Иммунокоррекция в терапии COVID-19 у амбулаторных пациентов

Abstract

Objective. To evaluate the clinical efficacy of including Azoximer bromide in the complex outpatient treatment for individuals with a confirmed diagnosis of COVID-19 with moderate to severe symptoms. Patients and methods. This study included 40 patients who were treated for a novel coronavirus infection (COVID-19) in outpatient settings in Ufa in September to November 2021. Patients were divided into two groups: the study group (n = 20), where Azoximer bromide was included in the complex treatment, and the comparison group (n = 20), which received only standard therapy. The dynamics of clinical presentation and laboratory parameters characterizing inflammation served as a criterion for assessing the effectiveness of treatment. Results. The results of the study showed that patients receiving Azoximer bromide had relief of respiratory syndrome 3 days earlier than in the comparison group. This included disappearance of such symptoms as cough, sputum separation, and normalization of respiratory rate. The objective criterion to assess the efficacy of Azoximer bromide therapy were the findings of multi-slice computed tomography (MSCT) against the background of complex treatment with inclusion of Polyoxidonium – the percentage of lung parenchymal lesions did not exceed 8% on day 17 of treatment; in the comparison group, 6 patients had the percentage of lung parenchymal lesions up to 12% on day 17 of treatment according to MSCT. In the remaining patients in the comparison group, the percentage of lung lesions was comparable to the results in the study group. Analysis of the manifestations of multisystem inflammatory syndrome revealed that the period of normalization of body temperature (<37°C) in patients receiving immunomodulatory therapy was 13.20 ± 2.45 days versus 17.70 ± 2.53 days in the comparison group (p = 0.0001). A white blood cell (WBC) count and erythrocyte sedimentation rate (ESR) against the background of treatment in the study group normalized on average 2 days faster, although there were no significant differences between the groups. In the study group, WBC count and ESR on admission were 3.9 × 109/L and 40 mm/h, respectively, after treatment – 6.3 × 109/L and 18.6 mm/h, respectively. In the comparison group, these indices were 3.8 × 109/L and 39 mm/h on admission and 6.2 × 109/L and 20.6 mm/h after treatment, respectively. The level of C-reactive protein also decreased in both groups, amounting to 7.18 ± 3.06 mg/L and 3.744 ± 1.73 mg/L on day 17 of treatment in the study group and comparison group, respectively, which was more than 2 times lower than baseline levels in both groups. Conclusion. Inclusion of Azoximer bromide in the complex treatment of patients with a novel coronavirus infection allows to achieve faster normalization of patients’ condition, which is accompanied by positive clinical dynamics manifested in faster relief of multisystem inflammatory syndrome and lung parenchymal lesions compared to patients who were only on standard therapy. No adverse events were observed during medication administration. Key words: coronavirus infection, SARS-CoV-2, COVID-19, pneumonia, immune correction, Azoximer bromide