The use of an Inhaled Surfactant in Patients With Severe and Extremely Severe new Coronavirus Infection COVID-19 With Concomitant Cardiovascular Pathology
N. A. Trofimov,
V. E. Babokin,
A. V. Dubova,
A. V. Koshelkova,
O. V. Dimitrieva,
A. L. Rodionov,
I. N. Abizov,
E. V. Oreshnikov,
S. A. Anurov,
S. S. Zamlikhanova,
Yu. A. Igonin,
K. E. Gordeeva,
T. V. Surkova,
V. O. Nikolsky https://doi.org/10.18087/cardio.2022.8.n1815
Abstract
Aim To study the effectiveness of nebulized surfactant therapy as a part of a multimodality treatment of severe and extremely severe COVID-19 viral pneumonia with concomitant cardiovascular diseases (CVDs).
Material and methods This retrospective controlled study analyzed a multimodality treatment of 38 patients with severe and extremely severe COVID-19 viral pneumonia and concomitant CVDs who were administered nebulized surfactant for correction of acute respiratory distress syndrome (ARDS). The control group consisted of 105 patients with severe and extremely severe novel coronavirus infection with concomitant CVDs who were not administered surfactant as a part of the multimodality therapy.
Results Administration of nebulized surfactant as a part of the multimodality treatment in patients with COVID-19 allowed alleviating the severity of respiratory insufficiency (р<0.001), which decreased the death rate of patients with severe and extremely severe COVID-19 and undoubtedly demonstrated the effectiveness of this medicine. The timely multimodality therapy, including nebulized surfactant, improves the course of the disease. Thus, the absence of a possibility for administering nebulized surfactant for more than 4 days was associated with fatal outcomes (р=0.045).
Conclusion Administration of nebulized surfactant as a part of the multimodality treatment of severe and extremely severe COVID-19 and concomitant CVDs increases the survival (р<0.001) and reduces the mortality by 46 %. The risk factors of an unfavorable outcome of this disease include an age older than 65 (р=0.020), a positive polymerase chain reaction test (р=0.037), a ferritin concentration at baseline >600 mg /ml (р<0.001), and a surfactant treatment duration < 4 days (р=0.045). Further study of the efficacy of nebulized surfactants as a part of the multimodality therapy is required and should include randomized clinical trials with a large number of patients and the development of distinct criteria for the treatment of ARDS.
Supporting agencies: The article had no financial support. No conflict of interest is reported.
About the Authors
N. A. Trofimov
I.N. Uljyanov Chuvash State University, Cheboksary;
Chuvash Republic Cardiological Dispensary, Cheboksary;
Institute for Advanced Medical Education, Cheboksary;
Federal Center for Traumatology, Orthopedics, and Arthroplasty, Cheboksary;
Privolzhsky Research Medical University, Nizhny Novgorod
Russian Federation
Russian Federation
Doctor of Medical Sciences, Associate Professor of the Department of Surgical Diseases and General Surgery of the I.N. Ulyanov ChSU, Professor of the Department of Surgery of the Cheboksary Institute of Advanced Medical Training, Chief Freelance Cardiovascular Surgeon of the Ministry of Health of the Chuvash Republic, Deputy Chief Physician of the Republican Cardiological Dispensary of the Ministry of Health of Chuvashia
V. E. Babokin
I.N. Uljyanov Chuvash State University, Cheboksary;
Chuvash Republic Cardiological Dispensary, Cheboksary;
Institute for Advanced Medical Education, Cheboksary
Russian Federation
Russian Federation
Doctor of Medical Sciences, Head of the Department of Surgical Diseases of the I.N. Ulyanov ChSU, Professor of the Department of Surgery of the Institute of Advanced Medical Training in Cheboksary, Chief Physician of the Republican Cardiological Dispensary of the Ministry of Health of Chuvashia.
A. V. Dubova
I.N. Uljyanov Chuvash State University, Cheboksary;
Chuvash Republic Cardiological Dispensary, Cheboksary
Russian Federation
Russian Federation
Candidate of Medical Sciences, Associate Professor of the Department of Faculty and Hospital Therapy of I.N.Ulyanov ChSU, Deputy Chief Physician for the medical part of the Republican Cardiological Dispensary of the Ministry of Health of Chuvashia
A. V. Koshelkova
Chuvash Republic Cardiological Dispensary, Cheboksary
Russian Federation
Russian Federation
Head of the 2nd cardiology department of the Republican Cardiology Dispensary of the Ministry of Health of Chuvashia, cardiologist
O. V. Dimitrieva
I.N. Uljyanov Chuvash State University, Cheboksary;
Chuvash Republic Cardiological Dispensary, Cheboksary
Russian Federation
Russian Federation
Assistant of the Department of Faculty and Hospital Therapy of I.N.Ulyanov ChSU, Head of the Department for Quality Control and Safety of Medical Activity of the Republican Cardiological Dispensary of the Ministry of Health of Chuvashia, cardiologist
A. L. Rodionov
I.N. Uljyanov Chuvash State University, Cheboksary;
Chuvash Republic Cardiological Dispensary, Cheboksary
Russian Federation
Russian Federation
Candidate of Medical Sciences, Assistant of the Department of Surgical Diseases of the I.N. Ulyanov ChSU, Head of the Cardiac Surgery Department of the Republican Cardiological Dispensary of the Ministry of Health of Chuvashia
I. N. Abizov
I.N. Uljyanov Chuvash State University, Cheboksary
Russian Federation
Russian Federation
Assistant of the Department of General Surgery and Oncology of the I.N. Ulyanov ChSU, Chief Physician of the Emergency Hospital of the Ministry of Health of Chuvashia.
E. V. Oreshnikov
I.N. Uljyanov Chuvash State University, Cheboksary
Russian Federation
Russian Federation
Candidate of Medical Sciences, Associate Professor of the Department of Faculty and Hospital Therapy of the I.N.Ulyanov ChSU, Deputy Chief Physician for the medical part of the Emergency Hospital of the Ministry of Health of Chuvashia
S. A. Anurov
I.N. Uljyanov Chuvash State University, Cheboksary
Russian Federation
Russian Federation
Assistant of the Department of Surgical Diseases of the I.N. Ulyanov ChSU, Deputy Chief Physician for Surgery of the Emergency Hospital of the Ministry of Health of Chuvashia
S. S. Zamlikhanova
I.N. Uljyanov Chuvash State University, Cheboksary
Russian Federation
Russian Federation
Candidate of Medical Sciences, Associate Professor of the Department of Obstetrics and Gynecology of the I.N. Ulyanov ChSU
Yu. A. Igonin
I.N. Uljyanov Chuvash State University, Cheboksary
Russian Federation
Russian Federation
Candidate of Medical Sciences, Head of the Department of General Surgery and Oncology of the I.N. Ulyanov ChSU
K. E. Gordeeva
I.N. Uljyanov Chuvash State University, Cheboksary;
Chuvash Republic Cardiological Dispensary, Cheboksary
Russian Federation
Russian Federation
Resident doctor for cardiovascular surgery of the Republican Cardiological Dispensary of the Ministry of Health of Chuvashia
T. V. Surkova
I.N. Uljyanov Chuvash State University, Cheboksary
Russian Federation
Russian Federation
5th year student of the Faculty of Medicine of the I.N. Ulyanov ChSU
V. O. Nikolsky
Nizhny Novgorod Regional Clinical Antituberculosis Dispensary, Nizhny Novgorod
Russian Federation
Russian Federation
pathologist, MD, associate professor
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Review
For citations:
Trofimov N.A., Babokin V.E., Dubova A.V., Koshelkova A.V., Dimitrieva O.V., Rodionov A.L., Abizov I.N., Oreshnikov E.V., Anurov S.A., Zamlikhanova S.S., Igonin Yu.A., Gordeeva K.E., Surkova T.V., Nikolsky V.O. The use of an Inhaled Surfactant in Patients With Severe and Extremely Severe new Coronavirus Infection COVID-19 With Concomitant Cardiovascular Pathology. Kardiologiia. 2022;62(8):27-32. https://doi.org/10.18087/cardio.2022.8.n1815
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