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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">nmp</journal-id><journal-title-group><journal-title xml:lang="ru">Журнал им. Н.В. Склифосовского «Неотложная медицинская помощь»</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Sklifosovsky Journal "Emergency Medical Care"</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2223-9022</issn><issn pub-type="epub">2541-8017</issn><publisher><publisher-name>“N.V. Sklifosovsky Research Institute for Emergency Medicine”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.23934/2223-9022-2021-10-3-452-459</article-id><article-id custom-type="elpub" pub-id-type="custom">nmp-1205</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>НОВОЕ О COVID-19</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>NEW ABOUT COVID-19</subject></subj-group></article-categories><title-group><article-title>Развитие рабдомиолиза в отдаленном периоде перенесенной новой коронавирусной инфекции COVID-19 (клиническое наблюдение)</article-title><trans-title-group xml:lang="en"><trans-title>Development of Rhabdomyolysis in the Long-term Period of Previous New Coronavirus Infection COVID-19 (Clinical Case Report)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3726-3256</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бердников</surname><given-names>Г. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Berdnikov</surname><given-names>G. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p> кандидат медицинских наук, старший научный сотрудник отделения неотложной хирургии, эндоскопии и интенсивной терапии </p><p> Российская Федерация, 129090, Москва, Б. Сухаревская пл., д. 3 </p></bio><bio xml:lang="en"><p> Candidate of Medical Sciences, Senior Researcher of the Department of Emergency Surgery, Endoscopy and Intensive Therapy </p><p> 3 B. Sukharevskaya Sq., Moscow 129090, Russian Federation </p></bio><email xlink:type="simple">polina1905@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1647-1635</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кудряшова</surname><given-names>Н. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Kudryashova</surname><given-names>N. Y.</given-names></name></name-alternatives><bio xml:lang="ru"><p> доктор медицинских наук, главный научный сотрудник отделения лучевой диагностики</p><p> Российская Федерация, 129090, Москва, Б. Сухаревская пл., д. 3 </p></bio><bio xml:lang="en"><p> Doctor of Medical Sciences, Chief Researcher of the Department of Diagnostic Radiology </p><p> 3 B. Sukharevskaya Sq., Moscow 129090, Russian Federation </p></bio><email xlink:type="simple">numedsklif@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7521-487X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мигунова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Migunova</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p> кандидат медицинских наук, старший научный сотрудник отделения лучевой диагностики</p><p> Российская Федерация, 129090, Москва, Б. Сухаревская пл., д. 3 </p></bio><bio xml:lang="en"><p> Candidate of Medical Sciences, Senior Researcher of the Department of Diagnostic Radiology </p><p> 3 B. Sukharevskaya Sq., Moscow 129090, Russian Federation </p></bio><email xlink:type="simple">emigunovasklif@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7802-2283</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рей</surname><given-names>С. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Rey</surname><given-names>S. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p> кандидат медицинских наук, старший научный сотрудник отделения неотложной хирургии, эндоскопии и интенсивной терапии  </p><p> Российская Федерация, 129090, Москва, Б. Сухаревская пл., д. 3 </p></bio><bio xml:lang="en"><p> Candidate of Medical Sciences, Senior Researcher, the Department of Emergency Surgery, Endoscopy and Intensive Therapy </p><p> 3 B. Sukharevskaya Sq., Moscow 129090, Russian Federation </p></bio><email xlink:type="simple">fanwal@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гурок</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Gurok</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p> врач-радиолог отделения рентгеновской компьютерной томографии и радиоизотопной диагностики </p><p> Российская Федерация, 129090, Москва, Б. Сухаревская пл., д. 3 </p></bio><bio xml:lang="en"><p> Radiologist, Department of X-ray Computed Tomography and Radioisotope Diagnostics </p><p> 3 B. Sukharevskaya Sq., Moscow 129090, Russian Federation </p></bio><email xlink:type="simple">eka-gurok@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абдуламитов</surname><given-names>Х. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Abdulamitov</surname><given-names>Kh. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p> врач-хирург отделения лечения острых эндотоксикозов </p><p> Российская Федерация, 129090, Москва, Б. Сухаревская пл., д. 3 </p></bio><bio xml:lang="en"><p> Surgeon of the Department for the Treatment of Acute Endotoxemia </p><p> 3 B. Sukharevskaya Sq., Moscow 129090, Russian Federation </p></bio><email xlink:type="simple">homa_22@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3349-0451</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Клычникова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Klychnikova</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат медицинских наук, заведующая клинико-биохимической лаборатории экстренных методов исследования </p><p> Российская Федерация, 129090, Москва, Б. Сухаревская пл., д. 3 </p></bio><bio xml:lang="en"><p> Candidate of Medical Sciences, Head of the Clinical and Biochemical Laboratory for Emergency Research Methods </p><p> 3 B. Sukharevskaya Sq., Moscow 129090, Russian Federation </p></bio><email xlink:type="simple">klychnikovae@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макляева</surname><given-names>О. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Maklyayeva</surname><given-names>O. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p> врач-токсиколог отделения лечения острых эндотоксикозов </p><p> Российская Федерация, 129090, Москва, Б. Сухаревская пл., д. 3 </p></bio><bio xml:lang="en"><p> Toxicologist of the Department for the Treatment of Acute Endotoxicosis </p><p> 3 B. Sukharevskaya Sq., Moscow 129090, Russian Federation </p></bio><email xlink:type="simple">Soch71@list.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского ДЗМ»<country>Россия</country></aff><aff xml:lang="en">N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>16</day><month>11</month><year>2021</year></pub-date><volume>10</volume><issue>3</issue><fpage>452</fpage><lpage>459</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Бердников Г.А., Кудряшова Н.Е., Мигунова Е.В., Рей С.И., Гурок Е.В., Абдуламитов Х.К., Клычникова Е.В., Макляева О.Г., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Бердников Г.А., Кудряшова Н.Е., Мигунова Е.В., Рей С.И., Гурок Е.В., Абдуламитов Х.К., Клычникова Е.В., Макляева О.Г.</copyright-holder><copyright-holder xml:lang="en">Berdnikov G.A., Kudryashova N.Y., Migunova E.V., Rey S.I., Gurok E.V., Abdulamitov K.K., Klychnikova E.V., Maklyayeva O.G.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.jnmp.ru/jour/article/view/1205">https://www.jnmp.ru/jour/article/view/1205</self-uri><abstract><sec><title>Актуальность</title><p>Актуальность. Одним из осложнений новой коронавирусной инфекции COVID-19 является рабдомиолиз, который может быть причиной острого почечного повреждения (ОПП). Причиной развития рабдомиолиза в нашем наблюдении у пациента после перенесенного COVID-19 в отдаленном периоде явилась повышенная мышечная нагрузка.</p></sec><sec><title>Цель работы</title><p>Цель работы. Представление случая развития рабдомиолиза с ОПП у пациента, перенесшего COVID-19 в отдаленном периоде.</p></sec><sec><title>Материал и методы</title><p>Материал и методы. В клиническом наблюдении представлен пациент Л. 25 лет, находившийся на лечении в отделении лечения острых эндотоксикозов ГБУЗ «НИИ СП им. Н.В. Склифосовского ДЗМ». В 2020 году заболел COVID-19, осложнившимся развитием рабдомиолиза и ОПП в отдаленном периоде.</p></sec><sec><title>Результаты</title><p>Результаты. При обследовании отмечено повышение креатинфосфокиназы (КФК) — 106 000,0 ЕД/л, аланинаминотрансферазы (АЛТ) — 553,0 ЕД/л, аспартатаминотрансферазы (АСТ) — 1582,0 ЕД/л, лактатдегидрогеназы (ЛДГ) — 2809,0 ЕД/л, уровней сывороточного креатинина 164 мкмоль/л и миоглобина — 201 нг/мл. Вирусологическое исследование: IgM — 0,27 ЕД/мл; IgG — 7,28 ЕД/мл. При трехфазной сцинтиграфии с 99mТс-пирфотехом выявлены признаки некротических изменений мышц верхней половины спины, мышц груди (преимущественно справа), мышц плеча и верхней половины предплечья с двух сторон. Со стороны почек: снижение перфузии правой почки (относительно левой), умеренное замедление уродинамики на уровне чашечно-лоханочного комплекса с двух сторон.</p></sec><sec><title>Выводы</title><p>Выводы. Причиной развития рабдомиолиза в отдаленном периоде у пациента после перенесенного COVID-19 явилась повышенная мышечная нагрузка. Проведение целевых исследований и сбор анамнеза способствует выявлению признаков рабдомиолиза. Использование радионуклидного метода диагностики позволяет выявить зоны поражения мягких тканей с одномоментной оценкой функции почек при рабдомиолизе в остром периоде заболевания, а также оценить эффективность лечения при динамическом наблюдении. При подтверждении рабдомиолиза необходимо проводить детоксикационно-инфузионную терапию, контролировать функцию почек с целью выявления острого почечного повреждения, а при ухудшении почечной функции и интоксикации показано проведение методов заместительной почечной терапии.</p></sec></abstract><trans-abstract xml:lang="en"><p>Relevance. Rhabdomyolysis is one of the complications of the new coronavirus infection COVID-19, which may cause acute kidney injury (AKI). The reason for the development of rhabdomyolysis in our observation in a patient after suffering COVID-19 in the long-term period was an increased muscle load.Aim of study. Presentation of a case of rhabdomyolysis with AKI in a patient after COVID-19 in the long-term period.Material and methods. In clinical observation, a 25-year-old patient L. is presented, who was being treated in the Department for the Treatment of Acute Endotoxicosis of the N.V. Sklifosovsky Research Institute for Emergency Medicine. In 2020, he developed COVID-19, complicated by rhabdomyolysis and AKI in the long term period.Results. Examination revealed an increase in creatinine phosphokinase (CPK) — 106,000.0 U/L, alanine aminotransferase (ALT) — 553.0 U/L, aspartate aminotransferase (AST) — 1582.0 U/L, lactate dehydrogenase (LDH) — 2809.0 U/L, levels of serum creatinine 164 μmol/L and myoglobin — 201 ng/ml. Virological research: IgM — 0.27 units per ml; IgG — 7.28 units per ml. 3 Three-phase scintigraphy with 99mTc-pyrfotech revealed signs of necrotic changes in the muscles of the upper half of the back, muscles of the chest (mainly on the right), muscles of the shoulder and upper half of the forearm on both sides. Kidneys: decreased perfusion of the right kidney (relative to the left), moderate slowdown of urodynamics at the level of the calyx-pelvis complex on both sides.Conclusions. The reason for the development of rhabdomyolysis in the long-term period in the patient after suffering from COVID-19 was an increased muscle load. Targeted research and medical history can help identify signs of rhabdomyolysis. The use of the radionuclide diagnostic method makes it possible to identify areas of soft tissue damage with a one-step assessment of renal function in rhabdomyolysis in the acute period of the disease, as well as to evaluate the effectiveness of treatment with dynamic observation. When rhabdomyolysis is confirmed, it is necessary to carry out detoxification and infusion therapy, to monitor renal function in order to detect acute kidney injury, and in case of deterioration of renal function and intoxication, renal replacement therapy is indicated.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>новая коронавирусная инфекция COVID-19</kwd><kwd>коронавирус SARS-CoV-2</kwd><kwd>острое почечное повреждение</kwd><kwd>сцинтиграфия</kwd><kwd>рабдомиолиз</kwd></kwd-group><kwd-group xml:lang="en"><kwd>new coronavirus infection COVID-19</kwd><kwd>coronavirus SARS-CoV-2</kwd><kwd>acute kidney injury</kwd><kwd>scintigraphy</kwd><kwd>rhabdomyolysis</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. 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