The Postkovidny syndrome (from English Post-COVID-19 Syndrome, it is also known under the term Long Covid) represents a syndrome of consequences of a koronavirusny infection (COVID-19) at which up to 20% of the people who had a koronavirusny infection in the past suffer from the long-term symptoms lasting up to 12 weeks and in certain cases even longer.
The postkovidny syndrome has no exact terms of manifestation. The residual phenomena can let know about themselves as right after the postponed infection, and later. The fact that the postkovidny syndrome meets also at an easy form of a koronavirusny infection is also interesting. According to the British data, every tenth caught a coronavirus continued to suffer from long-term symptoms which lasted three months and more.
Residual damage of lungs represents one of the most widespread options of a postkovidny syndrome. In spite of the fact that in general at a koronavirusny infection severe damage of lungs meets not so often, at most of persons with a severe disease damage of lungs takes place to be. Extent of this defeat can be various and demand in the course of treatment of an acute form of a disease of various options of respiratory support, beginning from inhalation of the moistened oxygen and finishing with extracorporal membrane oxygenation. In addition to a direct injury of lungs, the mechanism when the coronavirus, getting into nervous system through olfactory receptors in the top nasal sink, can damage directly structures of a brain, in particular, a respiratory center is not excluded. Besides, the coronavirus causes myocarditis and various tromboembolic episodes. Receptors of ACE2 to which the coronavirus is attached are in any human fabric, and their maximum quantity is found in intestines, on the second and third place — heart and lungs. Therefore we can deal both with direct, and with the mediated defeat of a respiratory organs which proceeds a long time.
As some of options of manifestation of a postkovidny syndrome can meet at patients: an asthma, feeling of shortage of air, an incomplete breath, apnoea episodes in a dream, weight behind a breast, discomfort in a thorax. And the above-stated symptoms can take place without signs of the expressed damage of lungs, at normal control x-ray films and KT-researches.
The remaining asthma can indicate also decrease in warm function owing to koronavirusny myocarditis. Generally it concerns the patients who had average and heavy forms of a koronavirusny infection. Untimely diagnostics of complications and lack of treatment can cause irreversible changes in a cardiac muscle and lead to chronic disturbances of a rhythm and heart failure. Such patients need to conduct detailed examination and to establish a myocardium damage rate.
Asthma which does not pass for a long time can be sign of development of fibrosis of pulmonary fabric that represents irreversible changes.
Noninvasive ventilation of the lungs can be used as one of elements of complex treatment of patients with a koronavirusny infection at a rehabilitation stage (after excommunication of the patient from the fan and stabilization at it vital functions) and also in therapy of a postkovidny syndrome. The technique of periodic support can be used as a technique of continued noninvasive respiratory support, especially at an early stage of rehabilitation, and (for example, at night day).
It is worth meaning that allocation of a coronavirus, according to the majority of the available researches, stops after 21 days of a disease at overwhelming number of patients. Therefore when using at a stage of rehabilitation of noninvasive ventilation there is no danger of massive virus planting, unlike its use in the acute period of a disease. Nevertheless, it is recommended to execute the PTsR-test for the purpose of an exception of a possibility of allocation of a virus by the patient.
As fans stationary models with function of noninvasive ventilation of the lungs can be used. At later stages of rehabilitation if the patient needs use of periodic respiratory support, so-called home fans for noninvasive IVL can be used. Especially it is important if the patient even before developing of a koronavirusny infection suffered from a syndrome of a sleepy apnoea. Such fans allow to carry out high-quality respiratory therapy through CPAP and to provide to the patient more comfortable breath when a need is had it.