The novel coronavirus (COVID-19) pandemic announced by the World Health Organization in March 2020 has brought new tasks to the medical community that require immediate solutions. Recent studies have shown that invasive aspergillosis associated with coronavirus infection caused by COVID-19 often aggravates the course of the disease and leads to death. The article presents a clinical case of acute invasive aspergillosis in a COVID-19 patient with chronic somatic pathology but no risk factors for developing invasive pulmonary aspergillosis. The disease was progressing rapidly and led to a fatal outcome.Conclusion. In the case presented, invasive pulmonary aspergillosis was diagnosed with the help of histological examination of autopsy material.
Objective. To evaluate the efficacy and safety of human recombinant interferon alpha-2b (VIFERON®) as a part of comprehensive treatment for coronavirus infection COVID-19. Patients and methods. This prospective, comparative, controlled study included 140 patients with COVID-19 randomized in two groups. The experimental group (EG) included 70 patients who received standard therapy plus VIFERON® (one rectal suppository 3,000,000 IU three times a day and gel 36,000 IU/g 5 times a day applied to the nasal mucosa and palatine tonsils for 14 days); the control group (CG) comprised 70 patients who received standard therapy alone. Results. Patients in the EG demonstrated more rapid resolution of main symptoms, such as intoxication, bronchopulmonary and catarrhal manifestations. Normalization of the total score in the EG was observed 7 days earlier than in the CG. In the EG, the proportions of patients who had their D-dimer and CRP levels normalized were 42.7% and 18.7% higher than those in the CG, respectively (р < 0.05). Follow-up computed tomography demonstrated that the proportion of patients with positive dynamics in the EG was 8.1% higher than that among controls, whereas advanced disease with 51%–75% of lung tissue affected was 11.9% less common in participants from the EG than in controls (р = 0.019). We observed no adverse events associated with interferon alpha-2b (VIFERON®) or other medicines included in the treatment scheme. Conclusion. Our findings suggest high efficacy and safety of recombinant interferon alpha-2b (VIFERON®) used in combination with symptomatic agents, antibiotics, anticoagulants, which allows us to recommend this drug for inclusion into standard treatment schemes for COVID-19. Key words: COVID-19, coronavirus infection, human recombinant interferon alpha-2b
Objectives to define the possibilities of diagnosing tuberculosis in patients of pulmonology hospital, including patients with HIV infection. Material and methods. During this retrospective one-step study, we analyzed 103 medical records of patients in pulmonology departments who had received a full range of laboratory and instrumental examinations, including the Mantoux test and the test with a recombinant tuberculosis allergen (Diaskintest). The patients were divided into two groups depending on their HIV status: Group 1 included 78 HIV-negative patients, Group 2 consisted of 25 HIV-positive patients. Results. A microscopy of sputum and bronchial lavage did not reveal acid-resistant mycobacteria in all patients. PCR test for M. tb DNA was positive in three patients in Group 1 (33.3 13.9% of the total number of examined patients) and in one patient in Group 2 (25.0 13.9%) (2 = 0.01; p = 0.931). According to the results of immunodiagnostics, a positive normergic reaction to the Mantoux test was observed in 24 patients in Group 1 and in 7 patients in Group 2 (30.8 5.2% and 28.9 9.0% respectively), 2 = 0.04; p = 0.846. The reaction for recombinant tuberculosis allergen (Diaskintest) was positive in 9 patients in Group 1 (11.5 3.6%) and in 5 patients in Group 2 (20.0 8.0%), 2 = 0.85; p = 0.358. Based on clinical, laboratory, instrumental and immunological examinations by a TB doctor, in total 12 patients (11.7%) were diagnosed with tuberculosis. These patients were distributed among the study groups as follows: 9 people (11.5 3.6%) in Group 1 and 3 people (12.0 6.5%) in Group 2 (2 = 0.0; p = 0.956). Conclusion. The inclusion of the Mantoux test and the reaction for recombinant tuberculosis allergen (Diaskintest) in the set of diagnostic tests for patients of the pulmonology department of the general hospital simplified the differential diagnosis of tuberculosis and pneumonia, both for a pulmonologist and a TB specialist.
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