medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-18-86-93medsovet-6556Research ArticleПРАКТИКАPRACTICEРоль этиотропной терапии в лечении и профилактике осложнений гриппа в условиях пандемии COVID-19Role of etiotropic therapy in the treatment and prevention of influenza complications amidst the COVID-19 pandemichttps://orcid.org/0000-0002-4293-3285ОрловаН. В.OrlovaN. V.

Орлова Наталья Васильевна – доктор медицинских наук, профессор, профессор кафедры факультетской терапии педиатрического факультета.

117997, Москва, ул. Островитянова, д. 1.

Natalia V. Orlova - Dr. Sci. (Med.), Professor, Professor of Department of Intermediate Level Therapy, Faculty of Pediatrics, Pirogov Russian National Research Medical University.

1, Ostrovityanov St., Moscow, 117997.

vrach315@yandex.ruЛомайчиковВ. В.LomaychikovV. V.

Ломайчиков Валерий Валерьевич - ассистент кафедры факультетской терапии педиатрического факультета.

117997, Москва, ул. Островитянова, д. 1.

Valeriy V. Lomaychikov - Assistant Professor of Department of Intermediate Level Therapy, Faculty of Pediatrics, Pirogov Russian National Research Medical University.

1, Ostrovityanov St., Moscow, 117997.

lomaychikov@yandex.ruРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian Federation2021301120210188693Copyright © Орлова Н.В., Ломайчиков В.В., 20212021Орлова Н.В., Ломайчиков В.В.Orlova N.V., Lomaychikov V.V.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/6556

Грипп остается одним из наиболее распространенных респираторно-вирусных заболеваний, сопровождающихся высоким риском развития осложнений. В условиях пандемии C0VID-19 возникает вероятность одновременной циркуляции двух вирусов, что обуславливает необходимость проведения дифференциальной диагностики. Грипп и C0VID-19 имеют общие пути передачи возбудителя и схожие симптомы, поэтому оптимальным в дифференциальной диагностике является применение тест-систем на оба вируса. На фоне гриппа и C0VID-19 могут развиваться осложнения со стороны различных органов и систем. В статье подробно рассмотрены осложнения гриппа со стороны сердечно-сосудистой системы. После заражения вирусом гриппа происходит 6-10-кратное повышение риска острого инфаркта миокарда и 3-8-кратное повышение риска инсульта. С COVID-19 ассоциированы артериальная гипертензия, сахарный диабет, нарушения ритма сердца, миокардит, высокий риск развития острого инфаркта миокарда, сердечная недостаточность. В статье приведены данные собственных исследований, свидетельствующих, что перенесенное заболевание COVID-19 повышает риск острого коронарного синдрома независимо от наличия факторов риска сердечно-сосудистых событий. Профилактикой развития осложнений гриппа является раннее назначение этиотропной противовирусной терапии. Многочисленные исследования подтверждают эффективность в терапии гриппа ингибитора нейраминидазы осельтамивира. Применение осельтамивира уменьшает выраженность клинических проявлений, сокращает длительность заболевания, снижает риск осложнений и летального исхода. Наиболее эффективной мерой профилактики гриппа и C0VID-19 является специфическая иммунизация. В ряде случаев может быть использована химиопрофилактика. В статье рассмотрены исследования по эффективности химиопрофилактики гриппа с применением ингибиторов нейраминидазы.

Influenza remains one of the most common respiratory viral diseases with a high risk of complications. In the context of the COVID-19 pandemic, there is a possibility of simultaneous circulation of two viruses, which makes it necessary to conduct a differential diagnosis. Influenza and COVID-19 have common pathways of transmission of the pathogen and similar symptoms, so the optimal differential diagnosis is the use of test systems for both viruses. Against the background of influenza and COVID-19, complications from various organs and systems can develop. The article describes in detail the complications of influenza from the cardiovascular system. After infection with the flu virus, there is a 6-to 10-fold increase in the risk of acute myocardial infarction and a 3 - to 8-fold increase in the risk of stroke. COVID-19 is associated with arterial hypertension, diabetes mellitus, cardiac arrhythmias, myocarditis, high risk of acute myocardial infarction, and heart failure. The article presents the data of our own research, indicating that the transferred COVID-19 disease increases the risk of acute coronary syndrome, regardless of the presence of risk factors for cardiovascular events. Prevention of the development of influenza complications is the early administration of etiotropic antiviral therapy. Numerous studies confirm the effectiveness of the neuraminidase inhibitor oseltamivir in the treatment of influenza. The use of oseltamivir reduces the severity of clinical manifestations, reduces the duration of the disease, reduces the risk of complications and death. The most effective measure to prevent influenza and COVID-19 is specific immunization. In some cases, chemoprophylaxis can be used. The article discusses studies on the effectiveness of influenza chemoprophylaxis with the use of neuraminidase inhibitors.

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