Issue №3-20, 2020

https://doi.org/10.38025/2078-1962-2020-97-3-3-13

Challenges and approaches to medical rehabilitation of patients with Covid-19 complications

View article (Download PDF file)



Download XML file

1 Fesyun A.D., 1 Lobanov A.A., 1 Rachin A.P., 1 Yakovlev M.Y., 1 Andronov S.V., 1 Konchugova T.V., 1 Gilmutdinova I.R., 1 Barashkov G.N., 1 Mitroshkina E.E., 2 Bogdanova E.N., 1 Lebedev Y.O., 1 Nikitina A.M.

1 National Medical Research Center of Rehabilitation and Balneology, Moscow, Russian Federation
2 Northern (Arctic) Federal University named after M.V. Lomonosov, Arkhangelsk, Russian Federation


ABSTRACT

The Covid-19 pandemic could reach several million people worldwide. Presumably, 5-15% of them will need medicalrehabilitation after suffering from pneumonia and acute respiratory distress syndrome. A comprehensive search wasperformed in the databases MEDLINE, CENTRAL, EMBASE, Web of Science and MedPilot, CyberLeninka, and eLIBRARY ondrugrehabilitation methods that prevent the development of Covid-19 complications. The goals of medical rehabilitationat the preclinical stage are to achieve the correction of diseases that contribute to the development of Covid-19complications (COPD, bronchial asthma, rhinosinusitis, diabetes mellitus), mainly due to non-drug methods. Non-drugtechnologies have a number of advantages over medications that have a side effect, and such as glucocorticoids andantibiotics lead to a worse prognosis of the underlying disease. Medical rehabilitation in the intensive care unit is aimedat reducing the risk of complications and increasing the functional reserves of the body, as well as reducing the areaand degree of lung damage, preventing extrapulmonary complications, including secondary infection. The main goalof medical rehabilitation in a hospital is to reduce the severity of symptoms, resorption and repair in the lesion of lungtissue, reduce the development of fibrosis, and provide bronchial drainage to prevent secondary infection. In addition,timely transfer of the patient to a specialized stage of medical rehabilitation can increase the functional reserve of therespiratory muscles and exercise tolerance. The second, specialized stage of medical rehabilitation can be carried out inthe conditions of a sanatorium-resort organization. The goals of this stage are not only to reduce symptoms and increasetolerance to physical activity, but also to improve the quality of life, psychological rehabilitation, and recovery.


KEYWORDS: Covid-19, medical rehabilitation, Spa treatment, prevention of complications, inhalation therapy, vibrotherapy, climate therapy.

For citation: Fesyun A.D., Lobanov A.A., Rachin A.P., Yakovlev M.Yu., Andronov S.V., Konchugova T.V., Gilmutdinova I.R., Barashkov G.N., Mitroshkina E.E., Bogdanova E.N., Lebedev Ya.O., Nikitina A.M. Challenges and approaches to medical rehabilitation of patients with Covid-19 complications. Bulletin of rehabilitation medicine. 2020; 97 (3): 3-13. https://doi.org/10.38025/2078-1962-2020-97-3-3-13



References:

  1. European Centre for Disease Prevention and Control. Outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): increased transmission beyond China - fourth update, 14 February 2020. ECDC. Stockholm. 2020. https://www.ecdc.europa.eu/en/publications-data/outbreak-severe-acute-respiratory-syndrome-coronavir....
  2. Inui S, Fujikawa A, Jitsu M, et al. Findings in cases from the cruise ship «Diamond Princess» with coronavirus disease 2019 (COVID-19). Radiol Car-diothorac Imaging. 2020; 2(2): e200110. https://pubs.rsna.org/doi/full/10.1148/ryct.2020200110
  3. WHO, «Coronavirus disease 2019 ( COVID-19 ) Situtation report» vol. 2020, no. 46. (6 March 2020). https://www.who.int/emergencies/diseases/ novel-coronavirus-2019/situation-reports
  4. Ng, C.K., J.W. Chan, T.L. Kwan, T.S. To, Y.H. Chan, F.Y. Ng, and T.Y. Mok. Six month radiological and physiological outcomes in severe acute respiratory syndrome (SARS) survivors. Thorax. 2004; 59: 889-891.
  5. Hui DS. Impact of severe acute respiratory syndrome (SARS) on pulmonary function, functional capacity and quality of life in a cohort of survivors. Thorax. 2005; 60(5): 401-409.
  6. Avdeev S.N., Karchevskaya N.A., Baimakanova G.E., Cherniak A.V. Godichnoe nablyudenie za bol'nymi, perenesshimi ostroe povrezhdenie legkih / ostryj respiratornyj distress sindrom, vyzvannyj virusom grippa A / H1N1 [A one-year follow-up study of patients survived after ALI / ARDS caused by influenza A / H1N1]. Pul'monologiya. 2011; 4: 58-66. (In Russ.) DOI:10.18093/0869-0189-2011-0-4-58-66
  7. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, Fan Y, Zheng C (2020) Radiological fndings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. The Lancet Infectious Diseases. DOI: 10.1016/S1473-3099(20)30086-4
  8. Svetlickaja O.I., Judina O.A., Kashanskij R.V., Kanus I.I. Morfologicheskaya harakteristika porazheniya vnutrennih organov pri ostrom respiratornom distress-sindrome virusno-bakterial'noj etiologii [Morfologicheskaja harakteristika porazhenija vnutrennih organov pri ostrom respiratornom distress-sindrome virusno-bakterial'noj jetiologii]. Vestnik VGMU. 2018; 17(2): 55-62. (in Russ.)
  9. World Health Organization, Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. 2020, March 14. https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf?sfvrsn=bc7....
  10. Mukharlyamov F.Y., Sycheva M.G., Rassulova M.A., Razumov A.N. Pul'monologicheskaya reabilitaciya: sovremennye programmy i perspektivy [Pulmonary rehabilitation: novel programmes and perspectives]. Pul'monologiya. 2013; 6: 99-105. (In Russ.) DOI:10.18093/0869-0189-2013-0-6-99-105
  11. Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. American Journal of Respiratory and Critical Care Medicine. 2013; 188: 13-64 DOI: 10.1164/rccm.201309-1634ST
  12. Uyanaeva A.I., Ajrapetova N.S., Badalov N.G., Tupicyna Yu.Yu., L'vova N.V., Nitchenko O.V., Uyanaeva M.A., Ksenofontova I.V. Fiziobal'neoterapiya v profilaktike pogodoobuslovlennyh obostrenij u bol'nyh s hronicheskoj obstruktivnoj bolezn'yu legkih [Physiobalneotherapy in the prevention of weather-related exacerbations in patients with chronic obstructive pulmonary disease]. Voprosy kurortologii, fizioterapii i lechebnoj fizicheskoj kul'tury. 2015; 6: 17-22. (In Russ.)
  13. Bolotova E.V., Shul'zhenko L.V., Sholin I.Y., Ezugbaya B.S., Porkhanov V.A. Sluchaj rannej reabilitacii pacientki s tyazheloj formoj pandemicheskogo grippa A / H1N1, oslozhnennogo pnevmoniej i ostrym respiratornym distress-sindromom [A case of early rehabilitation of a patient with severe pandemic influenza A / H1N1 complicated by pneumonia and acute respiratory distress syndrome]. Pul'monologiya. 2016; 26(1): 108-112. (In Russ.) DOI:10.18093/0869-0189-2016-26-1-108-112
  14. Ivanova G.E., Polyaev B.A. Lajsheva O.A. et al. Metodicheskie Rekomendacii: Ispol'zovanie terapevticheskih trenazherov Motomed (Reck-Technik, Germaniya) v klinicheskoj praktike [Guidelines: Use of Motomed therapeutic simulators (Reck-Technik, Germany) in clinical practice]. 2008: 6-7. (In Russ.)
  15. Kamenev L.I., Borisova O.N., Kupeev R.V. (2018). Mekhanotrenazhery dyhatel'noj muskulatury v sanatorno-kurortnoj praktike [Mechanical trainers of respiratory muscles in Spa practice]. Vestnik novyh medicinskih tekhnologij. Elektronnoe izdanie. 2018; 2: 165-170. (In Russ.) http://www.medtsu. tula.ru/VNMT/Bulletin/E2018-2/3-5.pdf
  16. Konchugova TV, Orekhova EM, Kul’chitskaya DB. Osnovnye dostizheniya i napravleniya razvitiya apparatnoj fizioterapii [The major achievements and future directions of the development of instrumental physiotherapy]. Voprosy kurortologii, fizioterapii i lechebnoj fizicheskoj kul'tury. 2013; 90(1): 26-31. (In Russ.). DOI:10.17116/kurort2013126-31
  17. Troitsky M.S., Fedorov S.Yu., Borisova O.N., Korzhuk N.L. Innovacii v trenirovke dyhatel'noj muskulatury (literaturnyj obzor) [Innovations in respiratory muscle training (literary review)]. Vestnik novyh medicinskih tekhnologij. Elektronnoe izdanie 2015; 2: 241-245. (In Russ.) DOI: 10.12737/11911 http://www.medtsu.tula.ru/VNMT/Bulletin/E2015-2/5192.pdf
  18. Varekojis SM, Douce FH, Flucke RL, Filbrun DA, Tice JS, McCoy KS, et al. A comparison of the therapeutic effectiveness of and preference for postural drainage and percussion, intrapulmonary percussive ventilation, and high-frequency chest wall compression in hospitalized cystic fibrosis patients. Respiratory Care. 2003; 48(1): 24-8.
  19. Avdeev S.N. Patofiziologiya obostrenij hronicheskoj obstruktivnoj bolezni legkih [Pathologic physiology of exacerbations of chronic obstructive pulmonary disease]. Vestnik anesteziologii i reanimatologii. 2019; 16(2): 75-82. (In Russ.) DOI:10.21292/2078-5658-2019-16-2-75-82
  20. Lobanov A.A., Bazhenov E.E. [Low-frequency endobronchial vibration massage of the lungs in the complex treatment of patients with CNPD]. Ma-terialy konferencii Aktual'nye voprosy vnutrennej patologii [Conference Proceedings Topical issues of internal pathology]. Omsk. 2002: 70. (In Russ.)
  21. Judith A., Voynow M.D., Thomas F. Scanlin M.D. Pediatric Pulmonology. Chapter 7. Cystic Fibrosis. The Requisites. 2005: 116-130 DOI:10.1016/B978-0-323-01909-5.50014-1
  22. Malyavin A.G. Respiratornaya medicinskaya reabilitaciya: (prakticheskoe rukovodstvo dlya vrachej) [Respiratory medical rehabilitation]. M. Prak-ticheskaya medicina. 2006: 415 p. ISBN: 5-98811-022-3 (In Russ)
  23. Bobrovnitskiy I.P., Nagornev S.N., Lebedeva O.D., Yakovlev M.Yu., Tatarinova L.V., Badtieva V.A., Efendieva M.T., Polunin A.A. Personalizaciya programm medicinskoj reabilitacii bol'nyh rasprostranennymi somaticheskimi zabolevaniyami [Personalization of medical rehabilitation programs for patients with common medical conditions]. Kurortnye vedomosti. 2012; 4: 4-5. (In Russ.)
  24. Nikitin M.V., Chukina I.M., Knyazeva T.A. Effektivnost' vysokotekhnologichnoj medicinskoj pomoshchi v profilaktike i lechenii meteopaticheskih reakcij u kardiologicheskih pacientov na etape rannej reabilitacii v sanatorno-kurortnyh usloviyah [Effectiveness of high-tech medical care in the prevention and treatment of meteopathic reactions in cardiological patients at the stage of early rehabilitation in sanatorium-resort conditions]. Fizioterapevt. 2019; 4: 57-61. (In Russ.)
  25. Klyachkin L.M., Schegolkov A.M. Principy sovremennoj klimatoterapii i ee znachenie v pul'monologii [Principles of climatotherapy and its importance in pulmonology]. Pul'monologiya. 2000; 4: 88-92. (in Russ)
  26. Uyanaeva A.I., Tupitsina Yu.Yu., Rassulova M.A,. Turova E.A., Lvova N.V., Airapetova N.S. Vliyanie klimata i pogody na mekhanizmy formirovaniya povyshennoj meteochuvstvitel'nosti (obzor) [The influence of climate and weather on the mechanisms of formation of increased meteosensitivity (review)]. Voprosy kurortologii, fizioterapii i lechebnoj fizicheskoj kul'tury. 2016; 93(5): 52-57. (In Russ.)
  27. Zherlicina L.I., Efimenko N.V., Povolotskaya N.P., Velikanov I.I. Sposob lecheniya i rannej (ekstrennoj) i planovoj profilaktiki meteopaticheskih reak-cij u bol'nyh ishemicheskoj bolezn'yu serdca, gipertonicheskoj bolezn'yu I-II stadii s sindromom dezadaptacii s ispol'zovaniem metoda transkranial'noj mezodiencefal'noj modulyacii [Method of treatment and early (emergency) and planned prevention of meteopathic reactions in patients with ischemic heart disease, stage I—II hypertension with maladaptation syndrome using the method of transcranial mesodiencephalic modulation]. Patent RU no. 2422128, 2011. (In Russ.)
  28. Kang Y, Han Y, Guan T, Wang X, Xue T, Chen Z, Jiang L, Zhang L, Zheng C, Wang Z, Gao R. Clinical blood pressure responses to daily ambient temperature exposure in China: An analysis based on a representative nationwide population. Sci Total Environ. 2020; 705: 135762
  29. Klyachkin L.M., Shchegol'kov A.M. Medicinskaya reabilitaciya bol'nyh s zabolevaniyami vnutrennih organov [Medical rehabilitation of patients with diseases of internal organs]. M. Medicina, 2000: 328 p. (In Russ.)
  30. Liang N.A., Khan M.A. Medicinskaya reabilitaciya detej s bronhial'noj astmoj [Medical rehabilitation of children with bronchial asthma]. Aller-gologiya i immunologiya v pediatrii. 2016; 2(45): 17. (In Russ.)
  31. Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, Pinto Plata V, Cabral HJ. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. The New England Journal of Medicine. 2004; 350: 1005-1012.
  32. Badalov N.G., Barashkov G.N., Persiyanova-Dubova A.L. Terrenkury i fizicheskaya trenirovka hod'boj [Terrenkurs and physical training by walking]. Fizioterapiya, bal'neologiya i reabilitaciya. 2016; 15(6): 317-322. (In Russ.) DOI: 10.18821/1681-3456-2016-15-6-317-322
  33. Torres-Ronda L., I del Alcazar X.S. (2014). The properties of water and their applications for training. Journal of Human Kinetics. 2014; 44: 237-248. PubMed DOI:10.2478/hukin-2014-0129
  34. Guarnieri G, Ferrazzoni S, Scarpa M, C, Lalli A, Maestrelli P: Effects of Inhalation of Thermal Water on Exhaled Breath Condensate in Chronic Obstructive Pulmonary Disease. Respiration. 2010; 79: 216-221. DOI:10.1159/000227801
  35. Kuimov A.D., Krivosheev A.B., Khavin P.P. Nemedikamentoznaya korrekciya funkcii vneshnego dyhaniya u bol'nyh hronicheskim obstruktivnym bronhitom [Non-Medicinal correction of external respiratory function in patients with chronic obstructive bronchitis]. Byulleten' SO RAMN. 2007; 1: 15-9. (In Russ)
  36. Braga P, C, Sambataro G, Dal Sasso M, Culici M, Alfieri M, Nappi G: Antioxidant Effect of Sulphurous Thermal Water on Human Neutrophil Bursts: Chemiluminescence Evaluation. Respiration. 2008; 75: 193-201. DOI: 10.1159/000107976
  37. Lobanov A.A. Profilaktika obostrenij hronicheskoj obstruktivnoj bolezni legkih s pomoshch'yu aerozolej, soderzhashchih serebro (kliniko-eksperimental'noe issledovanie). Avtoref. diss. dok. med. nauk. [Prevention of exacerbations of chronic obstructive pulmonary disease using silver-containing aerosols (clinical and experimental study). Author's abstract. Diss. doctor of medical Sciences: 14.01.25]. SPb. 2010: 39 p. (In Russ.)
  38. Drake PL, Hazelwood KJ. Exposure-related health effects of silver and silver compounds: A review. The Annals of Occupational Hygiene. 2005; 49: 575-585
  39. Morones, J.R., J.L. Elechiguerra, A. Camacho, K. Holt, J.B. Kouri, J.T. Ramirez, and M.J. Yacaman. The bactericidal effect of silver nanoparticles. Nanotechnology. 2005; 16: 2346-2353. DOI:10.1088/0957-4484/16/10/059.
  40. Shahverdi AR, Fakhimi A, Shahverdi HR, Minaian S. Synthesis and effect of silver nanoparticles on the antibacterial activity of different antibiotics against Staphylococcus aureus and Escherichia coli. Nanomedicine. 2007; 3: 168-171
  41. Nomiya K, Noguchi R, Ohsawa K, Tsuda K, Oda M. Synthesis, crystal structure and antimicrobial activities of two isomeric gold(I) complexes with nitrogen-containing heterocycle and triphenylphosphine ligands, [Au(L)(PPh3)] (HL = pyrazole and imidazole). Journal of Inorganic Biochemistry. 2000; 78(4): 363370. DOI:10.1016/s0162-0134(00)00065-9
  42. Chopra I. The increasing use of silver-based products as antimicrobial agents: A useful development or a cause for concern? Journal of Antimicrobial Chemotherapy. 2007; 59: 587-590
  43. Lobanov A.A., Chernova S.N., Andronov S.V. et al. Vozdejstvie metallicheskogo serebra na fagocitarnuyu aktivnost' nejtrofilov u bol'nyh hro-nicheskoj obstruktivnoj bolezn'yu lyogkih [Effect of metallic silver on the phagocytic activity of neutrophils in patients with chronic obstructive pulmonary disease]. Vestnik novyh medicinskih tekhnologij. 2009; Vol. XVI (2): 43 p. (In Russ.)
  44. Lobanov A.A., Chernova S.N., Andronov S.V., Kochkin R.A. Immunotropnoe dejstvie metallicheskogo serebra pri ingalyacionnom vvedenii u bol'nyh HOBL [Immunotropic effect of metallic silver during inhalation administration in patients with COPD]. Vestnik novyh medicinskih tekh-nologij. 2008; Vol. XV (4): 65-66. (In Russ.)
  45. Lu L, Sun R, Chen R, Hui C, Ho C, Luk J, Lau G, Che C Silver nanoparticles inhibit hepatitis B virus replication. Antiviral Therapy. 2008; 13: 253-262
  46. Sun, RW, Chen, R, Chung, NP, Ho, CM, Lin, CL, Che, CM. 2005. Silver nanoparticles fabricated in Hepes buffer exhibit cytoprotective activities toward HIV-1 infected cells. Chemical Communications (Cambridge). 2005: 5059-5061.
  47. Sun, L.; Singh, A. K.; Vig, K.; Pillai, S. R.; Singh, S. R. Journal of Biomedical Nanotechnology. 2008; 4: 149 p. DOI: 10.1039/b510984a
  48. Baram-Pinto, D.; Shukla, S.; Perkas, N.; Gedanken, A.; Sarid, R. Inhibition of herpes simplex virus type 1 infection by silver nanoparticles capped with mercaptoethane sulfonate. Bioconjugate Chemistry. 2009; 20: 1497-1502. DOI: 10.1021/bc900215b.
  49. Lara, H.H., Ayala-Nunez, N.V., Ixtepan-Turrent, L. et al. Mode of antiviral action of silver nanoparticles against HIV-1. Journal of Nanobiotechnology. 2010; 8: 1 p. DOI: 10.1186/1477-3155-8-1
  50. Contoli M, Gnesini G, Forini G, Marku B, Pauletti A, Padovani A, et al. Reducing agents decrease the oxidative burst and improve clinical outcomes in COPD patients: a randomised controlled trial on the effects of sulphurous thermal water inhalation. The Scientific World Journal. 2013: 7 p. DOI: 10.1155/2013/927835
  51. Pellegrini M, Fanin D, Nowicki Y, et al. Effect of inhalation of thermal water on airway inflammation in chronic obstructive pulmonary disease. Respiratory Medicine. 2005; 99(6): 748754. DOI: 10.1016/j.rmed.2004.11.001
  52. Ulashchik V.S., Lukomsky I.V. Obshchaya fizioterapiya. Uchebnik dlya stud. vyssh. uch. zaved [General physical therapy. Textbook for students higher education institution]. Mn. Izdvo Knizhnyj dom. 2008: 512 p. ISBN 978-985-489-850-6. (In Russ)
  53. Ushakov A.A. Prakticheskaya fizioterapiya: rukovodstvo dlya vrachej [Practical physical therapy: hands. for doctors]. M. Izdvo MIA. 2013: 688 p. ISBN 978-5-9986-0123-1 (In Russ.)
  54. Ponomarenko G.N. Fizicheskaya i reabilitacionnaya medicina. Nacional'noe rukovodstvo [Physical and rehabilitation medicine. National leadership]. M. GEOTAR-Media. 2016: 688 p. (In Russ.) ISBN 978-5-9704-3606-6
  55. Khan M.A., Kotenko K.V., Korchazhkina N.B., CHervinskaya A.V., Mikitchenko N.A., Lyan N.A. Perspektivnye napravleniya razvitiya galoterapii v pe-diatrii [Promising directions of halotherapy development in pediatrics]. Voprosy kurortologii, fizioterapii i lechebnoj fizicheskoj kul'tury. 2016; 93(6): 61-66 (In Russ.) DOI:10.17116/kurort2016661-66



Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©

Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.

Aссоциация НАЭСКЛ