Наукові праці. Кафедра інфекційних хвороб, дитячих інфекційних хвороб, фтизіатрії та пульмонології
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Item Features of the course of toxoplasmic encephalitis in hiv-infected patients(2024) Veliieva, Tunzala; Bodnia, Kateryna; Makarenko, Valentyna; Pavliy, V.; Krokhmal, I.This article presents the results of a retrospective analysis of clinical characteristics and examination outcomes in 23 patients with toxoplasmic encephalitis (TE) among HIV-infected individuals. Among the examined individuals, 11 (47.8%) were men and 12 (52.2%) were women. The patients' ages ranged from 31 to 55 years, with an average age of 37.5 ± 0.38 years. The average CD4+ lymphocyte count was 102.5 ± 21.2 cells/μl, and the HIV RNA load in plasma was 292,773.8 ± 113,180 copies/mL. All patients were confirmed to have stage 4 HIV infection (according to the CDC classification, 1993). Toxoplasmosis infection was confirmed by blood serology (presence of anti-Toxoplasma IgG antibodies via ELISA), and toxoplasmic encephalitis was diagnosed through MRI with characteristic focal brain changes. According to our analysis toxoplasmic encephalitis in HIV-infected patients develops gradually, with cognitive and psychiatric disorders as primary manifestations, followed by focal neurological impairments (hemiparesis, seizures, speech problems). All HIV patients with detected Toxoplasma antibodies at the onset of the disease can be considered at risk for developing toxoplasmic encephalitis. TE in the brain manifests when CD4+ cell levels drop below 200 cells/μL and is characterized by polysymptomatic presentation, with an average of 5.67±0.37 symptoms in our patients. The data from our correlation analysis between altered blood parameters and the presence of symptoms in TE among HIV-infected patients showed that the greater the severity, activity, and duration of toxoplasmic infection (indicated by eosinophilia), the more diverse the symptoms. This, in turn, leads to an increase in ESR, the development of leukocytopenia, and hypochromic anemia.Item Features of blood coagulation indicators in surgical patients with a confirmed diagnosis of COVID- 19(European Surgery, 2024-05-16) Andrusovych, Inna; Korolevska, Anna; Komarchuk, I.Timely and accurate assessment of the state of the hemostasis system in patients with the different severity of the course of COVID-19 is the key to the correct appointment appropriate volume of anticoagulant therapy in order to prevent complications disease. Thromboelastography is a non-invasive method evaluation of the hemostasis system – not only provides data on the state of the links thrombus formation, but also the processes of fibrinolysis, a comprehensive assessment of which can contribute to the personalized selection of anticoagulant therapy. The aim of the research. Determine the relationship between the difficulty of the course and the tension of the system hemostasis in patients with different course of the COVID-19 coronavirus disease.Item Determination of the degree of inflammatory response in patients with COVID-19 infection by interleukin-6 levels(MDPC Publishing, 2024) Andrusovych, InnaAn inflammatory reaction and subsequent severe organ damage play an undeniable role in the pathogenesis of disorders in patients with COVID-19 infection. Clinically, this is manifested by severe acute respiratory syndrome, which is characterized by diffuse damage to the alveoli at the level of hyaline membranes. The immune response in this case can manifest itself in the form of a cytokine storm: in the vast majority of patients, there is a significant increase in the levels of interleukin (IL)-6, IL-17A and tumor necrosis factor-α.Item Concomitant pathology of patients with COVID-19 infection(Perfect Publishing, 2024) Andrusovych, InnaMany studies have shown that a more severe course of COVID-19 is associated with the presence of comorbidities. Thus, the risk of hospitalization in patients with bronchial asthma is 1.5 times higher, and in patients with chronic kidney disease and diabetes mellitus - 4 and 3 times higher, respectively. Among the risk factors that significantly affect the deterioration of COVID-19, the researchers consider the following: older age, male gender, and comorbidities. For example, in the presence of concomitant hypertension, the risk of mortality increases by at least 1.7-3.5 times, and in the presence of grade I-II obesity - by 3 times. According to Pranata et al, cardiovascular and cerebrovascular pathology was the leading comorbidity in patients with COVID-19. Another meta-analysis by Pranata et al. showed the impact of concomitant hypertension on the course of COVID-19: hypertension was significantly associated with total negative outcomes of COVID-19: hazard ratio (HR) = 2.11 [95.0% confidence intervals (CI) 1.85-2.40], p < 0.001.Item Value of clinical blood analysis indicators of patients with COVID-19 infection(SPC “Sci-conf.com.ua”, 2024) Andrusovych, InnaEmerging in late 2019, the coronavirus disease (COVID-19) has quickly become global with extraordinary rates of morbidity and mortality. The World Health Organization defines COVID-19 as a severe acute respiratory syndrome caused by coronavirus type 2 (SARS-CoV-2). This is the third zoonotic coronavirus that has caused an epidemic in recent years. Bats can be considered the primary reservoir of infection, as the virus isolated from them has a high affinity to SARS-CoV-2. This type of coronavirus primarily affects the epithelium of the respiratory tract, entering the cells through interaction with the receptors of the angiotensin 2-converting enzyme.Item Lesions in the functional state of the cardiovascular system of patients with COVID-19 infection(MDPC Publishing, 2024) Andrusovych, InnaThe coronavirus family has been known since the 20th century, but until the outbreak of severe acute respiratory syndrome coronavirus disease (COVID-19) and Middle East respiratory syndrome (MERS-CoV), they were not given appropriate clinical and epidemiological significance. Thus, the most severe respiratory diseases were caused by 3 beta coronaviruses, in particular SARS-CoV, SARS-CoV-2 and MERS-CoV. Although most patients with COVID-19 have a predominantly respiratory tract involvement, a certain cohort has a more severe course of the disease with the development of systemic involvement characterized by resistant fever, acute lung injury and severe acute respiratory syndrome, shock and subsequent multiorgan failure. The combination of diffuse intravascular coagulation with the formation of large-caliber vascular thrombosis is also associated with the development of multiple organ failure. Mortality rates from COVID-19 reach at least 10.0%.Item Damage to the respiratory system of patients SARS-CoV-2 associated with COVID-19 infection(Міжнародний центр наукових досліджень, 2024) Andrusovych, InnaCorona virus disease (COVID-19) is associated with a number of clinical conditions mainly of the respiratory system, including both mild lesions of the upper respiratory tract and severe viral pneumonia. Manifestations of interstitial pneumonia are determined among at least 14.0% of infected patients, which has a significant chance of developing into a severe acute respiratory syndrome with subsequent need for intensive therapy. In addition, damage to peripheral pulmonary vessels and vessels involved in gas exchange significantly affects the balance of ventilation and perfusion, which causes the development of hypoxemia and requires a change in the patient's position during oxygenation.Item Correlations between clinical, laboratory and instrumental characteristics of patients with COVID-19 infection(2024) Andrusovych, InnaCOVID-19 is a leading disease in terms of prevalence (more than 100 million cases) and mortality (more than 10.0%). Most often, COVID-19 is accompanied by hemostatic disorders (manifestations of COVID-19-associated coagulopathy) and blood coagulation.Item Predicting the risk of death in patients with covid-19 infection(2024) Andrusovych, InnaThe article presents the associations of clinical, laboratory, and clinical and instrumental features of patients with COVID-19 with increased risks of death and survival. The final model for predicting the risks of developing a lethal outcome in COVID-19 was determined, which has high classification qualities (optimal threshold value of the calculated model is equal to -1.6149; sensitivity – 97.1%; and specificity – 82.6%. The purpose of our study was to determine the risks of developing fatal outcomes in patients with COVID-19 based on their clinical, laboratory and instrumental features. The study was performed at the Department of Infectious and Pediatric Infectious Diseases, Parasitology, Phthisiology and Pulmonology of the Kharkiv National Medical University in accordance with the current bioethical norms and rules. All patients signed informed consent. 179 patients with COVID-19 aged 20–88 years (average age was [58.75±13.82] years) were observed. Medical and statistical calculations were performed using the IBM SPSS 25.0 software package. The associations of indicators with the binomial dependent variable were calculated using multiple logistic regression analysis with the calcula-tion of β coefficients. The significance of differences was determined using the Mann-Whitney U-test with a threshold of statistical significance p=0.05. Based on the results, the final prog-nostic model of the risk of developing a lethal outcome of COVID-19 indicates an increased risk of death in COVID-19 with increasing age (by 13.9%), leukocyte count (by 14.4%), D-dimers (by 0.001%) on day 5–7. According to the model, an increase in the probability of sur-vival in COVID-19 was significantly proved with an increase in hemoglobin (by 6.1%) at the day of hospitalization, monocyte count (by 17.1%) on day 5–7 and the use of ceftriaxone (by 87.8%).Item Relation of the immunologic status of blastocystosis patients with the effectiveness of their therapy(2024) Bodnia, Kateryna; Yurko, Kateryna; Bodnia, IgorTo study the presence of a relationship between the state of immunologic homeostasis and the effectiveness of blastocystosis therapy, the values of immunity indices were compared in 300 patients with blastocystosis in alternative groups: group A − with good therapeutic effect (n = 162) and group B − with satisfactory effect (n = 138). Group A included patients who had an overall clinical symptom regression rate of ≥33% after 1 month of treatment, and group B included patients who had an overall regression rate of ≤32%. When comparing the correlation structures of immunity indices in the groups, it was found that they differ significantly (by 90%) in their “portrait” properties (nature of correlation). In patients with a good therapeutic effect in comparison with the alternative group is characterized by a more pronounced antibodyalogenesis of all classes of antibodies (Ig M, Ig A, Ig G and IgE), which indicates their leading role in the formation of protective reactions in patients with blastocystosis. The established significant (90%) differences in the nature of relationships in the groups indicate that in patients depending on the effectiveness of their therapy, fundamentally different pathogenetic matrices of immune homeostasis are formed, which substantiates the possibility of using immune indicators as predictors.