Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC140210.15690/vramn1402INFECTIOUS DISEASES: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ ИНФЕКЦИОННЫХ БОЛЕЗНЕЙReview ArticleConceptual approaches to finding effective treatment for a new coronavirus infection at different stagesКонцептуальные подходы к поиску эффективного лечения новой коронавирусной инфекции на разных этапахhttps://orcid.org/0000-0003-4251-75456609-5468KamalovArmais A.КамаловАрмаис Альбертович
Russian Federation

MD, PhD, Professor, Academician of the RAS

д.м.н., профессор, академик РАН

priemnaya@mc.msu.ruhttps://orcid.org/0000-0002-7285-2048554108739009465-8979MareevViacheslav Y.МареевВячеслав Юрьевич
Russian Federation

MD, PhD, Professor

д.м.н., профессор

prof_mareev@ossn.ruhttps://orcid.org/0000-0002-8160-5612245034603003153-8373OrlovaIana A.ОрловаЯна Артуровна
Russian Federation

MD, PhD, Associate Professor

д.м.н., доцент

5163002@bk.ruhttps://istina.msu.ru/profile/YAOrlova@mc.msu.ru/Medical Research and Educational Center of Lomonosov Moscow State UniversityМедицинский научно-образовательный центр МГУ имени М.В. Ломоносова1204202176143502107202030122020Copyright ©; 2021, "Paediatrician" Publishers LLCCopyright ©; 2021, Издательство "Педиатръ"2021"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/article/view/1402

The article attempts to analyze the change in philosophy in approaches to the treatment of COVID-19 that have occurred in recent months, based on published research and their own experience in the treatment of a new coronavirus infection at the medical research and education center of Moscow state University. Emphasis is placed on the rationale for the phased use of different types of therapy. The reasons for using spironolactone in patients with COVID-19 as a drug for etiotropic and pathogenetic therapy are discussed in detail. The authors conclude that the use of antiviral drugs in combination with drugs that prevent the entry of the SARS-CoV-2 virus into cells from the first days of the disease should be supplemented with pre-emptive anti-inflammatory therapy that interrupts the progression of the disease. The parallel use of anticoagulants that reduce the risk of thrombotic and thromboembolic complications.

В статье проведена попытка проанализировать изменение философии в подходах к лечению COVID-19, которые произошли в течение последних месяцев, на основе опубликованных научных исследований и собственного опыта лечения новой коронавирусной инфекции в Медицинском научно-образовательном центре МГУ (МНОЦ МГУ), который в разгар эпидемии работал как «COVID-госпиталь». Делается акцент на обосновании этапного использования разных видов терапии. Подробно обсуждаются основания для применения у пациентов с COVID-19 спиронолактона как препарата для этиотропной и патогенетической терапии. Авторы приходят к выводу, что применение с самых первых дней болезни противовирусных препаратов в комбинации с препаратами, препятствующими входу вируса SARS-CoV-2 в клетки, должно быть дополнено упреждающей противовоспалительной терапией, прерывающей прогрессирование болезни, и параллельным использованием антикоагулянтов, снижающих риск тромботических и тромбоэмболических осложнений.

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