Difficulties in the Treatment of Complications and Rehabilitation after COVID-19. A Clinical Case
S. A. Andreichenko,
M. A. Slepukhina,
M. V. Bychinin,
T. V. Klypa,
M. A. Atamanova,
V. G. Shirinsky,
G. E. Karapetyan https://doi.org/10.21292/2078-5658-2022-19-4-89-96
Abstract
The severe course of the new coronavirus infection (COVID-19) is associated with multiple life-threatening complications that lead to delayed initiation of active rehabilitation and unfavorable long-term treatment outcomes. Tracheoesophageal fistula is one of these complications. The specific feature of this event in COVID-19 is delayed tissue regeneration which requires a non-standard approach to management of such patients.
The article presents a clinical case of a pregnant patient after a complicated severe course of COVID-19 with the development of tracheoesophageal fistula, sepsis, and weakness syndrome acquired in ICU. The combination of complications of the disease led to a prolonged (about five months) period of rehabilitation.
Modern standard components of intensive therapy of such patients including regular monitoring of endotracheal/tracheostomy tube cuff pressure, dynamic assessment of nutritional status and its correction, rational antimicrobial therapy, screening of psychiatric disorders and early rehabilitation, will minimize the number of both early and delayed complications of COVID-19.
About the Authors
S. A. Andreichenko
Central Clinical Hospital of RZD-Medicine; Academy of Postgraduate Education, Federal Scientific Clinical Center of Specialized Medical Care and Medical Technologies, Federal Medical Biological Agency
Russian Federation
Russian Federation
Sergey A. Andreichenko, Head of Anesthesiology and Intensive
Care Department with Intensive Care Wards
2, Budayskaya St., Moscow, 129128
M. A. Slepukhina
Academy of Postgraduate Education, Federal Scientific Clinical Center of Specialized Medical Care and Medical Technologies, Federal Medical Biological Agency
Russian Federation
Russian Federation
Maria A. Slepukhina, Resident Physician of Anesthesiology and Intensive Care Department
91, Volokalamskoye Ave., Moscow, 125371
M. V. Bychinin
Academy of Postgraduate Education, Federal Scientific Clinical Center of Specialized Medical Care and Medical Technologies, Federal Medical Biological Agency
Russian Federation
Russian Federation
Mikhail V. Bychinin, Candidate of Medical Sciences, Associate Professor of Anesthesiology and Intensive Care Department
91, Volokalamskoye Ave., Moscow, 125371
T. V. Klypa
Academy of Postgraduate Education, Federal Scientific Clinical Center of Specialized Medical Care and Medical Technologies, Federal Medical Biological Agency
Russian Federation
Russian Federation
Tatiana V. Klypa, Doctor of Medical Sciences, Head of Anesthesiology and Intensive Care Department, Deputy Chief Physician for Anaesthesiology and Intensive Care
91, Volokalamskoye Ave., Moscow, 125371
M. A. Atamanova
Central Clinical Hospital of RZD-Medicine
Russian Federation
Russian Federation
Marina A. Atamanova, Candidate of Medical Sciences, Deputy Chief Physician for Medical Activities
2, Budayskaya St., Moscow, 129128
V. G. Shirinsky
Central Clinical Hospital of RZD-Medicine
Russian Federation
Russian Federation
Vladislav G. Shirinsky, Doctor of Medical Sciences, Deputy Chief Physician for Surgical and Oncological Care
2, Budayskaya St., Moscow, 129128
G. E. Karapetyan
Central Clinical Hospital of RZD-Medicine
Russian Federation
Russian Federation
Georgiy E. Karapetyan, Doctor of Medical Sciences, Director
2, Budayskaya St., Moscow, 129128
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For citations:
Andreichenko S.A., Slepukhina M.A., Bychinin M.V., Klypa T.V., Atamanova M.A., Shirinsky V.G., Karapetyan G.E. Difficulties in the Treatment of Complications and Rehabilitation after COVID-19. A Clinical Case. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2022;19(4):89-96. (In Russ.) https://doi.org/10.21292/2078-5658-2022-19-4-89-96
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