problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl12376problendo-12376Research ArticleПроблемы организации эндокринологической службы и преподавания эндокринологииEndocrinology healthcare network and professional educationПандемия COVID-19 и эндокринопатииCOVID-19 pandemic and endocrinopathieshttps://orcid.org/0000-0002-9717-9742МокрышеваНаталья ГеоргиевнаMokryshevaNatalia G.

д.м.н., исполнительный директор

MD, PhD

nm70@mail.ruhttps://orcid.org/0000-0001-6581-4521ГалстянГагик РадиковичGalstyanGagik R.

д.м.н., профессор

MD, PhD, Professor

galstyangagik964@gmail.comКиржаковМихаил АнатольевичKirzhakovMichael A.

врач-эпидемиолог

epidemiologist

kirzhakovma@mail.ruhttps://orcid.org/0000-0001-6667-062XЕремкинаАнна КонстантиновнаEremkinaAnna K.

к.м.н., и.о. зав. отделением патологии околощитовидных желез

PhD

a.lipatenkova@gmail.comhttps://orcid.org/0000-0001-6539-466XПигароваЕкатерина АлександровнаPigarovaEkaterina A.

к.м.н.

MD, PhD

kpigarova@gmail.comhttps://orcid.org/0000-0002-5634-7877МельниченкоГалина АфанасьевнаMelnichenkoGalina A.

доктор медицинских наук, профессор, академик РАН, директор института Клинической эндокринологии

MD, PhD, Professor

teofrast2000@mail.ruНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian FederationНаучный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian Federation202004082020661713Copyright © Мокрышева Н.Г., Галстян Г.Р., Киржаков М.А., Еремкина А.К., Пигарова Е.А., Мельниченко Г.А., 20202020Мокрышева Н.Г., Галстян Г.Р., Киржаков М.А., Еремкина А.К., Пигарова Е.А., Мельниченко Г.А.Mokrysheva N.G., Galstyan G.R., Kirzhakov M.A., Eremkina A.K., Pigarova E.A., Melnichenko G.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.probl-endojournals.ru/jour/article/view/12376

Большинство заболеваний эндокринной системы имеет хроническое течение, до 80% случаев приходится на пациентов с эндокринопатиями, в первую очередь сахарным диабетом и заболеваниями щитовидной железы, получающих регулярную амбулаторную помощь. Для таких людей эндокринолог является чаще всего и врачом общей практики, поэтому именно на них ложится ответственность – оперативно разъяснить пациентам с диабетом, заболеваниями щитовидной железы, гипофиза и надпочечников, опухолями эндокринной системы, как вести себя в новых условиях пандемии коронавирусной болезни (COVID-19). Тяжелее всего это инфекционное заболевание протекает у лиц старше 65 лет, имеющих хронические заболевания, особенно эндокринопатии. Данный обзор литературы суммирует имеющиеся на сегодня сведения о патогенезе и течении COVID-19, в том числе в наиболее уязвимых группах. В статье представлена актуальная информация о мерах профилактики заражения, особенностях контакта «пациент–врач» в условиях самоизоляции и карантинных мероприятий, а также о том, какие дополнительные лечебные мероприятия необходимы при развитии COVID-19 у пациентов с наиболее тяжелыми эндокринопатиями.

Many endocrinopathies have chronic course; patients with endocrinopathies (above all diabetes mellitus and thyroid diseases) who receive outpatient care on a regular basis amount up to 80% of patients with chronic diseases. Endocrinologists most likely play the role of general practitioners for these patients; therefore, they should quickly and efficiently explain the patients with diabetes, thyroid, hypophysis and adrenal diseases how to behave in new setting of COVID19 pandemic (coronavirus infection). The most severe course of the infection can be observed in patients older than 65 years with chronic diseases, especially endocrinopathies. This review sums up the currently available data on the disease pathogenesis and progression. It also provides information about patient responsibility to prevent infection, special aspects of communication between the patient and the physician in the setting of self-isolation and quarantine, additional care needed in case of COVID19 in patients with most severe endocrinopathies.

COVID-19SARS-CoV-2эндокринопатиясахарный диабетсамоизоляциятелемедицинадистанционное консультированиеCOVID-19SARS-CoV-2endocrinopathydiabetes mellitusisolationtelemedicinedistance counselingReferencesCascella M, Rajnik M, Cuomo A, et al. Features, evaluation and treatment coronavirus (COVID-19). StatPearls; 2020. Available from: https://www.statpearls.com/kb/viewarticle/52171.Cascella M, Rajnik M, Cuomo A, et al. Features, evaluation and treatment coronavirus (COVID-19). StatPearls; 2020. Available from: https://www.statpearls.com/kb/viewarticle/52171.Surveillances V. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) − China, 2020. China CDC Weekly. 2020;2(8):113−122.Surveillances V. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) − China, 2020. China CDC Weekly. 2020;2(8):113−122.Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270–273. doi: https://doi.org/10.1038/s41586-020-2012-7.Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270–273. doi: https://doi.org/10.1038/s41586-020-2012-7.Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271−280.e8. doi: https://doi.org/10.1016/j.cell.2020.02.052.Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271−280.e8. doi: https://doi.org/10.1016/j.cell.2020.02.052.Simões e Silva AC, Silveira KD, Ferreira AJ, Teixeira MM. ACE2, angiotensin-(1-7) and mas receptor axis in inflammation and fibrosis. Br J Pharmacol. 2013;169(3):477–492. doi: https://doi.org/10.1111/bph.12159.Simões e Silva AC, Silveira KD, Ferreira AJ, Teixeira MM. ACE2, angiotensin-(1-7) and mas receptor axis in inflammation and fibrosis. Br J Pharmacol. 2013;169(3):477–492. doi: https://doi.org/10.1111/bph.12159.Cheng H, Wang Y, Wang GQ. Wang, organ-protective effect of angiotensin-converting enzyme 2 and its effect on the prognosis of COVID-19. J Med Virol. 2020. doi: https://doi.org/10.1002/jmv.25785.Cheng H, Wang Y, Wang GQ. Wang, organ-protective effect of angiotensin-converting enzyme 2 and its effect on the prognosis of COVID-19. J Med Virol. 2020. doi: https://doi.org/10.1002/jmv.25785.Fyhrquist F, Saijonmaa O. Renin-angiotensin system revisited. J Intern Med. 2008;264(3):224–236. doi: https://doi.org/10.1111/j.1365-2796.2008.01981.x.Fyhrquist F, Saijonmaa O. Renin-angiotensin system revisited. J Intern Med. 2008;264(3):224–236. doi: https://doi.org/10.1111/j.1365-2796.2008.01981.x.Liu J, Zheng X, Tong Q, et al. Overlapping and discrete aspects of the pathology and pathogenesis of the emerging human pathogenic coronaviruses SARS-CoV, MERS-CoV, and 2019-nCoV. J Med Virol. 2020;92(5):491–494. doi: https://doi.org/10.1002/jmv.25709.Liu J, Zheng X, Tong Q, et al. Overlapping and discrete aspects of the pathology and pathogenesis of the emerging human pathogenic coronaviruses SARS-CoV, MERS-CoV, and 2019-nCoV. J Med Virol. 2020;92(5):491–494. doi: https://doi.org/10.1002/jmv.25709.Cheng ZJ, Shan J. 2019 Novel coronavirus: where we are and what we know. Infection. 2020;48(2):155–163. doi: https://doi.org/10.1007/s15010-020-01401-y.Cheng ZJ, Shan J. 2019 Novel coronavirus: where we are and what we know. Infection. 2020;48(2):155–163. doi: https://doi.org/10.1007/s15010-020-01401-y.Deng SQ, Peng HJ. Peng, Characteristics of and public health responses to the coronavirus disease 2019 outbreak in China. J Clin Med. 2020;9(2):E575. doi: https://doi.org/10.3390/jcm9020575.Deng SQ, Peng HJ. Peng, Characteristics of and public health responses to the coronavirus disease 2019 outbreak in China. J Clin Med. 2020;9(2):E575. doi: https://doi.org/10.3390/jcm9020575.Zhang JJ, Dong X, Cao YY, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020. doi: https://doi.org/10.1111/all.14238.Zhang JJ, Dong X, Cao YY, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020. doi: https://doi.org/10.1111/all.14238.Ruan Q, Yang K, Wang W, et al. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020. doi: https://doi.org/10.1007/s00134-020-05991-x.Ruan Q, Yang K, Wang W, et al. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020. doi: https://doi.org/10.1007/s00134-020-05991-x.Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020. doi: https://doi.org/10.1515/cclm-2020-0198.Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020. doi: https://doi.org/10.1515/cclm-2020-0198.Wu Z, McGoogan JM. Characteristics of and important lessons from the Coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA. 2020. doi: https://doi.org/10.1001/jama.2020.2648.Wu Z, McGoogan JM. Characteristics of and important lessons from the Coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA. 2020. doi: https://doi.org/10.1001/jama.2020.2648.Guan WJ, Liang WH, Zhao Y, et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: a nationwide analysis. Eur Respir J. 2020. pii: 2000547. doi: https://doi.org/10.1183/13993003.00547-2020.Guan WJ, Liang WH, Zhao Y, et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: a nationwide analysis. Eur Respir J. 2020. pii: 2000547. doi: https://doi.org/10.1183/13993003.00547-2020.Врачи РФ [интернет]. Диабет и коронавирус: мнение экспертов. Профессор Галстян Г.Р. 2020. [Vrachi RF. [Internet]. Diabet i koronavirus: mnenie ekspertov. Professor Galstian G.R. (In Russ).] Доступно по: https://vrachirf.ru/company-announce-single/71811. Ссылка активна на 27.03.2020.Врачи РФ [интернет]. Диабет и коронавирус: мнение экспертов. Профессор Галстян Г.Р. 2020. [Vrachi RF. [Internet]. Diabet i koronavirus: mnenie ekspertov. Professor Galstian G.R. (In Russ).] Доступно по: https://vrachirf.ru/company-announce-single/71811. Ссылка активна на 27.03.2020.Gupta R, Ghosh A, Singh AK, Misra A. Clinical considerations for patients with diabetes in times of COVID-19 epidemic. Diabetes Metab Syndr. 2020;14(3):211–212. doi: https://doi.org/10.1016/j.dsx.2020.03.002.Gupta R, Ghosh A, Singh AK, Misra A. Clinical considerations for patients with diabetes in times of COVID-19 epidemic. Diabetes Metab Syndr. 2020;14(3):211–212. doi: https://doi.org/10.1016/j.dsx.2020.03.002.Gagliardino JJ, Chantelot JM, Domenger C, et al. Impact of diabetes education and self-management on the quality of care for people with type 1 diabetes mellitus in the middle east (the international diabetes mellitus practices study, IDMPS). Diabetes Res Clin Pract. 2019;147:29–36. doi: https://doi.org/10.1016/j.diabres.2018.09.008.Gagliardino JJ, Chantelot JM, Domenger C, et al. Impact of diabetes education and self-management on the quality of care for people with type 1 diabetes mellitus in the middle east (the international diabetes mellitus practices study, IDMPS). Diabetes Res Clin Pract. 2019;147:29–36. doi: https://doi.org/10.1016/j.diabres.2018.09.008.Driggin E, Madhavan MV, Bikdeli B, et al. Cardiovascular considerations for patients, health care workers, and health systems during the coronavirus disease 2019 (COVID-19) pandemic. J Am Coll Cardiol. 2020. pii: S0735-1097(20)34637-4. doi: https://doi.org/10.1016/j.jacc.2020.03.031.Driggin E, Madhavan MV, Bikdeli B, et al. Cardiovascular considerations for patients, health care workers, and health systems during the coronavirus disease 2019 (COVID-19) pandemic. J Am Coll Cardiol. 2020. pii: S0735-1097(20)34637-4. doi: https://doi.org/10.1016/j.jacc.2020.03.031.HFSA/ACC/AHA statement addresses concerns re: using RAAS antagonists in COVID-19. American College of Cardiology; 2020. Available from: https://www.acc.org/latest-in-cardiology/articles/2020/03/17/08/59/hfsa-acc-aha-statement-addresses-concerns-re-using-raas-antagonists-in-covid-19.HFSA/ACC/AHA statement addresses concerns re: using RAAS antagonists in COVID-19. American College of Cardiology; 2020. Available from: https://www.acc.org/latest-in-cardiology/articles/2020/03/17/08/59/hfsa-acc-aha-statement-addresses-concerns-re-using-raas-antagonists-in-covid-19.De Simone G. Position statement of the ESC Council on hypertension on ACE-inhibitors and angiotensin receptor blockers. European Society of Cardiology; 2020. Available from: https://www.escardio.org/Councils/Council-on-Hypertension-(CHT)/News/position-statement-of-the-esc-council-on-hypertension-on-ace-inhibitors-and-ang.De Simone G. Position statement of the ESC Council on hypertension on ACE-inhibitors and angiotensin receptor blockers. European Society of Cardiology; 2020. Available from: https://www.escardio.org/Councils/Council-on-Hypertension-(CHT)/News/position-statement-of-the-esc-council-on-hypertension-on-ace-inhibitors-and-ang.Шляхто Е.В., Конради А.О., Виллевальде С.В., и др. Руководство по диагностике и лечению болезней системы кровообращения (БСК) в контексте пандемии COVID-19 (краткая версия) [интернет]. [Shliakhto EV, Konradi AO, Villeval’de SV, et al. Rukovodstvo po diagnostike i lecheniiu boleznei sistemy krovoobrashcheniia (BSK) v kontekste pandemii COVID-19 (kratkaia versiia). (In Russ).] Доступно по: https://scardio.ru/content/Guidelines/COVID-19.pdf. Ссылка активна на 27.03.2020.Шляхто Е.В., Конради А.О., Виллевальде С.В., и др. Руководство по диагностике и лечению болезней системы кровообращения (БСК) в контексте пандемии COVID-19 (краткая версия) [интернет]. [Shliakhto EV, Konradi AO, Villeval’de SV, et al. Rukovodstvo po diagnostike i lecheniiu boleznei sistemy krovoobrashcheniia (BSK) v kontekste pandemii COVID-19 (kratkaia versiia). (In Russ).] Доступно по: https://scardio.ru/content/Guidelines/COVID-19.pdf. Ссылка активна на 27.03.2020.Yang JK, Lin SS, Ji XJ, Guo LM. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetol. 2010;47(3):193–199. doi: https://doi.org/10.1007/s00592-009-0109-4.Yang JK, Lin SS, Ji XJ, Guo LM. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetol. 2010;47(3):193–199. doi: https://doi.org/10.1007/s00592-009-0109-4.Пигарова Е.А., Дзеранова Л.К. Диагностика и лечение центрального несахарного диабета // Ожирение и метаболизм. — 2014. — Т. 11. — №4. — C. 48-55. [Pigarova EA, Dzeranova LK. Diagnosis and treatment of central diabetes insipidus. Obesity and metabolism. 2014;11(4):48-55. (in Russ.)] doi: https://doi.org/10.14341/omet2014448-55Пигарова Е.А., Дзеранова Л.К. Диагностика и лечение центрального несахарного диабета // Ожирение и метаболизм. — 2014. — Т. 11. — №4. — C. 48-55. [Pigarova EA, Dzeranova LK. Diagnosis and treatment of central diabetes insipidus. Obesity and metabolism. 2014;11(4):48-55. (in Russ.)] doi: https://doi.org/10.14341/omet2014448-55

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