Vol 75, No 5S (2020)


Thermal Helium-Oxygen Mixture as Part of a Treatment Protocol for Patients with COVID-19

Shogenova L.V., Petrikov S.S., Zhuravel S.V., Gavrilov P.V., Utkina I.I., Varfolomeev S.D., Ryabokon A.M., Panin A.A., Chuchalin A.G.


Background. The paper discusses the use of a thermal helium-oxygen mixture (t-Не/О2 ), a novel technology, in treating patients with the 2019-nCoV acute respiratory disease (COVID-19) who develop life-threatening respiratory failure.

Aim – to evaluate the safety and efficacy of t-Не/О2 inhalation combined with standard therapy in the treatment of acute respiratory failure in patients with COVID-19.

Materials and Methods. This was a single-center, randomized, prospective study of 70 patients with COVID-19. All patients were divided into two groups: in Group 1 (n = 38) patients received t-He/О2 in addition to the standard COVID-19 treatment; and in Group 2 (n = 32) patients were given the standard treatment in accordance with the Clinical Treatment Guidelines for patients with COVID-19, developed by the Ministry of Health of the Russian Federation. The male/female ratio was 18/20 in Group 1 and 18/14 in Group 2. The mean age of the patients in the study was 53.5 years (43; 62): 56 years (42; 64) in Group 1 and 52 years (43; 66) in Group 2. All patients had computed tomography (CT) signs of lung injury: ground-glass opacities and areas of consolidation. SARS-CoV-2 RNA was detected in 30 Group 1 patients and 28 Group 2 patients. The patients were matched by sex, age, body mass index (BMI), area of pulmonary involvement, and laboratory findings. All patients provided voluntary informed consent to participate in the study and signed a consent form.

Results. Inhalation of thermal helium-oxygen mixture combined with standard therapy did not cause any procedure-related side effects in any of the patients. The following changes were observed in all patients: pO2 /FiO2 , SpO2 , and lymphocyte counts increased, C-reactive protein (CRP) levels decreased, and D-dimer and ferritin levels returned to normal. In Group 1 statistically significant changes in the above-mentioned parameters were seen within three days, while in Group 2 the same changes were observed between Days 7 and 10 of treatment. In Group 1 patients cleared SARS-CoV-2 within 48–72 hours after initiation of inhalation, which was confirmed by polymerase chain reaction (PCR), and in Group 2 virus elimination was achieved within 72–168 hours.

Conclusion. The addition of inhalation of a thermal gas mixture of helium and oxygen (t-He/О2 ) to the standard therapy for patients with SARS-CoV-2 infection, CT signs of pneumonia (grades СT2 or CT3), and acute respiratory failure improves gas exchange, contributes to a more rapid virus elimination, and indirectly reduces inflammation.

Annals of the Russian academy of medical sciences. 2020;75(5S):353-362
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Children’s Psychiatric Clinic in the Context of the COVID-19 Pandemic: from Employee Psychology to Management Decisions

Bebchuk M.A., Aksenova E.I., Dovbysh D.V., Zhorina Y.Y., Gimranova E.A., Timoshenko S.I., Popil E.S.


Background. The well-being and safety of health workers in a pandemic situation is recognized by the World Health Organization as a priority area of research and practice. Most of the materials postulate the presence of anxious, depressive experiences in workers who have direct contact with patients infected with COVID-19, and those who do not have such experience.

Aims — to study the features of the experience of the situation related to COVID-19, among the staff of the Center n.a. G.E. Sukhareva to improve the quality of specialized care for children.

Methods. The study took place on May 18–20 2020, was continuous and voluntary — all employees were asked to fill out an anonymous questionnaire in paper or online format. The developed author’s questionnaire included several blocks containing questions about: 1) changing attitudes towards patients and colleagues; 2) emotional experiences in connection with COVID-19; 3) ways to cope with a pandemic; 4) received social support; 4) attitude to finance.

Results. Participants in the study were 380 employees (psychiatrists, clinical psychologists, nurses, educators, non-medical staff) of the Center n.a. G.E. Sukhareva, divided into two groups: working directly with patients with COVID-19 (115 people) and those without this experience (265 people). The data obtained allows us to talk about the differences between the two groups. Clinical observational staff have an increased desire for peer support, a greater focus on collaboration and team input, and positive expectations for the administration. The leading motivation in making a decision to work with COVID-19 was the attitude of duty — 25.4% emphasized the particular importance of their activities. Management decisions in a situation of limited time and human resources were made; this decisions aimed at managing internal and external communications, enhancing the professional component in an interdisciplinary team and preventing burnout.

Conclusions. A number of timely personnel, administrative, organizational and financial decisions aimed at improving the adaptation of medical workers to the situation of the COVID-19 pandemic allow specialists to continue working in a well-coordinated team and provide patients with care in accordance with the highest standards.

Annals of the Russian academy of medical sciences. 2020;75(5S):363-371
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Organization of Urological and Oncourological Care for Patients in a Pandemic of COVID-19: Overcoming Existing Limitations

Vasilyev A.O., Ruvinova R.D., Kolotarev K.B., Sazonova N.A., Govorov A.V., Shiraev A.A., Pushkar D.Y.


The new coronavirus infection pandemic has certainly changed all spheres of human activity, the healthcare system was completely transformed and reassignment in a short time. The built model of a personalized approach to each patient was replaced by the provision of health services to groups of patients with similar symptoms of the disease and severity, and conditions not associated with coronavirus infection, anyway, took a back seat. Since the announcement of the COVID-19 pandemic, the main human and material resources have been directed at combating the new infection. To date, almost every country has cases of coronavirus infection. The planned surgical care was temporarily stopped, what could not but affect the outcomes of diseases. A special category of patients is represented by patients with diagnosed malignant neoplasms, the delay in treatment of which can significantly reduce the life expectancy and/or quality of life. The current state of the problem served as a catalyst for the development of telemedicine technologies, which simplified communication in the patient-physician and physician-physician relationship. Urinary tract infections are one of the most common reasons for visiting a urologist, which implies the prescription of antibacterial drugs. However, in a pandemic, remote prescription of these drugs is limited by the lack of face-to-face specialist consultations. This enabled make it possible to use drugs based on bacteriophages. Patient management problems were solved by using distance counseling techniques. In this article we present an algorithm for providing urological and oncourological care to patients in the context of the COVID-19 pandemic, as well as an overview of the existing world practice in the implementation of telemedicine consultations in the current epidemiological situation.

Annals of the Russian academy of medical sciences. 2020;75(5S):372-377
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Assessment of Infection Risk Factors and the Effectiveness of Anti-Epidemic Measures to Prevent the Spread of COVID-19 Coronavirus Infection among Employees of the Moscow Aviation Hub Airport

Orlova N.V., Karseladze N.D., Makhnev S.A., Novikova E.Y., Latysheva Y.L., Katsyuba A.V., Anischuk L.P., Suranova T.G., Bonkalo T.I., Spiryakina Y.G.


Background. The new coronavirus infection COVID-19 has reached a pandemic in a few months. Large-scale measures have been taken to prevent the spread of infection, both in Russia and around the world. Analysis of the effectiveness of measures to prevent the spread of coronavirus infection COVID-19 is an urgent task to optimize the measures used to prevent the disease.

Aims — to identify infection risk factors, evaluate the effectiveness of the developed and implemented measures to prevent the spread of COVID-19 coronavirus infection at the airport of the Moscow Aviation Hub.

Material and methods. Developed and implemented measures to prevent the spread of coronavirus infection COVID-19 on the territory of the airport complex, which is part of the Moscow Aviation Hub (UIA). An assessment of the incidence among employees was conducted, laboratory testing of airport employees for coronavirus infection COVID-19 was carried out: PCR for the detection of SARS-CoV-2 virus RNA; Anti-SARS-CoV-2 IgG.

Conclusions. It was revealed that the complex of the developed measures has proven its effectiveness, made it possible to prevent the spread of infection among airport employees.

Annals of the Russian academy of medical sciences. 2020;75(5S):378-385
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Modern Russian and Foreign Methods of Healthcare Personnel Protection from New Coronavirus Infection (COVID-19) Risks: Analytical Review

Vosheva N.A., Kamynina N.N., Voshev D.V., Klimov Y.A.


Introduction. On December 31, 2019, the World Health Organization announced the coronavirus (COVID-19) outbreak and medical workers appeared on the frontline in combating the new threat. Daily interactions with infected patients, extended working hours and psychological overload: all this makes healthcare professionals extremely vulnerable to a new danger. Therefore, the actual priority is to prevent the nosocomial spread of the disease and the protection of medical personnel.

Aim — exploration and generalization of Russian and international experience of COVID-19 pandemic combating in terms of creating the most efficient system of health workers’ protection against the infection, caused by a new virus SARS-CoV-2.

Methods and materials. The systematic reviews and meta-analyzes reporting method (PRISMA) were used in the review. The search was carried out in the bibliographic databases Elibrary, PubMed, MEDLINE, Scopus, Google Scholar. Moreover, Russian and foreign methodological documents from the official websites of organizations were analyzed.

Results. Examination of epidemiologically safe space organizing models in different countries showed that the majority of the existing in the world community approaches to protect medical personnel from contracting a new coronavirus infection are based on five basic strategies of infection prevention and control to prevent or limit the transmission of COVID-19 proposed by the World Health Organization. The article proposes a sixth strategy in addition to the above: psychological support for health workers.

Conclusion. Effective use of the listed complex of six protective measures can minimize the risk of medical workers’ infection with coronavirus.

Annals of the Russian academy of medical sciences. 2020;75(5S):386-394
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Differential Diagnosis of Lungs Lesions in a New Coronavirus Infection COVID-19 and Diseases of Non-Viral Etiology on the Clinical Cases by Computed Tomography Scans in Outpatient CT Centers

Lobanov M.N., Bronov O.Y., Abovich Y.A., Ledikhova N.V., Turavilova E.V., Morozov S.P., Kamynina N.N.


New coronavirus infection (COVID-19) viral pneumonia diagnosed by a complex assessment of the epidemiological history, clinical symptoms, radiological and laboratory tests. Radiologists often play a leading role in diagnosis of viral pneumonia, since they may encounter suspicious changes according to radiological studies before clinicians. However, in a number of diseases, including diseases of non-infectious non-viral etiology with a corresponding similar clinical symptoms, it may be difficult to correctly assess the changes detected by computed tomography. This study uses clinical cases to show the main differential diagnostic criteria for COVID-19 viral pneumonia and non-infectious lesions such as pulmonary edema, pulmonary embolism, acute hypersensitive pneumonitis, drug-induced pneumonitis, non-specific interstitial pneumonia, and adenocarcinoma. All patients were hospitalized based on the results of computed tomography, where a diagnosis of non-infectious non-viral lung injuries was established based on morphological and/or typical clinical symptoms, laboratory or radiological data. We examined clinical cases with radiological signs similar to viral pneumonia, such as areas of ground glass opacities with the presence or absence of areas of consolidation, as well as thickening of the lung interstitium with decreased lung attenuation (“crazy paving” symptom). In a difficult epidemiological situation, it is important for a radiologist to suspect the above-mentioned pathological conditions in patients who are urgently admitted to outpatient CT centers.

Annals of the Russian academy of medical sciences. 2020;75(5S):395-405
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Outcomes of the New COVID-19 Coronavirus Infection in 68 Patients with Inflammatory Bowel Diseases

Kagramanova A.V., Knyazev O.V., Veselov A.V., Shkurko T.V., Li I.A., Fadeeva N.A., Kulakov D.S., Lishchinskaya A.A., Zvyaglova M.Y., Chernova M.E., Parfenov A.I.


Background. COVID-19 is an infectious respiratory syndrome with a wide range of manifestations and outcomes. Patients with inflammatory bowel disease (IBD) generally have a higher risk of infection, especially if they receive immunosuppressive therapy.

Aim — to describe the manifestations of COVID-19 in patients with IBD and to determine the risk factors for severe COVID-19.

Methods. The analysis included 68 patients with an established diagnosis of Crohn’s disease (CD) or ulcerative colitis and a confirmed new coronavirus infection. The diagnosis of coronavirus infection was established when SARS-CoV-2 was detected by PCR using nasopharyngeal smears, and computer tomography (CT) of the chest revealed inflammatory changes characteristic of coronavirus lung damage or high IgG and IgM titers based on the results of immunological blood analysis.

Results. 68 patients with IBD and COVID-19 were observed in the Department of IBD, including 27 (39.7%) patients with CD, 41 (60.3%) patients with UC. Among patients diagnosed with pneumonia, 100 % of patients received therapy with thiopurines and infliximab. 8 (11.8%) patients were diagnosed with COVID-19 during hospitalization for a severe IBD attack. There was no statistically significant difference between UC and CD patients in terms of disease activity (p = 0.13) during the period of coronavirus infection. In 37 patients (26 — UC, 11 — BC) with pneumonia (100%), there was an exacerbation of IBD. Statistical significance was found between the development of more severe lung damage (CT 3–4) and IBD activity at the time of diagnosis of COVID-19 (p < 0.001), the presence of comorbidities (p < 0.001) and taking GCS (p < 0.001) at the time of detection of COVID-19. However, the use of biological and immunosuppressive therapy was not associated with a higher risk of severe lung damage and the need for a ventilator. It was shown that the age of patients over 65 years was statistically correlated with the need for a ventilator (p = 0.02).

Conclusion. The exacerbation of the disease, especially in elderly patients with comorbidities, the use of glucocorticosteroids was associated with negative consequences of COVID-19, while biological and immunosuppressant drugs used for the treatment of IBD did not have such a negative effect.

Annals of the Russian academy of medical sciences. 2020;75(5S):406-413
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Clinical and Morphological Features of Myocardial Damage and the Course of Fulminant Myocarditis on the Background of СOVID-19, Diagnosis and Treatment Tactics

Oynotkinova O.S., Nikonov E.L., Zayratyants O.V., Rzhevskaya E.V., Krukov E.V., Voevoda M.I., Maslennikova O.M., Larina V.N., Demidova T.Y., Dedov E.I.


In a review article based on my own clinical experience of managing patients with acute myocardial injury and fulminant myocarditis, taking into account expert recommendations on the clinical treatment of myocardial damage associated with novel coronavirus infection a National clinical geriatric medical research center, division of cardiovascular diseases, the Chinese geriatrics society, Department of cardiology, Beijing Medical Association and European clinics discusses the pathogenesis, diagnosis and treatment of myocardial damage and FM patients, infected with SARS-CoV-2 in the context of the COVID-19 pandemic. Clinical features and diagnostic criteria are presented, including screening tests of markers of myocardial damage in the form of a highly sensitive troponin test, a natriuretic peptide. The article discusses in detail the pathogenesis and mechanisms of myocardial damage, including immune mechanisms, cytokine storm, systemic inflammation with macro- and microvascular dysfunction and the development of myocardial dysfunction with acute heart failure, hypotension, cardiogenic shock and/or life-threatening heart rhythm disorders caused by hypoxia and metabolic disorders at the cellular level. Features of the clinical course of fulminant myocarditis in infected patients (SARS-CoV-2) in the conditions of the COVID-19 pandemic are presented. For the first time, a detailed histo-morphological analysis of pathological myocardial injuries and complications is presented on the basis of unique autopsy material on post-mortem diagnostics of various pathoanatomic autopsies of those who died from COVID-19 in Moscow. Based on the clinical, functional and morphological material, the Protocol of etiopathogenetic treatment is presented. The basis of standard therapy is considered antiviral drugs, immunoglobulin G, the use of monoclonal antibodies to interleukin-6, anticoagulants, glucocorticoids, depending on the clinical situation, cardioprotectors and symptomatic treatment are recommended to maintain the heart, which in combination can achieve a certain clinical effectiveness. As adjuvant cardioprotective targeted therapy, the sodium salt of phosphocreatine is considered in order to preserve the myocardium, maintain its contractility and vital activity.

Annals of the Russian academy of medical sciences. 2020;75(5S):414-425
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Problems of Psycho-Emotional Well-Being of Medical Personnel Working in the Context of the COVID-19 Pandemic

Samushiya M.A., Ragimova A.A., Amosova N.A., Smolentseva I.G., Oinotkinova O.S., Bonkalo T.I., Berishvili T.Z.


Background. The COVID-19 pandemic has a significant impact on the mental state of not only quarantined citizens and patients, but also health workers.

Aims — asessment of the mental health of doctors involved in work in the “red zone” during the COVID-19 pandemic.

Materials and methods. 77 respondents were interviewed using the HADS questionnaires and the Maslach burnout test. For statistical data processing Microsoft Office Excel 2016, IBM SPSS were used.

Results. An increase on the depression scales was noted in 7%, anxiety in 23%, and anxiety and depression together 27%. According to the Maslach questionnaire, 32 doctors (41.5%) noted a reaction of the type of “emotional devastation”. 10 doctors (12.9%) noted a reaction “reduction of professional achievements”. Three doctors (3.8%) had a dehumanization reaction in the form of dull emotions to colleagues and patients.

Conclusions. Work in the “red zone” has a significant negative impact on the mental health of doctors and medical personnel.

Annals of the Russian academy of medical sciences. 2020;75(5S):426-433
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Features Contact with the Doctor and Satisfaction with the Quality of Care for Patients Hospitalized with COVID-19

Kiseleva M.G., Dovbysh D.V., Bonkalo T.I.


Background. The number of hospitalized patients diagnosed with coronavirus infection in March–May 2020 increased in almost all countries. Of course, such a pandemic has become a challenge for the entire health care system. In the current conditions, maintaining high standards of quality of medical care, establishing contact between specialists and the patient is a separate difficult task; at the same time, it is precisely the contact with specialists and the subjectively perceived quality of care that plays an important role in establishing compliance, and, therefore, in the success of patient treatment. Our research is devoted to the search for ways to solve this problem.

Aims — to study the features of the emotional state of patients hospitalized for COVID-19 and describe the contribution of these features to interaction in the doctor-patient dyad and satisfaction with the medical care received.

Methods. The study involved 127 people hospitalized with a confirmed diagnosis of COVID-19. The research methods used: 1) a questionnaire developed by the authors, which included socio-demographic data and a block of questions about interaction with a doctor and medical personnel; 2) the Russian-language version of the Beck Depression Inventory; 3) Russian-language version of the GAD-7 anxiety questionnaire.

Results. 25.4% of participants have pronounced signs of anxiety, 24.13% — signs of depression; 54% of patients indicate that the help they receive in the framework of hospitalization is sufficient; 7% speak of the need for support from a psychologist. Formulated information about what is happening with the patient is the key factor in contact with a doctor (for 62.9%), and a visible improvement in well-being is important only for 43.4%. The presence of anxious and depressive symptoms makes a qualitative difference in establishing contact with a doctor and assessing the severity of one’s own condition.

Conclusions. Based on the results of the study, in the future, it is possible to formulate various strategies for working with patients showing high rates of depressive and anxious experiences: such strategies should take into account the importance of close contact with the doctor and detailed information for patients. It is also important when building further work to take into account age characteristics (for example, a greater focus on working with a psychologist among the young population group), the time of hospitalization (whether they coincide with the dates traditionally significant in culture) and the gender of patients. It is also important to take into account that in a COVID-19 situation, it is decisive in contact with a doctor to obtain clear and accessible information about the patient’s condition and prescriptions made on time, and not a significant improvement in well-being.

Annals of the Russian academy of medical sciences. 2020;75(5S):434-445
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The Preparation of Convencent Plasma and Recruiting of Donors during the COVID-19 Pandemic

Kostin A.I., Petrikov S.S., Borovkova N.V., Doronina N.V., Godkov M.A., Simarova I.B., Mayorova O.A., Momotyuk K.S., Danilec V.V., Yarotskaya I.A., Gincburg A.L., Hripun A.I., Logunov D.Y., Dolschikova I.V., Mazus A.I., Vasilyeva E.Y., Vasin E.A., Ganchin V.V., Nikonov E.L., Pinchuk A.V., Bulanov A.Y., Lisenko M.A.


Background. The pandemic of the new coronavirus infection has challenged the medical community for quickly finding and implementing effective methods of treatment. In the absence of a vaccine or specific therapy with proven effectiveness, the usage of convalescent plasma can be the one of perspective methods. An important aspect of this technology is the efficient and safe preparation of convalescent plasma. To date, in the world literature there are practically no publications about donor recruitment and the specifics of the preparation of convalescent plasma.

Purpose of the research. Presentation of the experience of organizing a workflow for recruiting donors and stockpiling of convalescent plasma with a high titer of virus-neutralizing antibodies to SARS-CoV-2.

Methods. The analysis of the work of the Blood Service of the Moscow Department of Health for stockpiling of COVID-19 convalescent plasma has been executed. In total it has been stockpiled 1240 doses. The normative documentation has been developed by a working group on the basis of the current federal legislation of Russian federation and been approved by the Moscow Department of Health. The titer of neutralizing antibodies (VNA) has been determined as the basic method for assessing the immunological viability of convalescent plasma. The main characteristics of donors, the characteristics of the disease course, the results of preliminary testing for the presence of specific antibodies by ELISA and CLIA methods has been compared with VNA titers in the stockpiled convalescent plasma.

Results. Due to a Moscow Health Department’s order No. 325 dated 01.04.2020 (a basic local regulatory document) it has been developed a regulation for the stockpiling, examination, storage, safety and transfering of fresh frozen pathogen-reduced plasma of COVID-19 convalescent donors to medical organizations of the Moscow Health Department. For arranging an interaction with donors it has been created a call-center. For effective preliminary selection, it has been formed a donor characteristics list, which has been combined with screening of specific antibodies by ELISA and CLIA methods.

Conclusions. Developed a system of recruiting donors and procurement process of convalescent plasma for treatment СOVID-19, which includes the necessary regulations, algorithms for the selection and recruitment of donors, the registry of donors and recipients, algorithms, efficiency and safety of convalescent plasma.

Annals of the Russian academy of medical sciences. 2020;75(5S):446-454
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Asthma Activity and Respiratory Morbidity in Children during the COVID-19 Pandemic: Results of a Retrospective Comparative Observational Study

Levina J.G., Namazova-Baranova L.S., Vishneva E.A., Efendieva K.E., Alekseeva A.A., Kalugina V.G., Arimova P.S., Volkov K.S., Denisova A.R.


Background. According to available studies during the pandemic, the incidence of COVID-19 among children was significantly lower than among adults. However, it remains unclear whether children with allergies and asthma are at risk for COVID-19 and whether the respiratory morbidity have changed during the pandemic in children with asthma as well as the asthma activity.

Aims — to determine the respiratory morbidity in children with and without asthma before and during the COVID-19 pandemic, to estimate asthma activity.

Methods. The main group was formed of 60 children 6–17 y.o with confirmed asthma diagnosis, the control group — from 30 children aged 6–17 y.o. without asthma. Data on outcomes in children with asthma and in control group were obtained on the basis of the retrospective collected information from medical records of patients and from questionnaires, filled during telephone call in 2020. Respiratory morbidity was estimated in 2019 and during the COVID-19 pandemic period in 2020 till the end of May.

Results. The incidence of upper respiratory tract infections has decreased in 2020 in 72% of children with asthma by an average of 53%; in 86% of children without by an average of 62%. The frequency of lower respiratory tract infections decreased in 37% of children with asthma by an average of 61%, in 20% of children without asthma on 100%. According to the patients’ parents’ answers, none of the children were diagnosed with COVID-19. The number of episodes which required additional anti-asthma therapy decreased or didn’t change in 77% of patients. According to the results of the Asthma Control Test in 2020 asthma was fully controlled in 82% of patients, 65% of patients had complete adherence to therapy.

Conclusions. Children with asthma and allergies, as well as healthy children, do not seem to be at risk of contracting a new coronavirus infection. Lockdown, good adherence to therapy in children with asthma had a positive impact, led to a decrease of respiratory morbidity, exacerbations of asthma, improved disease control. Further monitoring of children with allergies and asthma during the COVID-19 pandemic is required.

Annals of the Russian academy of medical sciences. 2020;75(5S):455-464
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Radiology Diagnostics of a New Coronavirus Infection in Pregnant Women. Experience of O.M. Filatov Municipal Clinical Hospital No. 15, Moscow

Doroshenko D.A., Rumyantsev Y.I., Shapsigova O.A., Silaev B.V., Konisheva O.V., Gumenyuk S.A., Vechorko V.I.


Background. The pandemic of coronavirus pneumonia (COVID-19) is spreading globally at an accelerated rate and is a major health problem. The purpose of this study was to assess the possibility of using a combination of radiation diagnostic methods in lung lesions in pregnant women, with confirmed coronavirus infection and suspected COVID-19 pneumonia, hospitalized in O.M. Filatov Municipal Clinical Hospital No. 15, Moscow.

Methods. Retrospectively analyzed changes in lung parenchyma and pleura detected by multispiral computed tomography of chest organs and pulmonary ultrasound in 90 pregnant patients with clinical manifestations of viral pneumonia and confirmed coronavirus infection.

Results. Examined 90 patients with clinical manifestations of pneumonia and PCR-confirmed COVID-19. Among the clinical manifestations, coughing, fever, shortness of breath prevailed. Most changes detected by lung tomography (performed in 92% of patients), had a polysegmental and bilateral character, were more often localized in the peripheral departments, in 74 (89%) patients were involved in a pathological process of more than two lobes, in 77 (93%) of the patients were determined the centers of pulmonary tissue compaction by the type of “ground glass”, and the combination of the above manifestations with the presence of foci of consolidation and reticular changes was noted in 23 (28%) cases. Among the complications more common: thickening of the pleura, hydrothorax, less often pneumothorax. In 43 (48%) patients, MSCT was supplemented by ultrasound examination of the lungs and pleura, and in 21 (23%) patients, ultrasound was used in isolation as a dynamic control tool to reduce dose load and comply with the ALARA principle, while in 7 (8%) patients, ultrasound was used as the only diagnostic tool due to refusal to perform MSCT.

Conclusion. Radiosemiotics of lung lesions in pregnant women with COVID-19, detected in MSCT of thoracic organs, does not differ from that in non-pregnant patients. The appearance of specific zones of pulmonary tissue compaction in the form of a “gound glass”, as a manifestation of a unilateral or bilateral, mono- or polyphocal lung lesion, is highly likely to indicate a manifestation of COVID-19. Pulmonary ultrasound also allows detecting characteristic changes in lung parenchyma and pleura in pregnant women, correlating with MSCT data, primarily in patients with medium-severe forms of pneumonia. Use of ultrasonography corresponds to the principle of ALARA in medicine, remaining a choice method with the women refusing the visualization interfaced to beam loading that can be used in the period of COVID-19 pandemic.

Annals of the Russian academy of medical sciences. 2020;75(5S):465-472
pages 465-472 views

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