ПОКАЗАТЕЛИ СИСТЕМНОГО ВОСПАЛИТЕЛЬНОГО ОТВЕТА У БОЛЬНЫХ ВПЕРВЫЕ ВЫЯВЛЕННЫМ ТУБЕРКУЛЕЗОМ ЛЕГКИХ ПОСЛЕ ПЕРЕНЕСЕННОЙ ИНФЕКЦИИ COVID-19

Abstract

Introduction. It is known that both tuberculosis patients and COVID-19 patients develop a systemic inflammatory response with changes in the indicators of acute phase reactants, clinical blood analysis and the hemostasis and fibrinolysis system. Aim. To study in a comparative aspect, the level of acute phase reactants, clinical blood counts and markers of the state of hemostasis and fibrinolysis systems in newly diagnosed patients with pulmonary tuberculosis who had and did not have an infection caused by SARS-CoV-2. Material and Methods. A retrospective study was conducted in 60 patients with newly diagnosed pulmonary tuberculosis who had an infection caused by SARS-CoV-2: 30 patients with mild severity and 30 patients with moderate and severe severity. The comparison group included 30 patients who had not suffered an infection caused by SARS-CoV-2. The control group consisted of 47 healthy volunteers. We studied the frequency of changes and the median of laboratory parameters upon admission to the hospital. Results and discussion. It was found that in the groups of patients who had an infection caused by SARS-CoV-2 of moderate and severe severity, the indicators of the systemic inflammatory response - C-reactive protein, fibrinogen and ESR were significantly higher compared to both the group of patients who had not undergone and who have had a mild infection with SARS-CoV-2. At the same time, a hypercoagulable shift was observed in the system of hemostasis and fibrinolysis, as evidenced by the highest values of D-dimer in these patients. Conclusion. The development of a new tuberculosis process in patients after an infection caused by SARS-CoV-2, of moderate and severe severity, is accompanied by a systemic inflammatory response with the simultaneous development of a hypercoagulation shift, the severity of which is higher compared to patients who have had an infection caused by SARS-CoV-2, of mild severity.