russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2021-4487russjcardiol-4487Research ArticleКОНСЕНСУС ЭКСПЕРТОВEXPERT CONSENSUSНовая коронавирусная инфекционная болезнь COVID-19: особенности комплексной кардиологической и респираторной реабилитацииCoronavirus disease 2019: features of comprehensive cardiac and pulmonary rehabilitationhttps://orcid.org/0000-0003-2250-5942БубноваМ. Г.BubnovaM. G.

Доктор медицинских наук, профессор, руководитель отдела реабилитации и вторичной профилактики сердечно-сосудистых заболеваний, Вице-президент РосОКР

Москва

mbubnova@gnicpm.ruhttps://orcid.org/0000-0003-2929-0980ШляхтоЕ. В.ShlyakhtoE. V.

Доктор медицинских наук, профессор, академик РАН, генеральный директор, Президент РКО

Санкт-Петербург

St. Petersburg

https://orcid.org/0000-0003-0484-9805АроновД. М.AronovD. M.

Доктор медицинских наук, профессор, заслуженный деятель науки РФ, главный научный сотрудник, Президент РосОКР

Москва

Moscow

https://orcid.org/0000-0001-6050-724XБелевскийА. С.BelevskyA. S.

Доктор медицинских наук, профессор, зав. кафедрой пульмонологии, Президент РРО

Москва

Moscow

https://orcid.org/0000-0002-1741-7246ГерасименкоМ. Ю.GerasimenkoM. Yu.

Доктор медицинских наук, профессор, проректор по научной работе и инновациям, заведующий кафедрой физической терапии, спортивной медицины и медицинской реабилитации

Москва

Moscow

https://orcid.org/0000-0002-0995-1924ГлезерМ. Г.GlezerM. G.

Доктор медицинских наук, профессор, профессор кафедры кардиологии, функциональной и ультразвуковой диагностики

Москва

Moscow

ГордеевМ. Н.GordeevM. N.

Доктор медицинских наук, кандидат психологических наук, профессор, ректор, ведущий научный сотрудник

Москва

Moscow

https://orcid.org/0000-0002-4453-8430ДрапкинаО. М.DrapkinaO. M.

Доктор медицинских наук, профессор, член-корр. РАН, директор

Москва

Moscow

ИвановаГ. E.IvanovaG. E.

Доктор медицинских наук, профессор, заведующий кафедрой медицинской реабилитации, руководитель НИЦ медицинской реабилитации, Президент СРР

Москва

Moscow

https://orcid.org/0000-0001-6425-7428ИоселианиД. Г.IoselianiD. G.

Доктор медицинских наук, профессор, академик РАН, заведующий кафедрой интервенционной кардиоангиологии

Москва

Moscow

https://orcid.org/0000-0002-8604-712XКарамноваН. С.KaramnovaN. S.

Кандидат медицинских наук, руководитель лаборатории эпидемиологии питания

Москва

Krasnodar

https://orcid.org/0000-0001-8600-0199КосмачеваЕ. Д.KosmachevaE. D.

Доктор медицинских наук, профессор, заведующий кафедрой терапии № 1, заместитель главного врача по медицинской части

Краснодар

Krasnodar

https://orcid.org/0000-0003-0658-4871КулешовА. В.KuleshovA. V.

Кандидат медицинских наук, главный врач

Москва

Moscow

https://orcid.org/0000-0002-2290-3687КукшинаА. А.KukshinaA. A.

Доктор медицинских наук, ведущий научный сотрудник отдела медицинской реабилитации

Москва

Moscow

https://orcid.org/0000-0001-6972-7740ЛядовК. В.LyadovK. V.

Доктор медицинских наук, профессор, академик РАН, профессор кафедры спортивной медицины и медицинской реабилитации им. Н.В. Склифосовского

Химки, Московская область

Khimki, Moscow Oblast

https://orcid.org/0000-0001-6939-3234ЛяминаН. П.LyaminaN. P.

Доктор медицинских наук, профессор, заведующий отделом медицинской реабилитации

Москва

Moscow

МакароваМ. Р.MakarovaM. R.

Кандидат медицинских наук, ведущий научный сотрудник отдела медицинской реабилитации

Москва

Moscow

https://orcid.org/0000-0002-1757-4137МещеряковаН. Н.MeshcheryakovaN. N.

Кандидат медицинских наук, доцент кафедры пульмонологии

Москва

Moscow

https://orcid.org/0000-0002-4968-4517НикитюкД. Б.NikityukD. B.

Доктор медицинских наук, профессор, член-корреспондент РАН, директор, Вицепрезидент РОСНДП

Москва

Moscow

https://orcid.org/0000-0002-8121-4160ПасечникИ. Н.PasechnikI. N.

Доктор медицинских наук, профессор, заведующий кафедрой анестезиологии и реаниматологии

Москва

Moscow

https://orcid.org/0000-0002-8508-5327Персиянова-ДуброваА. Л.Persiyanova-DubrovaA. L.

Кандидат медицинских наук, старший научный сотрудник

Москва

Moscow

https://orcid.org/0000-0001-5123-5991ПогонченковаИ. В.PogonchenkovaI. V.

Доктор медицинских наук, директор

Москва

Moscow

https://orcid.org/0000-0003-2101-6936СветА. В.SvetA. V.

Кандидат медицинских наук, главный врач

Москва

Moscow

https://orcid.org/0000-0001-9262-9233СтародубоваА. В.StarodubovaA. V.

Доктор медицинских наук, заведующий директора по научной и лечебной работ

Москва

Moscow

https://orcid.org/0000-0002-4164-8992ТутельянВ. А.TutelianV. A.

Доктор медицинских наук, профессор, академик РАН, Научный руководитель, Президент РОСНДП

Москва

Moscow

ФГБУ Национальный медицинский исследовательский центр терапии и профилактической медицины Минздрава России, МоскваРоссияNational Medical Research Center for Therapy and Preventive Medicine, MoscowRussian FederationФГБУ Национальный медицинский исследовательский центр имени В. А. Алмазова Минздрава РоссииRussian FederationAlmazov National Medical Research CenteRussian FederationФГБУ Национальный медицинский исследовательский центр терапии и профилактической медицины Минздрава РоссииRussian FederationNational Medical Research Center for Therapy and Preventive MedicineRussian FederationФГАОУ ВО Российский национальный исследовательский медицинский университет им. Н. И. Пирогова Минздрава РоссииRussian FederationPirogov Russian National Research Medical UniversityRussian FederationФГБОУ ДПО Российская медицинская академия непрерывного профессионального образования Минздрава РоссииRussian FederationRussian Medical Academy of Continuous Professional EducationRussian FederationФГАОУ ВО Первый московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)Russian FederationI.M. Sechenov First Moscow State Medical UniversityRussian FederationЧОУ ДПО Институт Милтона Эриксона; ФГУ Федеральный центр мозга и нейротехнологий Федеральное медико-биологическое агентство РоссииRussian FederationMilton H. Erickson Institute; Federal Center of Brain Research and NeurotechnologiesRussian FederationФГАОУ ВО Российский национальный исследовательский медицинский университет им. Н. И. Пирогова Минздрава России; ФГУ Федеральный центр мозга и нейротехнологий Федеральное медико-биологическое агентство РоссииRussian FederationPirogov Russian National Research Medical University; Federal Center of Brain Research and NeurotechnologiesRussian FederationФГБУ Национальный медицинский исследовательский центр терапии и профилактической медицины Минздрава РоссииRussian FederationKuban State Medical University; Research Institute — S.V. Ochapovsky Regional Clinical Hospital № 1Russian FederationФГБОУ ВО Кубанский государственный медицинский университет Минздрава России; ГБУЗ Научно-исследовательский институт — Краевая клиническая больница № 1 им. профессора С.В. Очаповского Минздрава Краснодарского краяRussian FederationKuban State Medical University; Research Institute — S.V. Ochapovsky Regional Clinical Hospital № 1Russian FederationКлиника респираторной медицины ИнтеграМедRussian FederationIntegraMed Respiratory Medicine ClinicRussian FederationГАУЗ города Москвы Московский научно-практический центр медицинской реабилитации, восстановительной и спортивной медицины Департамента здравоохранения города МосквыRussian FederationMoscow Scientific and Practical Center of Medical Rehabilitation, Restorative and Sports MedicineRussian FederationФГАОУ ВО Первый московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет); ООО Многопрофильный медицинский центр “Клиники Лядова”Russian FederationI.M. Sechenov First Moscow State Medical University; OOO Multidisciplinary Medical Center “Lyadov’s Clinics”Russian FederationФГБУН Федеральный исследовательский центр питания, биотехнологии и безопасности пищиRussian FederationFederal Research Center of Nutrition, Biotechnology and Food SafetyRussian FederationФГБУ ДПО Центральная государственная медицинская академия Управления Делами Президента Российской ФедерацииRussian FederationCentral State Medical Academy of the Presidential Administration of the Russian Federation, MoscowRussian FederationГАУЗ города Москвы Первая Градская больница им. Н.И. Пирогова Департамента здравоохранения города МосквыRussian FederationPirogov City Clinical Hospital № 1Russian Federation20212704202126544874487Copyright © Бубнова М.Г., Шляхто Е.В., Аронов Д.М., Белевский А.С., Герасименко М.Ю., Глезер М.Г., Гордеев М.Н., Драпкина О.М., Иванова Г.E., Иоселиани Д.Г., Карамнова Н.С., Космачева Е.Д., Кулешов А.В., Кукшина А.А., Лядов К.В., Лямина Н.П., Макарова М.Р., Мещерякова Н.Н., Никитюк Д.Б., Пасечник И.Н., Персиянова-Дуброва А.Л., Погонченкова И.В., Свет А.В., Стародубова А.В., Тутельян В.А., 20212021Бубнова М.Г., Шляхто Е.В., Аронов Д.М., Белевский А.С., Герасименко М.Ю., Глезер М.Г., Гордеев М.Н., Драпкина О.М., Иванова Г.E., Иоселиани Д.Г., Карамнова Н.С., Космачева Е.Д., Кулешов А.В., Кукшина А.А., Лядов К.В., Лямина Н.П., Макарова М.Р., Мещерякова Н.Н., Никитюк Д.Б., Пасечник И.Н., Персиянова-Дуброва А.Л., Погонченкова И.В., Свет А.В., Стародубова А.В., Тутельян В.А.Bubnova M.G., Shlyakhto E.V., Aronov D.M., Belevsky A.S., Gerasimenko M.Y., Glezer M.G., Gordeev M.N., Drapkina O.M., Ivanova G.E., Ioseliani D.G., Karamnova N.S., Kosmacheva E.D., Kuleshov A.V., Kukshina A.A., Lyadov K.V., Lyamina N.P., Makarova M.R., Meshcheryakova N.N., Nikityuk D.B., Pasechnik I.N., Persiyanova-Dubrova A.L., Pogonchenkova I.V., Svet A.V., Starodubova A.V., Tutelian V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/4487

В соглашении экспертов российских сообществ обсуждаются вопросы комплексной медицинской реабилитации больных с новой коронавирусной инфекцией. Коронавирусная болезнь 2019 (COVID-19) — контагиозное инфекционное заболевание, которое может вызывать респираторные, кардиологические, двигательные, метаболические, нейрокогнитивные и психические нарушения, т.е. полиорганную дисфункцию. Больные, выжившие после COVID-19, особенно после тяжелой формы, сталкиваются с серьезными проблемами психологического и физического характера, посттравматическим стрессом, когнитивной дисфункцией, нутритивной недостаточностью и обострением сопутствующих хронических заболеваний. У части больных независимо от тяжести течения коронавирусной инфекции отмечается продолжительное течение болезни (“chronic-COVID”, “long COVID”). Появились данные о развитии “пост-COVID-19 синдрома”. В этой связи больные, перенесшие COVID-19, будут нуждаться в проведении реабилитационных мероприятий. В Консенсусе экспертов Российских сообществ представлены общие принципы, этапы и аспекты медицинской реабилитации после COVID-19, показания и противопоказания к реабилитационным вмешательствам. Консенсусный документ включает рекомендации по комплексной кардиологической и респираторной реабилитации, а также особенности реабилитационной помощи при разных вариантах клинического течения COVID-19 в рамках национальной трехэтапной системы медицинской реабилитации.

The expert consensus of the Russian communities discusses the issues of comprehensive medical rehabilitation of patients with coronavirus disease 2019 (COVID-19). COVID-19 is a contagious infectious disease that can cause pulmonary, cardiac, motor, metabolic, neurocognitive and mental disorders, that is, multiple organ dysfunction. COVID-19 survivors, especially after a severe clinical course, face serious psychological and physical problems, posttraumatic stress, cognitive dysfunction, nutritional deficiencies and exacerbation of concomitant chronic diseases. Some patients, regardless of the COVID-19 severity, have a long clinical course of the disease (“chronic-COVID”, “long COVID”). There is evidence of post-acute COVID-19 syndrome. In this regard, patients after COVID-19 will need rehabilitation measures. The expert consensus of the Russian communities presents general principles, stages and aspects of medical rehabilitation after COVID-19, indications and contraindications for rehabilitation interventions. The paper includes recommendations on comprehensive cardiac and pulmonary rehabilitation, as well as specifics of rehabilitation care for different COVID-19 courses within the national three-stage rehabilitation system.

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