DOI: https://doi.org/10.22263/2312-4156.2024.1.58
M.K. Azaronak1, T.L. Alenskaya1, A.G. Nikalayeva1,2, T.D. Zhuk3
A randomized trial of the effectiveness of rehabilitation components and the level of cytokeratin 19 fragment (CYFRA 21-1) as a predictor of the development of interstitial pulmonary fibrosis in patients with a coronavirus infection
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2Vitebsk City Clinical Hospital No. 1, Vitebsk, Republic of Belarus
3Vitebsk State University named after P.M. Masherov, Vitebsk, Republic of Belarus
Vestnik VGMU. 2024;23(1):58-67.
Abstract.
30 patients who suffered coronavirus infection and were selected according to the inclusion criteria, were randomly divided into three groups in order to study the clinical effectiveness of rehabilitation components such as kinesiology taping, hypobaric pressure chamber adaptation, and their combination. The effectiveness was evaluated by clinical and statistical methods, as well as by filling in questionnaires, performing functional tests, and assessing the level of cytokeratin 19 fragment (CYFRA 21-1) in the blood serum. All components of rehabilitation demonstrated relatively high efficiency, regardless of the duration of the infection, which led to an improvement in the patients life quality. The concentration of cytokeratin 19 fragment (CYFRA 21-1) >1.5 ng/ml during the rehabilitation period up to 60 days and the rehabilitation period during 180-360 days indicates the severity of the infection, and its fluctuations >1 ng/ml may testify to the reversibility of interstitial pulmonary fibrosis or be a predictor of an increase in pulmonary symptoms and require further study.
Keywords: coronavirus infection, post-COVID syndrome, peri-COVID period, rehabilitation, cytokeratin-19 fragment, interstitial pulmonary fibrosis, hypobaric pressure chamber adaptation, kinesiotaping.
References
1. Alison EJ, Chitra J, Gisli J, Tatler AL. COVID19 and pulmonary fibrosis: A potential role for lung epithelial cells and fibroblasts. Immunol Rev. 2021 Jul;302(1):228-40. doi: http://dx.doi.org/10.1111/imr.12977
2. Townsend L, Dowds J, O'Brien K, Sheill G, Dyer AH, O'Kelly B, et al. Persistent Poor Health after COVID-19 Is Not Associated with Respiratory Complications or Initial Disease Severity. Ann Am Thorac Soc. 2021 Jun;18(6):997-1003. doi: http://dx.doi.org/10.1513/AnnalsATS.202009-1175OC
3. Zolotnitskaya VP, Speranskaya AA, Kuzubova NA, Titova ON, Amosova OV. Long-term effects of COVID-19 in patients as measured by lung function-radiation studies. RMZh Med Obozrenie. 2022;6(7):360-6. (In Russ.). doi: http://dx.doi.org/10.32364/2587-6821-2022-6-7-360-366
4. Vorobyev PA. Recommendations for the management of patients with COVID-19 coronavirus infection in the acute phase and with postcovid syndrome on an outpatient basis. Problemy Standartizatsii Zdravookhranenii. 2021;(7-8):3-96. (In Russ.). doi: http://dx.doi.org/10.26347/1607-2502202107-08003-096
5. National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN). COVID-19 rapid guideline: managing the longterm effects of COVID-19. Available from: https://www.nice.org.uk/guidance/ng188. [Accessed 21th March 2024].
6. Proal1 AD, VanElzakker MB. Long COVID or Post-acute Sequelae of COVID-19 (PASC): An Overview of Biological Factors That May Contribute to Persistent Symptoms. Front Microbiol. 2021 Jun 23:12:698169. doi: http://dx.doi.org/10.3389/fmicb.2021.698169
7. Kiener M, Roldan N, Machahua C, Sengupta A, Geiser T, Guenat OT, et al. Human-Based Advanced in vitro Approaches to Investigate Lung Fibrosis and Pulmonary Effects of COVID-19. Front Med (Lausanne). 2021 May;8:644678. doi: http://dx.doi.org/10.3389/fmed.2021.644678
8. Bilichenko TN. Postcovoid syndrome: risk factors, pathogenesis, diagnosis and treatment of patients with respiratory damage after COVID-19 (research review). Rus Med Zhurn. 2022;6(7):367-75. (In Russ.). doi: http://dx.doi.org/10.32364/2587-6821-2022-6-7-367-375
9. Farghaly S, Badedi M, Ibrahim R, Sadhan MH, Alamoudi A, Alnami A, et al. Clinical characteristics and outcomes of post-COVID-19 pulmonary fibrosis. A case-control study. Medicine (Baltimore). 2022 Jan;101(3):e28639. doi: http://dx.doi.org/10.1097/MD.0000000000028639
10. Zou JN, Sun L, Wang BR, Zou Y, Xu S, Ding YJ, et al. The characteristics and evolution of pulmonary fibrosis in COVID-19 patients as assessed by AI-assisted chest HRCT. PLoS One. 2021 Mar;16(3):e0248957. doi: http://dx.doi.org/10.1371/journal.pone.0248957
11. Ambardar SR, Hightower SL, Huprikar NA, Chung KK, Singhal A, Collen JF. Post-COVID-19 Pulmonary Fibrosis: Novel Sequelae of the Current Pandemic. J Clin Med. 2021 Jun;10(11):2452. doi: http://dx.doi.org/10.3390/jcm10112452
12. Molyneaux PL, Fahy WA, Byrne AJ, Braybrooke R, Saunders P, Toshner R, et al. CYFRA 21-1 Predicts Progression in Idiopathic Pulmonary Fibrosis: A Prospective Longitudinal Analysis of the PROFILE Cohort. Am J Respir Crit Care Med. 2022 Jun 15;205(12):1440-8. doi: http://dx.doi.org/10.1164/rccm.202107-1769OC
13. Chang CH, Juan YH, Hu HC, Kao KC, Lee CS. Reversal of lung fibrosis: An unexpected finding in survivor of acute respiratory distress syndrome. QJM. 2018 Jan;111(1):47-8. doi: http://dx.doi.org/10.1093/qjmed/hcx190
14. Noble PW, Barkauskas CE, Jiang D. Pulmonary fibrosis: Patterns and perpetrators. J Clin Invest. 2012 Aug;122(8):2756-62. doi: http://dx.doi.org/10.1172/JCI60323
15. Nikolaeva AG. The use of adaptation to hypoxia in medicine and sports. Vitebsk: VGMU; 2015. 150 р. (In Russ.)
16. Olenskaya TL, Nikolaeva AG, Azarenok MK, Yukhno YuS, Shishko OI. Components of outpatient and home-based medical rehabilitation for older people after suffering from COVID-19 pneumonia. Retsept. 2021;24(2):247-60. (In Russ.)
17. Kołodziej M, Wyszyńska J, Bal-Bocheńska M. COVID-19: A New Challenge for Pulmonary Rehabilitation? J Clin Med. 2021 Jul;10(15):3361. doi: http://dx.doi.org/10.3390/jcm10153361
Information about authors:
M.K. Azaronak – lecturer of the Chair of Medical Rehabilitation with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University,
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Marina K. Azaronak;
T.L. Alenskaya – Doctor of Medical Sciences, associate professor, head of the Chair of Medical Rehabilitation with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University;
A.G. Nikalayeva –Candidate of Medical Sciences, associate professor of the Chair of Medical Rehabilitation with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University; head of the department of hypobaric therapy and baroclimatic adaptation, Vitebsk City Clinical Hospital No. 1;
T.D. Zhuk – lecturer of the Chair of Applied and Systems Programming, Vitebsk State University named after P.M. Masherov.
