Prediction and influence of comorbid conditions on the degree of severity of acute intestinal infection caused by opportunistic pathogens in elderly and patients against the COVID-19 background

Abstract

Analysis of comorbid conditions in elderly and senile patients with COVID-19 and acute intestinal infection (AII) caused by representatives of opportunistic flora, conducted on 71 patients of the infectious disease department, including 42 women (59.15%) and 29 (40.85%) men. In patients, acute intestinal infection was caused by enteropathogenic bacilli ‒ 38 (53.52%) patients, bacteria of the genus Pseudomonacea ‒ 10 (14.09%), and St. aureus ‒ 23 (32.39%). The average age of the patients was 71.48±7.53 years. Analysis of comorbid conditions and prediction of disease progression was performed according to the severity of the disease and using the Charlson comorbidity index, the ABCD scoring system, the COVID-19 severity index, and the NEWS questionnaire. It was established that the examined patients have a high propensity for a severe course of diseases with their comorbid burden. A reliable lack of relationship between the comorbidity index and the degree of severity of AKI has been proven. Patients with AII had a low to moderate risk of developing infectious complications and also required continuous supplemental oxygen support and intensive care. According to the results of a survey on the NEWS system, patients who have a constant supply of oxygen have a higher probability of the formation of severe AII (OR=7.50; CI (1.28‒43.84); p=0.02), and a lower probability in relation to the average degree of severity (OR=0.13; CI (0.02‒0.78); p=0.02). Predicting the degree of severity of an acute intestinal infection that has developed against the background of COVID-19 affects the choice of treatment methods, in particular oxygen therapy, accelerates decision-making and the effectiveness of therapy. Keywords: acute intestinal infection, coronavirus disease COVID-19, dysbiosis, comorbid pathology, infectious complications, intestinal microbiocenosis.