Preview

User

Not a user? Register with this site Forgot your password?

Russian Journal of Cardiology

Advanced search

Rehabilitation after COVID-19. Resolution of the International Expert Council of the Eurasian Association of Therapists and the Russian Society of Cardiology

https://doi.org/10.15829/1560-4071-2021-4694

Abstract

By the middle of 2021, the official global number of coronavirus disease 2019 (COVID-19) patients was close to 230 million, but the number accounting for asymptomatic patients was much higher. Consequences and rehabilitation after COVID-19 are of particular interest and raise many controversial and unresolved issues. On May 18, 2021, the Eurasian Association of Therapists organized an international panel of experts to analyze challenges associated with the post-COVID-19 period. This panel aimed to develop approaches to identify gaps in the discussed issues. This interdisciplinary team of leading experts reviewed the current literature and presented their data to formulate practical guidance on management of patients after COVID-19. The panel of experts also presented recommendations on how to implement the gained knowledge into health care practices.

About the Authors

A. G. Arutyunov
Association “Eurasian Association of Therapists”; Pirogov Russian National Research Medical University
Russian Federation

MD, PhD, Associate Professor, Secretary General; Professor of the Department of Propaedeutics of Internal Diseases, Faculty of Pediatrics

 Moscow


P. Seferovic
Belgrade University
Serbia

MD, PhD, Professor, Head of the University Hospital of heart failure. President of the Serbian National Committee for cardiovascular disease. President of the Society for Heart Failure Serbia. Board member of the European Association for heart failure

Belgrade


I. G. Bakulin
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

MD, PhD, professor, Dean of the General Medicine Faculty, Head of the department of Propedeutics of Internal Diseases, Gastroenterology and Dietology named after S.M. Ryss, Internal Medicine Adviser to the Ministry of Health

Saint Petersburg

 


N. V. Bakulina
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

MD, PhD, Professor, Head of the department of Internal Diseases, Clinical Pharmacology and Nephrology

Saint Petersburg


M. M. Batyushin
Rostov State Medical University
Russian Federation

M.D, PhD, Professor, Department of Internal Medicine with the Basics of General Physiotherapy #2, Head, Nephrologic Division, Rostov State Medical University Clinic; Chairman, Rostov Regional Society of Nephrology

Rostov-on-Don


M. V. Boldina
Privolzhsky Research Medical University
Russian Federation

Associate Professor of the Department of therapy and cardiology, PhD in Medicine

Nizhny Novgorod


G. Krstačić
Institute for Cardiovascular Prevention and Rehabilitation; Josip Juraj Strossmayer University; Zagreb University
Croatia

MD, PhD, professor, director of the Institute for Cardiovascular Prevention and Rehabilitation, professor of internal medicine and cardiology at the Faculty for Dental Medicine and Health and School;  scientific advisor in a permanent position at the Faculty of Medicine; editorial board member of EP Europace and JMIR Cardio, FESC, FEHRA

Osijek, Zagreb


Dj. Macut
Belgrade University
Croatia

MD, PhD, Full Professor, Head of the Department of Endocrine Tumors and Hereditary Cancer Syndromes, Deputy Director of Clinic of Endocrinology, Diabetes and Metabolic Diseases, Faculty of Medicine

Belgrade


V. V. Salukhov
Military Medical Academy named after S. M. Kirov
Russian Federation

MD, PhD, Professor Head of the 1st Department (Therapy for Advanced Training of Doctors)

Saint Petersburg


T. Shimosawa
University of Health and Welfare
Japan

MD, PhD, Chief and Professor at the Department of Clinical Laboratory, Faculty of Medicine

Narita, Chiba


V. V. Shustov
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation

Clinical Laboratory Diagnostic Physician, Clinical Immunology Laboratory

Moscow


E. I. Tarlovskaya
Association “Eurasian Association of Therapists”; Volga Research Medical University
Russian Federation

MD, PhD, Professor, head of the Department of therapy and cardiology; Chairperson of Eurasian Association of Therapists branch in Nizhny Novgorod

Nizhny Novgorod


B. Vrtovec
University of Ljubljana
Slovenia

MD, PhD, Professor, Medical Director of Advanced Heart Failure and Transplantation Center, Department of Cardiology

Ljubljana


C. Wanner
University of Wuerzburg, Wuerzburg; Charles University
Germany

MD, PhD, professor, Head of the Division of Nephrology, Department of Medicine; visiting professor at Charles University

Prague


Z. R. Aisanov
Pirogov Russian National Research Medical University
Russian Federation

MD, PhD, Professor, Department of Pulmonology, Faculty of Postgraduate Physician Training

Moscow


G. P. Arutyunov
Association “Eurasian Association of Therapists”; Pirogov Russian National Research Medical University
Russian Federation

MD, PhD, Professor , Corresponding Member of the Russian Academy of Sciences, President of the Eurasian Association of Therapists, Head Professor of the Department of Propedeutics of Internal Diseases, Faculty of Pediatrics

Moscow


S. N. Avdeev
I.M.Sechenov First Moscow State Medical University; Pulmonology Scientific Research Institute under FMBA of Russia
Russian Federation

MD, PhD, Professor, Corresponding Member of Russian Academy of Sciences, Head of Department of Pulmonology; Head of Clinical Division

Moscow


A. P. Babin
Nicolae Testemitanu State University of Medicine and Pharmacy
Moldova, Republic of

MD, PhD, Associate Professor at the Department of Family Medicine

Kishinev


M. Cattaneo
University of Milan; ASST Santi Paolo e Carlo
Italy

MD, PhD, professor, Department of Health Sciences; Unit of Internal Medicine

Milan


A. I. Chesnikova
Rostov State Medical University
Russian Federation

MD, PhD, Professor, Professor in the Department of Internal Medicine No.1

Rostov-on-Don


M. V. Ezhov
A. L. Myasnikov Institute of Clinical Cardiology of FSBI "National Medical Research Center of Cardiology" Ministry of Health of the Russian Federation
Russian Federation

MD, PhD, principal researcher of at the Laboratory for Lipid Disorders of Atherosclerosis Department; President of the Russian National Atherosclerosis Society (RNAS)

Moscow


U. K. Kamilova
Republican Specialized Scientific and Practical Medical Center for Therapy and Medical Rehabilitation
Uzbekistan

MD, PhD, Professor, Deputy Director of Scientific Work

Tashkent


N. A. Koziolova
Perm State Medical University
Russian Federation

MD, PhD, professor, Head of the Introduction to Internal Medicine Dept No 2. Chairperson of the Eurasian Association of Therapists branch in Perm. Member of the Executive Committee of the Russian Society of Cardiology, President of the Perm Region Society of Cardiology (a non-profit public organization)

Perm


Yu. M. Lopatin
Volgograd State Medical University
Russian Federation

MD, PhD, Professor Head of the Department of Cardiology and Functional Diagnostics

Volgograd


N. P. Mitkovskaya
Belarusian State Medical University
Belarus

MD, PhD, Professor, Head of the Department of Cardiology and Internal Medicine; Chairperson of the Belarusian Society of Cardiologists and Physicians

Minsk


J. Morais
University of Porto; Leiria Hospital Center
Portugal

MD, PhD, professor, Faculty of Medicine; coordinator, research centre, Head of Cardiology Division

Leiria


G. R. Galstyan
The National Medical Research Center for Endocrinology of Ministry of Health of the Russian Federation
Russian Federation

MD, PhD, Professor, Highest Category Board Certified, Russia, Chief Researcher, Head of the Diabetic Foot Department, Acting Deputy Director of Diabetes Institute

Moscow


A. Sh. Sarybaev
National Center of Cardiology and Internal Medicine named after prof. M. Mirrakhimov
Kyrgyzstan

MD, PhD, Head

Bishkek


A. B. Sugraliev
Asfendiyarov Kazakh National Medical University
Kazakhstan

PhD, head of the Department of Internal Diseases with a Course of Propaedeutics

Almaty


I. S. Yavelov
Pirogov Russian National Research Medical University; National Medical Research Center for Therapy and Preventive Medicine
Russian Federation

MD, PhD, Head of the Division of Fundamental and Clinical Issues of Thrombosis Accompanied with Non-Infectious Diseases; Professor of the Department of Clinical Pharmacology

Moscow


A. M. Essaian
Pavlov First St. Petersburg State Medical University, Ministry of Health Care of the Russian Federation
Russian Federation

M.D., PhD, Professor, Head of the Department of Nephrology and Dialysis, Faculty of Postgraduate Education

 St. Petersburg


I. A. Zolotovskaya
Samara State Medical University
Russian Federation

MD, PhD, Professor of the Department of Hospital Therapy with courses of polyclinic therapy and transfusiology, Chief Outpatient Therapist, Ministry of Health of the Samara Region

Samara


Sh. B. Zhangelova
Asfendiyarov Kazakh National Medical University, Research Institute of Cardiology and Internal Diseases
Kazakhstan

PhD, Associate Professor, Professor, Department of Internal Medicine with Course of Propaedeutics; independent expert of Scientific Research

Almaty


S. K. Zyryanov
Peoples' Friendship University of Russia
Russian Federation

MD, PhD, Professor, Head of the Department of General and Clinical Pharmacology

Moscow


E. S. Melnikov
Association “Eurasian Association of Therapists”; North-Western State Medical University named after I.I. Mechnikov
Russian Federation

medical advisor; postgraduate student of the department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E. E. Eichwald 2020-2023

Saint Petersburg


R. A. Bashkinov
Association “Eurasian Association of Therapists”; North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Medical advisor; postgraduate student of the department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E. E. Eichwald 2019-2022

Saint Petersburg


E. V. Shlyakhto
Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation
Russian Federation

MD, PhD, General Director, Chief Cardiologist St. Petersburg and North-West Federal District, President of the Russian Society of Cardiology, Board member of the Society for heart failure, Honored Worker of Science Almazov National Medical Research Centre” of the Ministry of Health of the Russian Federation, CSC

Saint Petersburg


References

1. World Health Organization (WHO). https://www.who.int.

2. COVID-19 rapid guideline: managing the long-term effects of COVID-19 (NG188): Evidence review 5: interventions. London: National Institute for Health and Care Excellence (UK). NICE Guideline 2020;(188). Available from: https://www.ncbi.nlm.nih.gov/books/NBK567264/.

3. Arutyunov GP, Tarlovskaya EI, Arutyunov AG, et al. The International Registry “Analysis of Chronic Non-infectious Diseases Dynamics After COVID-19 (ACTIV SARS-CoV-2) Infection in Adult Patients”: methodology and design. Kardiologiia. 2020;60(11):35-7. (In Russ.) doi:10.18087/cardio.11.n1398.

4. Goërtz YMJ, VanHerck M, Delbressine JM, et al. Persistent symptoms 3 months after a SARS-CoV-2 infection: the post-COVID-19 syndrome?. ERJ OpenRes. 2020;6(4):00542- 2020. doi:10.1183/23120541.00542-2020.

5. Temporary guidelines “Medical rehabilitation after a new coronavirus infection (COVID19). Version 2 (31.07.2020)” (approved by the Ministry of Health of Russia). (In Russ.) https://xn--80aesfpebagmfblc0a.xn--p1ai/ai/doc/461/attach/28052020_Preg_COVID-19_v1.pdf.

6. Li Y, Zhao K, Wei H, et al. Dynamic relationship between D-dimer and COVID-19 severity. Br J Haematol. 2020;190(1):e24-e27. doi:10.1111/bjh.16811.

7. Thachil J, Tang N, Gando S, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID‐19. Journal of Thrombosis and Haemostasis. 2020;18(5):1023- 6. doi:10.1111/jth.14810.

8. Shlyakhto YV, Arutyunov GP, Belenkov YuN, et al. Use of Statins, Anticoagulants, Antiplatelet and Antiarrhythmic Drugs in Patients With COVID-19. The Agreed Experts’ Position of Russian Society of Cardiology, Eurasian Association of Therapists, National Society on Atherothrombosis, Societies of Experts in Urgent Cardiology, Eurasian Arrhythmology Association. Kardiologiia. 2020;60(6):4-14. (In Russ.) doi:10.18087/cardio.2020.6.n1180.

9. Zhang Y, Coats AJS, Zheng Z, et al. Management of heart failure patients with COVID-19: a joint position paper of the Chinese Heart Failure Association & National Heart Failure Committee and the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2020;22(6):941-56. doi:10.1002/ejhf.1915.

10. Seferovic PM, Ponikowski P, Anker SD, et al. Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2019;21(10):1169-86. doi:10.1002/ejhf.1531.

11. Arutyunov GP, Tarlovskaya EI, Arutyunov AG, et al. The International Registry “Analysis of the dynamics of Comorbid diseases in patients who have been infected with SARSCoV-2 (AKTIV SARS-CoV-2)”: analysis of 1,000 patients. Russian Journal of Cardiology. 2020;25(11):4165. (In Russ.) doi:10.15829/1560-4071-2020-4165.

12. Kang Y, Chen T, Mui D, et al. Cardiovascular manifestations and treatment considerations in COVID-19. Heart. 2020;106(15):1132-41. doi:10.1136/heartjnl-2020-31.

13. Shlyakhto EV. State and prospects for the development of cardiology care in the Russian Federation. Meeting of the Profile Commission on Cardiology, Ministry of Health of the Russian Federation, Moscow [Powerpoint presentation]. 2018. (In Russ.) https://cardioweb.ru/glavnyj-vneshtatnyj-spetsialistkardiolog-minzdrava-rossii/item/1998-profilnaya-komissiya.

14. Arutyunov GP, Tarlovskaya EI, Arutyunov AG, et al. International register “Dynamics analysis of comorbidities in SARS-CoV-2 survivors” (AKTIV SARS-CoV-2): analysis of predictors of shortterm adverse outcomes in COVID-19. Russian Journal of Cardiology. 2021;26(4):4470. (In Russ.) doi:10.15829/1560-4071-2021-4470.

15. Characteristics of COVID-19 patients dying in Italy: report based on available data on March 20th, 2020 COVID-19 Surveillance Group — Rome, Italy: Instituto Superiore Di Sanita, 2020. https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf

16. Arutiunov GP, Tarlovskaia EI, Koziolova NA, et al. The Agreed Experts’ Position of the Eurasian Association of Therapists, on strategies for clinical management of patients with comorbidities infected with SARS-Cov-2. Therapeutic Archive. 2020;92(9):108-124. doi:10.26442/00403660.2020.09.000703.

17. 2020 Clinical practice guidelines for Chronic heart failure. Russian Journal of Cardiology. 2020;25(11):4083. (In Russ.) doi:10.15829/1560-4071-2020-4083.

18. Chazova IE, ZhernakovaYuV on behalf of the experts. Clinical guidelines. Diagnosis and treatment of arterial hypertension. Systemic Hypertension. 2019;16(1):6-31. (In Russ.) doi:10.26442/2075082X.2019.1.190179.

19. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2019;40(5):475. doi:10.1093/eurheartj/ehy686.

20. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021-104. doi:10.1093/eurheartj/ehy339.

21. Writing Committee; Maddox TM, Januzzi Jr JL, et al. 2021 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: Answers to 10 Pivotal Issues About Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2021;77(6):772-810. doi:10.1016/j.jacc.2020.11.022.

22. Shlyakhto EV, Konradi AO, Arutyunov GP, et al. Guidelines for the diagnosis and treatment of circulatory diseases in the context of the COVID-19 pandemic. Russian Journal of Cardiology. 2020;25(3):3801. (In Russ.) doi:10.15829/1560-4071-2020-3-3801.

23. Huang C, Wang Y, Li X, et al. Clinical Features of Patients Infected With 2019 Novel Coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi:10.1016/S0140-6736(20)30183-5.

24. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;201585. doi:10.1001/jama.2020.1585.

25. Yang X, Yu Y, Xu J, et al. Clinical Course and Outcomes of Critically Ill Patients With SARSCoV-2 Pneumonia in Wuhan, China: A Single-Centered, Retrospective, Observational Study. Lancet Respir Med. 2020;8(5):475-81. doi:10.1016/S2213-2600(20)30079-5. Erratum in: Lancet Respir Med. 2020;8(4):e26.

26. Deng Y, Liu W, Liu K, et al. Clinical Characteristics of Fatal and Recovered Cases of Coronavirus Disease 2019 (COVID-19) in Wuhan, China: A Retrospective Study. Chin Med J (Engl). 2020;133(11):1261-7. doi:10.1097/CM9.0000000000000824.

27. Association of Nephrologists. Clinical recommendations. Chronic kidney disease (CKD). 2021. (In Russ.) https://www.rusnephrology.org/wpcontent/uploads/2020/12/CKD_final.pdf.

28. Association of Nephrologists. Scientific Society of Nephrologists of Russia. Association of Anesthesiologists-Resuscitators of Russia. National Society of Specialists in the Field of Hemapheresis and Extracorporeal Hemocorrection. Clinical recommendations. Acute kidney injury (AKI). 2020. (In Russ.) https://www.rusnephrology.org/wp-content/uploads/2020/12/AKI_final.pdf.

29. Langford BJ. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis. Clin Mic Inf. 2020;26(12):1622-9. doi:10.1016/j.cmi.2020.07.016.

30. McDonald LC, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018;66:e1-48. doi:10.1093/cid/cix1085.

31. Savarino V, Marabotto E, Furnari M, et al. Latest insights into the hot question of proton pump inhibitor safety — a narrative review. Dig Liver Dis. 2020;52(8):842-52. doi:10.1016/j.dld.2020.04.020.

32. Lee SW, Ha EK, Yeniova AÖ, et al. Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching. Gut. 2021;70(1):76-84. doi:10.1136/gutjnl-2020-322248.

33. Almario CV, Chey WD, Spiegel BMR. Increased Risk of COVID-19 Among Users of Proton Pump Inhibitors. Am J Gastroenterol. 2020;115(10):1707-15. doi:10.14309/ajg.0000000000000798.

34. Drapkina OM, Mayev IV, Bakulin IG, et al. Provisional guidelines: “Diseases of the digestive organs in conditions of a pandemic new coronavirus infection (COVID-19)”. Version 2. Profilakticheskaya Meditsina. 2021;25(5-2):4-41. (In Russ.) doi:10.17116/profmed2021240524.

35. Robb CT, Goepp M, Rossi AG, Yao, C. Non-steroidal anti-inflammatory drugs, prostaglandins, and COVID-19. Br J Pharmacol. 2020;177:4899-920. doi:10.1111/bph.15206.

36. Páramo-Zunzunegui J, Ortega-Fernández I, Calvo-Espino P, et al. Severe Clostridium difficile colitis as potential late complication associated with COVID-19. Ann R Coll Surg Engl. 2020;102(7):e176-e179. doi:10.1308/rcsann.2020.0166.


Supplementary files

Review

For citations:

Arutyunov A.G., Seferovic P., Bakulin I.G., Bakulina N.V., Batyushin M.M., Boldina M.V., Krstačić G., Macut D., Salukhov V.V., Shimosawa T., Shustov V.V., Tarlovskaya E.I., Vrtovec B., Wanner C., Aisanov Z.R., Arutyunov G.P., Avdeev S.N., Babin A.P., Cattaneo M., Chesnikova A.I., Ezhov M.V., Kamilova U.K., Koziolova N.A., Lopatin Yu.M., Mitkovskaya N.P., Morais J., Galstyan G.R., Sarybaev A.Sh., Sugraliev A.B., Yavelov I.S., Essaian A.M., Zolotovskaya I.A., Zhangelova Sh.B., Zyryanov S.K., Melnikov E.S., Bashkinov R.A., Shlyakhto E.V. Rehabilitation after COVID-19. Resolution of the International Expert Council of the Eurasian Association of Therapists and the Russian Society of Cardiology. Russian Journal of Cardiology. 2021;26(9):4694. (In Russ.) https://doi.org/10.15829/1560-4071-2021-4694

Views: 2295


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1560-4071 (Print)
ISSN 2618-7620 (Online)

119049, Moscow, ul. Shabolovka, 23-254

Russian Federation

 

Processing of personal data
supported by NEICON (Elpub lab)