Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2025
[Effect of the new coronavirus infection COVID-19 on the course and prognosis of tuberculous meningoencephalitis in HIV-infected patients].
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Savin A A, Tsomaeva E B, Bugun A V, Sergeeva S P, Zyuzya M R, Savin L A, Romanova E Yu, Girusova O A
Аннотация
OBJECTIVE: To study the effect of the new coronavirus infection COVID-19 on the course and prognosis of tuberculous meningoencephalitis in HIV-infected patients.
MATERIAL AND METHODS: The main group included 46 patients with human immunodeficiency virus (HIV) and tuberculous meningoencephalitis who were infected with a new coronavirus infection. The comparison group included 52 patients with tuberculous meningoencephalitis and HIV who had no history of the new coronavirus infection. All patients underwent laboratory tests for infectious diseases (including analysis of cerebrospinal fluid (CSF)), parameters of the hemostasis system, CT of the lungs and brain as part of an inpatient examination.
RESULTS: The analysis of the obtained data showed that coronavirus infection aggravates the course of tuberculous meningoencephalitis, increases mortality, affects the mechanisms of thanatogenesis, significantly increasing the frequency of multi-organ failure compared to the comparison group. In patients with coronavirus infection, according to the results of computed tomography of the brain, hydrocephalus was recorded more often, mycobacterium DNA was reliably detected in the CSF using polymerase chain reaction, the syndrome of impaired consciousness at presentation was more common, the period from admission to death was significantly reduced.
CONCLUSION: New data were obtained, suggesting correlations between the combination of manifestations of tuberculous meningoencephalitis, HIV, and coronavirus infection with acute toxic-infectious encephalopathy syndrome, as well as the role of DIC syndrome, which is common in this category of patients.
MATERIAL AND METHODS: The main group included 46 patients with human immunodeficiency virus (HIV) and tuberculous meningoencephalitis who were infected with a new coronavirus infection. The comparison group included 52 patients with tuberculous meningoencephalitis and HIV who had no history of the new coronavirus infection. All patients underwent laboratory tests for infectious diseases (including analysis of cerebrospinal fluid (CSF)), parameters of the hemostasis system, CT of the lungs and brain as part of an inpatient examination.
RESULTS: The analysis of the obtained data showed that coronavirus infection aggravates the course of tuberculous meningoencephalitis, increases mortality, affects the mechanisms of thanatogenesis, significantly increasing the frequency of multi-organ failure compared to the comparison group. In patients with coronavirus infection, according to the results of computed tomography of the brain, hydrocephalus was recorded more often, mycobacterium DNA was reliably detected in the CSF using polymerase chain reaction, the syndrome of impaired consciousness at presentation was more common, the period from admission to death was significantly reduced.
CONCLUSION: New data were obtained, suggesting correlations between the combination of manifestations of tuberculous meningoencephalitis, HIV, and coronavirus infection with acute toxic-infectious encephalopathy syndrome, as well as the role of DIC syndrome, which is common in this category of patients.