Features of case management with neuromuscular disease during COVID-19. Clinical impression

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Abstract

The new COVID-19 coronavirus infection, which has become a pandemic, is a very dangerous disease, the clinical picture of which can vary from mild to extremely severe forms of the course. Currently, there are no complete data on the pathogenetic mechanism of SARS-CoV-2, but there are extensive data on the probable risk factors for the development of extremely severe forms of COVID-19. The study of such factors becomes most suitable in terms of preventing their development and influence on the course of the disease in individuals with compromised immune systems and patients with impaired neuromuscular transmission. The article describes two clinical cases of extremely severe COVID-19 in patients with impaired neuromuscular transmission. Based on the analysis of the course of diseases, the conclusions are made about the possible aggravation and mutual activation of the immunopathological process with the launch of the cascade mechanism of the “cytokine storm”. An assumption has been made about the influence of human leukocyte antigen (HLA) on the severity of COVID-19, which is confirmed by a positive dynamics against the background of administration of IVIG, glucocorticosteroids (GCS), virusinactivated plasma and extracorporeal detoxification methods.

About the authors

Olga V. Karpova

State Research Center — Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency

Author for correspondence.
Email: dr.ovkarpova@yandex.ru
SPIN-code: 7818-8525

MD, PhD

Russian Federation, Moscow

Yury D. Udalov

State Research Center — Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency

Email: udalov@fmbcfmba.ru
ORCID iD: 0000-0001-7108-1774
SPIN-code: 7016-7538

MD, PhD

Russian Federation, Moscow

Alexander S. Samoylov

State Research Center — Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency

Email: asamoilov@fmbcfmba.ru
ORCID iD: 0000-0003-4824-5683
SPIN-code: 3771-4848

Corresponding Member of RAS, MD, PhD

Russian Federation, Moscow

Roman A. Kudryavtsev

State Research Center — Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency

Email: romangde@gmail.com

MD

Russian Federation, Moscow

References

  1. World Health Organization. Tedros Adhanom Ghebreyesus. Breaking [cited 2020 March 11]. Available from: https://www.who.int/ru/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
  2. Wei-Jie Guan, Zheng-Yi Ni, Yu Hu, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–1720. doi: 10.1056/NEJMoa2002032.
  3. Всемирная организация здравоохранения [интернет]. Вопросы и ответы о COVID-19 [доступ от 1 марта 2020]. [WHO. Voprosy i otvety o COVID-19. (In Russ).] Доступно по: https://www.who.int/ru/emergencies/diseases/novel-coronavirus-2019/advice-for-public/q-a-coronaviruses.
  4. CDC. Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19). U. S. Centers for Disease Control and Prevention; 2020 [cited 2020 February 11]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html.
  5. Mao R, Qiu Y, He JS, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020;5(7):667–678. doi: 10.1016/S2468-1253(20)30126-6.
  6. Hess DC, Eldahshan W, Rutkowski E. COVID-19-Related Stroke. Transl Stroke Res. 2020;11(3):322–325. doi: 10.1007/s12975-020-00818-9.
  7. Рекомендации Британской Ассоциации Неврологов по COVID-19 для людей с неврологическими заболеваниями, их врачей и ухаживающих лиц. Версия 3 [доступ от 22 марта 2020]. [Rekomendatsii Britanskoy Assotsiatsii Nevrologov po COVID-19 dlya lyudey s nevrologicheskimi zabolevaniyami, ikh vrachey i ukhazhivayushchikh lits. Version 3. (In Russ).] Доступно по: https://www.ructrims.org/files/2020/rekomendacii_britanskoj_associacii_nevrologov_po_c.pdf. Ссылка активна на 22.03.2020.
  8. Phua J, Weng L, Ling L, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med. 2020;8(5):506–517. doi: 10.1016/S2213-2600(20)30161-2.
  9. Ye Q, Wang B, Mao J. Цитокиновый шторм при COVID-19 и его лечение // J Infection. — 2020. [Ye Q, Wang B, Mao J. Cytokine storm in COVID-19 and treatment. J Infection. 2020. (In Russ).] doi: 10.1016/j.jinf.2020.03.037.
  10. Heymann DL, Shindo N, WHO Scientific and Technical Advisory Group for Infectious Hazards. COVID-19: what is next for public health?. 2020;395(10224):542–545. : 3.
  11. Гасымлы Э.Д. Иммунопатогенез миастении гравис (обзор литературы) // Архивъ внутренней медицины. — 2018. — Т.8. — №3. — С. 176–185. [Gasymly ED. Immunopathogenesis of mhastienia gravis (review). The Russian Archives of Internal Medicine. 2018;8(3):176–185. (In Russ).] doi: 10.20514/2226-6704-2018-8-3-176-185.
  12. Белобородов Б.В., Гусаров В.Г., Дехнич А.В., и др. Методические рекомендации российской некоммерческой общественной организации «Ассоциация анестезиологов-реаниматологов», межрегиональной общественной организации «Альянс клинических химиотерапевтов и микробиологов», межрегиональной ассоциации по клинической микробиологии и антимикробной химиотерапии (МАКМАХ), общественной организации «Российский сепсис-форум» «Диагностика и антимикробная терапия инфекций, вызванных полирезистентными микроорганизмами» // Вестник анестезиологии и реаниматологии. — 2020. — Т.17. — №1. — С. 52–83. [Beloborodov VB, Gusarov VG, Dekhnich AV, et al. Guidelines of the Association of Anesthesiologists-Intensivists, the Interregional Non-Governmental Organization Alliance of Clinical Chemotherapists and Microbiologists, the Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy (IACMAC), and NGO Russian Sepsis Forum “Diagnostics and antimicrobial therapy of the infections caused by multiresistant microorganisms”. Vestnik anesteziologii i reanimatologii. 2020;17(1):52–83. (In Russ).] doi: 10.21292/2078-5658-2020-17-1-52-83.
  13. Давидов Н.Р., Виноградов О.И., Гороховатский Ю.И., Кузнецов А.Н. Полиневропатия критических состояний: причины, диагностика, подходы к лечению и профилактике // Неврологический журнал. — 2016. — Т.21. — №1. — С. 48–55. [Davidov NR, Vinogradov OI, Gorokhovatsky YuI, Kuznetsov AN. Polyneuropathy of critical conditions: causes, diagnosis, management and preventive approaches. Journal Neurology. 2016;21(1):48–55. (In Russ).] doi: 10.18821/1560-9545-2016-21-1-48-55.
  14. Супрун Е.Н. Динамика иммунного ответа // Аллергология и иммунология в педиатрии. — 2014. — №2. — С. 35–40. [Suprun EN. Dinamika immunnogo otveta. Allergologiya i immunologiya v pediatrii. 2014;(2):35–40. (In Russ).]
  15. Zhou Peng, Shi Zheng-Li. Discovery of a novel coronavirus associated with the recent pneumonia outbreak in humans and its potential bat origin. BiorXiv. 2020. doi: 10.1101/2020.01.22.914952.
  16. Li SR, Tang ZJ, Li ZH, Liu X. Searching therapeutic strategy of new coronavirus pneumonia from angiotensin-converting enzyme 2: the target of COVID-19 and SARS-CoV. Version 2. Eur J Clin Microbiol Infect Dis. 2020;39(6):1021–1026. doi: 10.1007/s10096-020-03883-y.
  17. Wang K, Chen W, Zhou YS, et al. SARS-CoV-2 invades host cells via a novel route: CD147-spike protein. BioRxiv. 2020. doi: 10.1101/2020.03.14.988345.
  18. Gheblawi M, Wang K, Viveiros A, et al. angiotensin-converting enzyme 2: sars-cov-2 receptor and regulator of the renin-angiotensin system: celebrating the 20th anniversary of the discovery of ACE2. Circ Res. 2020;126(10):1456–1474. doi: 10.1161/CIRCRESAHA.120.317015.
  19. Wan Y, Shang J, Graham R, et al. Receptor recognition by the novel coronavirus fromWuhan: An analysis based on decade-long structural studies of SARS. J Virology. 2020;94(7):e00127-20. doi: 10.1128/JVI.00127-20.
  20. Коровин А.Е., Новицкий А.А., Макаров Д.А. Острый респираторный дистресс-синдром. Современное состояние проблемы // Клиническая патофизиология. — 2018. — Т.24. — №2. — С. 32–41. [Korovin AE, Novitskiy AA, Makarov DA. Acute respiratory distress syndrome. Current state of the problem. Cilinicail patihophiysiolog’y. 2018;24(2):32–41. (In Russ).]
  21. Светлицкая О.И., Сирош Ю.А., Блатун В.П., Канус И.И. Риск развития острого респираторного дистресс-синдрома у пациентов с внегоспитальными вирусно-бактериальными пневмониями // Экстренная медицина. — 2018. — Т.7. — №4. — С. 564–569. [Sviatlitskaya V, Sirash Y, Blatun V, Kanus I. The risk of development of acute respiratory distress syndrome and prognosis in patients with community-acquired viral and bacterial pneumonia. Ekstrennaya meditsina. 2018;7(4):564–569. (In Russ).]
  22. Галкин А.А., Демидова В.С. Центральная роль нейтрофилов в патогенезе синдрома острого повреждения легких (острый респираторный дистресс-синдром) // Успехи современной биологии. — 2014. — Т.134. — №4. — С. 377–394. [Galkin AA, Demidova VS. The central role of neutrophils in pathogenesis of acute lung injury syndrome (ALI/ARDS). Advances in current biology. 2014;134(4):377–394. (In Russ).]

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Copyright (c) 2020 Karpova O.V., Udalov Y.D., Samoylov A.S., Kudryavtsev R.A.

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