grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2022-181-2-85-91grekov-1959Research ArticleОБЗОРЫREVIEWSПатологические изменения костно-суставной системы на фоне лекарственной терапии COVID-19 (обзор литературы)Pathological changes in the osteoarticular system during COVID-19 drug therapy (review of literature)https://orcid.org/0000-0001-8392-5380ЦедА. Н.TsedA. N.

Цед Александр Николаевич - доктор медицинских наук, профессор, руководитель 2-го травматолого-ортопедического отделения НИИ хирургии и неотложной медицины

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8

Tsed Alexandr N. - Dr. of Sci. (Med.), Professor, Head of the 2nd Traumatological and Orthopedic Department of the Research Institute of Surgery and Emergency Medicine

6-8, L’va Tolstogo str., Saint Petersburg, 197022

travma1@mail.ruhttps://orcid.org/0000-0002-7264-7861МуштинН. Е.MushtinN. E.

Муштин Никита Евгеньевич - кандидат медицинских наук, ассистент кафедры травматологии и ортопедии, врач – травматолог-ортопед 2-го травматолого-ортопедического отделения НИИ хирургии и неотложной медицины

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8

Mushtin Nikita E. - Cand. of Sci. (Med.), Assistant of the Department of Traumatology and Orthopedics, Orthopedic Traumatologist of the 2nd Traumatological and Orthopedic Department of the Research Institute of Surgery and Emergency Medicine

6-8, L’va Tolstogo str., Saint Petersburg, 197022

mushtin.nikita@yandex.ruhttps://orcid.org/0000-0003-4079-5541ДулаевА. К.DulaevA. K.

Дулаев Александр Кайсинович - доктор медицинских наук, профессор, заслуженный врач РФ, член АО «Травма России», руководитель отдела травматологии, зав. кафедрой травматологии и ортопедии

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8

Dulaev Alexandr K. - Dr. of Sci. (Med.), Professor, Honored Doctor of the Russian Federation, Member of AO Trauma Russia, Head of the Traumatology Department, Head of the Department of Traumatology and Orthopedics

6-8, L’va Tolstogo str., Saint Petersburg, 197022

akdulaev@gmail.comhttps://orcid.org/0000-0002-1181-6545ШмелевА. В.ShmelevA. V.

Шмелев Антон Владимирович - врач – травматолог-ортопед 2-го травматолого-ортопедического отделения НИИ хирургии и неотложной медицины

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8

Shmelev Anton V. - Orthopedic Traumatologist of the 2nd Traumatological and Orthopedic Department of the Research Institute of Surgery and Emergency Medicine

6-8, L’va Tolstogo str., Saint Petersburg, 197022

schmeljew@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И. П. Павлова» Министерства здравоохранения Российской ФедерацииРоссияPavlov UniversityRussian Federation20221404202218128591Copyright © Цед А.Н., Муштин Н.Е., Дулаев А.К., Шмелев А.В., 20222022Цед А.Н., Муштин Н.Е., Дулаев А.К., Шмелев А.В.Tsed A.N., Mushtin N.E., Dulaev A.K., Shmelev A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/1959

Рекомендуемые лекарственные препараты для лечения COVID-19 имеют, с одной стороны, экспериментальную направленность, но в то же время обладают множеством побочных эффектов, вызывающих отдаленные осложнения со стороны органов и систем, в том числе костно-суставной. Цель – на основании анализа современной отечественной и зарубежной литературы определить влияние не только новой коронавирусной инфекции COVID-19, но и используемых для ее лечения препаратов на костно-суставную систему человека. В процессе исследования был проведен научный поиск публикаций в электронных базах PubMed, MedLine и e-Library за период с января 2000 г. по октябрь 2021 г. по основным ключевым словам. В связи с последовательными «волнами» пандемии COVID-19 число пациентов, получающих неспецифическую терапию, включающую в себя глюкокортикостероиды (ГКС), в ближайшие годы будет увеличиваться. Предварительные данные о COVID-19 и аналогичных тенденциях при эпидемии Sars-COV-1 от 2003 г. показывают, что патогенез Sars-Cov-2 и ее лечение высокими дозами ГКС могут повышать риск остеонекроза у пациентов, что неизбежно приведет к росту ортопедических заболеваний у пациентов не только средневозрастной группы, но и у молодых пациентов в ближайшем будущем. В настоящее время требуются исследования, направленные на стратификацию рисков, изучение патогенеза поражения костно-мышечной системы после перенесенного COVID-19 и эффективности профилактических и терапевтических мероприятий у таких пациентов.

The recommended drugs for the treatment of COVID-19 are, on the one hand, experimental in nature, but at the same time, they have many side effects that cause long-term complications in organs and systems, including osteoarticular. Based on the analysis of modern domestic and foreign literature, to determine the effect of not only the new coronavirus infection COVID-19, but also the drugs used to treat it, on the human osteoarticular system. In the course of the study, a scientific search was made for publications in the electronic databases PubMed, MedLine and e-Library for the period from January 2000 to October 2021 for the main keywords. Due to successive “waves” of the COVID-19 pandemic, the number of patients receiving non-specific therapy, including corticosteroids, will increase in the coming years. Preliminary data on COVID-19 and similar trends during the Sars-COV-1 epidemic of 2003 show that the pathogenesis of Sars- Cov-2 and its treatment with high doses of corticosteroids may increase the risk of osteonercosis in patients, which will inevitably lead to an increase in orthopedic diseases in patients not only the middle age group, but also young patients in the near future. Currently, studies are required aimed at risk stratification, studying the pathogenesis of damage to the musculoskeletal system after COVID-19 and the effectiveness of preventive and therapeutic measures in such patients.

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The authors declare that there are no conflicts of interest present.