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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">thealth</journal-id><journal-title-group><journal-title xml:lang="ru">Здравоохранение Таджикистана</journal-title><trans-title-group xml:lang="en"><trans-title>Health care of Tajikistan</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0514-2415</issn><publisher><publisher-name>Редакция журнала «Здравоохранение Таджикистана»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.52888/0514-2515-2023-357-2-5-11</article-id><article-id custom-type="elpub" pub-id-type="custom">thealth-447</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Статьи</subject></subj-group></article-categories><title-group><article-title>Организация комплексного  лечения риноцеребральной формы мукормикоза в постковидном периоде</article-title><trans-title-group xml:lang="en"><trans-title>Organization of complex treatment of the rhinocerebral form of mucormicosis in the post-covid  period</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абдуллозода</surname><given-names>Дж. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Abdullozoda</surname><given-names>J. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>медицинский факультет</p></bio><bio xml:lang="en"><p>Faculty of Medicine</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ходжамурадов</surname><given-names>Г. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Khojamurаdov</surname><given-names>G. M.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шамсзода</surname><given-names>Х. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shamszoda</surname><given-names>Kh. A.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хамидов</surname><given-names>М. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Khamidov</surname><given-names>M. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хамидов Маъруф Гадоевич – кандидат медицинских наук, заместитель директора</p><p>Тел.: +992918180303</p></bio><bio xml:lang="en"><p>Khamidov Maruf Gadoyevich – Candidate of Medical Sciences, Deputy Director </p><p>Tel.: +992918180303</p></bio><email xlink:type="simple">m.khamidzoda@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Турсунов</surname><given-names>Р. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tursunov</surname><given-names>R. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>медицинский факультет</p></bio><bio xml:lang="en"><p>Faculty of Medicine</p></bio><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Министерство здравоохранения и социальной защиты населения Республики Таджикистан; Таджикский национальный университет</institution><country>Таджикистан</country></aff><aff xml:lang="en"><institution>Ministry of Health and Social Protection of the Population of the Republic of Tajikistan; Tajik National University</institution><country>Tajikistan</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Министерство здравоохранения и социальной защиты населения Республики Таджикистан</institution><country>Таджикистан</country></aff><aff xml:lang="en"><institution>Ministry of Health and Social Protection of the Population of the Republic of Tajikistan</institution><country>Tajikistan</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Национальный медицинский центр Республики Таджикистан «Шифобахш»</institution><country>Таджикистан</country></aff><aff xml:lang="en"><institution>National Medical Center of the Republic of Tatarstan “Shifobakhsh”</institution><country>Tajikistan</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Таджикский национальный университет</institution><country>Таджикистан</country></aff><aff xml:lang="en"><institution>Tajik National University</institution><country>Tajikistan</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>12</day><month>07</month><year>2023</year></pub-date><volume>0</volume><issue>2</issue><fpage>5</fpage><lpage>11</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Абдуллозода Д.А., Ходжамурадов Г.М., Шамсзода Х.А., Хамидов М.Г., Турсунов Р.А., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Абдуллозода Д.А., Ходжамурадов Г.М., Шамсзода Х.А., Хамидов М.Г., Турсунов Р.А.</copyright-holder><copyright-holder xml:lang="en">Abdullozoda J.A., Khojamurаdov G.M., Shamszoda K.A., Khamidov M.G., Tursunov R.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.zdrav.tj/jour/article/view/447">https://www.zdrav.tj/jour/article/view/447</self-uri><abstract><sec><title>Цель исследования</title><p>Цель исследования. Разработать оптимальный вариант комплексного лечения риноцеребральной формы мукормикоза в постковидном периоде.</p><p>Материалы и методы исследования. Проведен анализ лечения 48 больных с риноцеребральной формой мукормикоза, поступивших из разных регионов Республики Таджикистан.</p><p>Результаты исследования и их обсуждение. У обследованных больных, перенесших COVID-19 (n=12; 0,9%) с сопутствующими заболеваниями, в раннем постковидном периоде через 1-3 месяца, развивалась нейроваскулярная недостаточность, которая привела к прямому вирусно-опосредованному нарушению гематоэнцефалического барьера, состоянию гиперкоагуляции и нейроваскулярным осложнениям. Также установлено, что в процессе лечения, наряду с другими препаратами, пациенты получали антибиотики пятого поколения и глюкокортикостероиды.</p></sec><sec><title>Заключение</title><p>Заключение. Развитие риноцеребральной формы мукормикоза в постковидном периоде у больных с сопутствующими заболеваниями связано со снижением иммунитета вследствие длительного бесконтрольного назначения антибиотиков и глюкокортикостероидов, что в свою очередь приводит к активации патогенных и условно-патогенных грибков. Поэтому они должны быть госпитализированы в профильные лечебные учреждения.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Aim</title><p>Aim: To develop an optimal variant of complex treatment of the rhinocerebral form of mucormycosis in the postCOVID period.</p></sec><sec><title>Materials and Methods</title><p>Materials and Methods: Treatment data from 48 patients diagnosed with the rhinocerebral form of mucormycosis, sourced from various regions of the Republic of Tajikistan, was scrutinized for this analysis.</p></sec><sec><title>Results and Discussion</title><p>Results and Discussion: The analysis revealed that patients who had contracted COVID-19 (n=12; 0.9%) and had existing health conditions, experienced the onset of neurovascular insufficiency in the early stages of the post-COVID period, roughly 1-3 months subsequent to the infection. This condition was ostensibly triggered by the direct viral disruption of the blood-brain barrier, hypercoagulation, and ensuing neurovascular complications. It was also noted that these patients had been administered fifth-generation antibiotics and glucocorticosteroids during their treatment.</p></sec><sec><title>Conclusion</title><p>Conclusion: The study findings suggest that the emergence of the rhinocerebral form of mucormycosis in the postCOVID period, especially in patients with concurrent health conditions, could be linked to weakened immunity and immunodeficiency. These are often induced by the prolonged, unregulated use of antibiotics and glucocorticosteroids, consequently leading to an increase in pathogenic and opportunistic fungi. In light of these findings, it is recommended that such patients be admitted to specialized medical institutions for appropriate treatment.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>COVID-19</kwd><kwd>постковидный период</kwd><kwd>риноцеребральная форма мукормикоза</kwd></kwd-group><kwd-group xml:lang="en"><kwd>COVID-19</kwd><kwd>Post-COVID Period</kwd><kwd>Rhinocerebral Mucormycosis</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Абдуллозода Дж.А. Особенности течения и медико-социальные аспекты новой коронавирусной инфекции в Республике Таджикистан / Дж.А. Абдуллозода, С.Дж. Юсуфи, Р.А. Турсунов // Инфекционные болезни: новости, мнения, обучение. Москва. - 2022. - Т.11, №1. - С. 85-92.</mixed-citation><mixed-citation xml:lang="en">Abdullozoda Dzh.A. Osobennosti techeniya i mediko-sotsialnye aspekty novoy koronavirusnoy infektsii v Respublike Tadzhikistan [Features of the course and medical and social aspects of a new coronavirus infection in the Republic of Tajikistan]. Infektsionnye bolezni: novosti, mneniya, obuchenie - Infectious diseases: news, opinions, training, 2022, Vol. 11, No. 1, pp. 85-92.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Глыбочко П.В. Клиническая характеристика 1007 больных тяжелой SARS-CoV-2 пневмонией, нуждавшихся в респираторной поддержке / П.В. Глыбочко, В.В. Фомин, С.Н. Авдеев и др. // Клиническая фармакология и терапия. - 2020. - №29 (2). - С. 21-29.</mixed-citation><mixed-citation xml:lang="en">Glybochko P.V. Klinicheskaya kharakteristika 1007 bolnykh tyazheloy SARS-CoV-2 pnevmoniey, nuzhdavshikhsya v respiratornoy podderzhke [Clinical characteristics of 1007 patients with severe SARSCoV-2 pneumonia who needed respiratory support]. Klinicheskaya farmakologiya i terapiya - Clinical pharmacology and therapy, 2020, No. 29 (2), pp. 21-29.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Лобастов К.В. COVID-19-ассоциированная коагулопатия: обзор современных рекомендаций по диагностике, лечению и профилактике / К.В. Лобастов, И.В. Счастливцев, О.Я. Порембская, О.В. Дженина, А.Б. Барганджия, С.Н. Цаплин // Амбулаторная хирургия. - 2020. - №3-4. - С. 36-51</mixed-citation><mixed-citation xml:lang="en">Lobastov K.V. COVID-19-assotsiirovannaya koagulopatiya: obzor sovremennykh rekomendatsiy po diagnostike, lecheniyu i profilaktike [COVID-19-associated coagulopathy: a review of current recommendations for diagnosis, treatment and prevention]. Ambulatornaya khirurgiya - Ambulatory surgery, 2020, No. 3-4, pp. 36-51.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Турсунов Р.А. Анализ летальных случаев при первой волне новой коронавирусной инфекции – COVID-19 / Р.А. Турсунов, Д.А. Олимов, Г.М. Ходжамурадов // Инфекционные болезни: новости, мнения, обучение. Москва. - 2021. - Т.10, №3. - С. 33-40.</mixed-citation><mixed-citation xml:lang="en">Tursunov R.A. Analiz letalnykh sluchaev pri pervoy volne novoy koronavirusnoy infektsii – COVID-19 [Analysis of fatal cases during the first wave of a new coronavirus infection - COVID-19].</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Baig A.M., Khaleeq A., Ali U. Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chemical Neuroscience, 2020, No. 11, рр. 995–98.</mixed-citation><mixed-citation xml:lang="en">Infektsionnye bolezni: novosti, mneniya, obuchenie - Infectious diseases: news, opinions, training, 2021, Vol. 10, No. 3, pp. 33-40.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Klok F.A., Kruip M., van der Meer N.J.M. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thrombosis Research, 2020, No. 191, рр. 145-147.</mixed-citation><mixed-citation xml:lang="en">Baig A.M., Khaleeq A., Ali U. Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chemical Neuroscience, 2020, No. 11, рр. 995–98.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Li Y.C., Bai W.Z., Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19. Journal of Medical Virology, 2020, No. 27.</mixed-citation><mixed-citation xml:lang="en">Klok F.A., Kruip M., van der Meer N.J.M. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thrombosis Research, 2020, No. 191, рр. 145-147.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Lodise T.P., Rybak M.J. COVID-19: Important therapy considerations and approaches in this hour of need. Pharmacotherapy, 2020, No. 40 (5), рр. 379–381.</mixed-citation><mixed-citation xml:lang="en">Li Y.C., Bai W.Z., Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19. Journal of Medical Virology, 2020, No. 27.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Madjid M., Safavi-Naeini P., Solomon S.D. Potential Effects of Coronaviruses on the Cardiovascular System: A Review. JAMA Cardiology, 2020, Vol. 1, No. 5 (7), pp. 831-840.</mixed-citation><mixed-citation xml:lang="en">Lodise T.P., Rybak M.J. COVID-19: Important therapy considerations and approaches in this hour of need. Pharmacotherapy, 2020, No. 40 (5), рр. 379–381.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Mao L., Jin H., Wang M. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurology, 2020, No. 77 (6), рр. 683.</mixed-citation><mixed-citation xml:lang="en">Madjid M., Safavi-Naeini P., Solomon S.D. Potential Effects of Coronaviruses on the Cardiovascular System: A Review. JAMA Cardiology, 2020, Vol. 1, No. 5 (7), pp. 831-840.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Mehta P., McAuley D.F., Brown M. HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet, 2020, No. 395, рр. 1033–34.</mixed-citation><mixed-citation xml:lang="en">Mao L., Jin H., Wang M. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurology, 2020, No. 77 (6), рр. 683.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Nguyen J.L., Yang W., Ito К. Seasonal influenza infections and cardiovascular disease mortality. JAMA Cardiology, 2016, No. 1 (3), рр. 274-81.</mixed-citation><mixed-citation xml:lang="en">Mehta P., McAuley D.F., Brown M. HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet, 2020, No. 395, рр. 1033–34.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Oudit G.Y., Kassiri Z., Jiang C. SARS-Coronavirus Modulation of Myocardial ACE2 Expression and Inflammation in Patients with SARS. European Journal of Clinical Investigation, 2019, No. 39, pp. 618-625.</mixed-citation><mixed-citation xml:lang="en">Nguyen J.L., Yang W., Ito К. Seasonal influenza infections and cardiovascular disease mortality. JAMA Cardiology, 2016, No. 1 (3), рр. 274-81.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Sanders J.M., Monogue M.L., Jodlowski T.Z. Pharmacologic treatments for coronavirus disease 2019 (COVID-19): a review. JAMA, 2020, No. 323 (18), рр. 1824–1836.</mixed-citation><mixed-citation xml:lang="en">Oudit G.Y., Kassiri Z., Jiang C. SARS-Coronavirus Modulation of Myocardial ACE2 Expression and Inflammation in Patients with SARS. European Journal of Clinical Investigation, 2019, No. 39, pp. 618-625.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Sanders J.M., Monogue M.L., Jodlowski T.Z. Pharmacologic treatments for coronavirus disease 2019 (COVID-19): a review. JAMA, 2020, No. 323 (18), рр. 1824–1836.</mixed-citation><mixed-citation xml:lang="en">Sanders J.M., Monogue M.L., Jodlowski T.Z. Pharmacologic treatments for coronavirus disease 2019 (COVID-19): a review. JAMA, 2020, No. 323 (18), рр. 1824–1836.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
