Vol 12, No 2 (2021)

In the Consensus of experts from Russian societies, issues of comprehensive medical rehabilitation of patients with a new coronavirus infection are being discussed. Coronavirus Disease 2019 (COVID-19) is a contagious infectious disease that can cause respiratory, cardiac, motor, metabolic, neurocognitive and mental disorders, i.e. multiple organ dysfunction. Patients who survived COVID-19, especially after a severe course, face serious psychological and physical problems, post-traumatic stress, cognitive dysfunction, nutritional deficiencies and exacerbation of concomitant chronic diseases. Some patients, regardless of the severity of the coronavirus infection, have a long-term course of disease ("chronic COVID", "long-term COVID"). There is evidence of the development of "post-COVID-19 syndrome". In this regard, patients with COVID-19 need rehabilitation. The Consensus of experts from Russian societies provides general principles, stages and aspects of medical rehabilitation after COVID-19, indications and contraindications for rehabilitation interventions. The Consensus includes recommendations on comprehensive cardiac and respiratory rehabilitation, as well as the features of the rehabilitation of patients with different clinical course of COVID-19 within the framework of the national three-stage medical rehabilitation system.

The novel coronavirus infection (COVID-19) pandemic has become an unprecedented threat to the lives of those affected and has increased the burden on the healthcare system in most countries. The severity of COVID-19 is not always predictable. However, comorbid pathology and advanced age are risk factors for a severe course of the disease with the development of multiple organ failure. When treating COVID-19, clinicians place particular emphasis on nutritional support as part of intensive care. Correction of nutritional status is also important in the rehabilitation of patients with the syndrome after intensive care. The aim of the review was to show the need for a differentiated approach to nutritional support for patients with COVID-19 during treatment and rehabilitation. From more than 200 originally selected literature sources from various databases (Scopus, Web of science, RSCI, etc.), 49 publications were selected for analysis, mostly published over the past 5 years. Earlier articles were used if they were still relevant to clinicians. The review provides methods for assessing the nutritional status of patients with COVID-19. It is emphasized that patients with comorbid pathology and elderly patients often develop malnutrition, which progresses over the disease. The article discusses in detail the issues of correction of malnutrition, depending on the severity of the disease and the stage of treatment. The effectiveness of rehabilitation is enhanced with adequate nutritional support. Current approaches to providing COVID-19 patients with nutrients and energy include a gradation of nutritional support prescription depending on the severity of the disease. Particular attention is paid to the gradual achievement of target protein and energy levels, as well as the preferential use of the enteral method of delivery of food components. Continuity of nutritional status correction at the outpatient, inpatient and rehabilitation stages improves the quality of care for patients with COVID-19.