Опыт применения сурфактант-терапии при пневмонии, ассоциированной с COVID-19, у пациенток акушерского профиля

Abstract

Introduction. Pregnant women may be at increased risk for severe COVID-19 illness. Pregnant women are more likely to be hospitalized at ICU, needed the mechanical ventilation compared to nonpregnant women. The pregnant women are currently excluded from the most of the clinical trials of COVID-19 drug therapy. This limits the formulation of appropriate recommendations for the treatment of pregnant women with SARS-CoV-2 infection. Building on the experience of the effective use of surfactant therapy for influenza A/H1N1 treatment of pregnant women with COVID-19, the domestic/local drug Surfactant BL was included in the complex therapy. The objective. To evaluate the effectiveness of surfactant therapy in the integrated treatment of severe COVID-19 pneumonia of pregnant women and postpartum women. Materials and methods. The study included 69 pregnant and postpartum women with severe COVID-19 pneumonia. All ofthem received antiviral, anticoagulant and anti-inflammatory therapy. 47 patients (group 1) with an initially more severe course of the disease received inhalations with Surfactant BL in 1–2 days after admission to the intensive care unit, 22 patients (group 2) were prescribed surfactant therapy for 4–5 days, due to the progression of respiratory failure. Surfactant BL was administered at a dose of 75 mg 2 times a day through a nebulizer for 2–5 days. Result. In group 1 patients, SpO2 recovered faster and dyspnea decreased. All patients of group 1 did not require mechanical ventilation; in group 2, 3 patients (14.3%) required mechanical ventilation. In the group of early use of surfactant therapy with CT control, in most cases, there was a positive trend (67.6%), in contrast to group 2 (37.5%). Stay in ICU conditions in group 1 was 8.6 days, in group 2 – 13.2 days. No lethal outcomes were observed with surfactant therapy in both groups. Conclusion. Early surfactant therapy against the background of complex therapy allows to avoid mechanical ventilation, reducing the length of stay of patients in the intensive care unit and preventing mortality from COVID-19 pneumonia.