Abstract. The healthcare sector is faced with the need to find new innovative and multidisciplinary approaches for the prevention and treatment of Covid, post-Covid, long-Covid, chronic, comorbid disorders. The results of 30 years of experience in the use of halotherapy in the treatment of pulmonary pathology indicate that the authors of the article have established the optimal level of use of halotherapy in pathological pulmonary
processes. At the same time, clinical experience provides evidence for the optimal method of using
the halotherapy method in pulmonary nosologies. The method of using salt therapy in exudative
pleurisy, in fibrinous pleurisy, in fibrotic processes in the lungs has been theoretically substantiated,
developed, and implemented in clinical practice. It has been proven that halotherapy is an effective
treatment method for bronchial asthma, chronic obstructive pulmonary diseases, acute respiratory
viral infections, fibrinous and exudative pleurisy. The therapeutic effect of this method is observed only when using halogenerators with the ability to grind salt in the range of 1-5 microns. Halotherapy sessions in patients with bronchial asthma with mild and moderate severity lead to the development of nonspecific hyposensitization, which in turn provides long-term remission of attacks and reduces the need for
glucocorticosteroid drugs. Halotherapy has a confirmed immunomodulatory effect and activates local and T-cell immunity. It requires further study of the experience of halotherapy, conducting marketing, pharmacoeconomic and comparative analysis.
Keywords: halotherapy, pulmonary pathologies, thoracic pathology, bronchial asthma, fibrinous
pleurisy, post-covid syndrome, patient.
УДК 616.24-002-053.2:578.834](0.083.96)
Objective — to determine the features of pathogenesis in patients with the pulmonary form of SARS-CoV-2. To establish, based on clinical examination data and electron microscopy, that vasculitis of the respiratory
system is the main pathophysiological and pathomorphological factor in lung tissue damage in COVID-19.
Materials and methods. A total of 692 patients aged 18 to 73 years with severe SARS-CoV-2 were examined. The control group consisted of 50 patients (25 women and 25 men) aged 25—70 years with a moderately severe clinical course of SARS-CoV-2. 58 patients underwent immunological tests, which included the study of O-lymphocytes and D-lymphocytes, circulating small and large immune complexes. A group of 30 people who died of COVID-19 pneumonia underwent a pathohistological examination of tissue samples. A group of 10 people who died of COVID-19 pneumonia underwent electron microscopic examination of tissue samples.
Results and discussion. Immunological examination revealed an increase in the number of O-lymphocytes (53.3 ± 1.3), an increase in the number of D-lymphocytes (4.9 ± 0.7), which highlights the impairment of T-cells of immunity; the predominance of the total mass of an increased level of small CICs (71.3 ± 2.5), which indicates a particularly «malignant» autoimmune component with damage to the connective tissue structure, primarily the vessels of the lungs, and therefore the vessels of epithelial organs, and an increase in the number of large CICs, which explains the material basis of allergic complications that accompany the severe course of
SARS. Ultrastructural electron microscopic examination of the respiratory tract of patients who died from respiratory failure in COVID-19 revealed the development of degenerative changes in the capillaries and endothelium, characterised by the expansion of the tubules of the granular endoplasmic reticulum, the destruction of ribosomes, the appearance of vacuoles in the cytoplasm surrounded by a double-contour membrane and containing small virion-like bodies, the basement membrane of haemocapillaries was hetero-geneously thickened. The development of venulitis was recorded, which is characterised by the accumulation of neutrophils in the vessel wall, pronounced degenerative changes in the endothelium, accompanied by the
destruction of cytoplasmic organelles, vacuolisation of the cytoplasm and its heterogeneous osmophilia, the appearance of heterogeneous microvilli on the lumenal surface of the endothelium, and heterogeneous thickening of the cytoplasmic membrane. Ultrastructural changes in the vascular endothelium in COVID-19 indicate the primary occurrence of acute vasculitis as a pathogenetic dominant in COVID-19 pneumonia. Conclusions. Clinical manifestations and ultrastructural pathomorphological studies conducted by us reliably indicate that the primary pathogenetic basis of atypical pneumonia in COVID-19 syndrome is the occurrence of acute vasculitis with predominant damage to the vessels of the pulmonary system. The
«malignant» course of COVID-19 syndrome involves the transformation of acute vasculitis into systemic vasculitis with subsequent unpredictable damage to a number of systems (respiratory, cardiovascular, hepatobiliary, genitourinary).
Keywords SARS-CoV-2, COVID-19, vasculitis, pneumonia, pulmonary system, coronavirus infection, pathomorphology, electron microscopic changes, fatalities, forensic medicine.
УДК 615.07:543.544.3:547.856.1
УДК 615.9:616.36:577.112.7(043.3)
УДК 615.214.24:340.67