medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2021-4-56-63medalphabet-1922Research ArticleСтатьиРоль фармако- и микронутриентов в нутритивно-метаболической терапии COVID-19 и других вирусных инфекцийRole of pharmaco- and micronutrients in nutritional metabolic therapy of COVID-19 and other viral infectionsДмитриевА. В.DmitrievA. V.

 Дмитриев Александр Владимирович 

Санкт-Петербург

 Dmitriev Alexander V. 

Saint Petersburg

МачулинаИ. А.MachulinaI. A.

 Мачулина Ирина Александровна 

Москва

 Machulina Irina A. 

Moscow

ШестопаловА. Е.ShestopalovA. E.

 Шестопалов Александр Ефимович 

Москва

 Shestopalov Alexander E. 

Moscow

ashest@yandex.ruАссоциация «Северо-Западная ассоциация парентерального и энтерального питания»РоссияNorth-Western Association for Parenteral and Enteral NutritionRussian FederationГБУЗ «Городская клиническая больница № 70 имени Е.О. Мухина Департамента здравоохранения города Москвы»РоссияCity Clinical Hospital No. 70 n.a. E.O. MukhinaRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного последипломного образования» Минздрава России; 3ФГБУ «Главный военный клинический госпиталь имени академика Н.Н. Бурденко» Минобороны РоссииРоссияRussian Medical Academy for Postgraduate Continuous Education; Main Military Clinical Hospital n.a. N.N. Burdenko of the Ministry of Defense of RussiaRussian Federation20212603202104Кардиология и неотложная медицина (1)5663Copyright © Дмитриев А.В., Мачулина И.А., Шестопалов А.Е., 20212021Дмитриев А.В., Мачулина И.А., Шестопалов А.Е.Dmitriev A.V., Machulina I.A., Shestopalov A.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/1922

Недостаточность питания является неблагоприятным фоном для течения и исхода вирусных заболеваний, включая COVID-19. В соответствии с международными рекомендациями своевременная коррекция нутритивного статуса с помощью перорального, зондового энтерального и парентерального питания является необходимым и обязательным методом сопроводительной терапии COVID-19. Выполнен аналитический обзор результатов исследований клинического применения фармаконутриентов (глутамин; витамины А, С, D и Е; цинк, селен) с целью профилактики и лечения вирусных инфекций, включая COVID-19. В соответствии с данными клинических исследований, выполненных в 2019–2020 годах, применение глутамина и антиоксидантных микронутриентов в составе нутритивно-метаболической терапии позволяет снизить выраженность клинических симптомов и ускорить процесс восстановление пациентов с новой коронавирусной инфекцией COVID-19 и другими вирусными заболеваниями. С практической точки зрения, единственными источниками глутамина для энтерального введения, зарегистрированными в РФ, являются Глутамин Плюс для перорального энтерального питания и Интестамин для зондового энтерального введения, Дипептвен 20% – для парентерального введения. Применение фармаконутритивной терапии, в частности энтерального глутамина как компонента клинического питания у пациентов с вирусными инфекциями и нутритивной недостаточностью или риском ее развития, способствует улучшению клинических результатов, снижению тяжести течения заболевания и ускорению процесса реабилиитации.

Malnutrition is an unfavorable background for the course and outcome of viral diseases, including COVID-19. In accordance with international recommendations, timely correction of nutritional status using oral, tube enteral and parenteral nutrition is a necessary and mandatory method of concomitant therapy for COVID-19. An analytical review of the results of studies on the clinical use of pharmacological nutrients (glutamine; vitamins A, C, D, E; zinc, selenium) for the prevention and treatment of viral infections, including COVID-19, was performed. According to the data of clinical studies carried out in 2019–2020, the use of glutamine and antioxidant micronutrients as part of nutritional metabolic therapy can reduce the severity of clinical symptoms and accelerate the recovery process of patients with the new coronavirus infection COVID-19 and other viral diseases. From a practical point of view, the only sources of glutamine for enteral administration registered in the Russian Federation are Glutamine Plus for oral enteral nutrition and Intestamin for enteral tube administration and Dipeptiven 20% for parenteral nutrition. The use of pharmacological nutritional therapy, in particular, enteral or parenteral glutamine as a component of clinical nutrition in patients with viral infections and nutritional deficiency or the risk of its development, helps to improve clinical results, reduce the severity of the disease and accelerate the rehabilitation process.

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