- Konstantin Sergeevich, according  to UK doctors, up to half of patients who have had COVID-19 need medication and monitoring even after discharge. What is the situation with the rehabilitation of such patients in Russia?

- Among the lightly ill, and these are mainly young people, patients with damage to lung tissue 10-15%. In general, as a result of coronavirus disease, from 30% or more patients with one or another manifestation of respiratory failure, with damage to lung tissue, get to the hospital.

The severity of the injury can be very severe. According to CT data, in our patients on rehabilitation, it can reach 90% of the lungs at the peak. Some spend at least a month in the hospital, taking the hardest drugs.

  • In patients undergoing rehabilitation, lung damage at peak can be as high as 90%
  • Reuters
  • © Kirill Zykov / Moscow News Agency

People of age with concomitant diseases also require further rehabilitation, observation and compensation for the problems that have arisen. COVID-19 does not go away like ordinary pneumonia, when you got sick, got up and went on. Often, the disease is associated with severe intoxication of the body and a high temperature, which does not decrease in any way. All these are colossal health losses.

- Does “frosted glass” - the tissue of the lung damaged by a virus - always scar? After all, fibrosis is a serious problem - a scar that remains for life. What are the ways to restore lung function?

- Indeed, "frosted glass" appears in viral pneumonia. To reduce scarring during rehabilitation, patients take special medications. Laser exposure is also possible. A scar is a tissue that grows over the course of a year. It needs to be influenced in a timely manner. After a year, it becomes white and hard, nothing else can be done with it. It can be cut on the skin, but not in the lungs.

Therefore, rehabilitation is aimed at reducing the intoxication of the body and at combating the manifestation of fibrosis. Another technique is to use the spare parts of the lungs, their tops. We have all the organs and systems created with a margin just for such a case. The tops are underdeveloped because they are rarely used by anyone. And we teach this, give patients special exercises to develop the right muscles and teach them how to breathe differently.

These are special breathing exercises, physiotherapy exercises aimed at the formation of a new breathing pattern. In this way, up to 10% of the lung volume can be compensated, but not more.

  • In rehabilitation after COVID-19, special breathing exercises and physiotherapy exercises are used, aimed at forming a new breathing pattern
  • RIA News
  • © Ilya Pitalev

- Earlier, the Minister of Health Mikhail Murashko said that those who have had COVID-19 may face heart problems. In particular, people who have been ill may develop myocarditis. Is it true that thrombus formation increases, the risk of heart attacks and strokes increases?

- We already know that many organs have receptors for this virus. They are found in the pancreas, in the heart, in the tissues of the testicle. There is also a violation in the blood coagulation system. Therefore, patients take anticoagulants - blood thinning drugs. The need for taking vitamin K has been proven, which is involved in the coagulation system. Otherwise, strokes and heart attacks, brain are possible.

Why else is it so important to self-isolate? On a stream, when, for example, five thousand people per night are admitted, doctors may simply not have time to figure out the possible contraindications of the prescribed drugs. During a pandemic, there have been known deaths associated with the prescription of cardiotoxic drugs to people with chronic heart disease. At the peak of morbidity we have "military field surgery", and the losses are much higher. Therefore, remember that nothing is over yet. Until an affordable and effective vaccine is available, keep your distance, wash your hands and wear masks in public. 

- How much more problems with other organs and body systems have become?

- Recently, at one of the interdisciplinary conferences, it was reported that the receptors on which the virus lands are present in many organs. Lungs are not even in the first place in terms of the number of these receptors, but the most critical manifestation in coronavirus infection is just pulmonary pneumonia. It is she who sharply worsens the human condition. We do not know enough about what happens to other organs.

- How is COVID-19 related to endocrine disruption?

- The course of diabetes mellitus is getting worse. As a result of the previous infection, signs of type 2 diabetes mellitus often appear. There is a direct lesion of the pancreas. Indirectly, that is, through the same microthrombosis, damage to various organs is possible. Through cardiotoxic drugs, through antibiotics, there is an effect on the kidneys and liver.

- What mental and neurological disorders are associated with coronavirus disease?

- Depression, apathy and asthenic syndrome, that is, neuropsychic exhaustion, are common. Many families get sick, someone dies. Post-traumatic disorder manifests itself.

Such a long-term illness is associated with social problems. Even if no one has died, you have to be very optimistic in order to enjoy life after a month of being in a serious condition under the influence of a large number of drugs. Therefore, our team always includes a psychologist and a neurologist. We select medicines for depression, provide moral and psychological support to the patient. We do not abandon people, there are repeated, control visits, support groups, feedback.

- Chinese urologists recommend that young men undergo a fertility test after coronavirus. So there is a connection between coronavirus and men's health?

- COVID-19 is directly related to men's health. There are more receptors for the virus in the tissues of the testicle than in the tissues of the lung. The function of the organ is disrupted. Therefore, the recommendations of the Chinese experts are quite reasonable.

- The possibility of the arrival of the so-called second wave is being actively discussed. When to expect it, is the Russian healthcare system ready for such a test?

- Now I'm ready. Hospitals have been built, a huge number of beds deployed. There is personal combat experience, not Italian or Chinese. Trial and error has been made.

  • Rehabilitologist K.S. Ternovoy believes the Russian healthcare system is ready for a possible second wave of the COVID-19 pandemic
  • Reuters
  • © Maxim Shemetov

As for the second wave, it must be borne in mind that the disease is seasonal. The comfortable temperature for the reproduction of the virus is 8.5 ° C. We will have such weather by the beginning of October.

- In your opinion, is re-infection possible?

- Our research horizon is not very long yet - six months. The immune system cannot give answers so quickly.

Those who are already in rehabilitation have different amounts of antibodies. And it depends on the state of the immune system and on the viral load.