A case of effective treatment of a patient with COVID-19 complicated by bilateral pneumonia with damage to more than 60% of the lung tissue against a background of severe cardiovascular pathology

Sulyma, Volodymyr and Bidenko, Alla and Sulima, Olena (2021) A case of effective treatment of a patient with COVID-19 complicated by bilateral pneumonia with damage to more than 60% of the lung tissue against a background of severe cardiovascular pathology. In: International Symposium of Scientific Research and Innovative Studies, 22-25 February 2021. Bandirma Onyedi Eylul University, Bandirma, Turkey, pp. 2010-2018. ISBN 978‐625‐44365‐7‐4

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Abstract

Introduction. COVID-19 is a disease caused by a new coronavirus called SARS-CoV-2. WHO first became aware of this new WHO virus on 31 December 2019, when a cluster of viral pneumonia cases were reported in Wuhan, People's Republic of China. About 15% of patients develop a serious form of the disease, which requires oxygen therapy, and 5% - an extremely severe form that requires treatment in an intensive care unit. Fatal complications can occur, including respiratory failure, acute respiratory distress syndrome (ARDS), sepsis and septic shock, thromboembolism, and / or multiple organ failure, including heart, liver, or kidney damage. People aged 60 and over are at risk for severe disease, as well as people with underlying health conditions such as high blood pressure, heart and lung disease, diabetes, obesity, or cancer. However, the risk of contracting COVID-19 and severe illness or death affects everyone and is present in all age groups. Methods. The patient, a man of 60 years old, in his youth suffered from rheumatism with rheumatoid myocarditis, which developed later, suffers from arrhythmia with atrial fibrillation, and 8 months ago he underwent cardioversion-defibrillation with direct current and catheter ablation. Hospitalized with Covid-19, which was complicated by bilateral pneumonia affecting more than 60% of lung tissue, as confirmed by computed tomography, saturation average 92. With tachyarrhythmia’s arising from additional conduction pathways or ectopic foci of automatism, the lesion can be purposefully destroyed (removed) for the effectiveness of treatment. Prior to the application of energy, the ablation zones should be noted during the electrophysiological examination. Ablation efficiency is> 90% for reciprocal supraventricular tachycardia’s (atrioventricular [AV] - nodal or involving additional conduction pathways), focal atrial tachycardia’s, atrial flutter, focal idiopathic ventricular tachycardia’s (VT from the outlet tract of the right ventricular septum or along the legs of the bundle of His). Since atrial fibrillation (AF) is most often caused and / or maintained by arrhythmogenic zones in the pulmonary veins, this source can be electrically isolated by circumferential ablation of the pulmonary veins or in the left atrium. Transcatheter ablation is safe; the risk of death is higher with complex procedures. Mortality is <1/2000 with non-complex ablation procedures, but can be as high as 1/500 with pulmonary vein isolation during ablation for patients with atrial fibrillation or ventricular tachycardia. Complications include heart valve damage, pulmonary venous stenosis or occlusion (in the treatment of AF), stroke or other embolic complications, cardiac perforation, tamponade (1%), and unintentional ablation of the AV junction. The patient's operation was complicated by heart perforation. Results. Treatment of complications of Covid-19 for 7 days in the Department of Anesthesiology and Intensive Care with complex oxygen therapy, antibiotic therapy, cardiac drugs and hormones led to effective results and patient recovery.

Item Type:	Book Section
Uncontrolled Keywords:	Covid-19, Complication, Treatment.
Subjects:	Internal Medicine
Divisions:	Departments > Department of Surgery №1
Depositing User:	Елена Шрамко
Date Deposited:	07 Oct 2021 07:03
Last Modified:	07 Oct 2021 07:05
URI:	http://repo.dma.dp.ua/id/eprint/6969

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