RU2791808C2 - Method for treating dysosmia caused by coronavirus infection - Google Patents

Abstract

FIELD: medicine; otorhinolaryngology; infectology.

SUBSTANCE: method can be used to treat dysosmia caused by a coronavirus infection and includes several steps. At the first stage, external aeration of the skin in the eye area is performed, with the patient's eyelids closed, with an ozone/NO-containing gas mixture with an ozone concentration of 0.5 mg/l and a nitric oxide concentration of 0.1 mg/l. At the second stage, ozone/NO — or ozonide/NO-ultrasonic sanitation of the olfactory epithelium of the nasal mucosa, nasal and oropharyngeal mucosa is carried out. At the third stage, endonasal illumination of the olfactory region of the mucous membrane of the nasal cavities is performed for 20 seconds on each half of the nose with pulsed red spectrum laser radiation,λ =635 nm. At the fourth stage, an intravenous drip of an ozone/NO-containing saline solution with an ozone concentration of 1.5 mg/l and a nitric oxide concentration of 0.4 mg/l is carried out, and then sequentially in one session, a solution of an enzymatic antioxidant — superoxide dismutase Rexod 1.6 million U or antioxidant solution — 0.5% solution of Remaxol succinic acid. At the fifth stage, a thermal contrast effect is initiated on the patient's skin, followed by external aeration of the skin for 15 minutes with an ozone/NO-containing gas mixture with an ozone concentration of 3.0 mg/l and a nitric oxide concentration of 0.8 mg/l while simultaneously illuminating it with pulsed laser radiation of the red spectrumλ =635 nm. At the final stage, there is enteral intake before meals of 10% ozonide /NO-containing oil-in-water emulsion in a volume of 100 ml, as well as there is intake of succinic acid Forte — 1 tablet after meals, daily dose is 400 mg.

EFFECT: use of the invention makes it possible to increase the effectiveness of the treatment of dysosmia due to the relief of the inflammatory process and its consequences violating the protective functions of the cells of the olfactory epithelium.

1 cl, 14 dwg, 2 ex

Description

The invention relates to medicine, namely to otorhinolaryngology and infectology, and can be used in the complex treatment of patients with Covid-19 with dysosmia and its other manifestations caused by infection with a new coronavirus infection SARS-CoV-2 and other similar infections.

The sense of smell is the first of the five human senses to develop in the process of evolution, which plays an important role in the regulation of emotions, mood and memory, sexual behavior, warning a person about danger, informing about environmental changes, and in analyzing the taste of food (T. Weston, 1998). Olfactory disorders among the population are increasingly common, however, the true prevalence remains unclear [1, 2].

Disorders of the olfactory function are often associated with peripheral olfactory disorders caused by lesions at the level of neuroepithelial cells of the nasal cavity and olfactory nerves. At the same time, olfactory receptors are subject to a complex of environmental influences associated with breathing. The result of the impact of damaging factors on the structures of the olfactory epithelium is the partial or significant destruction and degeneration of olfactory receptor cells and olfactory glands and, as a result, a decrease in olfactory function. In diseases of the nasal cavity, damage to the olfactory cells and olfactory filaments, the initial part of the olfactory nerve, is often observed.

The prevalence of olfactory disorders is due to the polyetiology of olfactory disorders. One of the main etiological factors of impaired sense of smell is considered to be an infectious factor realized by bacteria and fungi, but viruses are most often the causative factor of dysosmia. This is determined by the ability of neurotropic viruses, such as influenza viruses, poliomyelitis and other dangerous infections, when the respiratory and olfactory epithelium, as well as sensitive and autonomic innervation are damaged, to penetrate from the nasal cavity along the axonal and perineural pathways into the cranial cavity [3-5]. In this case, not only the receptor apparatus of the olfactory analyzer is affected, but also the fibers of the olfactory nerve with impaired function of the central sections of the olfactory analyzer. When the receptor olfactory epithelium is damaged, degenerative changes in the olfactory bulbs are recorded [6, 7].

The current challenge was the factor implemented by a new coronavirus infection caused by the SARS-CoV-2 virus, which is a single-stranded RNA-containing virus, and other coronavirus infections: HCoV-229E, -OC43, -NL63, -HKU1, circulating year-round among the population in the structure acute respiratory infections and affecting, as a rule, the upper respiratory tract in mild and moderate form [8].

A new coronavirus infection - SARS-CoV-2 is included in the list of diseases dangerous to others [9], because has a high contagiousness, is transmitted by contact: by airborne droplets, through water, common objects, etc. The main means of protection against a dangerous infection are personal protection using a face mask, a respirator with a protective screen, a biological protection suit, gloves, body treatment , in particular, hands, cleaning solutions before and after contact with an infected object, etc.

The entrance gate of the pathogen is the epithelium of the upper respiratory tract and the epithelial cells of the stomach and intestines. Based on the clinical manifestations, the tropism of the virus to the ciliated epithelium of the respiratory tract, all over, alveolocytes of types I and II, is assumed. The SARS-CoV-2 virus is detected by immunohistochemical, PCR and ultrastructural studies in the ciliated cells of the bronchi, the epithelium of bronchioles, in alveolocytes and macrophages, as well as in the vascular endothelium.

The initial stage of infection is the penetration of the SARS-CoV-2 virus into target cells that have ACE2 type II angiotensin-converting enzyme receptors expressed on the surface of cells of the respiratory organs, esophagus, intestines, heart, adrenal glands, bladder, brain (hypothalamus) and pituitary gland, as well as endothelium and macrophages. The nucleocapsid protein of the virus is found in the cytoplasm of epithelial cells of the salivary glands, stomach, duodenum and rectum, urinary tract, lacrimal fluid.

Some indicators that are characteristic in the definition of Covid-19 disease, clinically manifested as an acute respiratory infection with a body temperature above 37.5 ° C and blood oxygen saturation according to pulse oximetry - SpO ₂ <95%, are one or more of the following signs: cough - dry or scanty sputum, shortness of breath, feeling of congestion and pain in the chest, obstruction of the airways and, first of all, bronchioles, bronchogenic infection with coronavirus in association with anaerobic infection, leading to inflammation, development of edema from the interstitial tissue, impaired microcirculation, hypoxia , acidosis, disorders of the immune system. Observed symptoms: sore throat, dryness in the nasal cavity, nasal congestion or moderate rhinorrhea - not expressed, decrease or loss of smell (hyposmia or anosmia), loss of taste - dysgeusia, conjunctivitis, weakness, muscle pain, headache, skin rash, vomiting , diarrhea in the absence of other reasons explaining the clinical picture, regardless of the epidemiological history [8].

Olfactory disorders caused by the SARS-CoV-2 virus are a common symptom in patients with this infection. The relevance of the problem is due to the fact that, with a confirmed diagnosis of Covid-19, from 20 to 85% of them complained about impaired sense of smell [8-11, etc.], often manifested with skin rashes typical of Covid-19, which, like dysosmia , are considered as subclinical markers and prognostic signs of the onset and relief of coronavirus infection.

It is known that the highest viral load in case of infection with the SARS-CoV-2 virus is observed in the nasal cavity [12]. The mechanism of loss of smell during SARS-CoV-2 infection is not well understood, but at the moment there are observations and data on the features of the development of this disease. So, in patients with Covid-19, studies of biopsy specimens of the peripheral receptor section of the olfactory analyzer, represented by the olfactory epithelium (olfactoryepithelium) - the neuroepithelium on the mucous membrane of the superior nasal concha and in the upper parts of the nasal septum, showed an increased level of TNF-α, compared with the control group healthy patients, which indicates the presence of an inflammatory process in the olfactory epithelium [13]. SARS-CoV-2 uses the S1 protein to bind to the ACE-2 receptors of the olfactory epithelium cell membrane, and for the virus to enter the cell, it uses the ACE 2 enzyme and the TMPRSS2 protein, which are mainly expressed in supporting cells, stem cells and perivascular cells of the olfactory epithelium, but not in the olfactory neurons themselves [14]. The virus attaches to the surface of the cilia of the epithelium, destroying them with impaired mucociliary clearance [15].

There are reports [16] indicating SARS-CoV-2 infection of supporting cells and vascular pericytes of the olfactory epithelium and olfactory bulb, which is explained by the high density of ACE-2 receptors in this area. According to MRI, the size of the infected olfactory bulb does not change [17]. However, there is a known clinical case of anosmia in a 27-year-old patient against the background of Covid-19, with signs of swelling of the olfactory bulbs and blockage of the olfactory fissure [18], which indicates the possibility of penetration of the SARS-CoV-2 virus into the cranial cavity and further into the central parts of the brain (Fig. 1). Apparently, the nasoencephalic barrier is overcome through the holes in the ethmoid bone of the nasal cavity, which are the way for the branches of the olfactory nerve to pass into the cranial cavity to the olfactory bulb [19, 20].

In general, in the pathogenesis of dysosmia initiated by the SARS-CoV-2 virus, it is possible to determine the presence of a number of links in the pathological circle of the development of the disease:

- penetration of the SARS-CoV-2 virus into the nasal cavity from the environment on inspiration or its transfer with lacrimal fluid from the conjunctiva through the nasolacrimal canal into the nasal cavity and oropharynx, and then into the respiratory tract, gastrointestinal tract and other organs and systems of the body;

- attachment to the receptors of the olfactory epithelium ACE-2 using the ACE-2 enzyme and the TMPRSS2 gene;

- the occurrence of a pronounced inflammatory process with a violation of the functions of the protective system of the olfactory epithelium;

- hypoxia of neuroreceptor cells of the olfactory epithelium, which forms pathological conditions caused by infection;

violation of the permeability of the membrane of the apical part of the cell - cilia and the top of the peripheral process to the potentiating ions of witness substances - odorous substances due to the inflammatory process in the nasal cavity;

- violation of intracellular metabolism;

- violation of the mechanisms of olfactory transduction, where calcium ions Ca ²⁺ participate as key regulators, blocking cAMP-dependent cation channels and activating ion channels in the cytoplasmic membrane of olfactory cells;

- violation of the mechanism of adaptation of olfactory receptor cells due to lack of Ca ²⁺ calcium ions, in the implementation of the enzymatic cascade of sensory signal transduction;

- violation of the function of protecting cells of the olfactory epithelium from peroxidation, including lipid areas of cell membranes - LPO;

- violation of the permeability of the microcirculatory bloodstream due to the tropism of the virus to the vascular endothelium;

- violation of the processes of regeneration of the olfactory epithelium with a long-term inflammatory process;

- initiation of the permeability of the cribriform plate - laminacribrosa with olfactory filaments passing through its openings - axons of olfactory neurons in the form of bundles - filaolfactoria and further - into the olfactory bulb, which is a nasoencephalic barrier that prevents the transneuronal transfer of toxic compounds, peptides, proteins, witness substances and viruses to the central parts of the brain - similar to the function implemented by the blood-brain barrier, etc.

Since SARS-CoV-2 coronavirus infection primarily affects the airways of the mucous membranes of the nasopharynx and oropharynx, and then indirectly the respiratory tract and further the bronchopulmonary system, then, taking into account the polyetiology and complexity of the pathogenesis of olfactory disorders, it is necessary to provide a combined effect of a complex of physical and physicochemical factors both on the peripheral part of the olfactory tract and on the body of an infected patient as a whole (general systemic exposure), including the possibility of inhibiting other alternative routes of entry of the SARS-CoV-2 virus, for example, by airborne droplets through the nasolacrimal canal and hematogenously from the lacrimal gland, tk. patients with conjunctivitis are considered as infectious carriers [21].

In this regard, inhalation therapy with aerosols of targeted medicinal substances administered prophylactically or at the initial stage of the disease into the airways of the nasopharynx and oropharynx and further into the bronchopulmonary system, onto the skin surface of the patient's body, onto the skin surface of the eyes and indirectly onto the ocular surface, nasolacrimal canal etc., which are potential target tissues for the penetration of SARS-CoV-2, will apparently be, along with other types of physical and physico-chemical effects, one of the available and effective methods not only for the treatment, but also for the prevention of this dangerous disease among the population and medical personnel. Therefore, the system-wide impact on the body of a patient with dysosmia infected with SARS-CoV-2, in our opinion, has great prospects in the prevention and treatment of this infection and the like.

A known method for the treatment of pneumonia, which consists in inhalation into the body, through the upper respiratory tract, medicinal substances in the form of an ozone-oxygen gas mixture [22].

However, this method of treating pneumonia cannot be used in the treatment of dysosmia caused by SARS-CoV-2 coronavirus infection due to irritating, and if the maximum permissible concentration of ozone is exceeded, its harmful toxic effects on the mucous membranes of the airways and the bronchopulmonary system and, before total, for lung surfactant. The use of significant concentrations when inhaling ozone for therapeutic purposes is prohibited, because. the ozone-oxygen gas mixture irritates the respiratory tract and damages the lung surfactant. Inhalation methods of ozone-oxygen therapy, occasionally used in the 60-70s. of the last century, are not currently used [23].

The closest in technical essence and the achieved result is a method for suppressing the SARS coronavirus [24], which includes stage-by-stage inhalation of the airways of the patient's body with an ultrasonic aerosol of an ozonide-containing medicinal substance in the form of ozonized vegetable oil or its ozonized oil-in-water emulsion, up to the term clinically confirmed patient recovery rates. At the same time, before meals and enterally, an ozonide-containing medicinal substance is prescribed in the form of an ozonized oil or an ozonized oil-in-water emulsion.

However, the method is not intended for the treatment of dysosmia caused by the SARS-CoV-2 virus due to the polyetiology and complexity of the pathogenesis of olfactory disorders, often manifested at the initial stage of the Covid-19 disease. The method does not provide for the complex use of highly effective ozone/NO- and ozonide/NO-containing medicinal substances in different phase states: gaseous, aerosol and liquid forms, which, on the one hand, make it difficult to adhere to the SARS-CoV-2 virus coming from the environment when inhaled and its coalescence with the olfactory neuroepithelium of the nasal mucosa, causing an inflammatory process and damage to olfactory cells, and on the other hand, to deactivate the virus and ensure the relief of an already developed pronounced inflammatory process and its consequences, which is appropriate at different phases of the manifestation of dysosmia against the background of a possibly existing infectious process in the bronchopulmonary system and the patient's body as a whole. In addition, it is not provided: relief of a possible violation of the mechanisms of olfactory transduction, where calcium ions Ca ²⁺ participate as key regulators, blocking cAMP-dependent cation channels and activating ion channels in the cytoplasmic membrane of olfactory cells; systemic intravenous drip administration of ozone / NO-containing medicinal substances in combination with antioxidants and external treatment of the patient's skin with an ozone / NO-containing gas mixture, outside of its contact with the bronchopulmonary system, as well as the possibility of exposure, in combination with the above, to the interested areas of the body pulsed laser radiation, for example, of the red spectrum, incl. with simultaneous aeration of the body with ozone/NO-containing gas mixture.

The technical result of the invention is to increase the effectiveness of the treatment of dysosmia and other manifestations of Covid-19, by suppressing the SARS-CoV-2 virus and stopping the inflammatory process caused by it, which disrupts the protection functions of olfactory epithelial cells, as well as initiating detoxification of local foci of infection and the patient's body in in general, which will reduce the duration of his treatment.

The technical result of the invention is achieved by the fact that a method for treating dysosmia caused by a coronavirus infection, including inhalation of the patient's airways with an ultrasonic aerosol of an ozonide-containing medicinal substance in the form of ozonized vegetable oil or an ozonized oil-in-water emulsion, up to the time of the patient's confirmed recovery indicators, and also daily, before meals and enterally, taking an ozonide-containing medicinal substance in the form of ozonized vegetable oil or an ozonized oil-in-water emulsion, characterized in that in a single technological process for each session of treatment of dysosmia, implemented taking into account the severity of the patient's condition : 1 time per day - in the morning or 2 times a day - in the morning and in the evening, carry out:

- at the first stage - external aeration of the skin in the eye area, with the patient's eyelids closed, for 60 seconds, with ozone / NO-containing gas mixture with an ozone concentration of 0.5 mg / l and a nitrogen oxide concentration of 0.1 mg / l, implemented in a sealed cavity delimited by closed-type goggles;

- at the second stage - ozone / NO- or ozonide / NO-ultrasonic sanitation of the olfactory epithelium of the nasal mucosa, mucous membranes of the nasopharynx and oropharynx, as well as, indirectly, of the bronchi and underlying parts of the lung, by spraying them with a torch of ultrasonic aerosols ozone / NO- or ozonide/NO-containing medicinal substances in the form of: ozone/NO-containing physiological solution with an ozone concentration of 1.5 mg/l and a nitric oxide concentration of 0.4 mg/l; ozonide/NO-containing vegetable oil with an ozonide peroxide value of P=200 or its 10% ozonide/NO-containing oil-in-water emulsion with an ozonide peroxide value of P=100, on the olfactory epithelium of the nasal mucosa, for 15 seconds, on each half of the nose, and on the mucous tissues of the airways of the oropharynx, bronchi and underlying parts of the lung, for 30 seconds, while endonasal and oral high-amplitude ultrasonic spraying with a jet-aerosol torch of aerosols is carried out at a frequency of ultrasonic vibrations - f = 26.5 kHz and at the amplitude of ultrasonic oscillations of the waveguide-tool - ξ=90 μm;

- at the third stage - endonasal illumination, without affecting the area of the orbit of the eyes, the olfactory region of the mucous membrane of the nasal cavities, for 20 seconds, for each half of the nose, with pulsed laser radiation of the red spectrum - λ=635 nm;

- at the fourth stage - intravenous drip administration of medicinal substances in the form of ozone / NO-containing physiological solution with an ozone concentration of 1.5 mg / l and a nitric oxide concentration of 0.4 mg / l, and then sequentially, in one session, a solution of an enzyme antioxidant - superoxide dismutase Rexod 1.6 million units. or an antioxidant solution - 0.5% solution of succinic acid Remaxol;

- at the fifth stage - initiation of a thermal contrast effect on the patient's skin, followed by external aeration of the skin, for 15 minutes, with an ozone/NO-containing gas mixture with an ozone concentration of 3.0 mg/l and a nitric oxide concentration of 0.8 mg/l while simultaneously illuminating it with pulsed laser radiation of the red spectrum - λ=635 nm, implemented in a sealed cavity of the procedural capsule with the exclusion of the effect of the specified gas mixture on the patient's respiratory system;

- at the final stage - enteral intake, before meals, of 10% ozonide / NO-containing oil emulsion of the "oil in water" type with a peroxide value of ozonides P = 100 in a volume of 100 ml, as well as intake of succinic acid Forte - 1 tablet each after meals, the daily dose is 400 mg.

The conducted patent search showed that at the date of filing the application for the invention, there is no known method for the treatment of dysosmia caused by coronavirus infection, with the indicated distinctive features, which is implemented by inhibiting the maximum possible number of the main links of the pathological circle of the development of the disease described above.

A method for treating dysosmia caused by a coronavirus infection is implemented in a single technological process for treating a patient, and is based on the complex effect of a number of physical and physico-chemical factors, namely, the effect on: the conjunctiva, indirectly, with the eyelids closed; olfactory epithelium of the nasal mucosa and mucous tissues of the airways of the near and far parts of the respiratory system; The gastrointestinal tract and other organs and systems of the body, including the lymphoregion of the head and neck, the skin in the eye area and the skin of the patient as a whole, with the exception of the possibility of damage to the surfactant of the lung respiratory system and conjunctiva of the eyes.

Among the physical and physico-chemical factors used: high-amplitude low-frequency ultrasound - f=26.5 kHz; ξ=90 µm; pulsed laser radiation of the red spectrum - λ=635 nm; a highly active medicinal substance, which is used as: ozone / NO-containing gas mixture, as well as ozone / NO- and ozonide / NO-containing medicinal substances in the form of ozone / NO-containing saline solution or ozonide / NO-containing medicinal substance, presented as an ozonide/NO-containing vegetable oil or its 10% ozonide/NO-containing oil-in-water emulsion; solutions of antioxidant substances represented by an enzymatic antioxidant - superoxide dismutase or an antioxidant - succinic acid. Each of these factors can be used in combination, as well as in different combinations at different phases of the pathological circle of development of dysosmia, and against the background of its accompanying manifestations of the infectious process caused by the SARS-CoV-2 virus, realizing its significant, for the successful solution of the problem of the invention properties and indicators.

1. Low-frequency ultrasound, f = 26.5 kHz - has a multifunctional effect on pathologically altered tissues and infection with ultrasound energy, both through intermediate drug solutions and without them, while simultaneously “sparing” effect on the tissues surrounding the focus of infection, while ensuring a high quality of sanitation and the effectiveness of the treatment of inflammatory and other diseases while reducing the duration of treatment (A.A. Orlova, 1975; G.A. Nikolaev, V.I. Loshchilov, 1980; V.V. Pedder, I.V. Mozgovoy et al., 1979 , etc.).

Remote high-amplitude ultrasonic treatment of biological tissues, which is a special case of ultrasonic sanitation of the focus of infection through an intermediate drug solution, uses the low-frequency range of ultrasound - f = 26.5 kHz, which implements the mode of high-amplitude ultrasonic spraying of the solution in the form of a jet-aerosol torch that remotely affects the focus of infection and surrounding tissues ( V. I. Loschilov, G. E. Tsybrov, A. A. Orlova, 1979, etc.). A complex of physical, physicochemical and biological processes initiated in the field of high-amplitude ultrasound: cavitation, variable sound pressure, acoustic flows, sound-capillary and sound-chemical effects, absorption of ultrasound by a medium with its dissipative heating, etc., affect the processes occurring at the interfaces "waveguide-instrument - medicinal solution - biological tissue", as well as in heterogeneous systems of biological tissues and biological objects, leading to: high-quality sanitation of the surface of the focus of infection from necrotic masses, deposition of pathogenic microorganisms, impregnation deep into the tissues of medicinal substances, vibration-wave massage at the cellular and tissue levels, acceleration of the regeneration of infected tissues, which generally reduces the duration of treatment of the disease while reducing the consumption of the drugs used.

2. Treatment of biotissues with pulsed laser radiation of the red spectrum - λ=630-635 nm.

It is known that the interaction of coherent, monochromatic and polarized low-intensity laser radiation (LILR) with biological tissues initiates the response of vital body systems (S.V. Moskvin, 1999-2020; A.V. Nikitin et al., 2000; A.V. Geinitz et al., 2012). The primary mechanism of its biological action is associated with thermodynamic shifts due to the absorption of laser light by intracellular components, as well as a short-term temperature gradient that initiates the thermodynamic launch of Ca ²⁺ - dependent processes both at the cellular and tissue levels, followed by the development of secondary responses of the organism normalizing the functioning of body systems: immune, nervous, circulatory and lymphatic, hormonal, regulating and supporting hemostasis (S.V. Moskvin, A.A. Minenkov, 2010). The possibility of transdermal administration of hydrophilic solutions of medicinal substances, initiated by LILI - laser phoresis, is an important direction in solving the growing problems in infectology. In general, LILI has a desensitizing effect, improves microcirculation and rheological properties of blood, stabilizes hemodynamics, reduces the hypercoagulable potential of blood, stimulates phagocytosis, activates the antioxidant system and the synthesis of endogenous interferons by cells, has anti-inflammatory, bactericidal, immunocorrective, regenerative effects, etc. radiation, in comparison with continuous, due to the high concentration of energy in the light pulse, increases the therapeutic effect with a lower average energy introduced into the illuminated tissues.

3. Ozone / NO- and ozonide / NO-containing medicinal substances (V.V. Pedder et al., 1985-2020: S. Rilling, R. Viban, 1985; S.P. Peretyagin, 1992; A.B. Shekhter, 1998; E.B. Menshikova, 2006, etc.) - implement the mechanisms of therapeutic action of exogenously introduced ozone (O ₃ ) and nitric oxide II (NO) (hereinafter - nitric oxide) as in the form of ozone / NO-containing air mixture , and in its complex with medicinal solutions that make it possible to obtain ozone / NO-containing physiological solution, ozonide / NO-containing oil-in-water emulsion or ozonide / NO-containing vegetable oil, which are azeotropic in relation to the body, t .e. behaving as biologically pure substances compatible with the body, simultaneously affecting many pathogenetic links of diseases associated with impaired blood and lymph circulation, diffuse hypoxia, anaerobic glycolysis, accumulation of active radicals, endogenous intoxication syndrome, hypercoagulation syndrome, immunodeficiency states, etc. .

The effectiveness of their application lies in:

- initiation of pronounced - bactericidal, fungicidal and virucidal effects, realized not only outside, but also at the intracellular level, where a significant part of the viral load accumulates;

- activation of oxygen-dependent processes, normalization of lipid peroxidation, acid-base state and the potential of the antioxidant system, a decrease in the likelihood of erythrocyte agglutination with an increase in the deformability of erythrocytes and the oxygen transport function of the blood, as well as in the saturating effect;

- regulation of photoreactivity of the system of blood and lymph microcirculation with the participation of, for example, nitric oxide under conditions of laser illumination of a biological object;

- direct supply of oxygen to the body, which prevents hypoxic damage to cells, reduces viscosity and improves the rheological properties of blood and lymph, normalizes microcirculatory disorders in the circulatory and lymphatic systems, enhances vascular trophism and tissue metabolism, reduces the content of lipids and glucose in the blood;

- a decrease in the level of platelet aggregation and adhesion of neutrophils to the vascular endothelium, etc.

It should be noted the key role of nitric oxide (NO) in the control of vascular tone, maintenance of hemostasis, in the regulation of respiration, immunity and neurotransmission mechanisms, the manifestation of cytotoxic and cytostatic effects. The lack of NO generation in the body often leads to a number of pathological conditions (V.G. Granik, N.B. Grigoriev, 2015).

The above provides stimulation of: oxygenating, antihypoxic, vasodilating, anticoagulant, virucidal, bactericidal, mycocidal, antioxidant, detoxifying, immunomodulatory, analgesic and other effects, which are decisive in solving the problems of treating patients with Covid-19, associated incl. with dysosmia, dermatosis and skin rash, gastrointestinal lesions - as its symptoms, as well as subsequent developing respiratory complications of coronavirus infection. At the same time, the combination of a thermocontrast effect on the patient's heated skin by external aeration of its cooling ozone/NO-containing gas mixture, while simultaneously illuminating the skin with pulsed red spectrum laser radiation, is promising in terms of initiating lipolysis, removing and detoxifying endogenous toxins, enhancing microcirculation and general blood and lymph flow, etc.

4. Antioxidant substances (E.B. Menshikova et al., 2006; V.G. Ivanov et al., 2009, etc.).

It is known that in pathological processes the amount of endogenous antioxidants is significantly reduced. The use of exogenously administered, for example, enzymatic antioxidant - superoxide dismutase or antioxidant - succinic acid and other antioxidants, inhibits free radical chain reactions that produce toxic oxygen radicals, promote excessive formation of ROS, the development of lipid peroxidation, cause oxidative modification of proteins, etc. Antioxidants implement a membrane stabilizing effect and reduce the level of cytolysis, inhibit the processes of atrophy of the nervous tissue, normalize metabolic processes, have an anti-inflammatory effect and stimulate reparative processes, accelerate the transition of anaerobic processes to aerobic ones, etc. Antioxidants enhance microcirculation in the blood, lymph and interstitial systems of the body, reducing the level of acidosis and endogenous intoxication , promote the absorption of oxygen by tissue cells, stabilize the structure and functional activity of mitochondria, increase the energy potential of cells and the body as a whole, etc.

The physiological meaning of the impact on the links of the pathological circle of development of dysosmia, which is a consequence of its accompanying manifestations of a pronounced infectious process in the body caused by the SARS-CoV-2 virus, the above complex of physical and physico-chemical factors: high-amplitude low-frequency ultrasound; low-intensity pulsed laser radiation of the red spectrum; ozone/NO- and ozonide/NO-containing drugs; thermal contrast effect; antioxidant medicinal substances, sold in different combinations and at different phases of its development, is to provide:

- endoecological rehabilitation and detoxification of the body as a whole, by inhibiting excessive free radical reactions and lipid peroxidation, deactivation and extraction of endogenous toxins, activation of disturbed physiological processes of detoxification; stimulation of vasodilation of the vascular system of the bloodstream, activation of microcirculation in the circulatory, lymphatic and interstitial systems of the body while reducing blood viscosity, enhancing its anticoagulant and antithrombotic properties;

- disinfection of pathogenic microorganisms and their associations with the achievement of virucidal, bactericidal and fungicidal effects, enhancing anti-inflammatory action;

- impregnation of targeted medicinal substances deep into pathologically altered tissues with the creation of a depot of medicinal substances;

- processes of oxygen assimilation by cells and normalization of cellular respiration;

- restoration of disturbed functional and metabolic processes;

- normalization of local and general immunity, etc.

The essence of the invention is illustrated by drawings, which show:

- in Fig. 1 - a diagram of the interaction of the damaging factor - the SARS-CoV-2 virus with the mucous membrane of the nasal cavity in the region of the olfactory field, which penetrated from the external environment on inspiration into the nasal cavity or from the side of the path: "conjunctiva - nasolacrimal canal - nasal cavity". Drawing basis

- from the source [25];

- in Fig. 2 - stage of aeration with an ozone / NO-containing gas mixture of the eye area, with the patient's eyelids closed, using goggles of a closed type, the sealed cavity of which is connected to a portable ozonizer and a residual ozone destructor;

- in Fig. 3 - scheme of the stage of high-amplitude ultrasonic treatment of the nasal cavity by its sanitation by distant jet-aerosol spraying of a medicinal substance solution - ozonide/NO-containing vegetable oil or its 10% ozonide/NO-containing oil-in-water emulsion;

- in Fig. 4 - diagram of the stage of high-amplitude ultrasonic treatment of the oropharynx by its sanitation by distant jet-aerosol spraying of a medicinal substance solution - ozonide/NO-containing vegetable oil or its 10% ozonide/NO-containing oil-in-water emulsion;

- in Fig. 5 - scheme of the stage of endonasal illumination of the olfactory region of the nasal mucosa, orbits of the eye and the region of the ethmoid plate of the ethmoid bone in the area of the olfactory bulbs, with pulsed laser radiation of the red spectrum;

- in Fig. 6 is a diagram of the stage of intravenous drip administration of medicinal substances into the body, for example, ozone / NO-containing saline solution or a solution of an enzyme antioxidant - superoxide dismutase or an antioxidant solution - succinic acid;

- in Fig. 7 - zone I in FIG. 6 is a diagram of intravenous drip administration of an ozone/NO-containing medicinal substance obtained by pre-sparging a physiological solution with an ozone/NO-containing gas mixture in a standard vial with Dufo needles;

- in Fig. 8 is a diagram of the stage that implements a thermal contrast effect on the patient's skin by external aeration with a cooling ozone / NO-containing gas mixture while simultaneously illuminating with pulsed laser radiation of the red spectrum, carried out in a sealed cavity of the procedural capsule with the exclusion of exposure to the respiratory system with a gas mixture;

- in Fig. 9 is a diagram of a device in the form of a procedural capsule that implements the stage of initiating a thermal contrast effect on the patient's skin by aerating it externally with a cooling ozone/NO-containing gas mixture while simultaneously illuminating it with pulsed red spectrum laser radiation (view A in Fig. 8);

- in Fig. 10 is a diagram of a shaping elastically deformable supporting frame of a procedural capsule (section B-B in Fig. 9);

- in Fig. 11 is a schematic representation of a resilient sealant gasket, made, for example, from a capillary-porous woven carbon material, fitting the patient's neck, the cavity of which is filled with activated carbon, which acts as a destructor of residual ozone (section B-B in Fig. 9);

- in Fig. 12 - shows an exemplary cyclogram of the technological process for the treatment of dysosmia caused by coronavirus infection in a patient with Covid-19 by complex exposure of the skin surface to an ozone / NO-containing gas mixture and pulsed red spectrum laser radiation under conditions of thermal contrast exposure to the patient's skin in a sealed cavity of the procedural capsule ;

- in Fig. 13 - (patient P.S., 65 years old). Dynamics of vital health indicators of a Covid-19 patient depending on the number of procedures implemented by the proposed treatment method (July 2020);

- in Fig. 14 - (patient P.V., 72 years old). Dynamics of vital health indicators of a Covid-19 patient depending on the number of procedures implemented by the proposed treatment method (October 2020).

To implement a method for treating dysosmia caused by a coronavirus infection, a hardware complex is used, consisting of devices used in stages (Fig. 2 - Fig. 11).

At the stage of aeration with an ozone / NO-containing air mixture of the face in the eye area (Fig. 2), a device is used that contains: goggles of a closed type 1 (sealed, with a wide obturation band), the working cavity of which is connected through a pipe 2 to a portable ozonizer, for example, Koronnet-MM 3 (LLC NPP Metromed, Omsk) (portable ozonator 3), generating ozone/NO-containing gas mixture with ozone concentration - 0.3 mg/l and nitric oxide concentration - 0.1 mg/l, and a catalytic residual ozone destructor 4 (residual ozone destructor 4). It is possible to use the apparatus for gas ozone therapy Ozotron (LLC NPP Metromed, Omsk).

At the stages of high-amplitude ultrasonic treatment of the nasal cavity (Fig. 3) and oropharynx (Fig. 4) during their sanitation with a remotely sprayed jet-aerosol torch 5 of a solution of a highly active medicinal substance 6, which has a large kinetic energy obtained by high-amplitude spraying of low-frequency ultrasound - frequency f = 26.5 kHz, oscillation amplitude of the waveguide-tool ξ=90 µm. In this case, a device is used containing: a generator of ultrasonic vibrations of the low-frequency range - an ultrasonic otorhinolaryngological apparatus Tonsillor-MM 7 (LLC NPP Metromed, Omsk); acoustic node 8 from the ultrasonic apparatus Tonsillor-MM 7 associated with a single half-wave waveguide tool 9 having a central hole; spray unit 10 in the form of a nasal dilator 10.1, coupled with a fluoroplastic sleeve-insulator 10.2, which excludes the "draining" of ultrasound from the waveguide-instrument 9 onto the patient and determines his position in the nasal cavity both in depth and along its midline. The nebulizer unit 10 with the waveguide-instrument 9 introduced into it implements ozone/NO-ultrasonic treatment of the nasal cavities and oropharynx by ultrasonic jet-aerosol spraying of the torch 5 of the medicinal substance solution 6, sequentially in one session, initially - ozone/NO-containing saline solution with ozone concentration - 1.5 mg / l and nitrogen oxide concentration - 0.4 mg / l or ozonide / NO-containing vegetable oil with a peroxide value of ozonides P = 200 or its 10% ozonide / NO-containing oil emulsion of the “oil in water” with an ozonide peroxide value of P=100, and then a solution of an enzymatic antioxidant - superoxide dismutase Rexod 1.6 million units. (LLC "RES-BIO", St. Petersburg) or an antioxidant solution - 0.5% solution of succinic acid Remaxol (NTFF "Polisan", St. Petersburg). The device also contains: an ozone/NO-containing gas mixture generator, for example, an apparatus for gas ozone therapy Ozotron 11; container 12 with a solution of medicinal substance 6 and a bubbler 13 associated with the generator ozone/NO-containing gas mixture 11 (ozone/NO-containing gas mixture with an ozone concentration of 3.0 mg/l and a nitrogen oxide concentration of 0.8 mg/l l); residual ozone destructor 14; syringe 15 for taking the prepared solution of the medicinal substance 6 from the container 12. The syringe 15 through the holder 16 is installed on the body of the acoustic unit 8 and is connected to the hydraulic system 17 with the flow regulator 18 of the solution of the medicinal substance 6 connected with the central hole of the waveguide-instrument 9. The syringe 15 provides supply of drug solution 6 to the radiating end of the waveguide tool 9, which implements high-amplitude ultrasonic spraying of the drug solution 6 in the form of a torch 5 in the nasal cavity or oropharynx.

At the stage of endonasal illumination (Fig. 5) of the olfactory region of the mucous membrane of the nasal cavity and nearby interested areas with pulsed laser radiation of the red spectrum - λ = 633 nm, a device is used that contains: a laser therapeutic device Lasmik 19, then - a laser device Lasmik 19 (LLC " Research Center "Matrix", Moscow), associated with a laser emitting head 20, coupled with an otorhinolaryngological nozzle 21 (nozzle 21), which implements manipulations in the nasal cavity and conducts stimulating illumination with defocused laser radiation 22, supplied to the interested zones of one of the sections of the primary focus infections, namely, to the olfactory region of the nasal mucosa.

At the stage of intravenous drip administration of medicinal substances into the body, a device is used containing (Fig. 6 and Fig. 7): an ozone/NO-containing gas mixture generator - an apparatus for gas ozone therapy Ozotron 11, connected through a supply pipe 23 and a needle 24 with a cavity a standard vial 25 with a volume of 250 ml or 400 ml with a physiological solution to be bubbling with an ozone / NO-containing gas mixture through a needle 24 until it is saturated with ozone and nitric oxide to obtain a solution of a medicinal substance 6. Inserted through the cork of the vial 25, the needle 26 is intended to remove degassed excess ozone from vial 25, which is not bound by saline solution, which is fed through pipe 27 to the destructor of residual ozone 14. Inserted through the stopper of vial 25, needle 28 is designed to remove a solution of medicinal substance 6 from it and infuse it into the patient's vein using a transfusion system for infusion solutions, for example, PK 21-01 - Sintez (Kurgan) . Bottle 25 with a prepared solution of medicinal substance 6 in the form of an ozone/NO-containing saline solution with an ozone concentration of -1.5 mg/l and a nitric oxide concentration of 0.4 mg/l or a solution of an enzymatic antioxidant - superoxide dismutase Rexod 1.6 million units . or antioxidant - 0.5% solution of succinic acid Remaxol, placed in the rack holder 29.

At the stage of external aeration of the patient's skin with an ozone/NO-containing gas mixture with its simultaneous illumination with pulsed laser radiation of the red spectrum, a device (Fig. 8 - Fig. 11) is used, containing: a procedural capsule 30 (capsule 30), made according to a technical solution [ 26], in the form of a deformable tubular polyethylene cover 31, not less than 0.5 mm thick, having a longitudinal section (for placing the patient in the cavity of the capsule 30) and located horizontally relative to the supporting surface of the couch 32. At one end of the capsule 30 there is a hole of variable size 33 (for placing the patient's head outside the capsule 30), the change of which, as well as the sealing of the cavity of the capsule 30, is carried out by a zipper 34 used to close and open it.

Maintaining the shape and volume of the capsule 30 is ensured by the shape-forming elastically deformable frames 35 of the supporting frame (not shown) located inside it, which are the support for:

- shaping tubular polyethylene cover 31;

- supply pipe 23, directing the ozone/NO-containing gas mixture with an ozone concentration of 3.0 mg/l and a nitrogen oxide concentration of 0.8 mg/l from the Ozotron 11 gas ozone therapy apparatus into the cavity of the capsule 30 with the patient in it;

- outlet pipe 36 supplying the spent ozone/NO-containing gas mixture to the residual ozone destructor 14;

- placement of a laser matrix emitting head 37, containing 8 laser diodes, designed to illuminate the skin with pulsed laser radiation of the red spectrum - λ = 635 nm, associated with the laser Lasmik device 19. Spatial angular rotation of the laser matrix emitting head 37, relative to the object of illumination, is provided a sealing elastic element in the form of a corrugation 38, integrally connected with a tubular polyethylene cover 31. Since the capsule 30 implements the stage of external aeration of the patient's skin with an ozone/NO-containing gas mixture while simultaneously illuminating with pulsed laser radiation, to prevent penetration into the environment ozone/NO-containing gas mixture and its impact on the respiratory system of both the patient and medical personnel, the variable size hole 33 of the capsule 30 is blocked by the seal 39.

The sealer 39 (Fig. 8, Fig. 9, Fig. 11) is made in the form of an elastic hollow gasket 39.1 (39.1 gasket) of a capillary-porous woven carbon material filled with activated carbon 39.2 and equipped with mating parts of a Velcro lock 39.3, providing a tight (without excessive compression of the patient's neck) fit of the gasket 39.1, by varying the size of its collar zone, followed by hermetic fixation of the gasket 39.1, relative to the capsule 30, with a zipper 34 locking connection. filled with activated carbon 39.2, performs an additional function - a destructor of residual ozone, which excludes the possible penetration of ozone / NO-containing gas mixture (in the neck) into the environment and its access to the patient's face and then to his respiratory tract.

The proposed method for the treatment of dysosmia caused by coronavirus infection is carried out in stages using the specified hardware complex, devices and medicines approved by Roszdravnadzor for use in healthcare.

At the preliminary stage of the implementation of the method for the treatment of dysosmia caused by coronavirus infection, in the prescribed manner, a physical examination of the patient is carried out; olfactometric study according to the method of Bershtein A.N. (using a set of odorous substances); choose the tactics of treatment and the conditions for providing assistance: outpatient - at home for the patient's stay or inpatient, depending on the severity of the manifestation of the disease. The antiviral drug favipiravir is prescribed along with anticoagulant therapy in accordance with the Interim Guidelines of the Ministry of Health of the Russian Federation [8]. Based on the examination data, they refine the treatment tactics and select medicines taking into account the characteristics of the causative agent of the disease, the presence of associative pathogenic microflora and their drug sensitivity, plan the number of treatment procedures, taking into account the severity of the patient's condition with Covid-19, the duration of his infection, as well as the absence of he is allergic to ozone or nitric oxide.

Then, the first stage of the implementation of the proposed method is carried out (Fig. 2). Since infection with the SARS-CoV2 virus often occurs not only from the external environment when inhaling into the nasal cavity, but also through the conjunctiva - in the direction: "conjunctiva of the eye - nasolacrimal canal - nasal cavity", then at this stage external aeration is carried out ozone / NO-containing gas mixture of the skin of the eye area, with the patient's eyelids closed, carried out using a portable ozonizer Coronnet 3 (it is possible to use an apparatus for gas ozone therapy Ozotron 11).

To stop the infection in the nasal cavity from the side of the conjunctiva of the eyes, the patient is put on goggles of a closed type 1, the inner cavity of which is connected to the supply pipe 2, which is attached to a portable ozonizer 3, placed in the pocket of the patient's outerwear. The portable ozonizer 3 is turned on and through the supply pipe 2 aerate, for 60 seconds, the sealed inner cavity of the goggles of the closed type 1, in the eye area, with ozone/NO-containing medicinal substance 6 in the form of ozone/NO-containing gas mixture with ozone concentration - 0.5 mg/l and nitric oxide concentration - 0.1 mg/l. Residual ozone from the spent ozone/NO-containing gas mixture is decontaminated to oxygen by residual ozone destructor 4. In the process of aeration, diffusion saturation of the skin surface of the eyelids with ozone and nitrogen oxide and indirectly of the conjunctiva, lacrimal gland, nasolacrimal canal, etc. is violated. from the links of the pathological circle of development of the Covid-19 disease, achieved by disinfection with highly active ozone/NO-containing medicinal substance 6 of both the SARS-CoV2 virus and, as a rule, the associated pathogenic microflora present. After the end of the stage, the portable ozonizer 3 is turned off, goggles of the closed type 1 with the attached pipe 2 are removed, and the next stage of the proposed method is started.

At the second stage of the implementation of the proposed method, the patient is placed in a treatment chair with a reclined headrest, in the "half-sitting" position, and the SARS-CoV-2 virus that has entered the nasal cavity and oropharynx from the external environment during inhalation is inhibited (Fig. 1).

Initially (Fig. 3), an endonasal exposure to a torch of ultrasonic aerosols 5 ozone / NO - or ozonide / NO-containing medicinal substance 6 is carried out in the form of: ozone / NO-containing saline with an ozone concentration of 1.3 mg / l and an oxide concentration nitrogen -0.4 mg/l or ozonide/NO-containing vegetable oil with an ozonide peroxide value of P=200 or its 10% ozonide/NO-containing oil-in-water emulsion with an ozonide peroxide value of P=100 per olfactory epithelium of the nasal mucosa, for 15 seconds on each half of the nose. To do this, the nasal dilator 10.1 of the nebulizer unit 10, coupled with the waveguide-instrument 9, the acoustic unit 8 of the ultrasonic device Tonsillor-MM 7 and the syringe 15 with the medicinal substance 6, is introduced into the vestibule of one of the halves of the nasal cavity. By squeezing the branches of the nasal dilator 10.1, its delimiting sponges expand the vestibule to the required limits, providing an overview of the state of the mucous cavity with the determination of the localization of the focus of infection in it. The regulator 18 sets the flow rate of the solution of the medicinal substance 6, which determines the mode of ultrasonic jet-aerosol spraying of the torch 5 on the focus of infection. The waveguide-instrument 9 is inserted into the sleeve-insulator 10.2, it is oriented relative to the delimiting jaws of the nasal dilator 10.1 and the visually determined focus of infection by spatial angular rotation and reciprocating movement of the waveguide-instrument 9 relative to the sleeve-insulator 10.2. The ultrasonic apparatus Tonsillor-MM 7 is turned on and carried out at a frequency of ultrasonic vibrations f=26.5 kHz and at an amplitude of ultrasonic vibrations of the waveguide-tool - ξ=90 μm, for 15 seconds, a sanitizing effect, one of the types indicated above, ozone / NO- or ozonide/NO-containing medicinal substance 6, on the infected mucous cavity of one of the halves of the nose. With remote ultrasonic irrigation of the focus of infection in the cavities of the nose and nasopharynx, a jet-aerosol torch 5, breaking off from the radiating end of the waveguide tool 9 in the form of a torch of aerosol particles with a dispersion of 10-50 microns, accumulations of individual drops and intermittent microjets, due to its kinetic energy , provides sanitation and disinfection of biological tissues from necrotic masses, introduction into the olfactory epithelium of the nasal mucosa and mucous tissues of the airways of the nasopharynx of an ozone / NO - or ozonide / NO-containing solution of a medicinal substance 6 with the suppression of SARS-CoV-2 and other pathogenic microorganisms. The latter is ensured by the formation, during cavitation in solution 6, of free radicals, etc., as well as ozone and ozonide derivatives, which have high virucidal, fungicidal and antibacterial activity. At the end of the manipulations associated with ozone / NO- or ozonide / NO-ultrasonic irrigation of the nasal cavities and nasopharynx, the supply of the drug solution 6 from the syringe 15 is blocked by the flow regulator 18. The nasal dilator 10.1 and the waveguide-instrument 9 are removed from the vestibule and nasal cavity, and then, on the other half of the nose, similarly, ultrasonic treatment of the mucous membrane of the nasal cavity and nasopharynx is performed with a jet-aerosol torch 5 ozone / NO- or ozonide / NO-containing solution of the medicinal substance 6. Simultaneously with the nasal cavities, the nasopharynx and sinuses communicating with them are sanitized .

According to the above manipulations, the procedure of the second stage (Fig. 4) is carried out, associated with oral sanitation of the oropharynx, namely, sanitation of the mucous tissues of the airways of the oropharynx, bronchi and underlying parts of the lung, carried out similarly to the previous procedure of endonasal exposure to the olfactory epithelium of the nasal mucosa (Fig. .3). This implements the disinfection of the focus of infection in the mucous membranes of the airways of the oropharynx, bronchi and underlying parts of the lung, carried out by oral sanitation by distant ultrasonic jet-aerosol spraying with a torch of ultrasonic aerosols 5 ozone / NO- or ozonide / NO-containing medicinal substance 6, for 30 seconds, with intermittent breath holding.

Technological parameters and modes of ozone/NO - or ozonide/NO-ultrasonic sanitation of the olfactory epithelium of the nasal mucosa, mucous membranes of the nasopharynx and oropharynx, as well as, indirectly, of the bronchi and underlying parts of the lung are as follows:

- frequency of ultrasonic vibrations - 26.5 kHz;

- amplitude of ultrasonic oscillations of the waveguide-tool - ξ=90 microns;

- exposure of endonasal ultrasonic jet-aerosol spraying of ozone / NO- or ozonide / NO-containing solution of a medicinal substance - 15 seconds on the mucous cavity of each of the halves of the nose;

- exposure of oral ultrasonic jet-aerosol spraying of a solution of ozone / NO - or ozonide / NO-containing medicinal substance - 30 seconds;

- ozone/NO-containing saline solution with ozone concentration - 1.5 mg/l and nitric oxide concentration - 0.4 mg/l;

- ozonide/NO-containing vegetable oil with ozonide peroxide value P=200;

- 10% ozonide/NO-containing oil-in-water emulsion with ozonide peroxide value P=100.

Ozone/NO- or ozonide/NO-containing medicinal substance 6 is obtained by bubbling physiological saline or, respectively, vegetable oil (olive, sunflower) ozone/NO-containing gas mixture generated by the apparatus for gas ozone therapy Ozotron 11 (Fig. 3).

The pathogenetic justification for the need for these procedures for a patient with Covid-19 is that during the inflammatory process, in the stage of acidosis, connective tissues consume more oxygen (Yu.F. Isakov, 1990), as well as nitric oxide, a universal regulator of cellular metabolism (B .G. Granik, N.B. Grigoriev, 2015) than tissues not affected by the process. In pathological processes, the amount of oxygen, nitric oxide and antioxidant components, for example, superoxide dismutase, succinic acid, catalase, etc., in the body decreases, which requires their appropriate correction, including the use of a complex of physical and physico-chemical factors proposed in this technical solution.

In the process of ultrasonic atomization of a solution of ozone/NO- or ozonide/NO-containing medicinal substance 6, the formed jet-aerosol torch 5 contains aerosol particles with a high value of Gibbs surface energy, which are associates of aqueous solution molecules with absorbed ozone and nitrogen oxide molecules and their derivatives, which are highly active chemicals. The jet-aerosol torch 5 of the drug solution 6 formed by high-amplitude ultrasound, containing aerosol particles with ozone and nitric oxide molecules, transfers them due to gravity and the kinetic energy of the ultrasonic flow to the surface of the focus of infection and contributes to the high penetrating ability of aerosols into hard-to-reach areas of the upper respiratory tract - VDP.

The subsequent adhesion and coalescence of aerosols with the surface of pollinated tissues ensures the creation, on the one hand, of a depot of the drug substance 6 in the focus of infection - the mucous cavities of the nose, nasopharynx, sinuses and oropharynx, and on the other hand, a chemically active film of the drug substance 6 covering the surface of the VRT cavities capable of adsorption and deposition of SARS-CoV-2 viral particles and other pathogenic microorganisms from the air flow inhaled and exhaled by the patient. The chemically active film of medicinal substance 6 and aerosol particles circulating in the cavities of the VRT with ozone and nitric oxide molecules interact with pathogenic microorganisms, altered biological tissues, tissue fluids, toxins, etc., which leads to the absorption of ozone by the latter with the formation of the corresponding ozonides, and after them hydrolytic cleavage - peroxides. Peroxides (superoxide and hydroxyl radicals, hydrogen peroxide, etc.), being effective catalysts, affect the processes of oxidation and transformation of the structure of the SARS-CoV-2 virus, membrane lipids of the cells of associative microorganisms of the focus of infection into peroxide compounds, causing them to be "poisoned" by oxygen through through free radicals (R. Gershman, 1978). Also, they affect the processes of destruction and inactivation of endogenous toxins of the focus of infection with the formation of toxoids (immunomodulators), etc., and, therefore, provide antiacidotic, virucidal and bactericidal effects, normalize enzymatic metabolic reactions, lead to pronounced oxygenation of biological tissues, blood, - lymph - and interstitial systems, stimulate local and general immunity, accelerate reparative processes (L.I. Gerasimova, I.Z. Nemtsev, 1980; A.B. Shekhter, 1998; A.F. Vanin, 1998; V.V. Pedder , 2013, etc.).

At the third stage of the implementation of the proposed method (Fig. 5), carried out in order to inhibit the SARS-CoV-2 virus that has penetrated through the conjunctiva of the eye and helmet canal or from the external environment on inspiration into the nasal cavity (Fig. 1), as well as to launch self-regulation mechanisms organism and its sanogenesis due to the initiation of laser-induced biological processes, which are Ca ²⁺ - dependent processes that enhance the synthesis of ATP, the processes of proliferation, exocytosis, etc. (S.V. Moskvin, 2014), endonasal illumination of the olfactory region of the mucous membrane of the nasal cavity is performed laser radiation of the red spectrum - λ=635 nm. This initiates the restoration of the disturbed mechanism of adaptation of olfactory receptor cells by replenishing Ca ²⁺ calcium ions, which implement the enzymatic cascade of sensory signal transduction.

Before the procedure, the patient is placed in a treatment chair with the headrest reclined in the half-sitting position. Both the patient and the medical staff, during the procedure, use special goggles to protect the eyes from laser radiation of the specified wavelength (protection level L2 according to GOST R 12.4.254-2-10).

Through one of the vestibules, into the nasal cavity, at the desired depth, a nozzle 21 is inserted, coupled with a laser emitting head 20, connected to the laser Lasmik 19 device. with a nozzle 21 relative to the vestibule of the nose, illuminated with pulsed laser radiation of the red spectrum 22, without affecting the area of the orbit of the eye, the mucous membrane of the nasal cavity, namely, the site of the primary focus of infection - the olfactory region of the mucous membrane of the nasal cavity (olfactory field, including olfactory cells, olfactory nerves, olfactory glands). Taking into account the penetrating ability of pulsed laser radiation of the red spectrum, an indirect stimulating effect is carried out on the olfactory nerves ending in the olfactory bulb, the olfactory bulb itself, the nerve fibers of the olfactory tract and further on the hippocampus and the cortical section of the olfactory analyzer. At the end of the exposure of the nasal mucosa to laser radiation, the laser Lasmik 19 device is turned off. Similarly, the nasal cavity is illuminated through the vestibule of the other half of the nose. Parameters and modes of illumination of the nasal mucosa:

- wavelength of laser radiation - λ=635 nm;

- laser illumination mode - pulsed;

- pulse power - 40 W;

- pulse duration - 100 ns (10 ^-7 s);

- exposure of illumination by laser radiation of the nasal mucosa - 20 seconds for each of the halves of the nose.

At the fourth stage of the implementation of the proposed method (Fig. 6, Fig. 7), systemic exposure is provided by a complex of physico-chemical factors that contribute to the achievement of: oxygenating, antihypoxic, vasodilating, detoxifying, anticoagulant. antioxidant, immunomodulatory, virucidal, fungicidal, bactericidal and other effects, initiating, in turn, a generalized effect, manifested in sufficient trophic supply of tissues by improving the oxygen-transport function of the blood, as well as sanitation of the endoecological environment of the body from toxins of endo- and exogenous origin and, above all, the blood, lymph and interstitial system of the infected patient. Systemic exposure is carried out sequentially in one session, initially - by intravenous drip injection into the body of ozone / NO-containing saline solution with an ozone concentration of 1.5 mg / l and a nitric oxide concentration of 0.4 mg / l, and then - a solution enzymatic antioxidant - superoxide dismutase Rexod 1.6 million units. or an antioxidant solution - 0.5% solution of succinic acid Remaxol.

Preparation of the patient for the procedure is carried out in the prescribed manner. It is placed in the “lying” position on a couch with a stand 29 installed nearby, equipped with a standard vial 25 with a solution of medicinal substance 6 in the form of an ozone/NO-containing gas mixture previously prepared by bubbling the initial physiological solution until saturation is reached. The patient is provided with venous access, a venous tourniquet is applied, an antiseptic treatment of the injection field zone is carried out. An intravenous needle is inserted into a peripheral vein and a solution of ozone/NO-containing medicinal substance 6 is supplied dropwise at a rate of 40-60 drops per minute until it is completely consumed in a vial 25, with a volume of 250 or 400 ml, prescribed by the attending physician. After that, without interruption, taking into account the comorbidity, antioxidant therapy is carried out, similarly to the above, with a non-ozonized antioxidant - a solution of an enzymatic antioxidant - superoxide dismutase or an antioxidant solution - succinic acid, previously dissolved in another bottle 25 with a volume of 250 ml. At the end of the procedure, in dynamics, the patient's condition is monitored by indicators: saturation, body temperature, pulse rate, blood pressure.

- at the fifth stage - the implementation of the proposed method (Fig. 8 - Fig. 12), the skin of the patient placed in the sealed cavity of the capsule 30 is exposed to a complex of physical and physico-chemical factors, including initially - natural heating in the capsule 30 of the air the body of the patient himself, and then carrying out external aeration of his skin with a cooling ozone/NO-containing gas mixture and simultaneous external illumination with pulsed laser radiation of the red spectrum, implemented by a laser matrix emitting head 37 (Fig. 12).

The sequence diagram shown in Fig. 12 is implemented by a complex effect on the patient's skin: contrasting temperatures, ozone / NO-containing gas mixture with an ozone concentration of 3.0 mg / l and a nitric oxide concentration of 0.8 mg / l and pulsed red spectrum laser radiation - λ = 635 nm ( laserophoresis), which have a multifunctional therapeutic effect both on external lesions of the skin in the form of dermatoses and skin rashes, and indirectly stimulate, mainly through the sweat glands and hair follicles, transdermal Ca ²⁺ - dependent transcytosis transport of a highly active solution of the drug mixture (ozone /NO+sweat) formed on the surface of the skin, which has high bactericidal, fungicidal and virucidal properties, as well as initiating body responses both at the cellular and tissue levels, normalizing the immune, nervous, circulatory, lymphatic and hormonal systems, supporting hemostasis .

Implementation of the fifth stage of the method for treating dysosmia caused by coronavirus infection, using the example of the cyclogram Fig. 12 is carried out as follows.

Initially, a capsule 30 is placed on the supporting surface of the couch 32, which is in a transport state, it is rolled out on the couch 32, the zipper 34 is opened, and a sanitary pad is placed on the bottom of the capsule 30. The patient, with the resilient-elastic gasket 39.1 of the sealer 39 (Fig. 8, Fig. 11) put on his collar zone of the neck, is placed inside the cavity of the capsule 30 with the position of the head outside its cavity. The supporting frame in the form of a row of interconnected, elastically deformable frames 35, which are supports for the formation of a tubular sheath 31, is installed above the patient (Fig. 8, Fig. 10), providing a stable internal volume for free placement of the patient in it. Sealing the cavity of the capsule 30 is carried out by a locking connection of the "lightning" type 34, which closes the cavity of the tubular cover 31 with the patient, and also fixes the position of the sealing gasket 39.1 of the sealant 39 relative to the capsule 30, eliminating gaps between the gasket 39.1, fitting the patient's neck and between the gasket 39.1 and the opening of the variable size 33 of the capsule 30. This ensures the sealing and delimitation of the cavity of the capsule 30 from the external environment, and the patient's body, except for the head, is in an isolated air space. After that (Fig. 12), during the time τ ₁ - 15 minutes, due to the heat of the patient, having an elevated body temperature of 37-39°C or more, the convective heating of the air between the skin and the inner surface of the tubular cover 31 occurs to a temperature 40-42°C or more, causing sweating. Having withstood the maximum temperature reached during the sweating time τ ₂ - 5 minutes, in the cavity of the capsule 30, the device for gas ozone therapy Ozotron 11 is simultaneously turned on, generating ozone / NO-containing gas mixture with an ozone concentration of 3.0 mg / l and a nitrogen oxide concentration - 0.8 mg/l. which is a refrigerant (working gas - ambient air with a temperature of 20-22°C) and laser device Lasmik 19, acting on the patient together for a total time τ ₃ +τ ₄ - 15 minutes. Where: τ ₃ - the period of time of cooling the patient's skin with a cooling factor - ozone / NO-containing gas mixture - 5 minutes, and τ ₄ - the period of time of natural heating of the skin to the initial body temperature after turning off the cooling factor - 10 minutes. Entering through the pipe 23 into the heated environment of the cavity of the capsule 30, the refrigerant displaces from it the air previously heated to 40-42°C or more and, at the same time, in the forced mode cools the heated skin. At the same time, the heated air displaced from the cavity of the capsule 30 is mixed with excess ozone/NO-containing gas mixture and drained out through the destructor of residual ozone 14. In this way, during the time τ ₃ - 5 minutes, a thermocontrast effect on the skin is carried out, carried out in conjunction with laser phoresis , which is excited by pulsed laser radiation of the red spectrum from a laser matrix emitting head 37, associated with a laser device Lasmik 19. It non-invasively illuminates the skin by a labile distant technique. In this case, the laser matrix emitting head 37 (Fig. 8 - Fig. 10), coupled with the elastic element - corrugation 38, based on the frame 35 of the capsule 30 supporting frame, due to its spatial angular rotations is directed to one or another area of the skin , sequentially affecting the interested zones of lesions with an exposure of 2 minutes for each focus, depending on its area. The total time of illumination by pulsed laser radiation in one session τ ₃ +τ ₄ - 15 minutes is sufficient to enhance mass transfer in the systems of lymph, blood and interstitial microcirculation. During the time τ ₃ , on the one hand, the formation of a highly active drug substance 6 is initiated, which occurs during the interaction of liquid (sweat) and gas (ozone and NO) phases, at heterogeneous interfaces "ozone / NO-containing gas mixture - tissue fluid ( sweat) - the surface of the "skin", the other - a sharp surface cooling of the previously heated skin from 40-42 ° C to a temperature close to the cooling ozone / NO-containing gas mixture, which initiates the effect of thermal contrast absorption of the medicinal substance 6 by the skin with penetration it into the internal environment of the body by overcoming the interface: "a water-soluble mixture of ozone / NO-containing medicinal substance 6 with sweat - the surface of the skin - the surface of the walls of the excretory ducts of the sweat glands - the surface of the walls of the outer root sheath of the hair follicles". Overcoming the indicated interfaces and further transport of the medicinal substance 6 is carried out by ongoing thermodynamic processes. On the one hand, by thermal contrast stimulation of the transglandular (rheological) and diffusion pathways of its penetration into the internal environment [27-29], and on the other hand, due to the transcytosis pathway of its penetration initiated by exposure of the skin surface to pulsed laser radiation of the red spectrum [30, 31] . At the same time, the transglandular path of penetration of the medicinal substance 6 into the internal environment is carried out through the excretory ducts of the sweat glands and root sheaths of the hair follicles and hair follicles, which are channels through which it bypasses the skin barrier enters the depth of the ducts and diffusely penetrates through their walls into the intercellular space and into the intercellular fluid, accumulating in the distal parts of the sweat ducts, root sheaths of hair follicles and hair follicles, densely wrapped in lymphatic and blood microcapillaries. This accelerates the penetration into the lymph and blood microcapillaries of the medicinal substance 6, which has accumulated in the area of the sweat ducts, sebaceous glands and hair follicles at the stage of exposure to the skin, both due to contrast temperatures and due to transcytosis (pinocytosis). Through the capillary network of the blood and lymphatic systems with the blood and lymph flow, it spreads deep into and further into the systemic circulation of the blood and lymph flow, saturating the interstitial space of the skin and the body as a whole with the creation of a long-term depot of the medicinal substance 6 containing ozone and its decomposition products into in the form of highly active groups of substances: atomic and molecular oxygen, ozonides, as well as nitric oxide and its derivatives, which have a high redox potential and disinfecting properties that allow effective suppression of viruses, bacteria, fungi in the foci of inflammation, as well as the deactivation of endotoxins (L.K. Gerunova, V.V. Pedder et al., 2013). Penetrating into the deep zones of the affected area with impaired trophism and, as a rule, having elements of local hypoxia, highly active drug substance 6 provides forced oxygenation of these areas, which, in turn, stimulates microcirculation with increased blood supply, and, consequently, mass transfer, immunomodulatory, trophic and reparative processes, etc. This implements non-invasive administration of solutions of medicinal substances at the level of the prelymphatic link, carried out in a period of time τ ₃ + τ ₄ (15 minutes), sufficient for the implementation of preventive and therapeutic measures, during which the device for gas ozone therapy Ozotron 11 and the laser device Lasmik 19 remains switched on, and the patient's body temperature returns to its original value. The parameters and modes that implement the processes of thermocontrast absorption of the medicinal substance 6 by the skin of the patient and the accompanying laser phoresis, implemented using a laser matrix emitting head 37, are as follows:

- the time of convective heating of the air in the sealed cavity of the procedural capsule from its own heat radiated by the skin of the patient - τ ₁ - 15 minutes with the achievement of an air temperature in the cavity of the procedural capsule of the order of - 40-42°C or more;

- the holding time of the highest temperature reached in the sealed cavity of the tubular cover from its own heat radiated by the patient's skin - τ ₂ - 5 minutes;

- external aeration of the skin with an ozone/NO-containing gas mixture with an ozone concentration of 3.0 mg/l and a nitric oxide concentration of 0.8 mg/l at an ozone/NO-containing gas mixture (refrigerant) temperature having an ambient temperature of air , about - 20-22°C;

- the time of implementation of jointly occurring processes: thermocontrast absorption of the medicinal substance by the skin and laser phoresis - τ ₃ +τ ₄ - 15 minutes;

- wavelength of laser matrix emitting head - λ=635 nm;

- laser illumination mode - pulsed;

- pulse duration - 100 ns (10 ^-7 s);

- pulse power - 40 W from 8 laser diodes;

- effective area of non-invasive illumination by remote method - 50 cm ² .

After the procedure of the fifth stage is completed, the Ozotron 11 gas ozone therapy apparatus and the Lasmik 19 laser apparatus are turned off. Carry out depressurization of the cavity of the capsule 30 with the patient in it. The exit of the patient outside and disassembly of the capsule 30 are carried out in the reverse order described above for the assembly of the capsule 30 and placement of the patient in its cavity. Capsule 30 is disinfected and sterilized, in the prescribed manner, according to MU 287-113.

At the final stage, 10% ozonide/NO-containing oil-in-water emulsion with an ozonide peroxide value of P=100 in a volume of 100 ml is taken enterally, before meals, as well as succinic acid Forte - but 1 tablet after food, daily dose - 400 mg.

According to the indications and prescription of the attending physician, the course of treatment using the proposed method for treating dysosmia caused by coronavirus infection is carried out for 12-15 days, taking into account the severity of the patient's condition - 1-2 times a day. In cases of uncomplicated and relatively mild disease, the indicated stages of the treatment session procedure are carried out daily - 1 time per day, in the morning, and in cases of complication of the ongoing disease, they are performed daily - 2 times a day, in the morning and evening.

The limitation of the use of the proposed technical solution in patients are known contraindications specific to physiotherapy, as well as individual intolerance to ozone and nitric oxide.

To date, the technological schemes of the indicated stages of the proposed method have been worked out, implemented using a hardware complex permitted by Roszdravnadzor in healthcare, including mass-produced medical devices: an otorhinolaryngological device of the Tonsillor-MM type (it is possible to use the Tonsillor-3MM Complex); apparatus for gas ozone therapy Ozotron; laser device Lasmik. In addition, prototypes of the Coronnet-MM portable ozonizer and a treatment capsule were developed and prepared for acceptance tests regulated by Roszdravnadzor.

When implementing the proposed method, medicinal substances available and produced by the pharmaceutical industry of the Russian Federation were used, namely, antioxidant preparations: an enzymatic antioxidant - superoxide dismutase Rexod (OOO "RESBIO", St. Petersburg) and a 0.5% solution of succinic acid Remaxol (NTFF "Polisan ”, St. Petersburg). According to the indications determined by the attending physician, a patient with Covid-19, during the entire course of treatment, is prescribed succinic acid Forte (Kvadrat-S LLC, Moscow) 1 tablet after meals, the daily dose is 400 mg, and in cases lesions of the gastrointestinal tract with coronavirus infection - daily, before meals and enterally, taking a 10% ozonide / NO-containing oil-in-water emulsion with an ozonide peroxide value of P = 100 in a volume of 100 ml.

From July 2020 to the present, the proposed method for the treatment of dysosmia caused by a coronavirus infection, often accompanied by damage to the skin, gastrointestinal tract and other manifestations of Covid-19, was implemented by the staff of the Department of Oncology of Omsk State Medical University, in consultation with specialists from the departments of otorhinolaryngology of the First Moscow State Medical University named after I.I. .M Sechenov and Altai State Medical University, more than 30 patients with Covid-19. Moreover, some of them had lung lesions in the amount of 10% and up to numbers - over 50%.

Since the proposed method of treatment uses, at its core, the capabilities of hospital-replacing ozone / NO-ultrasound technologies for the treatment of diseases using portable and transportable medical devices such as Tonsillor-MM, Ozotron, Coronnet-MM, Lasmik, a transformable procedural capsule, the treatment of patients with Covid -19 were mainly carried out on an outpatient basis at the home of their stay.

Example 1. Patient PS, 63 years old, surgeon. From the anamnesis: he fell ill acutely on July 20, 2020, 2 weeks after contact with a patient with Covid-19. Complaints of headache, weakness, dryness in the nasopharynx and oropharynx, loss of smell, fever with fever up to 39.8°C, hypotension - BP=110/70 - 90/60 mm Hg. The treatment was carried out on an outpatient basis - at home in self-isolation mode. Within 3 days from the onset of the disease, antipyretic therapy was carried out (analgin 0.25-0.5 g orally during the day), against which the fever remained at 38-39.5°C. Weakness, pain in the muscles of the limbs and body, symptoms of gastrointestinal lesions - diarrhea, lack of appetite were noted. Blood pressure at the level - 90/60-110/70 mm Hg, pulse at the level - 90-96 beats. min.

Examined by a doctor on July 23, 2020. Diagnosis: Covid-19. Community-acquired bilateral pneumonia.

Physical examination and olfactometric study according to the Bernstein method A.N. anosmia (olfactory agnosia) was determined, skin rashes (urticaria) and symptoms of gastrointestinal damage - diarrhea were noted. It is recommended to perform MSCT OGK. Added to the treatment: antibacterial and antiviral therapy according to the generally accepted scheme: intravenous drip: Levofloxacin 500 mg for 8 days, Ceftriaxone 2 g in saline for 8 days, and Azithromycin 500 mg 1 time per day.

07/24/2020 - at rest, severe shortness of breath appeared. Saturation by pulse oximeter - 89%.

07/25/2020 - MSCT of the OGK was performed with the conclusion: bilateral confluent polysegmental pneumonia with damage to more than 50% of the lung tissue. Complicated course of the disease. Given the MSCT data, the lack of positive dynamics in the treatment of the disease - the persistence of fibril fever and symptoms of intoxication, the presence of concomitant pathology (arterial hypertension, myocardial infarction, coronary artery bypass grafting), which create the risk of complications during the course of the underlying disease, as well as the patient's age - over 60 years, the treatment regimen was changed.

From 07/25/2020, according to the proposed technical solution, the following stages of treatment were added to the patient's treatment regimen, carried out daily - 2 times a day, associated with:

- aeration of the skin in the eye area of the patient, with closed eyelids, ozone / NO-containing gas mixture;

- ozone / NO - or ozonide / NO-ultrasonic sanitation of the olfactory epithelium of the nasal mucosa, mucous membranes of the nasopharynx and oropharynx, as well as, indirectly, of the bronchi and underlying parts of the lung, by spraying a torch of ultrasonic aerosol ozone / NO- or ozonide / NO on them - containing medicinal substances;

- endonasal illumination of the olfactory region of the mucous membrane of the nasal cavities with pulsed laser radiation of the red spectrum;

- intravenous infusion into the body of ozone/NO-containing physiological solution, and then sequentially in one session - a solution of the enzymatic antioxidant - superoxide dismutase;

- thermal contrast effect on the skin with its subsequent aeration with an ozone/NO-containing gas mixture while simultaneously illuminating with pulsed laser radiation of the red spectrum, implemented in a procedural capsule, with the exclusion of the effect of this gas mixture on the patient's respiratory system;

- ingestion orally and before meals - 10% ozonide / NO-containing oil emulsion of the "oil in water" type with a peroxide value for ozonides P = 100 in a volume of 100 ml;

- taking succinic acid Forte - 1 tablet after meals, daily dose - 400 mg.

Since the implementation of the proposed method of treatment, both subjective and objective positive dynamics in the patient's condition have been noted. Subjectively, patients noted a decrease in temperature, a decrease in shortness of breath and tachycardia. Stabilization of blood pressure at the level of 130/80 mm Hg.

On July 29, 2020, the sense of smell was completely restored, confirmed by an olfactometric study using the Bernstein method A.N.

By August 1, 2020, skin rashes disappeared and diarrhea was eliminated. By the end of the 3rd week, since the onset of the disease, the patients noted only a slight general weakness with moderate physical exertion. Objective data of vital signs of body functions, confirming the positive dynamics of the patient's condition, are presented graphically (Fig. 13), where the curves of body temperature and pulse since the start of additional therapy, according to the proposed method, tended to decrease from pathological to physiological indicators. Curves of the level of saturation of blood oxygen - before (S _p O ₂ ^* ) and after (S _p O ₂ ^** ) the start of additional therapy, show a rapid recovery of blood saturation indicators to normal values. The control MSCT of the OGK, 5 weeks after the onset of the disease, showed no signs of pneumonia.

Example 2. Patient P.V., 72 years old, bioengineer. From the anamnesis: he fell ill acutely on 10/19/2020, a week after contact with a patient with Covid-19. Noted: malaise, dizziness, fatigue, dryness in the nose and oropharynx, loss of smell, local skin rashes, fever with fever up to 38.2°C, chills. Self-treatment at home in self-isolation mode. From the onset of the disease, the patient carried out herbal medicine on her own without improving the general condition.

Examined by a doctor on October 24, 2020. Physical examination, determination of saturation by pulse oximeter - 92% and olfactometric study according to the Bernstein method A.N., anosmia (olfactory agnosia) was determined, skin rashes (urticaria) were noted. Diagnosis: uncomplicated Covid-19. Antiviral and antibacterial therapy was not carried out due to the refusal of the patient. Taking into account the absence of positive dynamics in the course of the disease, as well as the age of the patient - over 70 years old, which create the likelihood of developing the disease in a severe form, it was decided from October 24, 2020 to use a complex of physical and physico-chemical factors in the treatment of the patient, including effects on organs and body systems (1 time per day, in the morning both locally and systemically): low-frequency ultrasound, thermal contrast exposure, laser radiation and highly active drugs, including ozone/NO-containing gas mixture, ozone/NO- and ozonide/NO-containing solutions and antioxidant substances used according to the proposed technical solution and allowing to implement:

- aeration of the skin in the eye area of the patient, with closed eyelids, ozone / NO-containing gas mixture;

- ozone / NO- or ozonide / NO-ultrasonic sanitation of the olfactory epithelium of the nasal mucosa, mucous membranes of the nasopharynx and oropharynx, as well as, indirectly, of the bronchi and underlying parts of the lung, by spraying them with a torch of ultrasonic aerosol ozone / NO- or ozonide / NO - containing medicinal substances;

- endonasal illumination of the olfactory region of the mucous membrane of the nasal cavities with pulsed laser radiation of the red spectrum;

- intravenous infusion into the blood, lymph and interstitial systems of the body of ozone / NO-containing physiological solution, and then sequentially in one session - an antioxidant solution - succinic acid;

- thermocontrast effect on the skin, followed by its aeration with an ozone/NO-containing gas mixture with simultaneous illumination with pulsed laser radiation of the red spectrum, implemented in a procedural capsule with the exclusion of the effect of the gas mixture on the patient's respiratory system;

- ingestion enterally and before meals - 10% ozonide / NO-containing oil emulsion of the "oil in water" type with a peroxide number for ozonides P = 100 in a volume of 100 ml;

- taking succinic acid Forte - 1 tablet after meals, daily dose - 400 mg.

From October 27-28, 2020, after 4-5 sessions of the proposed method of treatment, the patients noted: a sharp improvement in general well-being, a decrease in body temperature to normal, the disappearance of dizziness and dryness in the nasopharynx and oropharynx. Since October 29, 2020 - olfactometric study according to the Bernstein method A.N. full restoration of smell is shown. On FIG. 14 graphically shows the restoration of vital signs of body functions, indicating a positive trend in the patient's condition, where the body temperature and pulse curves since the start of therapy, according to the proposed method, tended to normalize and corresponded to the physiological norm. The curves of blood oxygen saturation - blood saturation before (SpO ₂ ^* ) and after (S _p O ₂ ^** ) the start of active therapy, show the restoration of blood saturation to the physiological norm.

A subsequent blood test of the patient for IgG and IgM antibodies to the SARS-Cov-2 coronavirus, conducted on November 6, 2020, showed a positive immune response and no signs of pneumonia.

The above examples indicate the prospects of using the proposed technical solution - "Method for the treatment of dysosmia caused by coronavirus infection", which uses affordable and low-cost components for the treatment of dysosmia, which make it possible to implement a medical technology that is pathogenetically substantiated and biotropic, consisting in a combined energy and material effect on both the focus of SARS-Cov-2 infection, as well as on the complicated condition of the organs and systems of the body of the patient Covid-19 provoked by it, while ensuring, at the same time, not only the relief of such prognostic signs of infection of the body with SARS-Cov-2 coronavirus infection and the development of Covid-19 as dysosmia and various lesions of the skin, gastrointestinal tract, etc., but also the possibility of providing rehabilitation treatment and rehabilitation for patients with Covid-19 not only in inpatient treatment, but also on an outpatient basis at home in self-isolation mode.

The results of the treatment of a group of patients with Covid-19, more than 30 patients (mainly doctors and their families) with a history of dysosmia, along with other subclinical markers and predictive signs of their infection with the SARS-Cov-2 virus and the development of Covid-19, testified to a significant reduction in the time for suppression of infection and relief of dysosmia, namely, within 4-6 days from the start of therapeutic measures according to the proposed "Method for the treatment of dysosmia caused by coronavirus infection". At the same time, the known methods and means of treating dysosmia caused by the SARS-Cov-2 virus allow its relief in terms of up to 2 weeks or more.

In addition, the proposed technical solution allows, along with highly effective treatment of dysosmia, to simultaneously stop other signs of the development of Covid-19, manifested in the form of lesions of the skin, gastrointestinal tract, as well as lesions of the tissues of the upper and lower respiratory tract, and primarily lung tissues. The implementation of the treatment process is simple and sufficient in the mode of visiting a Covid-19 patient by an attending physician or a procedural nurse (outpatient at home in the self-isolation mode of the patient), which is important in pandemics in conditions of congestion in healthcare facilities and high overcrowding of the infected population, for example, in metropolitan areas, etc.

The claimed invention will accelerate the introduction, in the prescribed manner, of promising medical technology and methods for the prevention and treatment of dangerous viral infections, which include SARS-Cov-2 coronavirus infection, and in the future, other similar infections that provoke the growth of clinical infectology problems in the modern world. warring world, as well as in the treatment of chronoseptic diseases and diseases accompanied by immunodeficiency states, etc.

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Claims (7)

A method for treating dysosmia caused by a coronavirus infection, including inhalation of the patient's airways with an ultrasonic aerosol of an ozonide-containing medicinal substance in the form of ozonized vegetable oil or an ozonized oil-in-water emulsion, up to the period of the patient's confirmed recovery indicators, and also daily, before meals and enterally, taking an ozonide-containing medicinal substance in the form of ozonized vegetable oil or an ozonized oil-in-water emulsion, characterized in that in a single technological process of each session of treatment of dysosmia, implemented, taking into account the severity of the patient's condition - 1-2 times a day, namely with an uncomplicated form of the course of the disease - 1 time per day, in the morning, and with a complicated course of the disease - 2 times a day, in the morning and in the evening, is carried out in stages: - at the first stage - external aeration of the skin in the eye area, with the patient's eyelids closed, for 60 seconds, with ozone / NO-containing gas mixture with an ozone concentration of 0.5 mg / l and a nitrogen oxide concentration of 0.1 mg / l, implemented in a sealed cavity delimited by closed-type goggles; - at the second stage - ozone / NO- or ozonide / NO-ultrasonic sanitation of the olfactory epithelium of the nasal mucosa, mucous membranes of the nasopharynx and oropharynx, as well as, indirectly, of the bronchi and underlying parts of the lung, by spraying them with a torch of ultrasonic aerosol ozone / NO - or ozonide/NO-containing medicinal substances in the form of: ozone/NO-containing physiological solution with an ozone concentration of 1.5 mg/l and a nitric oxide concentration of 0.4 mg/l; ozonide/NO-containing vegetable oil with an ozonide peroxide value of P=200 or its 10% ozonide/NO-containing oil-in-water emulsion with an ozonide peroxide value of P=100, on the olfactory epithelium of the nasal mucosa, for 15 seconds on each half of the nose, and on the mucous tissues of the airways of the oropharynx, bronchi and underlying parts of the lung, for 30 seconds, while endonasal and oral high-amplitude ultrasonic spraying with a jet-aerosol aerosol torch is carried out at a frequency of ultrasonic vibrations - f = 26.5 kHz and at the amplitude of ultrasonic oscillations of the waveguide-tool - ξ=90 μm; - at the third stage - endonasal illumination, without affecting the area of the orbit of the eyes, the olfactory region of the mucous membrane of the nasal cavities, for 20 seconds, for each half of the nose, with pulsed laser radiation of the red spectrum - λ=635 nm; - at the fourth stage - intravenous drip administration of medicinal substances in the form of ozone / NO-containing physiological solution with an ozone concentration of 1.5 mg / l and a nitric oxide concentration of 0.4 mg / l, and then sequentially, in one session, a solution enzymatic antioxidant - superoxide dismutase Rexod 1.6 million units. or an antioxidant solution - 0.5% solution of succinic acid Remaxol; - at the fifth stage - initiation of a thermal contrast effect on the patient's skin, followed by external aeration of the skin, for 15 minutes, with an ozone/NO-containing gas mixture with an ozone concentration of 3.0 mg/l and a nitrogen oxide concentration of 0.8 mg /l while simultaneously illuminating it with pulsed laser radiation of the red spectrum - λ=635 nm, implemented in a sealed cavity of the procedural capsule with the exclusion of the effect of the specified gas mixture on the patient's respiratory system; - at the final stage - enteral intake, before meals, of a 10% ozonide / NO-containing oil-in-water emulsion with a peroxide value of ozonides P = 100 in a volume of 100 ml, as well as intake of succinic acid Forte - 1 tablet each after meals, the daily dose is 400 mg.

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