medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-12-72-88medsovet-6334Research ArticleНЕВРОЛОГИЯNEUROLOGYПредпосылки к созданию атласа постковидного воспаления как способа персонализированной фармакотерапии, а также прогнозирования и предупреждения органных и системных дисфункцийPrerequisites for the creation of an atlas of postcovid inflammation as a way of personalized pharmacotherapy, as well as predicting and preventing organ and systemic dysfunctionshttps://orcid.org/0000-0003-1449-8711КукесИ В.KukesI. V.

к.м.н., врач – клинический фармаколог, иммунолог, руководитель научно-клинического отдела,

109147, Москва, ул. Малая  Калитниковская, д. 2, к. 1

Cand. Sci. (Med.), Clinical Pharmacologist, Immunologist, Head of the Scientific and Clinical Department, 

2, Bldg. 1, Malaya Kalitnikovskaya St., Moscow, 109147

ilyakukes@gmail.comhttps://orcid.org/0000-0001-8524-0019СалмасиЖ. М.SalmasiJ. M.

д.м.н., профессор, заведующий кафедрой патофизиологии и клинической патофизиологии лечебного факультета, 

117997, Москва, ул. Островитянова, д. 1

Dr. Sci. (Med.), Professor, Head of the Department of Pathophysiology and Clinical Pathophysiology, Faculty of Medicine,

1, Ostrovityanov St., Moscow, 117997

profjms@yandex.ruhttps://orcid.org/0000-0003-2378-8163ТерновойК. С.TernovoyK. S.

к.м.н., доцент кафедры травматологии, ортопедии и хирургии катастроф, 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Cand. Sci. (Med.), Associate Professor of the Department of Traumatology, Orthopedics and Disaster Surgery, 

8, Bldg. 2, Trubetskaya St., Moscow, 119991

ternovoy@hotmail.comhttps://orcid.org/0000-0002-3079-4089КазимирскийА. Н.KazimirskiiA. N.

д.б.н., профессор кафедры патофизиологии и клинической патофизиологии лечебного факультета, 

117997, Москва, ул. Островитянова, д. 1

Dr. Sci. (Biol.), Associate Professor, Leading Researcher, Department of Molecular Technologies,

1, Ostrovityanov St., Moscow, 117997

alnica10@mail.ruhttps://orcid.org/0000-0003-3371-7537ОбодзинскаяТ. Е.ObodzinskayaT. E.

медицинский директор научно-лабораторного комплекса Хромолаб, 

117246,Москва, Научный проезд, д. 20, стр. 2

Medical Director of the Research and Laboratory Complex Chromolab, 

20, Bldg. 2, Nauchnyy proezd, Moscow, 117246

dr.obodzinskaya@gmail.comhttps://orcid.org/0000-0001-7134-5370ЛимВ. Г.LimV. G.

д.м.н., профессор кафедры спортивной медицины и медицинской реабилитации Клиники медицинской реабилитации Университетской клинической больницы № 2, 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Dr. Sci. (Med.), Professor of the Department of Sports Medicine and Medical Rehabilitation, Clinic of Medical Rehabilitation,University Clinical Hospital No. 2, 

8, Bldg. 2, Trubetskaya St., Moscow, 119991

lim_vg@yahoo.comhttps://orcid.org/0000-0002-8622-7008ГлаговскийП. Б.GlagovskiyP. B.

МВА, директор научно-лабораторного комплекса Хромолаб, 

117246, Москва, Научный проезд, д. 20, стр. 2

MBA, Director of the Research and Laboratory Complex Chromolab, 

20, Bldg. 2, Nauchnyy proezd, Moscow, 117246

glagovsky@gmail.comhttps://orcid.org/0000-0003-0783-2873МамедовИ. С.MamedovI. S.

к.м.н., директор научно-лабораторного комплекса Хромолаб, 

117246, Москва, Научный проезд, д. 20, стр. 2

Cand. Sci. (Med.), General Director of the Research and Laboratory Complex Chromolab, 

20, Bldg. 2, Nauchnyy proezd, Moscow, 117246

is_mamedov@mail.ruhttps://orcid.org/0000-0003-2010-3296ПорядинГ. В.PoryadinG. V.

член-корр. РАН, д.м.н., профессор кафедры патофизиологии и  клинической патофизиологии лечебного факультета, 

117997, Москва, ул. Островитянова, д. 1

Corr. Member RAS, Dr. Sci. (Med.), Professor of the Department of Pathophysiology and Clinical Pathophysiology, Faculty of Medicine,

1, Ostrovityanov St., Moscow, 117997

poryadin_GV@rsmu.ruhttps://orcid.org/0000-0003-1002-114XСавичеваА. С.SavichevaA. S.

ординатор кафедры спортивной медицины и медицинской реабилитации, 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Resident of the Department of Sports Medicine and Medical Rehabilitation,

8, Bldg. 2, Trubetskaya St., Moscow, 119991

Assavicheva96@yandex.ruhttps://orcid.org/0000-0002-2275-6875КукесЕ. А.KukesE. A.

научный сотрудник кафедры патофизиологии и клинической патофизиологии лечебного факультета, 

117997, Москва, ул. Островитянова, д. 1

Researcher, Department of Pathophysiology and Clinical Pathophysiology, Faculty of Medicine, 

1, Ostrovityanov St., Moscow, 117997

dr.antonova.ea@gmail.comhttps://orcid.org/0000-0001-9446-5332ПтицынМ. С.PtitsynM. S.

менеджер научных проектов научно-лабораторного комплекса Хромолаб, 

117246, Москва, Научный проезд, д. 20, стр. 2

Manager of Scientific Projects of the Research and Laboratory Complex Chromolab, 

20, Bldg. 2, Nauchnyy proezd, Moscow, 117246

m2907@mail.ruhttps://orcid.org/0000-0002-2655-1615АндреевА. Д.AndreevA. D.

студент, 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Student, 

8, Bldg. 2, Trubetskaya  St., Moscow, 119991

alex10_97@mail.ruМеждународная ассоциация клинических фармакологов и фармацевтовРоссияInternational Association of Clinical Pharmacologists and PharmacistsRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationООО «ХромсистемсЛаб»РоссияChromsystemsLab LLCRussian Federation2021140920210127288Copyright © Кукес И.В., Салмаси Ж.М., Терновой К.С., Казимирский А.Н., Ободзинская Т.Е., Лим В.Г., Глаговский П.Б., Мамедов И.С., Порядин Г.В., Савичева А.С., Кукес Е.А., Птицын М.С., Андреев А.Д., 20212021Кукес И.В., Салмаси Ж.М., Терновой К.С., Казимирский А.Н., Ободзинская Т.Е., Лим В.Г., Глаговский П.Б., Мамедов И.С., Порядин Г.В., Савичева А.С., Кукес Е.А., Птицын М.С., Андреев А.Д.Kukes I.V., Salmasi J.M., Ternovoy K.S., Kazimirskii A.N., Obodzinskaya T.E., Lim V.G., Glagovskiy P.B., Mamedov I.S., Poryadin G.V., Savicheva A.S., Kukes E.A., Ptitsyn M.S., Andreev A.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6334

SARS-CoV-2  – это новый коронавирус, который был идентифицирован как причина коронавирусной инфекции 2019  г. (COVID- 19), возникшей в городе Ухань, КНР, в конце 2019 г. и распространившейся по всему миру. По мере роста числа пациентов, выздоравливающих от  COVID-19, крайне важно понять, какие проблемы со  здоровьем у  них могут сохраняться. COVID- 19 в настоящее время признан инфекционным заболеванием, вызывающим полиорганные заболевания различной локализации. На основании этого введен новый термин: «постострый постковидный синдром COVID-19», характеризующийся сохранением ряда симптомов, присущих острой фазе заболевания, а также возникновением отложенных и (или) долгосрочных осложнений по истечении 4 нед. с момента начала заболевания. В ходе проведенной работы, отраженной в данной статье, рассматриваются портрет пациента с  постковидным синдромом, наиболее распространенные осложнения этого периода, а также механизмы их развития и возникающие в связи с этим метаболические, клеточные, тканные нарушения, приводящие в итоге к тканной и органной дисфункциям. На примере трех клинических случаев проведен комплексный биохимический и иммунологический скрининг для выявления наиболее значимых нарушений у этих пациентов и корреляции с их клиническим статусом в динамике. В частности, у таких пациентов выявлены факторы сосудистой дисфункции (развитие эндотелиальной дисфункции), факторы метаболической дисфункции (метаболический ацидоз, митохондриальная дисфункция, нарушение углеводного обмена, инсулинорезистентность, нарушение обмена ароматических и  разветвленных аминокислот), факторы неврологических нарушений (нейротоксичность образующихся метаболитов), факторы иммунологических нарушений (снижение эффективности работы систем детоксикации, вторичный иммунодефицит, риск вторичной бактериальной инфекции). 

SARS-CoV-2 is a novel coronavirus that has been identified as the cause of the 2019 coronavirus infection (COVID-19), which originated at Wuhan city of PRC in late 2019 and widespread worldwide. As the number of patients recovering from COVID-19 continue to grow, it’s very important to understand what health issues they may keep experiencing. COVID-19 is now recognized as an infectious disease that can cause multiple organ diseases of various localization. It is against this background that a new term was introduced: post-acute post-COVID-19 syndrome characterized by several persistent symptoms inherent in the acute phase of the disease, as well as the occurrence of delayed and (or) long-term complications beyond 4 weeks from the onset of the disease. The work reflected in this article revealed a portrait of a patient with post-COVID-19 syndrome, the most common complications of this period, as well as the mechanisms of their development and the resulting metabolic, cellular, tissue disorders leading to the tissue and organ dysfunctions. A comprehensive biochemical and immunological screening was carried out using the example of three clinical cases to identify the most significant disorders in these patients and to correlate with their clinical status over time. In point of fact, such patients were diagnosed with vascular dysfunction factors (development of endothelial dysfunction), metabolic dysfunction factors (metabolic acidosis, mitochondrial dysfunction, carbohydrate metabolism disorder, insulin resistance, altered branched-chain and aromatic amino acid metabolism), neurological disorder factors (neurotoxicity of the resulting metabolites), immunological disorder factors (decreased efficiency of detoxification systems, secondary immunodeficiency, risk of secondary bacterial infection). 

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The authors declare that there are no conflicts of interest present.