[Medical rehabilitation of patients with pneumonia associated with the new COVID-19 coronavirus infection]

[Natural therapeutic factors in medical rehabilitation of patients with post-COVID syndrome]

The feasibility of using therapeutic physical factors in post-COVID syndrome is due to their sanogenetic effects that ensure the restoration of impaired bodily functions, which serves as the basis for their use at various stages of medical rehabilitation of this category of patients.

OBJECTIVE

To develop a new medical technology for the 3^rd outpatient stage of medical rehabilitation of the patients with post-COVID syndrome using natural therapeutic factors of Nalchik resort.

MATERIAL AND METHODS

There has been carried out a controlled study in compliance with the principles of randomization to develop an outpatient medical rehabilitation program including 168 patients with post-COVID syndrome. All the patients were divided into four groups: the control group (n=40) was prescribed pharmacotherapy and physical therapy in the hall in accordance with federal clinical recommendations; comparison group 1 (n=43) had drinking mineral water in addition; comparison group 2 (n=43) received physical therapy on the route of Nalchik resort terrainkur in addition to the treatment in comparison group 1; the main group (n=42) included a group psychotherapy on the Terrainkur route in addition to the treatment in comparison group 2.

RESULTS

The results of the comparative analysis showed the feasibility of the developed outpatient medical rehabilitation program for the patients suffering from post-COVID syndrome: the overall effectiveness of rehabilitation measures increased compared to other follow-up groups by 10-15% due to the improvement of external breathing function (p<0.05), cognitive status (p<0.01), increased exercise tolerance (p<0.01), physical recovery (p<0.01) and mental health (p<0.01).

CONCLUSION

The summation and integration of sanogenetic effects of physical factors, psychocorrective techniques, and pharmacotherapy provide a significant improvement in the physical and mental status of the patients with post-COVID syndrome.

[Sanatorium-and-spa treatment of patients who have had a new coronavirus infection (COVID-19)]

PURPOSE OF THE STUDY

Evaluation of the effectiveness of sanatorium-and-spa treatment of patients who have undergone a new coronavirus infection (COVID-19), taking into account the polymorphism of symptom complexes.

MATERIAL AND METHODS

The study included 56 patients (22 men, 34 women; mean age 64.9±8.21 and 64.76±9.12 years, respectively) who had COVID-19 and were treated at a spa. The mandatory program of rehabilitation and rehabilitation sanatorium treatment included: exercise therapy with elements of breathing exercises, general massage with an emphasis on the chest, halo and speleotherapy, hydrotherapy, inhalations, as well as psychotherapeutic methods. The length of stay in the sanatorium was at least 2 weeks. We assessed the dynamics of indicators characterizing the activity of the cardiovascular and respiratory systems (BP, heart rate, Stange test), exercise tolerance (6-minute walk test), as well as psycho-emotional state (test «Health, Activity, Mood», SAN) up to and after treatment.

RESULTS

Against the background of sanatorium-and-spa treatment in patients who underwent COVID-19, the number of complaints significantly decreased: in men from 6.2±2.4 to 3.4±1.3, in women from 7.7±1.5 to 4.12±1.5 (p≤0.05). A similar dynamics of indicators characterizing the activity of the cardiovascular system was noted: the level of systolic blood pressure in men decreased by 7.3%, in women - by 10.3%; the level of diastolic blood pressure - by 4.1 and 1.4%, respectively. Heart rate in men decreased from 83.69±15.2 to 75.54±12.24 beats/min; in women - from 92.16±14.16 to 76.4±11.68 beats/min. The distance traveled for men (6-minute walk test) increased from 384.15±108.78 to 408.92±97.30 m; in women - from 371.84±75.9 to 397.12±76.2 m (p≤0.05). The breath holding time on inspiration (Stange test) in men increased from 38.00±10.64 to 45.69±9.51 s; in women - from 39.96±9.31 to 43.60±6.93 s. The values of the «Well-being» indicator (SAN test) in men significantly increased - from 4.5±1.8 to 5.1±0.9 points (p≤0.05); «Activity» - from 4.8±0.8 to 5.4±0.5 points (p≤0.05); «Mood» - from 4.7±1.4 to 5.4±0.6 points. Similar dynamics were observed in women.

CONCLUSION

Against the background of the sanatorium stage of treatment, a stable positive dynamics of the indicators of the functional state of the body was noted in both men and women. The analysis carried out confirms the need to develop and implement rehabilitation programs in sanatorium-resort conditions for patients who have had a new coronavirus infection.

The Use of Bioacoustic Stimulation of the Respiratory System in Complex Medical Rehabilitation at a Health Resort Facility for Patients who have had COVID-associated Pneumonia

BACKGROUND: In the context of the COVID-19 pandemic, the relevance of rehabilitation measures for patients with COVID-associated pneumonia has increased. AIM: The study aimed to review the effect of bioacoustic stimulation of the respiratory system (BSRS) with high-intensity low-frequency sounds on the dynamics of functional indicators of the respiratory system and the cardiovascular system, as well as indicators of psychoemotional and somatic states, the severity of post-traumatic stress disorders (PTSD) and cognitive capabilities in patients who have had COVID-associated pneumonia in the process of their medical rehabilitation at a health resort immediately after treatment of the disease in a hospital. MATERIALS AND METHODS: The randomized controlled open parallel prospective clinical study involved 28 patients undergoing medical rehabilitation after suffering moderate to severe COVID-19 complicated by community-acquired bilateral polysegmental pneumonia (COVID-associated pneumonia) of moderate to severe severity. Spirometry, pulse oximetry, compression oscillometry, bioelectrography, Mississippi Scale (civil version), and cognitive speed test were used to assess the functional parameters of the respiratory and cardiovascular systems, as well as indicators of psychoemotional and somatic states, the intensity of PTSD and cognitive abilities of patients before and after the course of rehabilitation measures. RESULTS: According to significant differences in changes in the indexes of external respiration, cardiac activity, psychological status, and the intensity of PTSD in patients of the main and control groups before and after a course of rehabilitation measures, it has been reliably established that the use of BSRS as a part of a complex of rehabilitation measures significantly increases the effectiveness of medical rehabilitation at a health resort for patients after COVID-associated pneumonia. CONCLUSION: The possibility and feasibility of using medical technology of BSRS with high-intensity low-frequency sound in complex medical rehabilitation of patients after COVID-associated pneumonia at the health resort stage have been scientifically substantiated.

Low-Level Laser Therapy in Prevention of the Development of Endothelial Dysfunction and Clinical Experience of Treatment and Rehabilitation of COVID-19 Patients

OBJECTIVES

The aim of the article is to justify the application of low-level laser therapy (LLLT) to prevent the development of endothelial dysfunction in COVID-19 patients. The results of treating and rehabilitating patients with COVID-19 and prevention of the disease using low-level laser therapy (LLLT) are evaluated.

METHODS

A literature review is conducted on mechanisms of vascular homeostasis regulation, biomodulating effect of laser light, and LLLT methods for preventing endothelial dysfunction. A total of 106 patients were treated in two COVID-19 healthcare centers in Russia. 22 patients with SARS (+) pneumonia at the stage of resolving the pathological lesion were admitted to rehabilitation using pulsed IR laser. 14 patients with acute forms of COVID-19 were treated using LASMIK device: wavelength 904 nm, pulsed mode, externally and ILBI-525 (intravenous laser blood illumination) + LUVBI (ultraviolet laser blood illumination). 70 persons underwent preventive courses of noninvasive LLLT.

RESULTS

It was shown that LLLT is effective in preventing the development of endothelial dysfunction. Clinical experience demonstrated good tolerability of the treatment, improvement in sputum discharge, and an improvement in overall health. The severity of general hypoxia decreased by the 5th procedure. The procedures for prevention of the disease were well tolerated; there were no cases of COVID-19.

CONCLUSION

Low-level laser therapy is a justified treatment method that promotes lung tissue regeneration and mitigates the consequences of the disease. The obtained results confirm that LLLT can be used for the effective prevention and treatment of COVID-19 patients.