medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-039medsovet-9197Research ArticleCOVID-19Клинические наблюдения пожилых пациенток с одышкой в отдаленный постковидный периодClinical observations of elderly patients with dyspnea in the late post-COVID-19 periodhttps://orcid.org/0000-0001-8737-4264СергееваВ. А.SergeevaV. A.

Сергеева Виктория Алексеевна, к.м.н., доцент кафедры терапии с курсами кардиологии, функциональной диагностики и гериатрии

410012, Саратов, ул. Большая Казачья, д. 112

Victoria A. Sergeeva, Cand. Sci. (Med.), Associate Professor of the Department of Therapy with Courses of Cardiology, Functional Diagnostics and Geriatrics

112, Bolshaya Kazachya St., Saratov, 410012

viktoriasergeeva@mail.ruЧелышеваИ. В.ChelyshevaI. V.

Челышева Ирина Владимировна, врач-пульмонолог, терапевт отделения терапии

410004, Саратов, 1-й Станционный проезд, д. 7а

Irina V. Chelysheva, Pulmonologist, Therapist of the Department of Therapy

7a, 1st Stantsionny Proezd, Saratov, 410004

dkbsar-2@yandex.ruКутинаМ. А.KutinaM. A.

Кутина Марина Александровна, заведующая отделением терапии

410004, Саратов, 1-й Станционный проезд, д. 7а

Marina A. Kutina, Head of the Department of Therapy

7a, 1st Stantsionny Proezd, Saratov, 410004

dkbsar-2@yandex.ruhttps://orcid.org/0009-0006-9693-8002ДжамалудиноваФ. И.DzhamaludinovaF. I.

Джамалудинова Фатима Исабеговна, клинический ординатор по специальности «терапия» кафедры терапии с курсами кардиологии, функциональной диагностики и гериатрии

410012, Саратов, ул. Большая Казачья, д. 112

Fatima I. Dzhamaludinova, Clinical Resident in the Specialty “Therapy” of the Department of Therapy with Courses of Cardiology, Functional Diagnostics and Geriatrics

112, Bolshaya Kazachya St., Saratov, 410012

dzhamaludinova_1995@mail.ruhttps://orcid.org/0009-0004-2101-0010ЛипчанскаяЕ. В.LipchanskayaE. V.

Липчанская Елизавета Викторовна, клинический ординатор по специальности «терапия» кафедры терапии с курсами кардиологии, функциональной диагностики и гериатрии

410012, Саратов, ул. Большая Казачья, д. 112

Elizaveta V. Lipchanskaya, Clinical Resident in the Specialty “Therapy” of the Department of Therapy with Courses of Cardiology, Functional Diagnostics and Geriatrics

112, Bolshaya Kazachya St., Saratov, 410012

989898@gmail.comСаратовский государственный медицинский университет имени В.И. РазумовскогоРоссияSaratov State Medical University named after V.I. RazumovskyRussian FederationКлиническая больница «РЖД-Медицина» города СаратовРоссияClinical Hospital “RZD-Medicine” of the City of SaratovRussian Federation202522062025098090Copyright © Сергеева В.А., Челышева И.В., Кутина М.А., Джамалудинова Ф.И., Липчанская Е.В., 20252025Сергеева В.А., Челышева И.В., Кутина М.А., Джамалудинова Ф.И., Липчанская Е.В.Sergeeva V.A., Chelysheva I.V., Kutina M.A., Dzhamaludinova F.I., Lipchanskaya E.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/9197

Одышка у пожилых пациентов является одним из наиболее распространенных симптомов в клинической практике, трактование которого требует тщательного диагностического поиска и исключения целого ряда патологических состояний и заболеваний. Многие пациенты, перенесшие новую коронавирусную инфекцию, длительное время после выписки из стационара или окончания амбулаторного курса терапии продолжали отмечать целый ряд клинических проявлений, которые впоследствии стали называть постковидным синдромом. Отдельное внимание заслуживают пациенты, у которых отмечалось тяжелое течение COVID-19 с повреждением легочной ткани. Как показывают клинические наблюдения, даже спустя несколько лет после перенесенной новой коронавирусной инфекции патологические изменения в легких у них могут сохраняться, а иногда и прогрессировать, что сопровождается респираторными симптомами, наиболее распространенным из которых является одышка. С учетом разнообразия патогенетических механизмов SARS-CoV-2 патологические изменения в легких могут иметь различный механизм и характер (условно фиброзные и нефиброзные), на развитие которых влияет совокупность экзогенных и эндогенных факторов пациента. В статье приводятся клинические наблюдения пациенток с одышкой в отдаленный постковидный период, перенесших COVID-19 в тяжелой форме с разными механизмами повреждения легочной ткани. Проводится анализ совокупности факторов потенциального риска сохранения и дальнейшего прогрессирования постковидных легочных изменений у представленных пациенток, идет их сопоставление с наиболее актуальными научными и клиническими данными мировой литературы. Дальнейшее накопление информации по обсуждаемой проблеме может помочь в разработке диагностических и терапевтических алгоритмов ведения пациентов с постковидными легочными повреждениями, что позволит улучшить качество жизни и увеличить ее продолжительность.

Dyspnea in elderly patients is one of the most common symptoms in clinical practice; its interpretation requires a deep diagnostic search and exclusion of different pathological conditions and diseases. Many patients who had suffered a new coronavirus infection, for a long time after being discharged from the hospital or completing an outpatient course of therapy, continued to notice a number of clinical manifestations, which later became known as Post-COVID-19 syndrome. Patients who had a severe course of COVID-19 with lung tissue damage deserve a special attention. As clinical observations demonstrate that even several years after new coronavirus infection, pathological changes in lungs can persist and sometimes progress, which is accompanied by respiratory symptoms, the most common of which is dyspnea. Taking into account the diversity of pathogenic mechanisms of SARS-CoV-2, pathological changes in the lung tissue may have a different mechanism and nature (conditionally fibrotic and non-fibrotic), the development of which is influenced by a combination of exogenous and endogenous factors of the patient. The article presents clinical observations of patients with dyspnea in the late post-COVID-19 period with different mechanisms of lung tissue damage, who suffered from severe COVID-19. The article analyzes a set of potential risk factors for the persistence and further progression of post-COVID-19 pulmonary changes in the presented patients, and compares data with the most relevant scientific and clinical information of the world scientific sources. Further accumulation of information on the current problem may help to develop diagnostic and therapeutic algorithms for the management the post-COVID-19 pulmonary injuries, which will improve the quality and duration of life in such patients.

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