Issue №3-20, 2020

https://doi.org/10.38025/2078-1962-2020-97-3-25-30

Acidosis and toxic hemolysis – goals of path genetic treatment of polyorgan pathology in Covid-19

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1 Lodyagin A.N., 1 Batotsyrenov B.V., 1 Shikalova I.A., 1 Voznyuk I.A.

1 Saint-Petersburg I.I. Dzhanelidze research institute of emergency medicine, Saint-Petersburg, Russian Federation


ABSTRACT

The article presents analyzis of the data of the clinical course of Covid-19 and probable pathogenetic mechanisms of lesions,which are presented in foreign and domestic literature. The hypothesis about the hematotoxic effect of the SARS-CoV-2 virusis considered, which may cause its multi-system action. An analogy is made of the pathogenesis of multiple organ lesionsin case of viral infection and in acute poisoning with hemolytic poisons and iron preparations, in which the developmentof metabolic acidosis, toxic hemolysis, and an increase in free hemoglobin and iron ions in the blood plasma are the centrallink. The article proposes to use a set of diagnostic measures aimed at confirming the hematotoxic component during SARSCoV-2 infection and methods for assessing the severity of the condition, adopted in clinical toxicology.Taking into accountthe experience of treating acute poisoning with hemolytic poisons, attention is focused on the importance of using alkalizingtherapy in order to remove the products of hemoglobin breakdown and prevent acute nephritic failure. When confirmingthe presence of a toxic factor, methods aimed at eliminating toxic products of hemolysis can be used – antidote therapyand methods of surgical detoxification. This complex of therapeutic measures in clinical toxicology is effective, aimed at theprevention of acute renal failure and toxic coagulopathy. The authors believe that the hypothesis of a hematotoxic factor inthe pathogenesis of Covid-19 requires a targeted therapeutic strategy and targeted study.


KEYWORDS: coronavirus infection, Covid-19, SARS-CoV-2, hemolysis, iron poisoning, free hemoglobin, chelate therapy, ironbinding therapy, acidosis, efferent therapy, hemoglobinuria nephrosis, toxic coagulopathy.

For citation: Lodyagin A.N., Batotsyrenov B.V., Shikalova I.A. Voznyuk I.A. Acidosis and toxic hemolysis – goals of pathogenetic treatment of polyorgan pathology in Covid-19. Bulletin of rehabilitation medicine. 2020; 97 (3): 25-30. https://doi.org/10.38025/2078-1962-2020-97-3-25-30



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