tibljТуберкулез и болезни легкихTuberculosis and Lung Diseases2075-12302542-1506Медицинские знания и технологии10.58838/2075-1230-2024-102-6-98-107tiblj-1856Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESНовая коронавирусная инфекция COVID-19 у пациентов с ВИЧ-инфекцией и предикторы неблагоприятного исхода в условиях стационараThe Novel Coronavirus Infection of COVID-19 in HIV Positive Patients and Predictors of an Unfavorable Outcome in In-Patient SettingsУрушадзеН. Д.UrushadzeN. D.

Урушадзе Наталья Дмитриевна - младший научный сотрудник научного отдела инфекционной патологии

Тел.: +7 (905) 704-71-30

127473, Москва, ул. Достоевского, д. 4, к. 2

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Natalia D. Urushadze - Junior Researcher of Infectious Pathology Research Department

Phone: +7 (905) 704-71-30

Build. 2, 4 Dostoevskiy St., Moscow, 127473

Phone: +7 (495) 681-11-66

nataliu98@mail.ruПшеничнаяН. Ю.PshenichnayaN. Yu.

Пшеничная Наталья Юрьевна - д. м. н., профессор, заместитель директора по клинико-аналитической работе

Тел.: +7 (495) 304-22-01, доб. 1205

111123, г. Москва, ул. Новогиреевская, д. 3А

Natalya Yu. Pshenichnaya - Doctor of Medical Sciences, Professor, Deputy Director for Clinical and Analytical Activities

Phone: +7 (495) 304-22-01, ext. 1205

3A Novogireevskaya St., Moscow 111123

natalia-pshenichnaya@yandex.ruПаролинаЛ. Е.ParolinaL. E.

Паролина Любовь Евгеньевна - д. м. н., профессор, руководитель Центра образования

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127473, Москва, ул. Достоевского, д. 4, к. 2

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Lyubov E. Parolina - Doctor of Medical Sciences, Professor, Head of Education Center

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Build. 2, 4 Dostoevskiy St., Moscow, 127473

Phone: +7 (495) 681-11-66

ParolinaLE@nmrc.ruЛизинфельдИ. А.LizinfeldI. A.

Лизинфельд Ирина Александровна - к. м. н., научный сотрудник научного отдела инфекционной патологии

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127473, Москва, ул. Достоевского, д. 4, к. 2

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Irina A. Lizinfeld - Candidate of Medical Sciences, Researcher of Infectious Pathology Research Department

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Build. 2, 4 Dostoevskiy St., Moscow, 127473

Phone: +7 (495) 681-11-66

LizinfeldIA@nmrc.ruhttps://orcid.org/0000-0002-0637-7955ВасильеваИ. А.VasilyevaI. A.

Васильева Ирина Анатольевна - д. м. н., профессор, директор, заведующая кафедрой фтизиатрии ФГАОУ ВО «РНИМУ им. Н. И. Пирогова» МЗ РФ

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Irina A. Vasilyeva - Doctor of Medical Sciences, Professor, Director, Head of Phthisiology Department, Pirogov Russian National Research Medical University, Russian Ministry of Health

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Build. 2, 4 Dostoevskiy St., Moscow, 127473

Phone: +7 (495) 681-11-66

vasil39@list.ruФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр фтизиопульмонологии и инфекционных болезней» Минздрава РоссииРоссияNational Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of HealthRussian FederationФедеральное бюджетное учреждение науки «Центральный научно-исследовательский институт эпидемиологии» Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человекаРоссияCentral Research Institute of Epidemiology of the Federal Service for Surveillance on Consumer Rights Protection and Human WellbeingRussian Federation202419122024102698107Copyright © Урушадзе Н.Д., Пшеничная Н.Ю., Паролина Л.Е., Лизинфельд И.А., Васильева И.А., 20242024Урушадзе Н.Д., Пшеничная Н.Ю., Паролина Л.Е., Лизинфельд И.А., Васильева И.А.Urushadze N.D., Pshenichnaya N.Y., Parolina L.E., Lizinfeld I.A., Vasilyeva I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tibl-journal.com/jour/article/view/1856Цель исследования

Цель исследования: выявление особенностей течения COVID-19 у пациентов с ВИЧ-инфекцией и факторов риска неблагоприятного исхода у них.

Материалы и методы

Материалы и методы. Проведено ретроспективное обсервационное исследование пациентов с COVID-19 независимо от ВИЧ-статуса, госпитализированных в стационар.

Результаты

Результаты. У пациентов с ВИЧ-инфекцией наблюдалось более тяжелое течение COVID-19, включая более обширное поражение легочной ткани и тяжелую степень дыхательной недостаточности. У пациентов с ВИЧ-инфекцией чаще встречалась одышка. По результатам лабораторных анализов отмечался пониженный противовирусный иммунный ответ, признаки анемии и поражения печени, а также склонность к тромбообразованию. При построении прогностической модели логистической регрессии у пациентов с COVID-19 и ВИЧ-инфекцией было выявлено, что риск наступления неблагоприятного исхода был связан с такими факторами, как снижение относительного количества лимфоцитов и уровня общего белка в перифирической крови на момент госпитализации.

Выводы

Выводы. Учитывая повышенный риск тяжелого течения и неблагоприятного исхода COVID-19 при сочетании с ВИЧ-инфекцией, у этих пациентов необходимо контролировать симптомы дыхательной недостаточности, и при их появлении принимать решение о госпитализации на более ранних сроках болезни.

The objective

The objective: to identify specific features of the COVID-19 course in HIV positive patients and risk factors for unfavourable outcomes in such patients.

Subjects and Methods

Subjects and Methods. Patients with COVID-19 regardless of their HIV status admitted to hospital were enrolled in a retrospective observational study.

Results

Results. HIV positive patients experienced a more severe course of COVID-19 including more extensive lung tissue damage and severe respiratory failure. Shortness of breath was more common of patients with HIV infection. Laboratory tests revealed adecreased antiviral immune response, signs of anemia and liver damage, and a tendency to develop blood clots. When developing a prognostic logistic regression model in patients with COVID-19 and HIV infection, it was revealed that the risk of an unfavorable outcome was associated with such factors as a decrease in the relative number of lymphocytes and level of total protein in peripheral blood at the moment of admission to hospital.

Conclusions

Conclusions. Given the elevated risk of a severe course and unfavorable outcome of COVID-19 in case of concurrent HIV infection, it is necessary to monitor symptoms of respiratory failure in these patients, and if they appear, make a decision about hospitalization at an earlier stage of the disease.

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