ABSTRACT
Objective. To improve perinatal outcomes in pregnant women with a new coronavirus infection COVID-19 by optimizing diagnostic, therapeutic, and prophylactic measures. Material and methods. The course of pregnancy, labor and perinatal outcomes were studied in 70 patients with COVID-19 during the present pregnancy who were delivered at the Moscow Regional Research Institute of Obstetrics and Gynecology (MORRIOG). The patients were divided into 2 groups depending on the timing of their visit to the outpatient department of MORRIOG: Group 1 comprised 45 pregnant women with new-onset coronavirus infection in the first to second trimesters of gestation, with subsequent presentation and follow-up at the MORRIOG outpatient department;Group 2 comprised 25 pregnant women who had new-on-set coronavirus (NCD) infection during gestation and presented to the outpatient department before delivery. In addition to a general clinical examination, all pregnant women underwent an extended haemostatic analysis, including a thrombodynamic test. Results. Analysis of the findings showed that hypercoagulable changes in the hemostatic system were observed in pregnant women with COVID-19 infection during gestation, but standard hemostatic tests did not reflect the characteristic postinfectional changes compared with the results of an extended coagulation potential study using the thrombodynamics test. Hypercoagulative changes were revealed irrespective of the severity of the COVID-19, which could be due to the combination of several risk factors and the presence of concomitant extragenital diseases. Conclusion. The most favorable gestational outcome in patients who have suffered a COVID-19 infection during pregnancy depends on the timely of the detection of hemostasis abnormalities after comprehensive examination and on the composition of available pathogenetic therapy. Rational anticoagulant and antiplatelet therapy under control of the coagulation parameters and achievement of normalization of coagulation tests result in a significant reduction in adverse obstetric and perinatal outcomes. © 2023, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
Objective. To improve perinatal outcomes in pregnant women with a new coronavirus infection COVID-19 by optimizing diagnostic, therapeutic, and prophylactic measures. Material and methods. The course of pregnancy, labor and perinatal outcomes were studied in 70 patients with COVID-19 during the present pregnancy who were delivered at the Moscow Regional Research Institute of Obstetrics and Gynecology (MORRIOG). The patients were divided into 2 groups depending on the timing of their visit to the outpatient department of MORRIOG: Group 1 comprised 45 pregnant women with new-onset coronavirus infection in the first to second trimesters of gestation, with subsequent presentation and follow-up at the MORRIOG outpatient department;Group 2 comprised 25 pregnant women who had new-on-set coronavirus (NCD) infection during gestation and presented to the outpatient department before delivery. In addition to a general clinical examination, all pregnant women underwent an extended haemostatic analysis, including a thrombodynamic test. Results. Analysis of the findings showed that hypercoagulable changes in the hemostatic system were observed in pregnant women with COVID-19 infection during gestation, but standard hemostatic tests did not reflect the characteristic postinfectional changes compared with the results of an extended coagulation potential study using the thrombodynamics test. Hypercoagulative changes were revealed irrespective of the severity of the COVID-19, which could be due to the combination of several risk factors and the presence of concomitant extragenital diseases. Conclusion. The most favorable gestational outcome in patients who have suffered a COVID-19 infection during pregnancy depends on the timely of the detection of hemostasis abnormalities after comprehensive examination and on the composition of available pathogenetic therapy. Rational anticoagulant and antiplatelet therapy under control of the coagulation parameters and achievement of normalization of coagulation tests result in a significant reduction in adverse obstetric and perinatal outcomes. © 2023, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
The objective: to study clinical and laboratory specific parameters of the COVID-19 course in patients with TB/HIV co-infection, to analyze changes in the lungs caused by COVID-19 in patients with pulmonary tuberculosis and concurrent HIV infection. Subjects and Methods. 68 HIV-infected patients aged 18-66 years old were included in the study, they all were admitted to the Novosibirsk State Regional Clinical Tuberculosis Hospital, Novosibirsk, with confirmed COVID-19 from May 2020 to May 2021. Clinical manifestations, CD4 count and HIV RNA level, and the presence of secondary infections were assessed. Results. In patients with severe and profound immunodeficiency, coronavirus infection was more often mild to moderate, and in immunocompetent patients - moderate to severe. However, patients with profound immunodeficiency were at greater risk of an adverse outcome due to lymphohematogenic progression of tuberculosis and concurrent opportunistic infections. Conclusion. When diagnosing and treating COVID-19 in patients with comorbid HIV infection and tuberculosis, it is important to consider the form of tuberculosis and CD4+ count. © 2022 New Terra Publishing House. All rights reserved.