The objective: to perform quantitative analysis of SARS-CoV-2 viral load (VL) levels in lung tissues in deceased patients with COVID-19 and to evaluate its association with the nature of histological changes in the lungs and the duration of stay in ICU till the lethal outcome.

Subjects and Methods. Sections of formalin-fixed and paraffin-embedded lung tissues of 36 deceased patients with COVID-19 were used. The SARS-CoV-2 viral load was quantitatively assessed using the original qPCR. VL was calculated using the following formula: copies SARS-CoV-2 / copies ABL1 × 100, expressed as the ratio of the true number of SARS-CoV-2 cDNA copies per 100 copies of ABL1 gene cDNA.

Results. In cases with no histological changes typical of diffuse alveolar lung injury (DAI), the detection rate of SARS-CoV-2 RNA and the average level of the SARS-CoV-2 viral load were 62.5% (5 out of 8 observations) and 104.75 (range 0-313) copies of SARS-CoV-2 cDNA per 100 copies of human ABL1 gene cDNA. The average level of the SARS-CoV-2 viral load in the lungs with prevailing histological changes characteristic of the proliferative and exudative phases of DAI differed by 60 times and amounted to 909 (18-2,657) and 54,924 (834-250,281) copies of SARS-CoV-2 cDNA per 100 copies of human ABL1 cDNA, respectively. The average duration of stay in the intensive care unit in the group of patients with exudative and proliferative phases of DAI was 10.64 (1-22) and 8.14 (1-21) bed-days, respectively. The detection rate of the SARS-CoV-2 RNA in patients with diffuse alveolar lung injury was 100%.

The objective of the study: to summarize experience of using a mobile technology to improve adherence in patients with tuberculosis and HIV infection (TB/HIV) who are psychoactive substance users.

Subjects and Methods. A smartphone app was used, it included daily patient inquiries about mood, stress levels, and medication intake; periodic reminders about outpatient appointments; and anonymous chats with the coordinating physician and other patients. Treatment results were evaluated in Group 1 (n = 54) and Group 2 (n = 50), where this technology was used and not used, respectively.

Results. The number of patients cured of tuberculosis was not significantly different between Groups 1 and 2 (32/51 vs. 27/48; χ2 = 0.61, p = 0.48). Patients from Group 2 died significantly more often during the follow-up period (14/48 vs. 3/51; χ2 = 7.86, p = 0.006) associated with antiretroviral therapy interruption or withdrawal. Increased CD4 count by 6 months of follow-up was found in both groups, most pronounced among those who started ART (W = 6.0, p = 0.004 – in Group 1 and W = 15.0, p = 0.004 – in Group 2). The total number of patients with viral suppression was greater in Group 1 than in Group 2 (34/47 vs. 20/39; χ2 = 4.05, p = 0.04).

Conclusion. The mobile app used is suitable for supporting the outpatient management of patients with TB/HIV coinfection but its direct impact was reflected only in the formation of ART adherence and lower number of deaths.

The objective of the study: to evaluate the possibility of using machine learning algorithms for prediction of relapses in multiple drug resistant tuberculosis (MDR TB) patients.

Subjects and Methods. Сlinical, epidemiological, gender, sex, social, biomedical parameters and chemotherapy parameters were analyzed in 346 cured MDR TB patients. The tools of the scikit-learn library, Version 0.24.2 in the Google Colaboratory interactive cloud environment were used to build forecasting models.

Results. Analysis of the characteristics of relapse prediction models in cured MDR TB patients using machine learning algorithms including decision tree, random forest, gradient boosting, and logistic regression using K-block stratified validation revealed high sensitivity (0.74 ± 0.167; 0.91 ± 0.17; 0.91 ± 0.14; 0.91 ± 0.16, respectively) and specificity (0.97 ± 0.03; 0.98 ± 0.02; 0.98 ± 0.02; 0.98 ± 0.02, respectively).

Five main predictors of relapse in cured MDR-TB patients were identified: repeated courses of chemotherapy; length of history of tuberculosis; destructive process in the lungs; total duration of treatment less than 22 months; and use of less than five effective anti-TB drugs in the regimen of chemotherapy.

The objective of the study: to study tuberculosis incidence in migrant workers in Russia from 2010 to 2019.
Subjects and Methods: data from Federal Statistical Surveillance Forms No. 8 and 33 for 2010-2019, Federal Migration Service data on the number of migrant workers, and Rosstat data on the population of Russia. Pearson's chi-squared test was used for data analysis.
Results. Over the past 10 years in Russia, the steadily decreasing tuberculosis incidence in the permanent population has had no direct impact on the spread of tuberculosis among migrant workers. The high incidence of tuberculosis among migrant workers which is many times higher than the one in the permanent population and reaches its maximum in the youngest age groups (18-24 and 25-34 years old), poses a serious threat to the infection control in the permanent population of Russia.

Clinical testing of the forced oscillation test (FOT) yielded criteria for bronchial obstruction: an increase in viscous respiratory resistance (VRR) (Rfo, Rin, Rex); the frequency dependence of VRR. The study of VRR promoted detection of bronchial malpatency in additional 20% of pulmonary tuberculosis patients who had no lung ventilation disorders, as evidenced by spirometry.

The objective: to study the degree of specific sensitization according to the results of intradermal immunodiagnostic tests in children with different manifestations of tuberculosis infection under the current epidemic situation.

Subjects and Methods. The degree of tuberculin sensitization was studied in 299 children from different age groups (0-14 years old) who were registered for dispensary follow-up in 2018-2019.

Based on the results of a tuberculosis recombinant allergen test (TRA), the degree of specific sensitization was studied in children with tuberculin tests conversion (n = 102) and infected with Mycobacterium tuberculosis (MTB) for 2 years or more (n = 165) exposed to tuberculous infection in their families and from healthy environment, and 145 patients under 14 years old with local respiratory tuberculosis.

Results. Moderate sensitization to tuberculin predominated in children with converted tuberculin test exposed to tuberculous infection in their families and those from healthy environments. According to the results of TRA test, a high degree of sensitization was observed 4.7 times more frequently in children with tuberculin test conversion exposed to tuberculosis in their families. In children from healthy environments, negative responses to TRA test were registered 2.4 times more frequently. In 73% of children infected with MTB, results of annual Mantoux tests didn’t differ much. Hyperergic reactions to TRA test in infected children exposed to tuberculous infection were 10 times more frequent than in those from healthy environments. A direct correlation was found between the high degree of sensitization to active M. tuberculosis and exposure to a tuberculosis case with a positive result of sputum test (χ² < 0.001, p < 0.05). In the case of converted tuberculin test and infection with M. tuberculosis for 2 years or more, pronounced and hyperergic reactions to TRA test were registered with equal frequency and did not depend on the timing and duration of infection. A high risk factor and predictor of the disease development is high sensitization of the host to active M. tuberculosis which is found in patients with tuberculosis using TRA test six times more frequently versus Mantoux test (OR 5.951, 95% CI 3.548 and 9.981). The demonstrated results are important for the identification of children facing a high risk to develop active tuberculosis and preventive treatment prescription.

Chronic cough is a common symptom of numerous diseases occurring in about 10% of general population. The number of cough impulses over a period of time is an objective marker of cough severity. Cough frequency is now considered the primary endpoint in studies of the effectiveness of cough suppressants, as a factor contributing to the spread of tuberculosis, and as one of the indicators of patient stabilization during exacerbations of chronic obstructive pulmonary disease. The review discusses data from 60 literature sources on the principles of automatic cough impulses counting, methods used for objective cough assessment, and forecasts for future development in this field.

The article describes a clinical case of a female patient with respiratory tuberculosis exposed to several cases of extensive drug resistance in their family. Tuberculosis progressed in this patient due to the late initiation of adequate treatment. Therefore, the total duration of chemotherapy made 5 years till cure was achieved and an endobronchial valve was used to heal persisting (for 3 years) lung destruction.