Sulodexide in the treatment of post-thrombotic disease complicated by the development of trophic defects of the lower extremities in patients with COVID-19 pneumonia

Abstract

Introduction. The problem of care for patients with trophic venous ulcers remains an urgent medical and social problem, which has been aggravated again against the background of the COVID-19 pandemic in 2020-2021. As is now known, after a COVID-19 viral infection, most patients with cardiovascular diseases experience a significant exacerbation of these ailments. This is also true for postthrombotic lower extremity disease (PTD). Many patients with edematous or edematous-painful forms of PTB after COVID-19-associated pneumonia experience formation of trophic ulcers of the distal parts of the lower extremities.Aim. To study characteristic features of the course of ulcerative process in PTB in patients after COVID-19-associated pneumonia and to search safe and effective means, accelerating wound epithelialization in such patients.Material and methods. Efficiency of sulodexide use in conservative therapy of 16 patients with PTB, in whom trophic defects (venous ulcers) of the lower third of the shin and foot first appeared after pneumonia due to SARS-CoV-2 infection, was evaluated. At the same time, trophic ulcers were highly resistant to conventional therapy aimed at their healing. All 16 patients were unable to achieve epithelialization more than one month after the occurrence of trophic ulcers. Results. According to the results of this study it was found that the use of sulodexide as an angiotropic agent having, among other things, anti-inflammatory effect on the vessel wall in patients with trophic ulcers formed after COVID-19-associated pneumonia is justified.Conclusions. The treatment of trophic defects of the lower limbs in patients with PTB after COVID-19-associated pneumonia has a number of regular features. Sulodexide showed high efficacy as an angiotropic agent, whose pharmacological properties are adequate to the pathogenesis of trophic ulcers taking into account the course of infection caused by SARS-CoV-2.