Features of the third stage of pulmonary rehabilitation of patients with chronic bronchoobstructive pathology who have suffered from coronavirus pneumonia

Background. In patients with bronchoobstructive pathology (BP), coronavirus infection (CI) can lead to an exacerbation of the underlying disease or increase its severity. Therefore, conducting research in long-term cases of CI on BP is relevant and requires an analysis of the effectiveness of various methods of a pulmonary rehabilitation. Aim. To determine optimal approaches to medical pulmonary rehabilitation in patients with chronic BP who suffered pneumonia associated with COVID-19. Materials and methods. Thirty four patients who suffered coronavirus pneumonia were included. Of these, 21 people had bronchial asthma, 13 had COPD. 18 patients received a course of pulmonary rehabilitation and formed the main group (MG); the remaining 16 patients, without pulmonary rehabilitation, were included in the comparison group (CG). Investigations such as markers of inflammation; indicators of thromboembolic complications, humoral immunity; functional indicators of external respiration, CT-scan of the lungs, international questionnaires were performed twice: at baseline and after 3 months. Results. In patients with MG, unlike CG, the total number of leukocytes and lymphocytes decreased by 2.4 times; ESR normalized, C-reactive protein decreased by 24%. D-dimer and fibrinogen levels came to the reference values. IgA in the main group increased by 1.83 times (p0.001). In patients with MG, the dyspnea index according to mMRS decreased by 0.65 points (p0.001), CAT-test – by 1.28 (p0.001). The average volume of lung tissue damage in the MG changed from 43.5% (±10.1) to 16% (±9.21) (p0.001), and in the CG changed from 39.6% (±8.87) to 37.8% (±7.24). In the main group, vital capacity and FEV1 increased by 1.5 times (p0.001) compared to the control group. Conclusion. The course of pulmonary rehabilitation turned out to be effective: patients showed positive dynamics in terms of blood test parameters, humoral immunity, external respiration function, and their quality of life improved and the risk of developing pulmonary fibrosis has decreased.