REASONS FOR UNSATISFACTORY TREATMENT RESULTS OF ACUTE PURULENT DESTRUCTIVE LUNG DISEASES IN PATIENTS WITH SARS-COV-2 INFECTION

Abstract

Objective: To identify the reasons for unsatisfactory treatment results for acute purulent destructive lung diseases (APDLD) in patients with SARS-CoV-2. Methods: Sixty-five patients with APDLD on the background of SARS-CoV-2 infection were included in the study; 37 (57%) patients (Group 1) with APDLD were treated in a Tashkent Specialized Clinic for Infectious Diseases, and 28 (43%) patients with APDLD (Group 2) were hospitalized in the clinic of the General and Children’s Surgery Department of the Tashkent Medical Academy with a history of a recent SARS-CoV-2 infection. The patients were investigated using clinical, laboratory, and instrumental methods; the results were processed using statistical methods. Results: Complete recovery of patients was achieved in 16% of patients of Group 1 and 32% of Group 2 (p>0.05); clinical recovery was shown in 30% and 43% of patients in Groups 1 and 2 respectively (p>0.05). In Group 1 the results of treatment were more frequently disappointing than in Group 2 (54% vs. 25%, p=0.036), of which 19% were fatal in Group 1 and 11% in Group 2 (p>0.05). For the fatal outcome, the most dangerous was the early period after hospitalization. Morphological changes in the lungs of deceased patients included homogeneous fibrin deposits, which were combined with pronounced interstitial edema and capillary microthrombi around purulent foci. Conclusion: Traditional clinical and laboratory methods for assessing the severity of the condition of patients of both groups during and after SARSCoV-2 infection do not reflect the complete objective picture of the disease, as an accurate picture can only be obtained by applying the criteria for septic complications. Traditional treatment for APDLD is acceptable for patients of Group II. In patients of Group I with a severe, complicated, and progressive course, many methods of conventional therapy proved to be ineffective. Keywords: Acute purulent destructive diseases of the lungs, SARS-CoV-2, endothelial dysfunction of the lungs, treatment results, complications.