian).

30. Kochetkov A.I. Tiazidnye i tiazidopodobnye diuretiki v lechenii arterial'noi gipertonii: est' li razlichiia? Ratsional'naia Farmakoterapiia v Kardiologii. 2020; 16 (6): 994–1001. DOI: 10.20996/1819-6446-2020-11-09 (in Russian).

31. Maxwell E. Living with Covid19. A dynamic review of the evidence around ongoing Covid19 symptoms (often called Long Covid). NIHR CED 30 September 2020. NIHR Evidence – Living with Covid19 – Informative and accessible health and care research. https://evidence.nihr.ac.uk/themedreview/living-with-covid19/

32. Callard F, Perego E. How and why patients made Long Covid. Soc Sci Med 2021; 268: 113426. DOI: 10.1016/j.socscimed.2020.113426

33. Dani M, Dirksen A, Taraborrelli P et al. Autonomic dysfunction in 'long COVID': rationale, physiology and management strategies. Clin Med (Lond) 2021; 21 (1): e63-e67. DOI: 10.7861/clinmed.2020-0896

34. Oronsky B, Larson C, Hammond TC et al. A review of persistent post-COVID syndrome (PPCS). Clin Rev Allergy Immunol 2021: 1–9. DOI: 10.1007/s12016-021-08848-3

35. Venkatesan P. NICE guideline on long COVID. Lancet Respir Med 2021; 9 (2): 129. DOI: 10.1016/S2213-2600(21)00031-X

36. Ayoubkhani D, Khunti K, Nafilyan V et al. Post-covid syndrome in individuals admitted to hospital with covid-19: retrospective cohort study. BMJ 2021; 372: n693. DOI: 10.1136/bmj.n693

37. Zaitsev AA, Savushkina OI, Cherniak AV et al. Kliniko-funktsional'naia kharakteristika patsientov, perenesshikh novuiu koronavirusnuiu infektsiiu COVID-19. Prakticheskaia pul'monologiia. 2020; 1: 78–81 (in Russian).

38. Al-Aly Z, Xie Y, Bowe B. High-dimensional characterization of post-acute sequelae of COVID-19. Nature 2021. Apr 22. DOI: 10.1038/ s41586-021-03553-9.

39. Sher L. Post-COVID syndrome and suicide risk. QJM 2021: hcab007. DOI: 10.1093/qjmed/hcab007

40. Carfì A, Bernabei R, Landi F. Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19. JAMA 2020; 324 (6): 603–5. DOI: 10.1001/jama.2020.12603

41. Huang C, Huang L, Wang Y et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021; 397: 220–32. DOI: 10.1016/S0140-6736(20)32656-8

42. Townsend L, Dowds J, O'Brien K et al. Persistent poor health post-COVID-19 is not associated with respiratory complications or initial disease severity. Ann Am Thorac Soc 2021. DOI: 10.1513/AnnalsATS.202009-1175OC

43. Butters D, Whitehouse M. COVID-19 and nutriceutical therapies, especially using zinc to supplement antimicrobials. Inflammopharmacology 2021; 29 (1): 101–5. DOI: 10.1007/s10787-020-00774-8

44. Vollbracht C, Kraft K. Feasibility of Vitamin C in the Treatment of Post Viral Fatigue with Focus on Long COVID, Based on a Systematic Review of IV Vitamin C on Fatigue. Nutrients 2021; 13 (4): 1154. DOI: 10.3390/nu13041154

45. Vishnupriya M, Naveenkumar M, Manjima K et al. Post-COVID pulmonary fibrosis: therapeutic efficacy using with mesenchymal stem cells – How the lung heals. Eur Rev Med Pharmacol Sci 2021; 25 (6): 2748–51. DOI: 10.26355/eurrev_202103_25438

46. Pavli A, Theodoridou M, Maltezou HC. Post-COVID syndrome: Incidence, clinical spectrum, and challenges for primary healthcare professionals. Arch Med Res 2021: S0188-4409(21)00081-3. DOI: 10.1016/j.arcmed.2021.03.010

47. Saeed S, Tadic M, Larsen TH et al. Coronavirus disease 2019 and cardiovascular complications: focused clinical review. J Hypertens 2021; 39 (7): 1282–92. DOI: 10.1097/HJH.0000000000002819

48. Igase M, Kohara K, Miki T. The Association between Hypertension and Dementia in the Elderly. Int J Hypertens 2012; 2012: 320648. DOI: 10.1155/2012/320648

49. Chillon JM, Baumbach GL. Effects of indapamide, a thiazide-like diuretic, on structure of cerebral arterioles in hypertensive rats. Hypertension 2004; 43 (5): 1092–7. DOI: 10.1161/01.HYP.0000122874. 21730.81

50. Martsevich S.Iu., Kutishenko N.P., Deev A.D., Iakusevich V.V. Izuchenie effektivnosti i perenosimosti preparata indap v sravnenii s preparatami arifon i arifon retard u bol'nykh miagkoi i umerennoi arterial'noi gipertoniei, naznachaemykh kak v vide monoterapii, tak i v kombinatsii s ingibitorami APF. Mnogotsentrovoe, otkrytoe, randomizirovannoe perekrestnoe issledovanie. Rossiiskii kardiologicheskii zhurnal. 2006; 2: 73–7. https://elibrary.ru/item.asp?id= 10133950 (in Russian).

51. Mamedov M.N. Vozmozhnosti primeneniia indapamida na razlichnykh etapakh serdechno-sosudistogo kontinuuma i v otdel'nykh gruppakh patsientov. Rossiiskii kardiologicheskii zhurnal. 2010; 6: 107–11. https://elibrary.ru/item.asp?id=15518059 (in Russian).

52. Trukhan D.I., Pavlova T.V., Viktorova I.A. Optimizatsiia nemedikamentoznogo i medikamentoznogo vozdeistviia na patogeneticheskie faktory razvitiia i techeniia arterial'noi gipertenzii v ramkakh novoi nauchno-issledovatel'skoi obrazovatel'noi ozdorovitel'noi programmy PERSPEKTIVA. Spravochnik poliklinicheskogo vracha. 2012. 11: 18–22. https://elibrary.ru/item.asp? id=23502186 (in Russian).

53. Kochetkov A.I., Ostroumova O.D. Klinicheskoe znachenie organoprotektivnykh svoistv antigipertenzivnykh preparatov v novykh rekomendatsiiakh po arterial'noi gipertonii: vozmozhnosti antagonistov kal'tsiia i diuretikov. Consilium Medicum. 2019; 21 (5): 11–8. DOI: 10.26442/20751753.2019.5.190417 (in Russian).

54. Pereverzev A.P., Ostroumova O.D. Rekomendatsii po arterial'noi gipertenzii 2018 i 2019 godov: ostaetsia li mesto svobodnym kombinatsiiam? Consilium Medicum. 2019; 12: 118–27. DOI: 10.26442/20751753.2019.12.190747 (in Russian).

55. Forette F, Seux ML. Staessen JA. Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe trial. Lancet 1998; 352: 1347–51. DOI: 10.1016/s0140-6736(98)03086-4

56. Bell RD, Zlokovic BV. Neurovascular mechanisms and blood-brain barrier disorder in Alzheimer’s disease. Acta Neuropathol 2009; 118: 103–13. DOI: 10.1007/s00401-009-0522-3

57. Gould RJ, Murphy KMM, Snyder SH. Autoradiographic localization of calcium channel antagonist receptors in rats brain with [3H] nitrendipine. Brain Res 1985; 330: 217–33. DOI: 10.1016/0006-8993(85)90680-8

58. Paris D, Bachmeier C, Patel N et al. Selective antihypertensive dihydropyridines lower Aβ accumulation by targeting both the production and the clearance of Aβ across the blood-brain barrier. Mol Med 2011; 17 (3–4): 149–62. DOI: 10.2119/molmed.2010.00180

59. Bachmeier C, Beaulieu-Abdelahad D, Mullan M et al. Selective dihydropyiridine compounds facilitate the clearance of β-amyloid across the blood-brain barrier. Eur J Pharmacol 2011; 659 (2–3): 124–9. DOI: 10.1016/j.ejphar.2011.03.048

For citation:Trukhan D.I., Davydov E.L., Chusova N.A., Chusov I.S. Opportunities of the therapist in prevention and at the rehabilitation stage after new coronaviral infection (COVID-19) in comorbid patients with arterial hypertension. Clinical review for general practice. 2021; 5: 6–15. DOI: 10.47407/kr2021.2.5.00064

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Clinical review for general practice