medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-16-60-77medsovet-6461Research ArticleCOVID-19Вирусные пневмонии: новый взгляд на старую проблему (обзор литературы)Viral pneumonia: a new look at an old problem (review)https://orcid.org/0000-0002-6521-7986ХаритоновМ. А.KharitonovM. A.

Харитонов Михаил Анатольевич, д.м.н., профессор 1-й кафедры (терапии усовершенствования врачей) им. академика Н.С. Молчанова

SPIN-код: 7678-2278

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Mikhail A. Kharitonov, Dr. Sci. (Med.), Professor of the N.S. Molchanov 1st Therapeutic Clinic of Postgraduate Education

6, Akademik Lebedev St., St Petersburg, 194044, Russia

micjul11@yandex.ruhttps://orcid.org/0000-0003-1851-0941СалуховВ. В.SalukhovV. V.

Салухов Владимир Владимирович, д.м.н., начальник 1-й кафедры и клиники (терапии усовершенствования врачей) им. академика Н.С. Молчанова

SPIN-код: 4531-6011

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Vladimir V. Salukhov, Dr. Sci. (Med.), Head of the N.S. Molchanov 1st Therapeutic Clinic of Postgraduate Education

6, Akademik Lebedev St., St Petersburg, 194044, Russia

vmeda-nio@mil.ruhttps://orcid.org/0000-0002-8396-1936КрюковЕ. В.KryukovE. V.

Крюков Евгений Владимирович, чл.‑ корр. РАН, д.м.н., профессор, начальник

SPIN-код: 3900–3441

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Evgeniy V. Kryukov, Corresponding Member RAS, Dr. Sci. (Med.), Professor, Chief

6, Akademik Lebedev St., St Petersburg, 194044, Russia

evgeniy.md@mail.ruhttps://orcid.org/0000-0001-8391-1691ПаценкоМ. Б.PatsenkoM. B.

Паценко Михаил Борисович, к.м.н., главный терапевт Министерства обороны РФ

SPIN-код: 5681-3603

109012, Россия, Москва, ул. Знаменка, д. 19

Mikhail B. Patsenko, Cand. Sci. (Med.), Chief Physician of the Ministry of Defense of the Russian Federation

19, Znamenka, Moscow, 109012, Russia

patsenko_mb@mail.ruhttps://orcid.org/0000-0001-7914-6173РудаковЮ. В.RudakovYu. V.

Рудаков Юрий Викторович, к.м.н., доцент 1-й кафедры (терапии усовершенствования врачей) им. академика Н.С. Молчанова

SPIN-код: 5864-3853

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Yuri V. Rudakov, Cand. Sci. (Med.), Docent of the N.S. Molchanov 1st Therapeutic Clinic of Postgraduate Education

6, Akademik Lebedev St., St Petersburg, 194044, Russia

rudakov_yura@mail.ruhttps://orcid.org/0000-0002-6110-1097БогомоловА. Б.BogomolovA. B.

Богомолов Алексей Борисович, к.м.н., преподаватель 1-й кафедры (терапии усовершенствования врачей) им. академика Н.С. Молчанова

SPIN-код: 4175-2774

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Аlexey B. Bogomolov, Cand. Sci. (Med.), Lecturer of the N.S. Molchanov 1st Therapeutic Clinic of Postgraduate Education

6, Akademik Lebedev St., St Petersburg, 194044, Russia

bg-ab@mail.ruhttps://orcid.org/0000-0003-2310-4518ИвановВ. В.IvanovV. V.

Иванов Владимир Владимирович, к.м.н., начальник пульмонологического отделения 1-й клиники (терапии усовершенствования врачей) им. академика Н.С. Молчанова

SPIN-код: 1736-8285

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Vladimir V. Ivanov, Cand. Sci. (Med.), Head of the Pulmonology Department of the N.S. Molchanov 1st Therapeutic Clinic of Postgraduate Education

6, Akademik Lebedev St., St Petersburg, 194044, Russia

sea-89@yandex.ruhttps://orcid.org/0000-0003-1525-3601МинаковА. А.MinakovA. A.

Минаков Алексей Александрович, адъюнкт 1-й кафедры (терапии усовершенствования врачей) им. академика Н.С. Молчанова

SPIN-код: 5344-7883

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Aleksey A. Minakov, Adjunct of the N.S. Molchanov 1st Therapeutic Clinic of Postgraduate Education

6, Akademik Lebedev St., St Petersburg, 194044, Russia

minakom@mail.ruВоенно-медицинская академия имени С.М. КироваРоссияMilitary Medical Academy named after S.M. KirovRussian FederationГлавное военно-медицинское управлениеРоссияMain Military Medical DirectorateRussian Federation2021291020210166077Copyright © Харитонов М.А., Салухов В.В., Крюков Е.В., Паценко М.Б., Рудаков Ю.В., Богомолов А.Б., Иванов В.В., Минаков А.А., 20212021Харитонов М.А., Салухов В.В., Крюков Е.В., Паценко М.Б., Рудаков Ю.В., Богомолов А.Б., Иванов В.В., Минаков А.А.Kharitonov M.A., Salukhov V.V., Kryukov E.V., Patsenko M.B., Rudakov Y.V., Bogomolov A.B., Ivanov V.V., Minakov A.A.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/6461

Актуальность пневмонии остается на передовой позиции и в последнее время привлекла внимание не только всего медицинского сообщества, но также всех политических и экономических институтов большинства государств планеты. Данная нозология продолжает оставаться в центре внимания, определяя одну из ключевых причин в частоте смертности населения. В представленной статье аккумулированы наиболее современные тезисы в отношении вирусных пневмоний на основании проведенного обзора большого количества научной литературы, отечественных и зарубежных исследований. Хотя термин «вирусная пневмония» уже более века используется в медицинской практике, тем не менее, нет окончательного диагностического алгоритма и устоявшейся окончательной концепции. В статье отражены особые исторические медицинские и мировоззренческие аспекты в изучении пневмоний начиная со времен Гиппократа и заканчивая современностью. Приведены эпидемиологические особенности, этиология, а также актуализирована терминологическая база вирусных пневмоний, тем самым закреплено понятие вирусной пневмонии в медицинских категориях. Представлена перспективная классификация вирусных пневмоний согласно МКБ-ХI. Обращено внимание на аутопсийную морфологическую характеристику бронхолегочного органокомплекса при вирусных пневмониях, приводятся посмертные описания со ссылками на авторитетные исследовательские источники. Описаны основные современные диагностические возможности научного медицинского сообщества в выявлении пневмоний, отражены вопросы становления новых диагностических алгоритмов. Подробно описана клиническая картина вирусных пневмоний, впервые представлен клинический концепт фазового течения заболевания на основе патоморфологических данных. Рассмотрены основные современные группы препаратов этиотропного и патогенетического лечения заболевания. В заключении отражены основные проблемные постулаты и перспективы в дальнейшем изучении заболевания.

The relevance of pneumonia remains at the forefront and has recently attracted the attention of not only the entire medical community, but also all political and economic institutions of most countries of the planet. This nosology continues to be in the center of attention, identifying one of the key causes in the frequency of mortality of the population. The presented article accumulates the most up-to-date theses regarding viral pneumonia on the basis of a review of a large number of scientific literature, domestic and foreign studies. Although the term “viral pneumonia” has been used in medical practice for more than a century, nevertheless, there is no final diagnostic algorithm and an established final concept. The article reflects special historical medical and philosophical aspects in the study of pneumonia from the time of Hippocrates to the present. The epidemiological features, etiology, and also the terminological base of viral pneumonia are updated, thereby the concept of viral pneumonia in medical categories is fixed. A promising classification of viral pneumonia according to ICD-XI is presented. Attention is drawn to the autopsy morphological characteristics of the bronchopulmonary organ complex in viral pneumonia, post-mortem descriptions are given with links to authoritative research sources. The main modern diagnostic capabilities of the scientific medical community in the detection of pneumonia are described, the issues of the formation of new diagnostic algorithms are reflected. The clinical picture of viral pneumonia is described in detail, the clinical concept of the phase course of the disease based on pathomorphological data is presented for the first time. The main modern groups of drugs for etiotropic and pathogenetic treatment of the disease are considered. The conclusion reflects the main problematic postulates and prospects for further study of the disease.

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