[Surgical approach for destructive pneumonia associated with COVID-19]. / Taktika khirurgicheskogo lecheniya destruktivnoi pnevmonii, assotsiirovannoi s infektsiei COVID-19.

There were over 400 million people with COVID-19 pneumonia worldwide and over 12 million in the Russian Federation after 2020. Complicated course of pneumonia with abscesses and gangrene of lungs was observed in 4% of cases. Mortality ranges from 8 to 30%. We report 4 patients with destructive pneumonia following SARS-CoV-2 infection. In one patient, bilateral lung abscesses regressed under conservative treatment. Three patients with bronchopleural fistula underwent staged surgical treatment. Reconstructive surgery included thoracoplasty with muscle flaps. There were no postoperative complications that required redo surgical treatment. We observed no recurrences of purulent-septic process and mortality.

[Diagnostic value of molecular biomarkers of infection in screening by Sepsis-3 criteria]. / Diagnosticheskoe znachenie molekuliarnykh biomarkerov infektsionnogo protsessa pri skrininge po kriteriiam Sepsis-3.

AIM: To compare diagnostic value of molecular biomarkers of sepsis in patients with surgical infection in screening via Sepsis-2 (Surviving Sepsis Campaign 2012, SSC 2012) and Sepsis-3 (The Third International Consensus Definitions for Sepsis and Septic Shock) criteria. MATERIAL AND METHODS: Septic patients according to Sepsis-2 and Sepsis-3 criteria were identified from general population with surgical infection. Logistic regression models quality was the criterion for assessment of diagnostic value of molecular biomarkers. Risk factors importance was estimated via odds ratios (OR) calculation. RESULTS: Sepsis-3 ROC-AUC for procalcitonin increased up to 0.933, cut-off value 2.35 ng/ml (Sepsis-2 AUC 0.768 (p=0.004), cut-off 1.72 ng/ml). Sepsis-3 ROC-AUC for presepsin increased up to 0.932, cut-off value - 772 pg/ml (Sepsis-2 AUC 0.865, cut-off 567 pg/ml). The highest risk of sepsis was observed in systemic response to inflammation combined with organ dysfunction (OR 69.667, S 0.636; 95% CI 20.03-242.4) (Sepsis-2 - OR 9.25, S 0.548; 95% CI 3.2-27.1, p<0.001). Increased levels of both biomarkers significantly increased the risk of sepsis (OR 22.5, S 0.794; 95% CI 4.74-106.6 and OR 20.97, S 0.58; 95% CI 6.705-65.6, respectively). CONCLUSION: Organ dysfunction assessment by Sepsis-3 criteria improves diagnostic possibilities in patients with suspected sepsis. Maximum predictive value is observed for systemic inflammation response combined with organ dysfunction. In these patients procalcitonin and presepsin are characterized by equivalent high diagnostic potential for evidence of infectious nature of the disease. Increased level of these markers can serve as a basis for antimicrobial therapy administration.