avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2021-11-3-186-195avk-1234Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESПост-ковидный период: современный взгляд и клинические особенностиPost-COVID 19 Period: Modern State and Clinical Featureshttps://orcid.org/0000-0001-7825-5597ЛаринаВ. Н.LarinaV. N.

Вера Николаевна Ларина 

Москва

Moscow

larinav@mail.ruhttps://orcid.org/0000-0002-0673-5775РыжихА. А.RyzhikhA. A.

Москва

Moscow

https://orcid.org/0000-0001-6054-5924БикбаеваЛ. И.BikbaevaL. I.

Москва

Moscow

ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России, кафедра поликлинической терапии лечебного факультетаРоссияN.I. Pirogov Russian National Research Medical UniversityRussian Federation202130052021113186195Copyright © Ларина В.Н., Рыжих А.А., Бикбаева Л.И., 20212021Ларина В.Н., Рыжих А.А., Бикбаева Л.И.Larina V.N., Ryzhikh A.A., Bikbaeva L.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1234

Коронавирусная болезнь (COVID-19) рассматривается в качестве серьезной проблемы общественного здравоохранения, о чем свидетельствует неуклонный рост вновь зараженных пациентов.Несмотря на то, что борьба с данной инфекцией длится более года, до сих пор недостаточно изучены малопрогнозируемые последствия COVID-19 в сочетании или без сочетания с сопутствующими хроническими заболеваниями, что несомненно является дополнительной нагрузкой на амбулаторное звено здравоохранения. Данная статья представляет собой обзор, современной доступной литературы, посвященной особенностям течения и длительности пост-ковидного периода. Проанализировано более 15 исследований, в которых авторы оценивали встречаемость симптомов в пост-ковидный период и его клинические характеристики.

Coronavirus disease (COVID-19) has proven to be a major global public health crisis, as evidenced by the steady increase in re-infected patients. In spite of the fight against this infection going on for more than a year, the unpredictable consequences of COVID-19, with or without concomitant chronic diseases, are still insufficiently studied, which undoubtedly is an additional burden on the outpatient health care unit. This article is a review of the available modern literature on the features of the course and duration of the post-COVID period. More than fifteen studies have been analyzed, in which the authors evaluated the incidence of symptoms in post-COVID period and its clinical characteristics.

COVID-19пост-ковидный периододышкаусталостьамбулаторный этапCOVID-19пост-ковидный периододышкаусталостьамбулаторный этапReferencesChen T., Wu D., Chen H., et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective. BMJ. 2020; 368: m1091. doi:10.1136/bmj.m1091.Chen T., Wu D., Chen H., et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective. BMJ. 2020; 368: m1091. doi:10.1136/bmj.m1091.Chen N., Zhou M., Dong X., et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet. 2020; 395 (10223):507-513. doi: 10.1016/S0140-6736(20)30211-7.Chen N., Zhou M., Dong X., et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet. 2020; 395 (10223):507-513. doi: 10.1016/S0140-6736(20)30211-7.Szymanek-Pasternak A., Sylwia Serafińska S., Kucharska M., et al. Severe course of COVID-19 in a middle-aged man without risk factors. 2020; 130(4). doi: 10.20452/pamw.15277.Szymanek-Pasternak A., Sylwia Serafińska S., Kucharska M., et al. Severe course of COVID-19 in a middle-aged man without risk factors. 2020; 130(4). doi: 10.20452/pamw.15277.Sheehy L.M. Considerations for Postacute Rehabilitation for Survivors of COVID-19. JMIR Public Health Surveill. 2020; 6(2): e19462. doi:10.2196/19462.Sheehy L.M. Considerations for Postacute Rehabilitation for Survivors of COVID-19. JMIR Public Health Surveill. 2020; 6(2): e19462. doi:10.2196/19462.Малявин А.Г., Адашева Т.В., Бабак С.Л. и др. Медицинская реабилитация больных, перенесших COVID-19 инфекцию. Методические рекомендации. Терапия. 2020; 5 (приложение): 1–48. doi: 10.18565/therapy.2020.5suppl.1-48. Malyavin A.G., Adasheva T.V., Babak S.L. et al. Medical rehabilitation of COVID-19-survived patients. Methodological recommendations. Therapy. 2020; 5 (Suppl): 1–48. doi: 10.18565/therapy.2020.5suppl.1-48. [In Russian].Малявин А.Г., Адашева Т.В., Бабак С.Л. и др. Медицинская реабилитация больных, перенесших COVID-19 инфекцию. Методические рекомендации. Терапия. 2020; 5 (приложение): 1–48. doi: 10.18565/therapy.2020.5suppl.1-48. Malyavin A.G., Adasheva T.V., Babak S.L. et al. Medical rehabilitation of COVID-19-survived patients. Methodological recommendations. Therapy. 2020; 5 (Suppl): 1–48. doi: 10.18565/therapy.2020.5suppl.1-48. [In Russian].Временные методические рекомендации: медицинская реабилитация при новой коронавирусной инфекции (covid-19), Версия 2 (31.07.2020). [Электронный ресурс]. URL: https://xn--80aesfpebagmfblc0a.xn--p1ai/ai/doc/461/attach/28052020_Preg_COVID-19_v1.pdf (дата обращения 10.12.2020) Interim guidelines: medical rehabilitation for new coronavirus infection (covid-19), Version 2 (31.07.2020). URL: https://xn--80aesfpebagmfblc0a.xn--p1ai/ai/doc/461/attach/28052020_Preg_COVID-19_v1.pdf (date of the application: 10.12.2021) [In Russian].Временные методические рекомендации: медицинская реабилитация при новой коронавирусной инфекции (covid-19), Версия 2 (31.07.2020). [Электронный ресурс]. URL: https://xn--80aesfpebagmfblc0a.xn--p1ai/ai/doc/461/attach/28052020_Preg_COVID-19_v1.pdf (дата обращения 10.12.2020) Interim guidelines: medical rehabilitation for new coronavirus infection (covid-19), Version 2 (31.07.2020). URL: https://xn--80aesfpebagmfblc0a.xn--p1ai/ai/doc/461/attach/28052020_Preg_COVID-19_v1.pdf (date of the application: 10.12.2021) [In Russian].Самородская И.В., Ларина В.Н., Назимкин К.Е. и др. Организационные и клинические проблемы диагностики COVID-19 на амбулаторном этапе. Врач. 2020; 31 (5): 23–29. doi: 10.29296/25877305-2020-05-05. Samorodskaya I.V., Larina V.N., Nazimkin K.E., Larin V.G. Organizational and clinical problems of diagnostics of COVID-19 at the outpatient stage. Doctor. 2020; 31 (5): 23-29. doi: 10.29296/25877305-2020-05-05. [In Russian].Самородская И.В., Ларина В.Н., Назимкин К.Е. и др. Организационные и клинические проблемы диагностики COVID-19 на амбулаторном этапе. Врач. 2020; 31 (5): 23–29. doi: 10.29296/25877305-2020-05-05. Samorodskaya I.V., Larina V.N., Nazimkin K.E., Larin V.G. Organizational and clinical problems of diagnostics of COVID-19 at the outpatient stage. Doctor. 2020; 31 (5): 23-29. doi: 10.29296/25877305-2020-05-05. [In Russian].Information about COVID-19 — World Health Organization. Электронный ресурс]. URL: https://www.who.int/classifications/classification-of-diseases/emergency-use-icd-codes-for-covid-19-disease-outbreak (date of the application: 14.01.2021)Information about COVID-19 — World Health Organization. Электронный ресурс]. URL: https://www.who.int/classifications/classification-of-diseases/emergency-use-icd-codes-for-covid-19-disease-outbreak (date of the application: 14.01.2021)Carlos del Rio, Lauren F. Collins, Preeti Malani,. Long-term Health Consequences of COVID-19. JAMA. 2020; 324 (17): 1723-1724. doi: 10.1001/jama.2020.19719.Carlos del Rio, Lauren F. Collins, Preeti Malani,. Long-term Health Consequences of COVID-19. JAMA. 2020; 324 (17): 1723-1724. doi: 10.1001/jama.2020.19719.Greenhalgh Trisha, Knight Matthew, A’CourtChristine, et al. Management of post-acute covid-19 in primary care. BMJ. 2020; 370: m3026.Greenhalgh Trisha, Knight Matthew, A’CourtChristine, et al. Management of post-acute covid-19 in primary care. BMJ. 2020; 370: m3026.National Guidance for post-COVID syndrome assessment clinics, 2020. [Electronic resource]. URL: https://www.england.nhs.uk/coronavirus/publication/national-guidance-for-post-covid-syndromeassessment-clinics/ (date of the application: 14.01.2021).National Guidance for post-COVID syndrome assessment clinics, 2020. [Electronic resource]. URL: https://www.england.nhs.uk/coronavirus/publication/national-guidance-for-post-covid-syndromeassessment-clinics/ (date of the application: 14.01.2021).Arnold D.T., Hamilton F.W., Milne A., et al. Patient outcomes after hospitalisation with COVID-19 and implications for follow-up: results from a prospective UK cohort. Thorax. 2020; thoraxjnl-2020-216086. doi:10.1136/thoraxjnl-2020-216086.Arnold D.T., Hamilton F.W., Milne A., et al. Patient outcomes after hospitalisation with COVID-19 and implications for follow-up: results from a prospective UK cohort. Thorax. 2020; thoraxjnl-2020-216086. doi:10.1136/thoraxjnl-2020-216086.Carfì A., Bernabei R., Landi F. et al. COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19. JAMA.2020;324(6):603-605. doi:10.1001/jama.2020.12603.Carfì A., Bernabei R., Landi F. et al. COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19. JAMA.2020;324(6):603-605. doi:10.1001/jama.2020.12603.Elizabeth T. Cirulli, Kelly M. Schiabor Barrett, Stephen Riffle et al. Long-term COVID-19 symptoms in a large unselected population. medRxiv. 2020. doi: 10.07.20208702.Elizabeth T. Cirulli, Kelly M. Schiabor Barrett, Stephen Riffle et al. Long-term COVID-19 symptoms in a large unselected population. medRxiv. 2020. doi: 10.07.20208702.Yiping Lu, Xuanxuan Li, Daoying Geng, et al. Cerebral MicroStructural Changes in COVID-19 Patients — An MRI-based 3-month Follow-up Study’, EClinicalMedicine, 2020;25:100484. doi: 10.1016/j.eclinm.2020.100484.Yiping Lu, Xuanxuan Li, Daoying Geng, et al. Cerebral MicroStructural Changes in COVID-19 Patients — An MRI-based 3-month Follow-up Study’, EClinicalMedicine, 2020;25:100484. doi: 10.1016/j.eclinm.2020.100484.Mandal S., Barnett J., Brill S.E., et al. «Long-COVID»: a crosssectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalization for COVID-19. 2020; thoraxjnl-2020-215818. doi:10.1136/thoraxjnl-2020-215818.Mandal S., Barnett J., Brill S.E., et al. «Long-COVID»: a crosssectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalization for COVID-19. 2020; thoraxjnl-2020-215818. doi:10.1136/thoraxjnl-2020-215818.Miyazato, Y., Shinichiro Morioka, Shinya Tsuzuki et al. Prolonged and Late-Onset Symptoms of Coronavirus Disease.Open Forum Infect Dis. 2019; 7(11): ofaa507. doi: 10.1093/ofid/ofaa507.Miyazato, Y., Shinichiro Morioka, Shinya Tsuzuki et al. Prolonged and Late-Onset Symptoms of Coronavirus Disease.Open Forum Infect Dis. 2019; 7(11): ofaa507. doi: 10.1093/ofid/ofaa507.Paterson R.W., Ross W Paterson, Rachel L Brown et al. ‘The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings’, Brain. 2020; 143(10): 3104-20. doi: 10.1093/brain/awaa240.Paterson R.W., Ross W Paterson, Rachel L Brown et al. ‘The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings’, Brain. 2020; 143(10): 3104-20. doi: 10.1093/brain/awaa240.Shah A.S., Wong A.W., Hague C.J., et al. COVID-19 and what comes after? Thorax. 2021; 0: 1–2. doi:10.1136/thoraxjnl-2020-216226. doi:10.1136/thoraxjnl-2020-216308.Shah A.S., Wong A.W., Hague C.J., et al. COVID-19 and what comes after? Thorax. 2021; 0: 1–2. doi:10.1136/thoraxjnl-2020-216226. doi:10.1136/thoraxjnl-2020-216308.Sollini M., Ciccarelli M., Cecconi M. et al. Vasculitis changes in COVID-19 survivors with persistent symptoms: an [18F]FDG-PET/CT study. Eur J Nucl Med Mol Imaging. 2020 Oct 30: 1–7. doi: 10.1007/s00259-020-05084-3.Sollini M., Ciccarelli M., Cecconi M. et al. Vasculitis changes in COVID-19 survivors with persistent symptoms: an [18F]FDG-PET/CT study. Eur J Nucl Med Mol Imaging. 2020 Oct 30: 1–7. doi: 10.1007/s00259-020-05084-3.Stavem K., Ghanima W., Olsen M.K., Gilboe H.M., Einvik G. Thorax 2020; 0: 1–3. doi:10.1136/thoraxjnl-2020-216377Stavem K., Ghanima W., Olsen M.K., Gilboe H.M., Einvik G. Thorax 2020; 0: 1–3. doi:10.1136/thoraxjnl-2020-216377Sudre Carole H., Benjamin Murray, Thomas Varsavsky et al. Attributes and predictors of Long-COVID: analysis of COVID cases and their symptoms collected by the Covid Symptoms Study App. medRxiv. 2020;10.19.20214494. doi: 10.1101/2020.10.19.20214494.Sudre Carole H., Benjamin Murray, Thomas Varsavsky et al. Attributes and predictors of Long-COVID: analysis of COVID cases and their symptoms collected by the Covid Symptoms Study App. medRxiv. 2020;10.19.20214494. doi: 10.1101/2020.10.19.20214494.Townsend, L., Adam H Dyer, Karen Jones, et al. Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection’, PLoS One. 2020; 15(11):e0240784. doi: 10.1371/journal.pone.0240784.Townsend, L., Adam H Dyer, Karen Jones, et al. Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection’, PLoS One. 2020; 15(11):e0240784. doi: 10.1371/journal.pone.0240784.Van den Borst B., Peters J.B., Brink M., et al. Comprehensive health assessment three months after recovery from acute COVID-19. Clin Infect Dis. 2020;ciaa1750. doi:10.1093/cid/ciaa1750.Van den Borst B., Peters J.B., Brink M., et al. Comprehensive health assessment three months after recovery from acute COVID-19. Clin Infect Dis. 2020;ciaa1750. doi:10.1093/cid/ciaa1750.Wong A.W., Aditi S. Shah, James C. Johnston, et al. Patient-reported outcome measures after COVID-19: a prospective cohort study’, Eur Respir J. 2020; 56(5): 2003276. doi: 10.1183/13993003.03276-2020.Wong A.W., Aditi S. Shah, James C. Johnston, et al. Patient-reported outcome measures after COVID-19: a prospective cohort study’, Eur Respir J. 2020; 56(5): 2003276. doi: 10.1183/13993003.03276-2020.Zhao Y.M., Yao-Min Shang, Wen-Bin Songet, et al. Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery’, E Clinical Medicine. 2020; 25: 100463. doi: 10.1016/j.eclinm.2020.100463.Zhao Y.M., Yao-Min Shang, Wen-Bin Songet, et al. Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery’, E Clinical Medicine. 2020; 25: 100463. doi: 10.1016/j.eclinm.2020.100463.Tenforde M.W., Kim S.S., Lindsell C.J., et al. IVY Network Investigators; CDC COVID-19 Response Team; IVY Network Investigators. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network: United States, March-June 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(30): 993-998. doi: 10.15585/mmwr.mm6930e1.Tenforde M.W., Kim S.S., Lindsell C.J., et al. IVY Network Investigators; CDC COVID-19 Response Team; IVY Network Investigators. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network: United States, March-June 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(30): 993-998. doi: 10.15585/mmwr.mm6930e1.British Society of Thoracic Radiologists COVID-19 CXR report proforma. 2020. URL: https://www.bsti.org.uk/media/resources/files/BSTI_COVID_CXR_Proforma_v.3-1.pdf (date of the application: 2 Aug 2020)British Society of Thoracic Radiologists COVID-19 CXR report proforma. 2020. URL: https://www.bsti.org.uk/media/resources/files/BSTI_COVID_CXR_Proforma_v.3-1.pdf (date of the application: 2 Aug 2020)Halpin, S.J., McIvor C., Whyatt G., et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A crosssectional evaluation. J Med Virol. 2021; 93(2): 1013–1022. doi: 10.1002/jmv.26368.Halpin, S.J., McIvor C., Whyatt G., et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A crosssectional evaluation. J Med Virol. 2021; 93(2): 1013–1022. doi: 10.1002/jmv.26368.Wootton D.G., Dickinson L., Pertinez H., et al. A longitudinal modelling study estimates acute symptoms of community acquired pneumonia recover to baseline by 10 days. Eur Respir J. 2017; 49(6): 1602170. doi: 10.1183/13993003.02170-2016.Wootton D.G., Dickinson L., Pertinez H., et al. A longitudinal modelling study estimates acute symptoms of community acquired pneumonia recover to baseline by 10 days. Eur Respir J. 2017; 49(6): 1602170. doi: 10.1183/13993003.02170-2016.Wyrwich K.W., Yu H., Sato R., et al. Observational longitudinal study of symptom burden and time for recovery from community acquired pneumonia reported by older adults surveyed nationwide using the CAP Burden of Illness Questionnaire. Patient Relat Outcome Meas. Patient Relat Outcome Meas. 2015; 6(30): 215–223. doi: 10.2147/PROM.S857792015.Wyrwich K.W., Yu H., Sato R., et al. Observational longitudinal study of symptom burden and time for recovery from community acquired pneumonia reported by older adults surveyed nationwide using the CAP Burden of Illness Questionnaire. Patient Relat Outcome Meas. Patient Relat Outcome Meas. 2015; 6(30): 215–223. doi: 10.2147/PROM.S857792015.WHO: Weekly epidemiological update. 29 December 2020. URL: https://www.who.int/publications/m/item/weekly-epidemiologicalupdate---29-december-2020 (date of the application: 15.01.2021).WHO: Weekly epidemiological update. 29 December 2020. URL: https://www.who.int/publications/m/item/weekly-epidemiologicalupdate---29-december-2020 (date of the application: 15.01.2021).Klok F.A., Boon G.J. A.M., Barco S., et al. The PostCOVID-19 Functional Status scale: a tool to measure functional status over time after COVID-19. Eur Respir J. 2020; 56(1): 2001494. doi: 10.1183/13993003.01494-2020.Klok F.A., Boon G.J. A.M., Barco S., et al. The PostCOVID-19 Functional Status scale: a tool to measure functional status over time after COVID-19. Eur Respir J. 2020; 56(1): 2001494. doi: 10.1183/13993003.01494-2020.

The authors declare that there are no conflicts of interest present.