Актуальность острых респираторных вирусных инфекций (ОРВИ) и гриппа обусловлена их широким распространением, поражением любых возрастных, профессиональных, половых групп населения, наличием тяжелых осложнений, трудностью лечения и большим социально-экономическим ущербом. Целью исследования явилось изучение особенностей современного течения ОРВИ и гриппа по данным инфекционного стационаре в сезоне 2018-2019 гг. Рассмотрено 572 истории болезней пациентов с диагнозом «ОРВИ» и 29 историй болезней пациентов с диагнозом «грипп», лечившихся в ГУЗ ЦПБ со СПИД и ИЗ г. Нальчика (эпидемический сезон 2018-2019 гг.). В работе дана сравнительная клиническая и эпидемиологическая характеристика больных ОРВИ и гриппом. Всем больным гриппом диагноз был установлен на основании ПЦР-диагностики, у 28 больных был выявлен вирус гриппа А (H1N1). У 1 больного был выявлен вирус гриппа В. Диагноз «ОРВИ» выставлялся клинически и эпидемиологически. Было установлено, что группы больных с ОРВИ и гриппом были сопоставимы по полу, возрасту и преморбидному фону. В группе больных гриппом заболевание протекало тяжелее, чем у больных ОРВИ. Больные гриппом провели больше койко-дней в стационаре. В отличие от больных ОРВИ у больных гриппом ведущим симптомом был сухой кашель, более высокая и длительная лихорадка, склерит, зернистость задней стенки глотки петехии на твердом небе, а также боли в глазных яблоках. У больных ОРВИ наиболее частым осложнением был бронхит, а у больных гриппом -острая пневмония. Все больные получали или тамифлю, или арбидол. Летальных случаев не было. Ключевые слова: грипп, острая респираторно-вирусная инфекция, заболеваемость, летальность.
The first patients with SARS-CoV-2 infection were registered in Kabardino-Balkar Republic (KBR) in the end of March 2020, when Hospital No 1 at the Center for AIDS and Infectious Diseases was completely equipped for the admission of COVID-19 patients. Objective. To assess clinical and laboratory characteristics of patients with severe and extremely severe COVID-19 treated in the intensive care unit of Hospital No 1 in Nalchik in 2020–2021. Patients and methods. A total of 283 patients were treated in the intensive care unit (ICU) during this year. More that one-third of patients (41.3%) died; most of them were male. The majority of patients in the ICU were between 61 and 70 years of age; the majority of deaths were registered among patients aged 71 to 80 years. One hundred and seventy-three individuals in the ICU required non-invasive or invasive ventilation; 105 of them (60.7%) died. Two hundred and fifty-two patients (89%) had severe concomitant diseases. The disease severity was also determined by advanced lung damage (more than 50%) in 143 patients (50.5%). Patients were examined and treated in accordance with temporary guidelines (effective at that time). Results. The most common causes of death among patients treated for COVID-9 in the ICU were pulmonary embolism (n = 50; 42.75%), sepsis (n = 19; 16.2%), and acute respiratory failure (n = 17; 14.5%). Key words: coronavirus infection, SARS-CoV-2, intensive care unit
Currently, we are witnessing the development of a new COVID-19 pandemic against the background of a relatively old, but ongoing HIV pandemic for more than 40 years. The presence of pronounced immunosuppression, concomitant diseases in HIV infection can aggravate the course of a new coronavirus infection. The immunosuppression present in HIV infection increases with coronavirus infection, especially if we are talking about patients who are not receiving antiretroviral therapy. The clinical observation of a patient in whom a coronavirus infection caused by SARS-COV-2 occurred against the background of a newly diagnosed, untreated HIV infection is given. Despite the ongoing treatment, including antiretroviral therapy (ART), transfer to the intensive care unit and taking the patient on a ventilator, her condition progressively worsened and she died with acute respiratory failure. The following factors contributed to this: late initiation of ART, the presence of numerous complications of HIV infection: immunodeficiency, pneumocystis pneumonia, oropharyngeal candidiasis: glossitis, pharyngitis, Kaposi's sarcoma of the skin. The addition of covid pneumonia, pneumothorax contributed to the development of acute respiratory failure and death of the patient. In addition, apparently, the fact that due to the presence of severe immunodeficiency caused by HIV infection, the patient did not receive targeted therapy also played a role.
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