cfpdБюллетень физиологии и патологии дыханияBulletin Physiology and Pathology of Respiration1998-5029Дальневосточный научный центр физиологии и патологии дыхания10.36604/1998-5029-2025-98-50-59cfpd-1292Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHКлинические профили пациентов, поступающих на реабилитацию после внебольничной пневмонииClinical profiles of patients admitted for rehabilitation after community-acquired pneumoniaШелудькоЕ. Г.SheludkoE. G.

Елизавета Григорьевна Шелудько, канд. мед. наук, старший научный сотрудник, лаборатория молекулярных и трансляционных исследований

675000, г. Благовещенск, ул. Калинина, 22

 

Elizaveta G. Sheludko, MD, PhD (Med.), Senior Staff Scientist, Laboratory of Molecular and Translational Research

22 Kalinina Str., Blagoveshchensk, 675000

liza.sheludko@mail.ruСемиречЮ. О.SemirechYu. O.

Юлия Олеговна Семиреч, канд. мед. наук, зав. отделением медицинской реабилитации

675000, г. Благовещенск, ул. Калинина, 22

Yuliya O. Semirech, MD, PhD (Med.), Head of Department of Medical Rehabilitation

22 Kalinina Str., Blagoveshchensk, 675000

julek-doc@bk.ruКнышоваВ. В.KnyshovaV. V.

Вера Васильевна Кнышова, д-р мед. наук, старший научный сотрудник лаборатории восстановительного лечения

690105, г. Владивосток, ул. Русская, 73 г

Vera V. Knyshova, MD, PhD (Med.), DSc (Med.), Senior Staff Scientist, Laboratory of Rehabilitation Treatment

73g Russkaya Str., Vladivostok, 690105

 

vfdnz_nch@mail.ruКолосовВ. П.KolosovV. P.

Виктор Павлович Колосов, академик РАН, д-р мед. наук, профессор, научный руководитель

675000, г. Благовещенск, ул. Калинина, 22

Victor P. Kolosov, MD, PhD (Med.), DSc (Med.), Academician of RAS, Professor, Scientific Director

22 Kalinina Str., Blagoveshchensk, 675000

kolosov@amur.ruФедеральное государственное бюджетное научное учреждение «Дальневосточный научный центр физиологии и патологии дыхания»Far Eastern Scientific Center of Physiology and Pathology of RespirationВладивостокский филиал Федерального государственного бюджетного научного учреждения «Дальневосточный научный центр физиологии и патологии дыхания» – Научно исследовательский институт медицинской климатологии и восстановительного леченияVladivostok Branch of Far Eastern Scientific Centre of Physiology and Pathology of Respiration – Research Institute of Medical Climatology and Rehabilitative Treatment2025231220250985059Copyright © Шелудько Е.Г., Семиреч Ю.О., Кнышова В.В., Колосов В.П., 20252025Шелудько Е.Г., Семиреч Ю.О., Кнышова В.В., Колосов В.П.Sheludko E.G., Semirech Y.O., Knyshova V.V., Kolosov V.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cfpd.elpub.ru/jour/article/view/1292

Цель. На основе характеристики особенностей клинико-функционального статуса пациентов после перенесенной внебольничной пневмонии (ВП) выделить клинические профили для обоснования необходимости и персонализации программ дальнейшей реабилитации.Материалы и методы. Оценивались демографические данные, анамнез (в т.ч. статус и стаж курения, эпизоды ВП в анамнезе, перенесённый COVID-19), жалобы, лабораторные показатели, функция внешнего дыхания и изменения лёгочной ткани по данным компьютерной томографии органов грудной клетки (КТ ОГК) у 104 пациентов при постановке диагноза ВП и при поступлении на реабилитацию.Результаты. Средний возраст пациентов – 47,3 ± 17,9 года; 57% – женщины. Тяжёлая ВП была выявлена у 25% и коррелировала с возрастом (ρ = 0,22; p = 0,029). Длительность госпитализации составила 10 [8;13] суток, увеличивалась с возрастом (ρ = 0,30; p = 0,001) и с коморбидностью (p = 0,039). По данным КТ ОГК в дебюте ВП двустороннее поражение было у 48,5%; к началу реабилитации объем поражения уменьшался с 3 [2;6] до 1 [0;3] сегмента. Основные жалобы включали: одышку (90,3%), слабость (87,4%); продуктивный кашель (чаще у курящих). Наблюдалась прямая корреляция между скоростью оседания эритроцитов крови и длительностью госпитализации (ρ = 0,28; p = 0,0075), а также выраженностью одышки и скоростными параметрами функции внешнего дыхания (p < 0,05). Проведенный кластерный анализ выделил два клинических профиля, различающихся выраженностью симптомов, резидуальными изменениями КТ ОГК, параметрами спирометрии.Заключение. Полученные результаты демонстрируют клиническую значимость реабилитации пациентов и подчёркивают необходимость проведения дальнейших исследований с проспективной валидацией фенотипов и разработкой профиль-ориентированных программ.

Aim. To delineate clinical profiles among the patients recovering from community-acquired pneumonia (CAP) based on their clinical and functional characteristics, in order to justify the need for and personalize subsequent rehabilitation programs.Materials and methods. The study enrolled 104 patients. Collected data included demographics, medical history (including smoking status and pack-year index, prior CAP episodes, and previous COVID-19), complaints, laboratory parameters, lung function and chest computed tomography (CT) findings at the moment of CAP diagnosis and at admission to rehabilitation.Results. The mean age of the patients was 47.3 ± 17.9 years; 57% were women. Severe CAP was present in 25% and correlated with age (ρ = 0.22; p = 0.029). The median hospital stay was 10 [8–13] days and increased with age (ρ = 0.30; p = 0.001) and comorbidity (p = 0.039). On initial chest CT bilateral lung involvement was observed in 48.5%; the median number of involved segments was 3 [2–6], decreasing to 1 [0–3] by the onset of rehabilitation. Predominant complaints were dyspnea (90.3%) and fatigue (87.4%); productive cough was more frequent in smokers, whereas dry cough predominated in non-smokers. Erythrocyte sedimentation rate correlated with length of hospitalization (ρ = 0.28; p = 0.0075). Dyspnea was associated with lower FEV1, FEV1/FVC, and FEF50 (ρ = 0.36–0.42; p < 0.05). Cluster analysis identified two clinical profiles differing in symptom severity, residual CT abnormalities, and degree of pulmonary function impairment.Conclusions. These findings support a personalized approach to rehabilitation and highlight the need for further prospective studies and profile-oriented programs.

внебольничная пневмониямедицинская реабилитацияклинические профилиcommunity-acquired pneumoniamedical rehabilitationclinical profilesReferencesWorld Health Organization. The top 10 causes of death. Fact sheet; 7 Aug 2024. URL: https://www.who.int/newsroom/fact-sheets/detail/the-top-10-causes-of-death (дата обращения: 22.10.2025).World Health Organization. The top 10 causes of death. Fact sheet; 2024 Aug 7. Available at: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death (accessed 2025-10-22).GBD 2021 Lower respiratory infections and antimicrobial resistance collaborators. Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990–2021: a systematic analysis from the global burden of disease study 2021 // Lancet Infect. Dis. 2024. Vol.24, №9. P.974–1002. https://doi.org/10.1016/S1473-3099(24)00176-2GBD 2021 Lower Respiratory Infections and Antimicrobial Resistance Collaborators. Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Infect. Dis. 2024; 24(9):974–1002. https://doi.org/10.1016/S1473-3099(24)00176-2Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека. Государственные доклады «О состоянии санитарно-эпидемиологического благополучия населения в Российской Федерации» за 2011–2023 гг. URL: https://rospotrebnadzor.ru (дата обращения: 22.10.2025).[Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor). State reports “On the sanitary and epidemiological well-being of the population in the Russian Federation,” 2011–2023]. Available at: https://rospotrebnadzor.ru (accessed 2025-10-22) (in Russian).Полянская Е.В. Анализ демографических тенденций Дальневосточного региона (на примере Амурской области) // Проблемы развития территории. 2023. Т.27, №3. С.99–112. https://doi.org/10.15838/ptd.2023.3.125.7Polyanskaya E.V. [Analysis of demographic trends in the Far Eastern region (on the example of the Amur oblast)]. Problemy razvitiya territoriy 2023; 27(3):99–112 (in Russian). https://doi.org/10.15838/ptd.2023.3.125.7Натыкан Ю.А., Курганова О.П., Троценко О.Е. Эпидемиологические проявления заболеваемости внебольничными пневмониями на территории Амурской области // Материалы XI съезда врачей-пульмонологов Сибири и Дальнего Востока (с международным участием). Благовещенск: ДНЦ ФПД, 2025. С.201–207. ISBN 978-5-905864-30-8. https://doi.org/10.36604/Congress-Pulmo-2025Natykan Yu.A, Kurganova O.P., Trotsenko O.E. [Epidemiological features of community-acquired pneumonia morbidity in the Amur Region. In: Proceedings of the XI congress of pulmonologists of Siberia and the Russian Far East (with international participation]. Blagoveshchensk; 2025:201–207 (in Russian). ISBN: 978-5-905864-30-8. https://doi.org/10.36604/Congress-Pulmo-2025Simonetti A.F., Garcia-Vidal C., Viasus D., Anton L., Dorca J., Gudiol F., Carratalà J. Declining mortality among hospitalized patients with community-acquired pneumonia // Clin. Microbiol. Infect. 2016. Vol.22, №6. P.567.e1–567.e7. https://doi.org/10.1016/j.cmi.2016.03.015Simonetti A.F., Garcia-Vidal C., Viasus D., Anton L., Dorca J., Gudiol F., Carratalà J. Declining mortality among hospitalized patients with community-acquired pneumonia. Clin. Microbiol. Infect. 2016; 22(6):567.e1–567.e7. https://doi.org/10.1016/j.cmi.2016.03.015American lung association, epidemiology and statistics unit; research and health education division. Trends in pneumonia and influenza morbidity and mortality. Chicago (IL): American lung association, 2015. URL: https://www.lung.org/getmedia/98f088b5-3fd7-4c43-a490-ba8f4747bd4d/pi-trend-report.pdfAmerican lung association, epidemiology and statistics unit, research and health education division. Trends in pneumonia and influenza morbidity and mortality. Chicago (IL): American Lung Association; 2015. Available at: https://www.lung.org/getmedia/98f088b5-3fd7-4c43-a490-ba8f4747bd4d/pi-trend-report.pdfMetlay J.P., Waterer G.W., Long A.C., Anzueto A., Brozek J., Crothers K., Cooley L.A., Dean N.C., Fine M.J., Flanders S.A., Griffin M.R., Metersky M.L., Musher D.M., Restrepo M.I., Whitney C.G. Diagnosis and treatment of adults with community-acquired pneumonia: an official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America // Am. J. Respir. Crit. Care. Med. 2019. Vol.200, №7. P.e45–e67. https://doi.org/10.1164/rccm.201908-1581STMetlay J.P., Waterer G.W., Long A.C., Anzueto A., Brozek J., Crothers K., Cooley L. A., Dean N.C., Fine M. J., Flanders S.A., Griffin M.R., Metersky M.L., Musher D.M., Restrepo M.I., Whitney C.G. Diagnosis and treatment of adults with community-acquired pneumonia: an official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am. J. Respir. Crit. Care. Med. 2019; 200(7):e45–e67. https://doi.org/10.1164/rccm.201908-1581STEekholm S., Ahlström G., Kristensson J., Lindhardt T. Gaps between current clinical practice and evidence-based guidelines for treatment and care of older patients with community-acquired pneumonia: a descriptive cross-sectional study // BMC Infect. Dis. 2020. Vol.20. Article number:73. https://doi.org/10.1186/s12879-019-4742-4Eekholm S., Ahlström G., Kristensson J., Lindhardt T. Gaps between current clinical practice and evidence-based guidelines for treatment and care of older patients with community-acquired pneumonia: a descriptive cross-sectional study. BMC Infect. Dis. 2020; 20:73. https://doi.org/10.1186/s12879-019-4742-4Pick H.J., Bolton C.E., Lim W.S., McKeever T.M. Patient-reported outcome measures in the recovery of adults hospitalized with community-acquired pneumonia: a systematic review // Eur. Respir. J. 2019. Vol.53, №3. Article number:1802165. https://doi.org/10.1183/13993003.02165-2018Pick H.J., Bolton C.E., Lim W.S., McKeever T.M. Patient-reported outcome measures in the recovery of adults hospitalized with community-acquired pneumonia: a systematic review. Eur. Respir. J. 2019; 53(3):1802165. https://doi.org/10.1183/13993003.02165-2018Auld S.C., Sheshadri A., Alexander-Brett J., Bertelson N., Chang S.Y., Chupp G.L., Cormier S.A., Debley J.S., Drake K.M., Echevarria C., Fabre V., Gentile G., Hagan R.S., Kolls J.K., Lynch S.V., Martinez F.J., Boushey H.A. Postinfectious pulmonary complications: establishing research priorities to advance the field: an official American Thoracic Society workshop report // Ann. Am. Thorac. Soc. 2024. Vol.21, №9. P.1219–1237. https://doi.org/10.1513/AnnalsATS.202406-651STAuld S.C., Sheshadri A., Alexander-Brett J., Bertelson N., Chang S.Y., Chupp G.L., Cormier S.A., Debley J.S., Drake K.M., Echevarria C., Fabre V., Gentile G., Hagan R.S., Kolls J.K., Lynch S.V., Martinez F.J., Boushey H.A. Postinfectious pulmonary complications: establishing research priorities to advance the field – an official American Thoracic Society workshop report. Ann. Am. Thorac. Soc. 2024; 21(9):1219–1237. https://doi.org/10.1513/AnnalsATS.202406-651STFang Y.Y., Ni J.C., Wang Y., Yu J.H., Fu L.L. Risk factors for hospital readmissions in pneumonia patients: a systematic review and meta-analysis // World J. Clin. Cases. 2022. Vol.10, №12. P.3787–3800. https://doi.org/10.12998/wjcc.v10.i12.3787Fang Y.Y., Ni J.C., Wang Y., Yu J.H., Fu L.L. Risk factors for hospital readmissions in pneumonia patients: a systematic review and meta-analysis. World J. Clin. Cases 2022; 10(12):3787–3800. https://doi.org/10.12998/wjcc.v10.i12.3787Kitaw T.A., Azmeraw M., Temesgen D., Haile R.N. Time to recovery from severe community-acquired pneumonia: a systematic review and meta-analysis // J. Glob. Health. 2024. Vol.14. Article number:04203. https://doi.org/10.7189/jogh.14.04203Kitaw T.A., Azmeraw M., Temesgen D., Haile R.N. Time to recovery from severe community-acquired pneumonia: a systematic review and meta-analysis. J. Glob. Health 2024; 14:04203. https://doi.org/10.7189/jogh.14.04203Tsoumani E., Carter J.A., Salomonsson S., Stephens J.M., Bencina G. Clinical, economic, and humanistic burden of community acquired pneumonia in Europe: a systematic literature review // Expert Rev. Vaccines. 2023 Vol.22, №1. Р.876–884. https://doi.org/10.1080/14760584.2023.2261785Tsoumani E., Carter J.A., Salomonsson S., Stephens J.M., Bencina G. Clinical, economic, and humanistic burden of community acquired pneumonia in Europe: a systematic literature review. Expert Rev. Vaccines 2023; 22(1):876-884. https://doi.org/10.1080/14760584.2023.2261785Safiri S., Mahmoodpoor A., Kolahi A.-A., Nejadghaderi S.A., Sullman M.J.M., Mansournia M.A., Ansarin K., Collins G.S., Kaufman J.S., Abdollahi M. Global burden of lower respiratory infections during the last three decades // Front. Public Health. 2022. Vol.10. Article number:1028525. https://doi.org/10.3389/fpubh.2022.1028525Safiri S., Mahmoodpoor A., Kolahi A.-A., Nejadghaderi S.A., Sullman M.J.M., Mansournia M.A., Ansarin K., Collins G.S., Kaufman J.S., Abdollahi M. Global burden of lower respiratory infections during the last three decades. Front. Public Health 2022; 10:1028525. https://doi.org/10.3389/fpubh.2022.1028525Molina J., González-Gamarra A., Ginel L., Peláez M.E., Juez J.L., Artuñedo A., Aldana G., Quesada E., Cabré J.J., Gómez A., Linares M., Marín M.T., Sánchez P.Y., Núñez L., Gonzálvez J., Mascarós E., López J., Cano A., Herrero J., Serra M. C., Cimas E., Pedrol M., Alfaro J.V., Martinón-Torres F., Cifuentes I., Méndez C., Ocaña D. CAPPRIC Study – characterization of community-acquired pneumonia in Spanish adults managed in primary care settings // Microorganisms. 2021. Vol.9, №3. Article number:508. https://doi.org/10.3390/microorganisms9030508Molina J., González-Gamarra A., Ginel L., Peláez M.E., Juez J.L., Artuñedo A., Aldana G., Quesada E., Cabré J.J., Gómez A., Linares M., Marín M.T., Sánchez P.Y., Núñez L., Gonzálvez J., Mascarós E., López J., Cano A., Herrero J., Serra M.C., Cimas E., Pedrol M., Alfaro J.V., Martinón-Torres F., Cifuentes I., Méndez C., Ocaña D. CAPPRIC study – characterization of community-acquired pneumonia in Spanish adults managed in primary care settings. Microorganisms 2021; 9(3):508. https://doi.org/10.3390/microorganisms9030508Grijalva C.G., Johnson K.D., Resser J.J., Whitney C.G., Baughman A., Kio M., Traenkner J., Johnson J., Miller K.F., Rostad C.A., Salazar L.W., Tanios R., Smith V.E., Cornelison S.A., Zhu Y., Han J.H., Yildirim I., Weiss T., Roberts C.S., Rouphael N., Self W.H.; PNEUMO Investigators. All-cause and pneumococcal community-acquired pneumonia hospitalizations among adults in Tennessee and Georgia // JAMA Netw. Open. 2025. Vol.8, №8. Article number:e2524783. https://doi.org/10.1001/jamanetworkopen.2025.24783Grijalva C.G., Johnson K.D., Resser J.J., Whitney C.G., Baughman A., Kio M., Traenkner J., Johnson J., Miller K.F., Rostad C.A., Salazar L.W., Tanios R., Smith V.E., Cornelison S.A., Zhu Y., Han J.H., Yildirim I., Weiss T., Roberts C.S., Rouphael N., Self W.H.; PNEUMO Investigators. All-cause and pneumococcal community-acquired pneumonia hospitalizations among adults in Tennessee and Georgia. JAMA Netw. Open 2025; 8(8):e2524783. https://doi.org/10.1001/jamanetworkopen.2025.24783Marziano Y., Itzhak D., Halperin Y., Gershman V., Avraham A. S., Nirkis M., Klaiman E., Glam L., Segal G., Lerner R.K. Profound anemia in hospitalized community-acquired pneumonia patients is associated with increased mortality and is prevalent in all patients’ age-groups: a retrospective analysis of 15,121 patients // BMC Infect. Dis. 2025. Vol.25. Article number:1297. https://doi.org/10.1186/s12879-025-11744-2Marziano Y., Itzhak D., Halperin Y., Gershman V., Avraham A. S., Nirkis M., Klaiman E., Glam L., Segal G., Lerner R.K. Profound anemia in hospitalized community-acquired pneumonia patients is associated with increased mortality and is prevalent in all patients’ age groups: a retrospective analysis of 15,121 patients. BMC Infect. Dis. 2025; 25:1297. https://doi.org/10.1186/s12879-025-11744-2Gonçalves-Pereira J., Froes F., Gonçalves Pereira F., Diniz A., Oliveira H., Mergulhão P. Community-acquired pneumonia mortality trends according to age and gender: 2009 to 2019 // BMC Pulm. Med. 2025. Vol.25. Article number:391. https://doi.org/10.1186/s12890-025-03875-8Gonçalves-Pereira J., Araújo J.P., Malheiro L., Gonçalves-Pereira J., Froes F., Gonçalves Pereira F., Diniz A., Oliveira H., Mergulhão P. Community-acquired pneumonia mortality trends according to age and gender: 2009 to 2019. BMC Pulm. Med. 2025; 25:391. https://doi.org/10.1186/s12890-025-03875-8Rünow E., Valeur F., Torisson G., Hansen K., Theilacker C., Riesbeck K., Ahl J. The incidence of radiologically verified community-acquired pneumonia requiring hospitalisation in adults living in southern Sweden, 2016–2018: a population-based study // BMC Infect. Dis. 2025. Vol.25, №1. Article number:80. https://doi.org/10.1186/s12879-025-10468-7Rünow E., Valeur F., Torisson G., Hansen K., Theilacker C., Riesbeck K., Ahl J. The incidence of radiologically verified community-acquired pneumonia requiring hospitalisation in adults living in southern Sweden, 2016–2018: a population-based study. BMC Infect. Dis. 2025; 25(1):80. https://doi.org/10.1186/s12879-025-10468-7Lüthi-Corridori G., Boesing M., Roth A., Giezendanner S., Leuppi-Taegtmeyer A.B., Schuetz P., Leuppi J.D. Predictors of length of stay, rehospitalization and mortality in community-acquired pneumonia patients: a retrospective cohort study // J. Clin. Med. 2023. Vol.12, №17. Article number:5601. https://doi.org/10.3390/jcm12175601Lüthi-Corridori G., Boesing M., Roth A., Giezendanner S., Leuppi-Taegtmeyer A.B., Schuetz P. Predictors of length of stay, rehospitalization and mortality in community-acquired pneumonia patients: a retrospective cohort study. J. Clin. Med. 2023; 12(17):5601. https://doi.org/10.3390/jcm12175601Рачина С.А., Купрюшина О.А., Стрелкова Д.А., Авдеев С.Н., Власенко А.Е., Яснева А.С., Юданова Т.А., Трофименко И.Н., Антонов В.Н., Агибалова М.Н., Мержоева З.М., Яцышина С.Б., Тихонова М.А., Елькина М.А., Ананичева Н.А., Бурмистрова Е.Н., Сухорукова М.В. Этиология внебольничной пневмонии у взрослых в стационарах РФ после пандемии COVID-19: результаты многоцентрового проспективного исследования // Клиническая микробиология и антимикробная химиотерапия. 2024. Т.26, №2. https://doi.org/10.36488/cmac.2024.2.141-147Rachina S.A., Kupryushina O.A., Strelkova D.A., Avdeev S.N., Vlasenko A.E., Yasneva A.S., Yudanova T.A., Trofimenko I.N., Antonov V.N., Agibalova M.N., Merzhoeva Z.M., Yatsyshina S.B., Tikhonova M.A., Elkina M.A., Ananicheva N.A., Burmistrova E.N., Sukhorukova M.V. [Etiology of community-acquired pneumonia in adults in Russian hospitals after the COVID-19 pandemic: results of a multicenter prospective study]. Kliniceskaa Mikrobiologia i Antimikrobnaa Himioterapia = Clinical Microbiology and Antimicrobial Chemotherapy 2024; 26(2):141–147 (in Russian). https://doi.org/10.36488/cmac.2024.2.141-147Vijayakumar B., Tonkin J., Devaraj A., Philip K.E.J., Orton C.M., Desai S.R., Shah P.L. CT lung abnormalities after COVID-19 at 3 months and 1 year and their association with severity // Radiology. 2022. Vol.304, №2. P.379–389. https://doi.org/10.1148/radiol.2021211746Vijayakumar B., Tonkin J., Devaraj A., Philip K.E.J., Orton C.M., Desai S.R., Shah P.L. CT lung abnormalities after COVID-19 at 3 months and 1 year and their association with severity. Radiology 2022; 304(2):379–389. https://doi.org/10.1148/radiol.2021211746Cha M.J., Solomon J.J., Lee J.E., Choi H., Chae K.J., Lee K.S., Lynch D.A. Chronic lung injury after COVID-19 pneumonia: imaging features and clinical implications // Radiology. 2024. Vol.311, №3. Article number:e231643. https://doi.org/10.1148/radiol.231643Cha M.J., Solomon J.J., Lee J.E., Choi H., Chae K.J., Lee K.S., Lynch D.A. Chronic lung injury after COVID-19 pneumonia: imaging features and clinical implications. Radiology 2024; 311(3):e231643. https://doi.org/10.1148/radiol.231643Brennan M., McDonnell M.J., Duignan N., Gargoum F., Rutherford R.M. The use of cough peak flow in the assessment of respiratory function in clinical practice: a narrative literature review // Respir. Med. 2022. Vol.193. Article number:106740. https://doi.org/10.1016/j.rmed.2022.106740Brennan M., McDonnell M.J., Duignan N., Gargoum F., Rutherford R.M. The use of cough peak flow in the assessment of respiratory function in clinical practice: a narrative literature review. Respir. Med. 2022; 193:106740. https://doi.org/10.1016/j.rmed.2022.106740Prasetyo A., Sadhana U., Budiman J. Nasal mucociliary clearance in smokers: a systematic review // Int. Arch. Oto rhinolaryngol. 2021. Vol.25, №1. P.e160–e169. https://doi.org/10.1055/s-0040-1702965Prasetyo A., Sadhana U., Budiman J. Nasal mucociliary clearance in smokers: a systematic review. Int. Arch. Otorhinolaryngol. 2021; 25(1):e160–e169. https://doi.org/10.1055/s-0040-1702965

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