docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2024-23-1-61-67docru-13Research ArticleОБЗОРЫREVIEWSОбоснование и опыт применения витамина В12 в комплексной терапии новой коронавирусной инфекции и постковидного синдромаRationale and Experience of Vitamin B12 Usage in Complex Therapy of COVID-19 and Post-COVID Syndromehttps://orcid.org/0000-0001-6581-4521ГалстянГ. Р.GalstyanG. R.

Галстян Гагик Радикович — д. м. н., профессор, заведующий отделением диабетической стопы; заведующий отделением эндокринологии 

117292, г. Москва, ул. Дмитрия Ульянова, д. 11

11 Dmitry Ulyanov Str., Moscow, 117292

61/2 Shchepkin Str., Moscow, 129110

galstyangagik964@gmail.comhttps://orcid.org/0000-0001-9371-5934СтарковаЕ. Ю.StarkovaE. Yu.

Старкова Елена Юрьевна / Starkova, E.Yu. — научный сотрудник отделения физиотерапии и реабилитации, ассистент кафедры травматологии и ортопедии

129110, Москва, ул. Щепкина, д. 61/2

61/2 Shchepkin Str., Moscow, 129110

elena.starkova@inbox.ruhttps://orcid.org/0000-0002-7498-1871МельниковаЕ. А.MelnikovaE. A.

Мельникова Екатерина Александровна — д. м. н., руководитель отделения физиотерапии и реабилитации, профессор курса реабилитации и физиотерапии при кафедре травматологии и ортопедии 

129110, г. Москва, ул. Щепкина, д. 61/2

61/2 Shchepkin Str., Moscow, 129110

melkaterina3@yandex.ruФГБУ «Национальный медицинский исследовательский центр эндокринологии» Министерства здравоохранения Российской Федерации; ГБУЗ МО «Московский областной научно-исследовательский клинический институт имени М.Ф. Владимирского»РоссияNational Medical Research Center for Endocrinology; Moscow Regional Research and Clinical InstituteRussian FederationГБУЗ МО «Московский областной научно-исследовательский клинический институт имени М.Ф. Владимирского»РоссияMoscow Regional Research and Clinical InstituteRussian Federation202412022025231ТЕРАПИЯ6167Copyright © Галстян Г.Р., Старкова Е.Ю., Мельникова Е.А., 20252025Галстян Г.Р., Старкова Е.Ю., Мельникова Е.А.Galstyan G.R., Starkova E.Y., Melnikova E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/13Цель обзора

Цель обзора. Анализ дефицита витамина В12 как фактора риска тяжелого течения новой коронавирусной инфекции и возможностей применения его в качестве средства адъювантной терапии при лечении COVID-19.

Основные положения

Основные положения. Новая коронавирусная инфекция (COVID-19) представляет наибольшую опасность для пожилых больных и лиц, страдающих сахарным диабетом 2 типа. Этим категориям пациентов чаще требуются длительная госпитализация и интенсивная терапия, а прогноз заболевания и риск возникновения жизненно опасных осложнений гораздо выше, чем в среднем в популяции. Определение факторов риска тяжелого течения COVID-19 и механизмов их возникновения помогает выбрать оптимальную тактику лечения и существенно улучшить прогноз выздоровления, снизить частоту негативных последствий заболевания, так называемого постковидного синдрома, и сократить сроки реабилитации пациентов после перенесенного COVID-19. Согласно одной из гипотез, повышенный риск тяжелого течения COVID-19 у данных групп пациентов объясняется дефицитом витамина B12. Возможно, этот фактор является объединяющим для лиц пожилого возраста и пациентов с сахарным диабетом 2 типа. Таким образом, возникает вопрос: повлияет ли устранение дефицита B12 на смертность от COVID-19 или показатели выздоровления? В данном обзоре мы рассмотрим последние данные, которые показывают, что B12 участвует во многих иммунологических, микробиологических и гематологических процессах, становящихся мишенями коронавирусной инфекции.

Заключение

Заключение. Данные нашего обзора подтверждают гипотезу о том, что дефицит B12 — потенциальный фактор риска тяжелого течения COVID-19, а замещение этого дефицита путем назначения препаратов витамина В12 может быть рассмотрено в качестве вспомогательной терапии и профилактики осложнений для данных категорий пациентов.

management of COVID-19

management of COVID-19.

Key points

Key points. The COVID-19 poses the greatest risk to older people and patients with diabetes mellitus type 2. These categories of patients often require long-term hospitalization and intensive care, and the prognosis of the disease and the risk of life-threatening complications are much higher than the average in the population. Determining the risk factors for a severe course of COVID-19 and the mechanisms of their occurrence helps to choose the optimal treatment tactics and significantly improve the prognosis of recovery, reduce the negative consequences of the disease, the so-called post-COVID syndrome, and shorten the rehabilitation period for patients after COVID-19. One of the hypotheses explaining the increased risk of severe COVID-19 in these groups of patients is vitamin B12 deficiency. Perhaps this factor is unifying for the elderly and patients with type 2 diabetes mellitus. Thus, the question arises whether the elimination of B12 deficiency will affect mortality from COVID-19 or recovery rates. In this review, we will analize the latest evidence that shows B12 is involved in many immunological, microbiological and hematological processes that are the target of coronavirus infection.

Conclusion

Conclusion. Our review data confirms the hypothesis that B12 deficiency is a potential risk factor for severe COVID-19, and replacement of this deficiency by prescribing vitamin B12 therapy can be considered as adjuvant therapy and prevention of complications for these categories of patients.

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