Сourse features of a new coronavirus infection in a comorbid patient

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Abstract

The appearance of a new coronavirus infection (COVID-19) in 2020 caused by the SARS-CoV-2 virus set tasks for doctors of various specialties to quickly diagnose, treat, and develop effective rehabilitation measures. The medical community’s knowledge about the respiratory tract lesions pathogenesis course in COVID-19 is going to improve, but the key accents placement in understanding this pathology course continues today. Suspected SARS-CoV-2 virus reference points are as follows: vascular endothelial dysfunction, coagulopathy, thrombosis resembling the antiphospholipid syndrome. Treatment is carried out in accordance with general recommendations aimed at the average patient despite the higher secondary infectious complications risk in patients suffering from cancer and a high severe COVID-19 risk. A successful inpatient treatment experience in patients suffering from comorbid pulmonary pathology and a new coronavirus infection is demonstrated on a separate example. The treatment duration and the complexity of selecting a rehabilitation measures course were due to the patient's history of central squamous cell lung cancer, surgical intervention (bilobectomy), radio- and chemotherapy, as well as complications in the form of pulmonary embolism. The concomitant respiratory pathology was differentiated (chronic obstructive pulmonary disease) during examination and treatment and basic therapy was selected, which made the medical rehabilitation stage more effective. The patient's condition required a more careful selection of combined anti-inflammatory, broncholytic, mucolytic, and antibacterial therapy than in patients without concomitant pathology. Treatment and a complex of rehabilitation measures, normalization of respiratory function, compensation for concomitant bronchopulmonary pathology was possible to be achieves as a result of the diagnosis of concomitant bronchopulmonary pathology. Careful diagnostic search and optimal treatment of all somatic pathology are important factors in the selection of adequate therapy for elderly patients suffering from coronavirus infection with comorbid pulmonary pathology.

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About the authors

Mihail A. Kharitonov

Military Medical Academy of S.M. Kirov

Email: micjul11@yandex.ru
ORCID iD: 0000-0002-6521-7986
SPIN-code: 7678-2278

Doctor of Medical Sciences

Russian Federation, Saint Petersburg

Vladimir V. Ivanov

Military Medical Academy of S.M. Kirov

Email: sea-89@yandex.ru
SPIN-code: 1736-8285

Candidate of Medical Sciences

Russian Federation, Saint Petersburg

Sergey L. Grishaev

Military Medical Academy of S.M. Kirov

Email: grishaev_med@mail.ru
ORCID iD: 0000-0002-4830-5220
SPIN-code: 3854-1566

Doctor of Medical Sciences

Russian Federation, Saint Petersburg

Olga A. Maltseva

Military Medical Academy of S.M. Kirov

Email: vmeda-nio@mil.ru
ORCID iD: 0000-0002-3131-9204
SPIN-code: 8699-2511

Pulmonologist

Russian Federation, Saint Petersburg

Elena S. Bulka

Military Medical Academy of S.M. Kirov

Email: elena.l-saburova@yandex.ru
ORCID iD: 0000-0001-9782-4599
SPIN-code: 9209-7789

Residency Student

Russian Federation, Saint Petersburg

Kirill A. Bulka

Military Medical Academy of S.M. Kirov

Author for correspondence.
Email: visoret@list.ru
ORCID iD: 0000-0002-8871-0335
SPIN-code: 2831-2165

Candidate of Medical Sciences

Russian Federation, Saint Petersburg

References

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Supplementary files

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1. JATS XML
2. Fig. 1. Spiral computed tomography of patient B’s chest organs during initial examination

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3. Fig. 2. Spiral computed tomography of patient B’s chest organs after bilobectomy during chemotherapy

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4. Fig. 3. Spiral computed tomography of patient B’s chest organs upon admission to rehabilitation treatment

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5. Fig. 4. Overview radiography of patient B at the end of the rehabilitation period

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