The effectiveness of the use of Api-Norm® remedies by women who have suffered a COVID-19 infection.

Professoer Podolsky V. V.

---

SU "Institute of Pediatrics, Obstetrics and Gynecology of the National Academy of Medical Sciences of Ukraine" Kyiv, Ukraine.

Chapter 1. SURVEILLANCE ALGORITHM FOR WOMEN OF FERTILITY AGE WHO HAD CORONAVIRUS INFECTION IMMEDIATELY AFTER RECOVERY (AND SURVEILLANCE STAGE) Taking into account the results of clinical, statistical, and sociological studies, regarding the health characteristics of children and women infected with the coronavirus, the determination of the role of medical and biological factors, as risk factors, the state of general, reproductive, psychosomatic health, identified genetic and epigenetic markers, the state of immunity, the metabolism of vitamin D in the body, there are reasons to believe that women who have suffered a coronavirus infection and recovered need close monitoring by family doctors, therapists, and obstetrician-gynecologists within a year from the date of recovery. At the same time, attention should be paid to the presence of medical and social risk factors in women, which should include:

- age of women in the category from 25 to 35 years and from 40 to 49 years; - the profession of women, which involves a significant number of contacts due to the peculiarities of professional activity - contact during working hours with a significant number of people (among whom may be infected with the coronavirus, which may be important for re-infection). Women with such professions include doctors, teachers, public transport workers, sellers, and others;

- marital status – married women are more often at risk of re-infection;

- social status - women with a low-income level and women from disadvantaged or single-parent families are more often at risk of re-infection;

- level of education - women with higher and secondary education are more often at risk of re-infection;

- bad habits: smoking and excessive alcohol consumption;

- occupational hazards that contribute to a decrease in immunity and have conditions for airborne or contact transmission of the coronavirus;

- work is associated with noise, chemical and physical hazards, and nervously tense and exhausting work; - the presence of stressors at work;

- low level of wages;

- low level of average total income for each family member;

- a long stay on public transport on the way to work and home;

- the need to purchase products in places of significant crowding (bazaars);

- unfavorable living conditions: living in dirty, polluted premises that are not ventilated, living in one area of more people than is prescribed by social and hygienic norms, living in apartment buildings or dormitories where protective measures to prevent the spread of coronavirus infection are not observed;

- living in environmentally unfavorable conditions: radiation-contaminated territories, pollution by pesticides, pollution by solar heavy metals, living near high-voltage transmission lines, iodine-deficient territories;

- the presence of stressors at home;

- lack of conditions for rest after work;

- lack of possibility of outdoor walks (park, forest);

- unbalanced diet (predominance of fatty foods in the diet, lack of sufficient amount of vegetables and fruits);

- the presence of excess weight or obesity;

- the presence of extragenital diseases: cardiovascular diseases, diseases of the respiratory system, endocrine diseases (diabetes), diseases of the ENT organs, kidneys, liver, and others;

- the presence of chronic foci of infection in the body;

- the presence of allergies;

- the presence of chronic inflammatory diseases of the genital organs in women;

- presence of reproductive health disorders in women.

The complex of diagnostic, treatment, and preventive measures for monitoring of LVVs who have undergone coronavirus infection consists of four stages. The first stage of observation of diagnostic and, if necessary, therapeutic actions is carried out immediately after the recovery of women who have suffered a coronavirus infection, the second stage of such actions is carried out one month after recovery, the third - three months after recovery, and the fourth - six months after recovery.

At the first stage, the monitoring algorithm for HCVs who have undergone coronavirus infection immediately after recovery should include the following examinations and, if necessary, medical measures.

Such women must be examined by a family doctor, a therapist, and an obstetrician-gynecologist after suffering a disease. All these doctors should work in close cooperation, supplementing data on the health status of terminally ill women and communicating and exchanging information and diagnostic and therapeutic measures prescribed for terminally ill women to avoid duplication and not to lose sight of the important positions of the proposed algorithm for monitoring such women. Immediately after recovery - within a week and, if possible, up to a month - a woman who has contracted a coronavirus infection should contact the indicated doctors for an examination. At the same time, the family doctor or general practitioner first finds out the woman's anamnestic data to determine the presence of risk factors for possible reinfection. Interviews women and finds out the presence of signs of post-coronavirus syndrome.

At the same time, with the help of screening tests to determine the psycho-emotional state of ill women (Reeder's scale, Lüscher's test, and others that the doctor has), the psycho-emotional state of these women and the level of stressor load on the body are determined. If such changes are detected, women who have suffered a coronavirus infection are directed to consult a psychologist or psychiatrist.

When manifestations of the post-coronavirus syndrome are detected, pronounced changes in the psycho-emotional state can be observed in women who have fallen ill, in the form of the appearance of panic attacks, depression, and hidden signs of depression. With such changes, sick women with post-coronavirus syndrome must be consulted by a psychologist or psychiatrist with the appointment of appropriate treatment. In the absence of signs of post-coronavirus syndrome, women who have fallen ill are recommended to undergo an examination by the developed algorithm. All women who consulted a family doctor or a general practitioner by the developed monitoring algorithm should be recommended to check the state of immunity, determine the level of vitamin D in the blood, and determine the parameters of the blood coagulation system. Examination of immunity in sick women must include the mandatory determination of the level of IgM and IgG to the coronavirus. If positive results are obtained with increased levels of IgM and IgG, it is advisable to recommend mandatory PCR diagnostics. In the event of a positive PCR diagnosis, women continue the necessary treatment for coronavirus infection with a repeat examination after completion. Such changes in the increase of IgM and IgG indicators after allegedly completed treatment and a positive PCR reaction indicate that the woman was not treated. This situation is observed in cases where, after 14 days of treatment, women do not undergo appropriate control of the indicators of the state of immunity.

According to the data of foreign scientists and our data, the disease of the coronavirus infection can last more than 14 days and last up to 24 days, and sometimes up to a month. That is why the developed algorithm provides a careful examination of the state of immunity in women who have fallen ill. When, after determining the levels of immunoglobulins in the blood of the coronavirus, a negative result is obtained, that is, a normal level of IgM and a positive (increase in the level) of IgG to the coronavirus, it is advisable to assign such women a more in-depth study of other indicators that characterize the state of immunity, in particular: determine the total content of IgA, the level of lymphocytes, granulocytes and monocytes, as well as individual monocyte subpopulations (CD14+ CD16), T-lymphocyte subpopulations (CD3, CD4, CD8), the level of the anti-inflammatory cytokine IL-6 and the IL-2 secretory receptor. It is appropriate to determine the serological status of IgG antibodies to cytomegalovirus and genital herpes virus. If an elevated level of IgG is detected and the indicators of an additional examination of the state of immunity in women who have fallen ill are unchanged, such women are recommended for further monitoring, a diet that includes the consumption of vegetables and fruits, taking into account the proven effect of those that have a positive effect on the general state of the body and the state immunity Such a diet is recommended for women to increase the body's defenses, and the application option should be a physiologically complete diet enriched with nutrients that are especially necessary for the functioning of immunocompetent cells.

In this regard, it is advisable to include the following products in the diet, in particular:

- meat: veal, turkey; liver (veal, pork, lamb);

- fish and seafood: fatty sea fish (Atlantic cod, cod liver, flounder, Atlantic saury, salmon, tuna). The weekly menu should include at least 400 g of fish of these species, as well as crabs and oysters. The peculiarity of culinary processing is not to cook! It is possible to consume canned food (in its juice);

- chicken eggs: no more than one per day;

- milk and dairy products: milk, unsalted butter, cream

35%, sour cream 30% fat, Dutch cheese, "Edem" cheese;

- vegetable oil: linseed oil (20-30 g/day) and olive oil;

- vegetables and greens: green, red and yellow vegetables (tomatoes, carrots, red pepper, etc.), green onions, green peas, kohlrabi cabbage, potatoes, spinach, dill;

- fruits: citrus fruits;

- berries: rose hips, mountain ash, strawberries;

- cereals: wheat (wheat bran and sprouts), oatmeal, lentils;

- other products: soy, brewer's yeast, porcini mushrooms, garlic, pistachios, coconut.

If among the listed risk factors women have such factors as an unbalanced diet (predominance of fatty foods in the diet, lack of a sufficient amount of vegetables and fruits), women with a low-income level, and women from disadvantaged or single-parent families, low level of wages and the low level of average total income for each family member, which makes it impossible for women to follow these recommendations for a physiologically complete diet to increase the body's defenses, it is advisable to recommend taking multivitamin complexes containing vital microelements within a month after recovery.

Women are recommended to give up bad habits, ease the work schedule, and take effective rest. It is also advisable to include in the diet food products that contain trace elements zinc and others that have a positive effect on the state of immunity, in particular:

- poultry meat. Beef, lamb, pork, and chicken, are excellent sources of zinc, so 100 grams of raw minced meat from these types of meat contain

4.8 mg of zinc (44% of the daily norm), and 100 grams of dark chicken meat give

16% of the daily norm;

- legumes. It is the best vegetarian source of zinc. Thus, a cup of baked beans allows you to get up to 38% of the required daily amount of zinc needed by the body; a cup of cooked chickpeas - 18% of the body's daily needs, also products of this group are rich in fiber, B vitamins, and iron;

- pumpkin seeds, a handful of 30-40 grams of which can provide up to 15% of the daily norm of zinc, in addition, the product provides the body with fiber, protein, magnesium, and antioxidants, which also effectively help to improve immunity;

- yogurt and dairy products in general, are an important food source of zinc, yogurt contains the most zinc - up to 11% of the daily requirement of the body in one glass, and yogurt also contains probiotics that improve the condition of the intestinal microflora and ensure good functioning of the immune system;

- eggs - one large chicken egg, which contains about 5% of the daily norm of this important trace element, and also contains vitamins of group B, selenium, and choline, which create conditions for a significant strengthening of immunity;

- seafood - oysters, which are the main source of zinc, it is necessary to consume up to 6 medium-sized oysters, which provide the body with 32 mg of zinc, or consume 150 g of raw lobster - 4.5 mg of zinc (30% of the daily norm), or 150 g of raw mussels - 2.4 mg of zinc (16% of the daily norm), or 100 g of raw shrimp - 1.1 mg of zinc (7% of the daily norm);

- green leafy vegetables, such as spinach, broccoli, cauliflower, and white cabbage, which are rich in zinc and also provide the body with water, fiber, vitamins (C, PP), and carotenoids;

- cocoa, dark chocolate - rich in zinc and contains the valuable antioxidant resveratrol.

If women have risk factors or other reasons that make it impossible to follow the recommendations regarding a diet enriched with products containing zinc, zinc preparations can be prescribed (for example, zinc gluconate

50 mg) for 1 tablet once a day for at least one month after the coronavirus infection. Detection of risk factors in women who have undergone coronavirus infection: living in environmentally unfavorable conditions (living in iodine-deficient areas) and an unbalanced diet (predominance of fatty foods in the diet, lack of a sufficient amount of vegetables and fruits, which creates obstacles for the normal intake of the trace element iodine in the body) requires the prescription of a diet that contains seafood rich in iodine (sea fish, seaweed) and for the therapeutic purpose of prescribing iodine preparations (in a dosage of 200 mcg, preferably in combination with folic acid in a dosage of 400 to 800 mcg per day, for one to three months, depending on the level of natural iodine deficiency and the presence of clinical signs) and for preventive purposes - 150 μg per day (maintenance dose for at least six months).

In case of determined changes in the results of the examination of additional indicators of the state of immunity, in addition to the diet, therapeutic agents are prescribed depending on the detected changes in the indicators of the state of immunity. Several drugs can be used to treat immunological changes. Correction of immunological changes should be carried out in a differentiated and strict manner, depending on the severity of immunological changes and the features of the spectrum of detected microbial or viral pathogens and taking into account the associative nature of the basic spectrum of microorganisms in the body (primarily at the level of the ENT organs and urogenital organs).

To strengthen the protective functions of the mucous membranes of the throat and oral cavity, it is advisable to use the spray for the mouth and throat Api-Norm Aero, which is a natural remedy, that includes: extracts of sage, St. John's wort, calendula, eucalyptus, propolis, sedum, thyme, natural calendula oils, sage, thyme, thyme essential oil, glycerin, ascorbic acid. The tool does not contain artificial flavors and dyes and facilitates their course in acute and chronic inflammations. This tool is used only for local use. Before use, it is necessary to shake the bottle thoroughly and direct the sprayer into the oral cavity or throat. The injection is carried out with the head in a vertical position. It is recommended to spray 2-3 times on the mucous membranes of the throat or oral cavity 3-4 times a day. The course of application can be 5-7 days. After one course, you should take a break for 3-5 days. For the prevention of respiratory diseases, the spray is used 1-2 times a day or every other day for 1-2 injections. To improve the effect of the product, you should refrain from eating and drinking. for 15-20 min. The spray contains complex natural extracts. People suffering from allergic reactions should be careful and consult a doctor.

The next recommendation according to the monitoring algorithm for women who have undergone a coronavirus infection immediately after recovery should be to determine the level of vitamin D in the blood. If the result obtained is interpreted as a suboptimal value of the content of vitamin D in the blood, women are offered a diet that includes eating products with a significant content of vitamin D and walks, during which sunlight must fall on the skin, since vitamin D enters the body only with food and is synthesized in the human body under the influence of ultraviolet rays. The list of products that contain a lot of vitamin D is quite limited, therefore it is advisable to include the following products in the diet in particular:

- fish oil, which contains 250-350 μg of cholecalciferol (vitamin D) in 100 g of the product;

- cod liver, 100 g of the product contains 100-200 μg of vitamin D;

- fatty fish (salmon, salmon, mackerel, chum, herring, trout, eel, halibut), 100 g of the product contains 10-30 μg of vitamin D;

- black caviar, 100 g of the product contains 8 μg of vitamin D;

- egg yolk, 100 g of product contains 7.7 μg of vitamin D;

- butter, 100 g of the product contains 1.5 μg of vitamin D

- goat's milk, 100 g of product contains 1.3 μg of vitamin D

- hard cheeses, 100 g of the product contains 1 μg of vitamin D.

When following the recommendations on diet and walking with sunlight on the skin, and if the result is interpreted as a suboptimal value of vitamin D in the blood, it is advisable for women who have suffered a coronavirus infection to take vitamin D preparations - vitamin D3 25 mcg (600 IU) at a time capsules 1 time a day for a month after recovery. Whenever the obtained result is interpreted as a deficiency of vitamin D content in the blood, it is advisable for women who have suffered a coronavirus infection to take vitamin D preparations - vitamin D3 150 mcg (from 1000 to 5000 IU, depending on the severity of the deficiency) in 1 capsule 1 time a day for a month after recovery and follow recommendations for diet and walks with exposure to sunlight.

All women who have suffered a coronavirus infection should have blood coagulation parameters determined immediately after recovery. When receiving results with normal indicators, this examination is repeated a month after recovery. Taking into account the results of our research and the data of foreign researchers regarding the possibility of blood clotting and thrombus formation in persons who have undergone a coronavirus infection, it is advisable to prescribe 1 tablet (75 mg) once a day for one month for preventive purposes after receiving the results of the examination. When the results of the examination revealed changes in the blood coagulation system of moderate severity, it is advisable to prescribe the drug acetylsalicylic acid in a dosage of 1 tablet (150 mg) 1-2 times a day for at least 2 weeks with a gradual transition to one tablet (75 mg ) 1-2 times a day for up to a month with monitoring of the state of the blood coagulation system. In the case of marked changes in the indicators of the blood coagulation system in women who have undergone a coronavirus infection, anticoagulant therapy is prescribed depending on the severity of the pathological changes with monitoring of the state of the blood coagulation system.

All women who have undergone coronavirus infection and are at risk of changes in the blood coagulation system, or who have such changes, must adhere to a diet aimed at consuming products that contribute to blood thinning, in particular:

- drinking a sufficient amount of liquid (it should be pure water, not boiled, but passed through a filter and settled), it should be remembered that for each person the daily need for water is individual, on average, about 30-40 ml of liquid is needed per day for each kilogram of weight (for example, with a weight of 60 kg, you need 1.8-2.4 liters of water, and with a weight of 90 kg - 2.7-3.6 liters of water every day - in general);

- green tea (at least one cup – 200-250 ml per day), which reduces the content of cholesterol, triglycerides, lipid peroxides, and fibrinogen, and also contains catechins, which prevent the formation of blood clots and thins the blood;

- cocoa has a blood-thinning effect similar to green tea;

- fruit and vegetable juices (cherry, tomato, apple, grape), or cranberry juice (containing at least two tablespoons of berries per glass of water), as well as from strawberries or raspberries (which contain salicylic acid, which normalizes blood density and reduces inflammatory manifestations);

- fruits and vegetables (containing up to 90% water), such as watermelon, melon, grapefruit, gooseberry, lemon, cucumbers, tomatoes, red cabbage, horseradish root, and celery;

- persimmon (contains many antioxidants and flavonoids, thins the blood, prevents the formation of blood clots, strengthens blood vessels, and normalizes the level of cholesterol in the blood);

- garlic has a significant blood-thinning effect (when prescribing drugs - anticoagulants, the use of garlic is stopped), is antioxidant, has an anti-inflammatory effect (no more than one clove per day);

- onion - has a similar effect to garlic, but less pronounced than garlic;

- ginger can reduce blood viscosity, as it contains gingerol, a substance that, in combination with fatty acids (omega-3 and omega-6), forms special enzymes that prevent platelets from sticking together;

- cinnamon is an extremely strong anticoagulant (use in the diet with caution, as a significant amount can harm the liver);

- Honey, has an extremely positive effect on the blood, thins it, prevents blood clots (at least one tablespoon per day);

- cod liver is the most effective food product, which has a significant effect on blood thinning (since the medicinal product heparin is produced from this product), the daily amount of consumption is from 30 to 50 grams;

- tuna, which is the largest source of auric acid entering the body, taurine, which is a membrane protector, a regulator of intracellular calcium, has antioxidant properties, is a detoxifier, participates in the exchange of fats and fat-soluble vitamins, and affects inflammatory processes, is a sulfur-containing amino acid that is not found in composition of proteins, but which plays a role in important physiological functions, including retinal and neurological development, osmoregulation, modulation of cellular calcium levels and immune function, and is actively involved in the removal of cholesterol, which ensures the elasticity of the vessel wall, blood thinning and prevents the formation of blood clots;

- fish and seafood, which are a source of omega-3 and omega-6 polyunsaturated fatty acids and taurine, which strengthen blood vessels, improve blood flow, and stabilize blood pressure;

- fish oil - has a similar effect as fish and seafood (one teaspoon per day, for one month);

- turkey meat, also among protein foods, is an important source of taurine;

- olive, linseed, or unrefined sunflower oil is a source of polyunsaturated fatty acids, and fat-soluble vitamins, which is why they also have a blood-thinning effect (at least one tablespoon per day);

- sunflower seeds, which have an effect similar to unrefined sunflower oil;

- apple vinegar has a positive effect on metabolic processes in the body, regulates fat metabolism, strengthens the vascular wall, and, thus, has a blood-thinning effect;

- Hercules took, or oat groats contain a significant amount of magnesium, which prevents the formation of blood clots.

In the event that among the identified risk factors in women there are such factors as: bad habits (tobacco smoking and excessive alcohol consumption), occupational hazards (which contribute to a decrease in immunity and have conditions for airborne or contact transmission of the coronavirus), work related with noise, chemical and physical hazards and nervously tense and exhausting work, the presence of stressors, the presence of excess weight or obesity, the presence of extragenital diseases (cardiovascular diseases, diseases of the respiratory system, endocrine diseases - diabetes, diseases of the ENT organs, kidneys, liver and others), the presence of chronic foci of infection in the body and the presence of allergies, women who are consulted by a family doctor or a therapist, if necessary, are referred for consultation to specialized specialists (doctors of psychologists, neurologists, cardiologists, pulmonologists, endocrinologists, nephrologists or urologists, hepatologists, ENT bodies and specialists in occupational diseases) depending on the need to correct the general state of health to receive consultative help and, if necessary, specialized treatment. If foci of chronic infection are found in the body, it is recommended to carry out measures for their rehabilitation and appropriate treatment.

According to the monitoring algorithm for women who have undergone a coronavirus infection immediately after recovery, these women are observed not only by a family doctor or a general practitioner but also by an obstetrician-gynecologist. When a woman turns to an obstetrician-gynecologist in the first place, he directs her to a consultation with a family doctor or a therapist and, in parallel with their actions, according to this algorithm, determines the state of reproductive health of women after suffering a coronavirus infection. If, after being referred for consultation to a family doctor or a general practitioner, these specialists (for unknown reasons) did not prescribe an examination and follow-up of women who had recovered from coronavirus infection, all appointments according to the algorithm for the observation of women who have undergone coronavirus infection immediately after recovery is prescribed by an obstetrician-gynecologist and determines the state of a woman's reproductive health. Women who have been infected with coronavirus, have undergone psychological testing and in whom no severe changes in the psycho-emotional state have been detected and have not received appropriate prescriptions after consultation with a psychologist or psychiatrist, can receive recommendations for improving their psycho-emotional state, if such risk factors are determined by an obstetrician-gynecologist, such as the social status of low-income women, women from disadvantaged or single-parent families, bad habits (tobacco smoking and excessive alcohol consumption), work associated with noise, chemical and physical hazards, and nervously stressful and exhausting work, presence of stressors at work and home, lack of conditions for rest after work. Correction of the psycho-emotional state can be prescribed by an obstetrician-gynecologist who focuses on solving psychosomatic problems of women and has skills in correcting the psycho-emotional state. An example of such corrections can be the office of psycho-emotional relief created in the department "Health Problems of Women of childbearing age" of the State University "Institute of Pediatrics, Obstetrics, and Gynecology named after Academician O.M. Lukyanova National Academy of Sciences of Ukraine". Women who have been infected with coronavirus and have undergone psychological testing, identified risk factors and who have not experienced severe changes in their psycho-emotional state, are prescribed appropriate treatment measures in the office of psycho-emotional relief: psychotherapy, self-training, and emotional relief. It is advisable to carry out such treatment measures in a specially created office, where music therapy can be carried out in comfortable conditions using modern computer technology (according to the Swedish School of Music Therapy). Along with this, during a music therapy session, it is advisable to conduct art therapy, which includes showing on a computer pictures of world-famous artists, selected according to existing recommendations. In parallel with music therapy and showing the paintings of famous artists, it is advisable to carry out phyto-aromatherapy aimed at reducing stressor loads on the body, improving the state of immunity and the psycho-emotional state of women. The duration of psychotherapy and emotional relief procedure should last 30 minutes and consist of 10 to fourteen sessions.

When performing aromatherapy in parallel with music therapy and viewing paintings by famous artists, you can successfully use essential orange oil. The psycho-emotional action, which consists of eliminating the feeling of anxiety, and restoring the developed overstrain, raises the mood. The effect of this drug is soothing, as well as immunostimulating. For aromatherapy, you can use the essential oil "Bergamot", which has a psycho-emotional effect in the form of recovery from mental overload, has a calming effect in case of stress, and lifts the mood. This drug normalizes blood pressure eliminates the symptoms of vegetative disorders, and has an immunostimulating effect and an antiviral effect.

In the presence of clinical signs indicating a violation of vegetative homeostasis (VHG) and changes detected during the questionnaire of women who have undergone coronavirus infection according to the scale of vegetative symptoms according to O.M. Wayne, such women are referred by a family doctor, or a therapist, or an obstetrician-gynecologist for consultation to a neurologist (vegetologist). PVH correction can be prescribed by an obstetrician-gynecologist who is oriented in solving psychosomatic and vegetative problems of women and has skills in PVH correction. Psychotherapy, self-training, and emotional relief are prescribed to all women after a coronavirus infection with PVH, especially in the presence of changes in reproductive health (RH). These therapeutic measures are carried out in a specially created room, where in comfortable conditions with the use of modern computer technology, music therapy according to the Swedish School of Music Therapy is carried out. Women who have undergone coronavirus infection and have PVH, especially in the presence of changes in the RH are divided into four groups, depending on the PVH (the first complex – is for women with autonomic dysfunction syndrome (VD), the second complex – for women with somatoform dysfunction of the autonomic nervous system ( SDVNS) according to the hypertensive type, the third - according to the hypotensive type and the fourth - according to the cardiac type, which is described in detail in declaratory patents No. 99669, 101742, 102430, 103377, 106922, 110539). Along with this, during the music therapy session, art therapy is performed, which includes the display on the computer of paintings by world-famous artists, which are selected depending on the type of PVG. In parallel with music therapy and the display of paintings by famous artists, phyto-aromatherapy is performed, also selected depending on the type of PVG. Aromatherapy in parallel with music therapy and viewing the paintings of famous artists for women with changes in RH and PVH in the form of autonomic dysfunction syndrome is carried out with the help of essential orange oil. For women with changes in RH and PVH in the form of hypertensive type of ADHD, aromatherapy is performed with the help of lavender essential oil, which has the following psycho-emotional effect: it helps to relax, has a calming effect in case of stress and nervousness and irritability, relieves feelings of anxiety, ensures good sleep. This drug lowers blood pressure, eliminates headaches, and migraines caused by spasms of blood vessels, promotes cerebral blood circulation, and eliminates tachycardia and neurotic heart pains. For women with changes in RH and PVH in the form of hypotonic type of ADHD, aromatherapy is performed with the help of Bergamot essential oil, which has a psycho-emotional effect in the form of recovery of mental overload, has a calming effect during stress, and lifts the mood. This drug normalizes blood pressure eliminates the symptoms of vegetative-vascular dystonia, and has an immunostimulating effect and an antiviral effect. For women with changes in RH and PVH in the form of SDVNS according to the cardiac type, aromatherapy is carried out with the help of essential oil "Sosna Sibirska", which has an antioxidant effect, relieves heart pain, has an anti-inflammatory and immunostimulating effect, this drug improves blood circulation.

The duration of the psychotherapy and emotional relief procedure was 30 minutes to 10 sessions.

With all types of PVH and in the presence of changes in the RH, or in the absence of them in women who have undergone a coronavirus infection, it is advisable to prescribe: a drug that contains: (root and rhizome of valerian 170 mg, powder of hop cones 50 mg; powder of lemon balm leaves 50 mg; powder 50 mg of motherwort herb) 2 tablets three times a day for 14 days; adaptol (mebikar) - 0.3 g, 1 tablet 2-3 times a day from 3 to 10 days; ubiquinone compositum is a complex homeopathic preparation, which includes: (wort, blueberry, spotted hemlock, podophyllum, passionflower, hydrostis, coenzymes and quinones, mineral ingredients) 2.2 ml – 1 ampoule intramuscularly 3 injections per a week – a course of 3 to 9 injections, depending on the severity of the disorder; a preparation of fish oil 3.3%, docosahexaenoic acid - 22%, coenzyme Q10 - 10.0 mg and vitamin E 1.0 mg, 1-2 capsules per day for 14 days.

In case of severe weather dependence in women with all forms of PVH and the presence of RH changes, or even in their absence, it is advisable to prescribe a drug that includes: antifront ek. ginger root, ek. licorice root, etc. lemon balm leaves, e.g. green tea leaves, e.g. turmeric root. The drug is prescribed for 10-15 drops until the symptoms of weather dependence are removed.

With the hypertensive type of ADHD, the following is additionally prescribed: homvio-nervin, which includes: Sepia D4 - 64 mg, ambergris D2 - 64 mg, hyoscyamus D3 - 32 mg, ignation D3 - 32 mg. The drug is prescribed 1-3 times a day, for 14 days, and after

1 tablet for up to one month.

With hypotonic type of ADHD, the following is additionally prescribed: Kalmavis, which includes: L-tryptophan - 100 mg, ek. valerian root - 25 mg, eq. medicinal chamomile - 25 mg, eq. lemon balm leaves - 25 mg, eq. Eschsoltia Californian - 25 mg, eq. Linden Flowers - 20 mg, eq. lavender flowers - 20 mg, eq. passionflower - 9 mg, magnesium oxide - 133.63 mg. The drug is prescribed 3 times a day for 14 days, 1 tablet for up to one month.

In the case of heart-type heartburn, the following is additionally prescribed: kralonin, which contains hawthorn fruits and its flowers, 15-20 drops until the symptoms of heart pain disappear 3 times a day, for 14 days to one month.

To reduce the manifestations of OS in complex therapy, it is advisable to prescribe Vit-E 100 mg x 3 times a day for 14 days. If it is necessary to treat the post-coronavirus syndrome and in the presence of vegetative or other neurological disorders, L-arginine hydrochloride 100 ml contains 4.2 g of arginine hydrochloride (100 ml contains 20 mmol of arginine and 20 mmol of chlorides), 100 ml of the drug is prescribed for complex therapy intravenous drip once a day for 10 days of treatment.

Alora can also be used for all forms of stressors and bad sleep, 1 tablet of which contains 100 mg of dry passion flower extract, and 5 ml of syrup contains 694.44 mg of liquid passion flower extract. The drug is prescribed for 1 tablet or 1 teaspoon 3 times a day before meals for 10 days, or until normal sleep. Passionflower extract is made from the medicinal plant Passiflora incarnata, which contains 0.04% indole alkaloids, some flavonoids, as well as coumarins, quinones, etc. The components of the extract inhibit the conduction of nerve impulses in the spinal cord and brain, reduce the excitability of the central nervous system, and cause a sedative effect. This drug improves mood in depressive states, reduces anxiety and mental stress, and has a mild hypnotic effect without the symptom of depression upon awakening. This effect of the drug is confirmed by the results of research, which established that on the background of the use of the drug, a rapid reduction of anxiety-depressive symptoms, normalization of the sleep-wake cycle, reduction of the level of neuropsychological tension, restoration of work capacity and social activity is noted.

It is advisable for all women who have suffered a coronavirus infection to perform breathing exercises every morning after waking up on an empty stomach according to well-known methods (for example, according to the method of O.M. Strelnikova), at least 2 times during the month after recovery. If women who have recovered from coronavirus infection still have symptoms of lack of air and there are changes in pulse oximeter indicators, a complex of therapeutic breathing exercises, their intensity, and frequency should be coordinated with a specialist in physical therapy.

According to our data, the determination of the state of RH in women showed that, among RH, such women often develop inflammatory diseases of the genital organs after recovery or exacerbation of CKD. Therefore, such women undergo a determination of the microbiocinosis of the urogenital organs and the necessary instrumental examinations (ultrasound, colposcopy). Depending on the detected changes in the state of the biotopes of the urogenital organs, antimicrobial treatment measures are prescribed to restore the microbiocenosis, taking into account the results of the biotope research and the presence of clinical signs of the inflammatory process. Such actions require antibiotic therapy, and according to the results of the examination, drugs that act on aerobes, fungi, and fungi are prescribed. The selection of drugs for the correction of microbiocenosis violations was necessarily carried out taking into account not only the results of the study of biotopes but also taking into account antibiotic resistance. If necessary, according to the results of examinations and taking into account the sensitivity of the detected pathogenic microorganisms, it is advisable to prescribe antibiotics that belong to the groups of fluoroquinolones, josemicin, and doxycycline. Probiotics are prescribed to protect the intestine from the harmful effects of antibiotics, treat dysbiosis, and restore the physiological microflora in complex therapy. If the activity of viruses causing an inflammatory process at the level of the urogenital organs is detected, antiviral treatment must be carried out with the help of acyclovir in tablet form, and if necessary, depending on the viral activity, in intravenous form. For the prevention and treatment of exacerbations of CKD in complex therapy, it is possible to prescribe a preparation in the form of vaginal suppositories, which contains a multicomponent composition based on beekeeping products and plant components.

For prevention and treatment of exacerbations of CKD in complex therapy, it is possible to prescribe the drug Api-Norm® in the form of vaginal suppositories, which contains a multicomponent composition based on beekeeping products and plant components and is a natural api-phytopreparation. The composition of the drug includes activated propolis extract, beeswax, St. John's wort extract, marigold extract, and sea buckthorn oil. According to the mechanism of action, the components of the drug provide many therapeutic effects, in particular: calendula extract has a bactericidal, anti-inflammatory effect, improves metabolism, and relieves spasms of smooth muscles, St. John's wort extract is antibacterial, antiseptic, pain-relieving, as well as regenerating, sea buckthorn oil has a regenerating effect on the skin and mucous membranes shell, accelerates epithelization, has a general strengthening, anti-inflammatory, cytoprotective and antioxidant effect, natural beeswax - anti-inflammatory, antiseptic and softening. The drug is used for acute inflammatory processes: administered after hygienic procedures, one candle per night for 10 days, for chronic diseases: one candle per night for 15-20 days. After 15-30 days, a repeat course of 10 days is prescribed, for preventive purposes, it is used for 3-5 days, depending on the state of health. The drug differs from other drugs of a similar focus by its balanced combination of beekeeping products and plant components. The combination of these components has a complex effect, which leads to a decrease in clinical manifestations in acute and chronic inflammatory diseases of the pelvic organs and the urinary system. Since it includes plant components and beekeeping products, it has a high level of effectiveness and safety from the point of view of evidence-based medicine. Studies conducted in specialized clinics demonstrated positive dynamics of clinical and laboratory indicators in women with diseases of the pelvic organs and urinary system and proved the high effectiveness of the drug, which is especially important for women who have experienced coronavirus infection. Therefore, it is advisable to use these vaginal suppositories both in complex therapy for the treatment of microbiocenosis disorders of the urogenital organs, and for preventive purposes in women who have undergone coronavirus infection.

Changes in menstrual function are observed among other violations of the state of RH in women who have undergone coronavirus infection. To diagnose such changes, it is advisable to examine the level of sex hormones in the body of such women (colpocytological, and if necessary, determine the level of hormones in the blood). According to the results of an examination of the level of sex hormones in the body of such women, appropriate correction is prescribed based on clinical signs. The principle of a differential approach to the correction of the pathology of the hormonal supply of the menstrual cycle in such women should be based on the severity of clinical manifestations and the stage of the pathological condition. In mild and moderately severe conditions (as well as in the stage of compensation or subcompensation), it is advisable to prescribe herbal preparations, taking into account their proven effectiveness and safety. Severe cases, as well as cases with laboratory-confirmed progesterone deficiency, prolactin excess, require the appointment of appropriate replacement therapy or the necessary chemical compounds (progestogens - in the form of sublingual form). In several moderate and severe conditions, herbal preparations can be prescribed as an adjuvant dosage form. Taking into account that hormonal changes in the body of women who have undergone a coronavirus infection cause an increased need for magnesium ions released from the body, there is a need for additional prescription of magnesium preparations. In case of violation of the hormonal regulation of the menstrual function, it is advisable to prescribe magnesium in combination with vitamin B6 in tablets, in a daily dose of 300 mg, during the treatment of hormonal changes until they disappear. Magnesium preparations have a pronounced antispasmodic, sedative, tocolytic, sedative, and tranquilizing effect and have a neuroprotective, normalizing blood pressure, and antiarrhythmic effect.

If the diagnostic and therapeutic measures carried out according to the algorithm for observation of LVVs who suffered coronavirus infection immediately after recovery gave a positive result, which is based on the absence of contraindications, the absence of changes in laboratory parameters, and a satisfactory state of general, psychosomatic and reproductive health, the date of vaccination is determined. At the same time, it is necessary to take into account the state of acquired immunity to the coronavirus infection (by determining the corresponding antibodies in the blood) obtained after being infected with the coronavirus.