The effectiveness of antihypoxic and cardioprotective drug in the rehabilitation of patients with COVID-19 associated pneumonia

The ability to recover from SARS-CoV-2 depends on the patient's rehabilitation potential and the degree of hypoxia. The possibility of improving the effectiveness of rehabilitation in patients on medications with antihypoxic and cardioprotective properties is relevant and requires study.

To study the effectiveness of rehabilitation in patients with COVID-19 pneumonia who were taking phosphocreatine sodium salt.

46 patients 63±25 years old, including 26 men and 20 women, who underwent COVID-19 associated pneumonia with 60±10% lung damage and were discharged from the hospitals for infectious diseases 14.6±5 days ago. According to recommendations of the European Respiratory Society for the 2nd stage of SARS-CoV-2 rehabilitation from 2021, all patients also received breathing exercises and physical therapy. 15 patients, out of 46, received a phosphocreatine sodium 2 g per100mL of saline once per day for 10 days. The duration of the entire rehabilitation was 21 days. The following instrumental examinations were performed: 24-hour Holter ECG monitoring, spiroergometry, and spirometry. For functional assessment and monitoring of patients, the following scaled were used: Borg rating of perceived exertion for dyspnea and fatigue, Hospital Anxiety and Depression Scale (HADS), and the EQ-5D Health-Related Quality of Life Questionnaire.

The following differences were obtained between groups 1 and 2: In group 1, the frequency of supraventricular rhythm disorders (premature supraventricular contractions (PSC) more often than 5000 per day and supraventricular tachycardia (SVT) or atrial tachycardia more than 5 complexes with a heart rate of 120-170 per minute) was 51±6%, whereas in group 2, 19± 5% (P<0.05). The frequency of ventricular heart rhythm disturbances (premature ventricular contractions more than 5000 per day) in group 1 was 20±7%, whereas in group 2, 9±3 (P <0.05). The workload increased from 2.2 ± 0.7 up to 4.1 ± 2.0 MET and from 2.2±0.5 to 5.2±1.2 MET in 1 and 2 groups accordingly. Rating of perceived exertion decreased from 9±2.8 to 4 ±1.4 points in 1 group and from 8.1±1.8 to 2±0.8 points in 2 group. The quality of life increased from 11±3.2 to 6±3.4 points and from 12±2.7 to 1.5±1.2 points. p<0.05.

For the rest of the indicators, there was a positive trend. However, there were no significant differences between groups 1 and 2, p>0.05. For groups 1 and 2, it was, respectively, tidal volume increased from 26±7.0 to 49±8.4 ml/kg, and from 25±6.0 to 52±6.5 ml/kg; anxiety decreased from 10±2 to 4±1.8 and from 10±1.0 to 2±2.0 points; depression decreased from 11±3.0 to 5±2.0 and from 11±0.5 to 4±2.0 points.

Drug with antihypoxic and cardioprotective properties can significantly increase the effectiveness of rehabilitation in patients with COVID-19, reduce the incidence of ventricular and supraventricular heart rhythm disorders, and increase the degree of physical recovery.