ABSTRACT
Objective. Evaluation of different options for the formulation of a pathoanatomical diagnosis in the combined course of HIV infection and a new coronavirus infection COVID19 Materials and methods. The study included the protocols of clinical autopsies performed at the S. P. Botkin Clinical Infectious Diseases Hospital from March 2020 to September 2021, with the simultaneous diagnosis of HIV infection and the new coronavirus infection COVID19. Results and discussion. Among the secondary diseases in HIV infection in combination with a new coronavirus infection, no significant difference was found in comparison with HIV monoinfection. On the part of the new coronavirus infection, no relationship was found between the course of the infection and the manifestations of secondary diseases in HIV infection. In cases with a protracted new coronavirus infection against the background of a mild HIV infection, the dominant disease in thanatogenesis is COVID-19. In the presence of severe secondary diseases of HIV infection, it acts as the main infection. In cases of the presence of other competing diseases in PAD, they play a leading role in thanatogenesis, or have a significant impact on the course of the disease. Conclusion. Based on the analysis of autopsy protocols with the simultaneous diagnosis of HIV infection and the new coronavirus infection COVID19, various options for the formulation of pathoanatomical diagnosis and encryption of observations are justified. © 2022,HIV Infection and Immunosuppressive Disorders. All Rights Reserved.
ABSTRACT
The genotype of the SARS-CoV-2 virus pathogen plays an important role in the epidemiological and clinical characteristics of a new coronovirus infection. There are no published data on the morphological features of lesions caused by different virus genotypes. The aim of the study was to evaluate clinical, laboratory and morphological changes depending on the genotype of the SARS-CoV-2 virus. Materials and methods. A retrospective analysis of the medical records of 39 patients with COVID-19 with a severe course of the disease, which ended in death, who were hospitalized at the St. Petersburg State Budgetary Infectious Diseases Clinical Hospital named after S.P. Botkin" in 2020-2022. Clinical and laboratory characteristics were assessed, including determination of the virus genotype, levels of leukocytes, lymphocytes, alanine aminotransferase, creatinine, ferritin, C-reactive protein, D-dimer, interleukin-6. Macro- and microscopic changes were assessed, including immunohistochemical examination of the lungs and other organs using sera to CD14 68, 163, type 1 and 3 collagen. The preparations were digitized on a Panoramic scanner, morphometric studies were carried out using the SlideViewer program, including the quantitative determination of the content of CD68+ macrophages in 12 cases. Results. In all patients, the disease was complicated by the development of pneumonia, the majority had concomitant diseases (94.6%). The average time of hospitalization was 19.0+/-1.6 days, the average time of stay in the intensive care unit was 7.7+/-1.2 days. The analysis, depending on the genotype of the SARS-CoV-2 virus, showed a statistical difference between the age of patients, the length of stay in the intensive care unit and the level of lymphocytes. Differences in the average duration of hospitalization, the level of laboratory parameters were not revealed. Histopathological picture in all examined was approximately the same. The content of CD68+ macrophages per unit area in different genotypes did not differ, but varied significantly within the same genotype. Conclusion. Thus, it was not possible to identify significant differences between the changes caused by different genotypes of the new coronavirus, which can probably be explained by the fact that mutations do not include genome regions that are relevant to virulence factors, although further research is needed.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
The genotype of the SARS-CoV-2 virus pathogen plays an important role in the epidemiological and clinical characteristics of a new coronovirus infection. There are no published data on the morphological features of lesions caused by different virus genotypes. The aim of the study was to evaluate clinical, laboratory and morphological changes depending on the genotype of the SARS-CoV-2 virus. Materials and methods. A retrospective analysis of the medical records of 39 patients with COVID-19 with a severe course of the disease, which ended in death, who were hospitalized at the St. Petersburg State Budgetary Infectious Diseases Clinical Hospital named after S.P. Botkin" in 2020-2022. Clinical and laboratory characteristics were assessed, including determination of the virus genotype, levels of leukocytes, lymphocytes, alanine aminotransferase, creatinine, ferritin, C-reactive protein, D-dimer, interleukin-6. Macro- and microscopic changes were assessed, including immunohistochemical examination of the lungs and other organs using sera to CD14 68, 163, type 1 and 3 collagen. The preparations were digitized on a Panoramic scanner, morphometric studies were carried out using the SlideViewer program, including the quantitative determination of the content of CD68+ macrophages in 12 cases. Results. In all patients, the disease was complicated by the development of pneumonia, the majority had concomitant diseases (94.6%). The average time of hospitalization was 19.0+/-1.6 days, the average time of stay in the intensive care unit was 7.7+/-1.2 days. The analysis, depending on the genotype of the SARS-CoV-2 virus, showed a statistical difference between the age of patients, the length of stay in the intensive care unit and the level of lymphocytes. Differences in the average duration of hospitalization, the level of laboratory parameters were not revealed. Histopathological picture in all examined was approximately the same. The content of CD68+ macrophages per unit area in different genotypes did not differ, but varied significantly within the same genotype. Conclusion. Thus, it was not possible to identify significant differences between the changes caused by different genotypes of the new coronavirus, which can probably be explained by the fact that mutations do not include genome regions that are relevant to virulence factors, although further research is needed.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
The genotype of the SARS-CoV-2 virus pathogen plays an important role in the epidemiological and clinical characteristics of a new coronovirus infection. There are no published data on the morphological features of lesions caused by different virus genotypes. The aim of the study was to evaluate clinical, laboratory and morphological changes depending on the genotype of the SARS-CoV-2 virus. Materials and methods. A retrospective analysis of the medical records of 39 patients with COVID-19 with a severe course of the disease, which ended in death, who were hospitalized at the St. Petersburg State Budgetary Infectious Diseases Clinical Hospital named after S.P. Botkin” in 2020-2022. Clinical and laboratory characteristics were assessed, including determination of the virus genotype, levels of leukocytes, lymphocytes, alanine aminotransferase, creatinine, ferritin, C-reactive protein, D-dimer, interleukin-6. Macro- and microscopic changes were assessed, including immunohistochemical examination of the lungs and other organs using sera to CD14 68, 163, type 1 and 3 collagen. The preparations were digitized on a Panoramic scanner, morphometric studies were carried out using the SlideViewer program, including the quantitative determination of the content of CD68+ macrophages in 12 cases. Results. In all patients, the disease was complicated by the development of pneumonia, the majority had concomitant diseases (94.6%). The average time of hospitalization was 19.0±1.6 days, the average time of stay in the intensive care unit was 7.7±1.2 days. The analysis, depending on the genotype of the SARS-CoV-2 virus, showed a statistical difference between the age of patients, the length of stay in the intensive care unit and the level of lymphocytes. Differences in the average duration of hospitalization, the level of laboratory parameters were not revealed. Histopathological picture in all examined was approximately the same. The content of CD68+ macrophages per unit area in different genotypes did not differ, but varied significantly within the same genotype. Conclusion. Thus, it was not possible to identify significant differences between the changes caused by different genotypes of the new coronavirus, which can probably be explained by the fact that mutations do not include genome regions that are relevant to virulence factors, although further research is needed. © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
The genotype of the SARS-CoV-2 virus pathogen plays an important role in the epidemiological and clinical characteristics of a new coronovirus infection. There are no published data on the morphological features of lesions caused by different virus genotypes. The aim of the study was to evaluate clinical, laboratory and morphological changes depending on the genotype of the SARS-CoV-2 virus. Materials and methods. A retrospective analysis of the medical records of 39 patients with COVID-19 with a severe course of the disease, which ended in death, who were hospitalized at the St. Petersburg State Budgetary Infectious Diseases Clinical Hospital named after S.P. Botkin" in 2020-2022. Clinical and laboratory characteristics were assessed, including determination of the virus genotype, levels of leukocytes, lymphocytes, alanine aminotransferase, creatinine, ferritin, C-reactive protein, D-dimer, interleukin-6. Macro- and microscopic changes were assessed, including immunohistochemical examination of the lungs and other organs using sera to CD14 68, 163, type 1 and 3 collagen. The preparations were digitized on a Panoramic scanner, morphometric studies were carried out using the SlideViewer program, including the quantitative determination of the content of CD68+ macrophages in 12 cases. Results. In all patients, the disease was complicated by the development of pneumonia, the majority had concomitant diseases (94.6%). The average time of hospitalization was 19.0+/-1.6 days, the average time of stay in the intensive care unit was 7.7+/-1.2 days. The analysis, depending on the genotype of the SARS-CoV-2 virus, showed a statistical difference between the age of patients, the length of stay in the intensive care unit and the level of lymphocytes. Differences in the average duration of hospitalization, the level of laboratory parameters were not revealed. Histopathological picture in all examined was approximately the same. The content of CD68+ macrophages per unit area in different genotypes did not differ, but varied significantly within the same genotype. Conclusion. Thus, it was not possible to identify significant differences between the changes caused by different genotypes of the new coronavirus, which can probably be explained by the fact that mutations do not include genome regions that are relevant to virulence factors, although further research is needed.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
The article presents clinical data and the results of a detailed pathology changes in a 2-month-old infant who died from a coronavirus infection, confirmed by the results of in vivo PCR and morphological examination, which included the detection of the SARS-Cov-2 spike antigen. Histological examination in the lungs, as well as in the brain revealed cytoproliferative and cytopathic changes similar to those described in coronavirus infection in adults, while other characteristic for them lesions were not determined. The unfavorable course of COVID-19 was facilitated by an activated intrauterine infection, mycoplasmosis or chlamydiosis according to morphological data.
ABSTRACT
During epidemics, the usual statistical approaches will not allow determining the readiness of the public health system to take urgent measures to counteract the increase in morbidity, spread and mortality of the population. The quality of the medical, socio-economic and managerial decisions at all levels will depend on the accuracy of statistical data and the possibility of creating adequate prognostic models. However, there are still problems with the identification of COVID-19 cases and the diagnostic accuracy of the methods used. Complex analytical efforts require in order to determine the COVID-19 impact on the health status and case fatality rate/mortality rate.
ABSTRACT
Among the problems associated with a new coronavirus infection, the possibility of its occurrence in pregnant women plays an important role. Until now, there is very little data on perinatal COVID-19, and there are no descriptions of structural changes in the afterbirth at all. Material and methods. A clinical and morphological analysis of 6 cases in which women with verified COVID-19 gave birth in an infectious hospital was performed. In all cases, the placenta was examined in detail morphologically using antibodies to the nucleoprotein and spike (S1 subunit spike protein) SARS-CoV-2. COVID-19 Results. It is shown that the clinical course of COVID-19 in pregnant women may be different, three were in the intensive care unit, including one was shown to be on a ventilator. 4 children were born at term, 2 children prematurely (at 31-33 weeks of pregnancy). The condition of children in 5 nab. was assessed as satisfactory, only one child in serious condition was transferred to a children’s hospital. Intrauterine infection with the polymerase chain reaction documented in a single observation. When histological examination of the afterbirth in all observations, both in the maternal and fetal parts, changes characteristic of RNA viral infection was detected. Both of the studied antigens were found in moderate amounts in IHC. Conclusions. Intrauterine transplacental infection with a new coronavirus is certainly possible. Its frequency and clinical significance require further comprehensive study.
ABSTRACT
Relevance of the problem of a new COVID-19 coronavirus infection is obvious. Among its most important aspects that require special study, are pathogenesis and morphological changes in severe forms of the disease. Material and methods. The analysis of 18 autopsy observations was carried out. Along with routine assessment of macro - and microscopic changes, immunohistochemical studies of lungs and other organs were performed using sera against antigens CD2,3,4,5,7, 20,31,34, 56,57,69;the presence of Fe2+and Fe3+ was detected in the lungs and liver. Results. Structural changes in the lungs may be associated with cytopathic and cytoproliferative effects of the virus with damage to both the ciliary and alveolar epithelium, as well as the formation of hyaline membranes. Cellular infiltration is mainly represented by suppressor populations of T-lymphocytes and macrophages. Endothelial damage, vascular thrombosis of vessels of different calibers, and hemorrhages were detected. Many organs (lymph nodes, spleen, intestines, brain, adrenal glands) show changes that may indicate generalization of viral infection, and infiltration of CD8+ lymphocytes in the kidneys, liver, adrenal glands, pericardium, and intestines indicates a probable autoimmune component of pathogenesis. In the liver and lungs deceased from COVID-19 only small clusters of Fe3+ and Fe2+granules were detected, which can be associated (including in our control observation) with liver damage in malaria.