Взгляд на патогенез постковидного синдрома

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Аннотация

В 2023 году пандемия новой коронавирусной инфекции, вызванной коронавирусом SARS-CoV-2, объявлена Всемирной организацией здравоохранения закончившейся. По-видимому, она перешла в разряд сезонных респираторных вирусных инфекций. Среди оставшихся после окончания пандемии проблем одно из ведущих мест занимает постковидный синдром — состояние, связанное с сохранением симптомов COVID-19 или вновь появившимися симптомами через 3 месяца после перенесённого заболевания. Наиболее общими механизмами при постковидном синдроме считаются иммунная дисрегуляция, персистенция вируса, продолжающееся генерализованное воспаление, аутоиммунные проявления, тромбозы и повреждение эндотелия сосудов, миокардиты, инфаркты миокарда, ишемическая болезнь, фиброз лёгких. Серьёзным аутоиммунным проявлением у больных с постковидным синдромом выступает высокая частота появления аутоантител, в том числе аутоантител к интерферонам, которые способны блокировать биологическую активность этих защитных цитокинов. В результате сочетанного действия данных механизмов возникает широкий спектр осложнений со стороны многих органов и систем организма, в том числе неврологических и нейропсихических осложнений. Точные патофизиологические механизмы постковидного синдрома и их причинно-следственные связи ещё предстоит установить. Это нужно для того, чтобы на основании накопленного опыта быть готовыми к новым возможным инфекционным вызовам, подойти к ним во всеоружии, избежать новых жертв. В обзоре рассмотрены вопросы симптоматики и патогенеза постковидного синдрома.

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Об авторах

Николай А. Климов

Институт экспериментальной медицины

Email: nklimov@mail.ru
ORCID iD: 0000-0002-5243-8085
SPIN-код: 6093-7430

канд. мед. наук

Россия, Санкт-Петербург

Андрей С. Симбирцев

Институт экспериментальной медицины; Государственный научно-исследовательский институт особо чистых биопрепаратов

Автор, ответственный за переписку.
Email: simbas@mail.ru
ORCID iD: 0000-0002-8228-4240
SPIN-код: 2064-7584

д-р мед. наук, профессор, член-корреспондент РАН

Россия, Санкт-Петербург; Санкт-Петербург

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