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An impact of CMV and HHV-6 reactivation on the course of early period after hematopoietic stem cell transplantation in patients with hematologic malignancies 巨细胞病毒和HHV-6再激活对血液恶性肿瘤患者造血干细胞移植后早期病程的影响
Pub Date : 2022-12-30 DOI: 10.22625/2072-6732-2022-14-5-41-50
T. V. Antonova, M. S. Nozhkin, О. Е. Pobegalova, О. V. Gorchakova, N. V. Sabadash, D. Lioznov
   Objective. To assess the impact of CMV and HHV-6 reactivation on the course of early post-transplant period in patients with hematologic malignancies.   Materials. Retrospective analysis of medical records of 339 patients with hematologic malignancies who received hematopoietic stem cell transplantation (HSCT) was performed, and markers of CMV and HHV-6 infections were detected (specific IgG, EIA). Blood and other materials from HSCT recipients were tested (PCR) for viral DNA in early post-transplant period (up to Day 100).   Results. Reactivation of viral infections after HSCT was discovered in 177 patients (52,2 %): CMV-infection was detected in 23 %, HHV-6 in 17,4 %, CMV+HHV-6 in 11,6 % of HSCT recipients. CMV DNA was predominantly identified in blood, while HHV-6 DNA was more frequently discovered in GIT mucosa and bone marrow. 40 % of 99 patients with HHV-6 reactivation had concomitant CMV+HHV-6 reactivation. In this group, the clinical manifestation of infections was registered significantly more frequently. Febrile neutropenia was more frequent in HSCT recipients with CMV reactivation, sepsis and graft hypofunction were diagnosed more frequently in presence of HHV-6 and predominantly HHV-6+CMV infections. The direct correlation (using Spearman’s method) between CMV and HHV-6 reactivation and terms of leukopoiesis recovery, engraftment terms, and transplant hypofunction was revealed. An impact of herpetic infections reactivation on the graft hypofunction and late recovery of leukopoiesis was confirmed using the logistic regression; its impact on the chimerism was revealed. In 72 % of cases, the graft failure in early post-transplant period occurred in patients with herpetic infections reactivation.   Conclusion. HHV-6 and CMV reactivation in the early period after HSCT correlates with terms of leukopoiesis recovery, contributes to development of complications, and is an additional factor aggravating the course of the post-transplant period.
目标。评估巨细胞病毒和HHV-6再激活对血液系统恶性肿瘤患者移植后早期病程的影响。材料。回顾性分析339例接受造血干细胞移植(HSCT)的恶性血液病患者的病历,检测巨细胞病毒(CMV)和HHV-6感染标志物(特异性IgG, EIA)。在移植后早期(最多100天)对HSCT受者的血液和其他材料进行病毒DNA检测(PCR)。结果。177例HSCT患者(52.2%)发现HSCT后病毒感染再激活:23%的HSCT患者检测到CMV感染,17.4%的HSCT患者检测到HHV-6, 11.6%的HSCT患者检测到CMV+HHV-6。CMV DNA主要在血液中发现,而HHV-6 DNA在GIT粘膜和骨髓中更常见。在99例HHV-6再激活的患者中,40%合并CMV+HHV-6再激活。在该组中,感染的临床表现明显更频繁。发热性中性粒细胞减少症在巨细胞病毒再激活的HSCT受者中更常见,败血症和移植物功能低下在HHV-6和主要是HHV-6+巨细胞病毒感染的情况下更常见。利用Spearman方法揭示了CMV和HHV-6再激活与白细胞生成恢复、移植期和移植功能低下之间的直接相关性。采用logistic回归分析证实疱疹病毒感染再激活对移植物功能减退和白细胞生成延迟恢复的影响;揭示了它对嵌合的影响。在72%的病例中,移植后早期移植失败发生在疱疹感染再激活的患者中。结论。HSCT术后早期HHV-6和巨细胞病毒的再激活与白细胞生成恢复相关,有助于并发症的发生,并且是加重移植后病程的另一个因素。
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引用次数: 0
Efficacy of COVID-19 vaccination in organized group: results of a prospective study 组织组COVID-19疫苗接种效果:一项前瞻性研究的结果
Pub Date : 2022-12-30 DOI: 10.22625/2072-6732-2022-14-5-35-40
I. Stoma, E. S. Korsak, E. Voropaev, O. Osipkina, A. A. Kovalev, O. Tumash, D. D. Redko
   Objective: to assess the efficacy of COVID-19 vaccination against in organized group.   Materials and methods: A total of 122 adults, employees of a higher education institution participated in the study. Study participants were observed prospectively and filled out a questionnaire where they indicated their age, presence of chronic diseases, history of COVID-19 and vaccination status.   Findings: the study participants were divided into two groups: 59 vaccinated (48.36 %) and 63 unvaccinated (51.64 %) individuals with no differences in age between the groups. There were significantly fewer confirmed cases of COVID-19 in the vaccinated group (р = 0,0008457, df = 1; χ2 = 11,138), significant differences (p = 0.0084; df = 4; χ2 =13.678) were observed in the number of cases among study participants based on their vaccination status.   Conclusion: participants diagnosed with pneumonia were 75 % unvaccinated (p = 0,00729; df = 1; χ2 = 7,2). All hospitalized study participants were unvaccinated (p = 0,004678; χ2 =8,0). None of the vaccinated participants needed respiratory support (p = 0,0455; df = 1; χ2 = 4,0). Chronic disease in vaccinated subjects made a significant (p = 0,04563; df = 2; χ2 = 6,1743) impact on COVID-19 severity.
目的:评价有组织人群新冠肺炎预防接种的效果。材料与方法:一共有122名高等教育机构的成年员工参与了本研究。研究人员对研究参与者进行了前瞻性观察,并填写了一份调查问卷,其中包括他们的年龄、慢性疾病的存在、COVID-19的病史和疫苗接种状况。研究结果:研究参与者被分为两组:59名接种疫苗的人(48.36%)和63名未接种疫苗的人(51.64%),两组之间没有年龄差异。接种疫苗组的COVID-19确诊病例明显减少(r = 0,0008457, df = 1;χ2 = 11,138),差异有统计学意义(p = 0.0084;Df = 4;χ2 =13.678)。结论:诊断为肺炎的参与者有75%未接种疫苗(p = 0.00729;Df = 1;χ2 = 7,2)。所有住院的研究参与者均未接种疫苗(p = 0.004678;χ2 = 0)。没有接种疫苗的参与者需要呼吸支持(p = 0,0455;Df = 1;χ2 = 4,0)。慢性疾病在接种疫苗的受试者中有显著差异(p = 0,04563;Df = 2;χ2 = 6,1743)。
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引用次数: 0
Invasive aspergillosis caused by Aspergillus non-fumigatus after allogeneic hematopoietic stem cell transplantation 异基因造血干细胞移植后由非烟曲霉引起的侵袭性曲霉病
Pub Date : 2022-12-29 DOI: 10.22625/2072-6732-2022-14-5-5-13
V. Markelov, Y. Rogacheva, M. Popova, A. G. Volkova, I. Nikolaev, O. Pinegina, A. A. Spididonova, S. Ignatieva, T. Bogomolova, O. Goloshchapov, Y. Vlasova, E. Morozova, M. D. Vladovskaya, S. Bondarenko, N. Klimko, A. Kulagin
   Objective. To study the features of invasive aspergillosis (IA) due to A. non-fumigatus versus A. fumigatus in adult (≥ 18 years) recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in 2016-2021.   Materials and methods. The study included 33 patients with IA caused by A. non-fumigatus (n = 20) and A. fumigatus (n = 13). A comparative analysis of cases of IA, the results of therapy and outcomes in patients after allo-HSCT in the RM Gorbacheva Research Institute was performed. Diagnostic criteria EORTC / MSGERC 2020 were used.   Results. Invasive aspergillosis caused by A. non-fumigatus made up the majority (60.6 %) of IA cases with an identified pathogen registered in patients after allo-HSCT in the period from 2016 to 2021. The main etiological agents in the A. non-fumigatus group were A. niger in 13 (65 %) patients, A. flavus – in 4 (20 %). The median day of diagnosis of A. non-fumigatus IAwas + 110 days (17–2093), for A. fumigatus it was + 46 days (2–866) (p = 0.171). Overall 12-week survival was 55 % and 59.2 % in the A. non-fumigatus and A. fumigatus groups, respectively (p = 0.617). The majority of patients in both the A. fumigatus (n = 10, 77 %) and A. non-fumigatus (n = 16, 80 %) groups received voriconazole as initial antifungal therapy. Second-linetherapy was required in 2 (10 %) patients with A. non-fumigatus IA: liposomal amphotericin B and echinocandins with or with-out posaconazole, and 2 (15 %) patients in the A. fumigatus group: liposomal amphotericin B and voriconazole in combination with echinocandins. A comparative analysis showed that in patients from the two groups, none of the assessed signs (gender, age, underlying disease, disease status at the time of transplantation, time from diagnosis to allo-HSCT, source of hematopoietic stem cells, conditioning regimen, donor type, antifungal prophylaxis, cytomegalovirus reactivation, severe acute and chronic graft-versus-host disease) did not differ significantly.   Conclusions. A. niger is the main causative agent of IA caused by A. non-fumigatus. Patients characteristics, their treatment and outcomes did not differ significantly between the A. non-fumigatus and A. fumigatus groups.
目标。研究2016-2021年同种异体造血干细胞移植(alloc - hsct)成人(≥18岁)受者非烟曲霉与烟曲霉所致侵袭性曲霉病(IA)的特征。材料和方法。本研究纳入33例由非烟曲霉属和烟曲霉属引起的IA患者(n = 20)和烟曲霉属(n = 13)。我们对戈尔巴乔夫研究所同种异体造血干细胞移植患者的IA病例、治疗结果和预后进行了比较分析。诊断标准为EORTC / MSGERC 2020。结果。2016年至2021年,在同种异体造血干细胞移植后登记的IA病例中,由非烟曲霉引起的侵袭性曲霉病占大多数(60.6%)。非烟曲霉组主要病原为黑曲霉13例(65%),黄曲霉4例(20%)。非烟曲霉诊断的中位天数为+ 110 d(17-2093),烟曲霉诊断的中位天数为+ 46 d (2-866) (p = 0.171)。非烟螨组和烟螨组12周总存活率分别为55%和59.2% (p = 0.617)。烟曲霉感染组(n = 10, 77%)和非烟曲霉感染组(n = 16, 80%)的大多数患者均以伏立康唑作为初始抗真菌治疗。2例(10%)非烟曲霉IA患者需要二线治疗:脂质体两性霉素B和棘白菌素联合泊沙康唑或不联合棘白菌素;烟曲霉组2例(15%)患者:脂质体两性霉素B和voriconazole联合棘白菌素。一项比较分析显示,两组患者的评估指标(性别、年龄、基础疾病、移植时的疾病状态、从诊断到异体造血干细胞移植的时间、造血干细胞来源、调节方案、供体类型、抗真菌预防、巨细胞病毒再激活、严重急性和慢性移植物抗宿主病)均无显著差异。结论。黑曲霉是非烟曲霉引起的内毒素的主要病原体。患者的特征、治疗和结果在非烟曲霉组和烟曲霉组之间没有显著差异。
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引用次数: 0
SARS-CoV-2 severity prediction in young adults using artificial intelligence 利用人工智能预测年轻人SARS-CoV-2严重程度
Pub Date : 2022-12-29 DOI: 10.22625/2072-6732-2022-14-5-14-25
K. V. Kas’janenko, K. Kozlov, K. Zhdanov, I. Lapikov, V. V. Belikov
   Aim: to build a predictive model for severe COVID-19 prediction in young adults using deep learning methods.   Materials and methods: data from 906 medical records of patients aged 18 to 44 years with laboratory-confirmed SARS-CoV-2 infection during 2020–2021 period was analyzed. Evaluation of laboratory and instrumental data was carried out using the Mann-Whitney U-test. The level of statistical significance was p≤0,05. The neural network was trained using the Pytorch framework.   Results: in patients with mild to moderate SARS-CoV-2 infection, peripheral oxygen saturation, erythrocytes, hemoglobin, total protein, albumin, hematocrit, serum iron, transferrin, and absolute peripheral blood eosinophil and lymphocyte counts were significantly higher than in patients with severe СOVID-19 (p< 0,001). The values of the absolute number of neutrophils, ESR, glucose, ALT, AST, CPK, urea, LDH, ferritin, CRP, fibrinogen, D-dimer, respiration rate, heart rate, blood pressure in the group of patients with mild and moderate severity were statistically significantly lower than in the group of severe patients (p < 0.001). Eleven indicators were identified as predictors of severe COVID-19 (peripheral oxygen level, peripheral blood erythrocyte count, hemoglobin level, absolute eosinophil count, absolute lymphocyte count, absolute neutrophil count, LDH, ferritin, C-reactive protein, D-dimer levels) and their threshold values. A model intended to predict COVID-19 severity in young adults was built.   Conclusion. The values of laboratory and instrumental indicators obtained in patients with SARS-CoV-2 infection upon admission significantly differ. Among them eleven indicators were significantly associated with the development of a severe COVID-19. A predictive model based on artificial intelligence method with high accuracy predicts the likelihood of severe SARS-CoV-2 course development in young adults.
目的:利用深度学习方法构建青年重症COVID-19预测模型。材料与方法:对2020-2021年期间906例18 ~ 44岁实验室确诊SARS-CoV-2感染患者的病历资料进行分析。使用Mann-Whitney u检验对实验室和仪器数据进行评估。差异有统计学意义,p≤0.05。神经网络使用Pytorch框架进行训练。结果:轻、中度SARS-CoV-2感染患者外周血氧饱和度、红细胞、血红蛋白、总蛋白、白蛋白、红细胞压积、血清铁、转铁蛋白、外周血嗜酸性粒细胞和淋巴细胞绝对计数均显著高于重症СOVID-19患者(p< 0.001)。轻、中度组患者中性粒细胞绝对值、ESR、血糖、ALT、AST、CPK、尿素、LDH、铁蛋白、CRP、纤维蛋白原、d -二聚体、呼吸频率、心率、血压均低于重度组,差异有统计学意义(p < 0.001)。确定了11项指标(外周血氧水平、外周血红细胞计数、血红蛋白水平、嗜酸性粒细胞绝对计数、淋巴细胞绝对计数、中性粒细胞绝对计数、乳酸脱氢酶、铁蛋白、c反应蛋白、d -二聚体水平)及其阈值作为重症COVID-19的预测指标。建立了一个旨在预测年轻人COVID-19严重程度的模型。结论。SARS-CoV-2感染患者入院时获得的实验室和仪器指标值存在显著差异。其中11项指标与COVID-19的严重发展显著相关。建立基于人工智能方法的预测模型,对青壮年SARS-CoV-2重症病程发展可能性进行高精度预测。
{"title":"SARS-CoV-2 severity prediction in young adults using artificial intelligence","authors":"K. V. Kas’janenko, K. Kozlov, K. Zhdanov, I. Lapikov, V. V. Belikov","doi":"10.22625/2072-6732-2022-14-5-14-25","DOIUrl":"https://doi.org/10.22625/2072-6732-2022-14-5-14-25","url":null,"abstract":"   Aim: to build a predictive model for severe COVID-19 prediction in young adults using deep learning methods.   Materials and methods: data from 906 medical records of patients aged 18 to 44 years with laboratory-confirmed SARS-CoV-2 infection during 2020–2021 period was analyzed. Evaluation of laboratory and instrumental data was carried out using the Mann-Whitney U-test. The level of statistical significance was p≤0,05. The neural network was trained using the Pytorch framework.   Results: in patients with mild to moderate SARS-CoV-2 infection, peripheral oxygen saturation, erythrocytes, hemoglobin, total protein, albumin, hematocrit, serum iron, transferrin, and absolute peripheral blood eosinophil and lymphocyte counts were significantly higher than in patients with severe СOVID-19 (p< 0,001). The values of the absolute number of neutrophils, ESR, glucose, ALT, AST, CPK, urea, LDH, ferritin, CRP, fibrinogen, D-dimer, respiration rate, heart rate, blood pressure in the group of patients with mild and moderate severity were statistically significantly lower than in the group of severe patients (p < 0.001). Eleven indicators were identified as predictors of severe COVID-19 (peripheral oxygen level, peripheral blood erythrocyte count, hemoglobin level, absolute eosinophil count, absolute lymphocyte count, absolute neutrophil count, LDH, ferritin, C-reactive protein, D-dimer levels) and their threshold values. A model intended to predict COVID-19 severity in young adults was built.   Conclusion. The values of laboratory and instrumental indicators obtained in patients with SARS-CoV-2 infection upon admission significantly differ. Among them eleven indicators were significantly associated with the development of a severe COVID-19. A predictive model based on artificial intelligence method with high accuracy predicts the likelihood of severe SARS-CoV-2 course development in young adults.","PeriodicalId":226950,"journal":{"name":"Journal Infectology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122382771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Immunological aspects of the lethal HIV / COVID-19 coinfected cohort 致死性HIV / COVID-19共感染队列的免疫学方面
Pub Date : 2022-12-29 DOI: 10.22625/2072-6732-2022-14-5-26-34
A. Mazus, E. V. Tsyganova, A. Zhilenkova, N. V. Glukhoedova, M. D. Geyne, Yu. A. Anikina, Y. Parkhomenko, N. Mozgaleva, P. Vedyapin, O. A. Tishkevich
   SARS-CoV-2 pandemic is now a global medical and social problem. Little is known about its impact on some vulnerable subgroups, such as immunocompromised patients. Therefore, there is still a strong interest in exploring the impact of SARS-CoV-2 infection among HIV-positive individuals worldwide.   Aim of the study: to analyze immunological aspects of the deceased patients with HIV/COVID-19 coinfection.   Materials and methods. We provided retrospective analysis of 258 patient’s electronic medical records. All patients were admitted to the Infectious diseases hospital № 2 with HIV / COVID-19 coinfection and died in May 2020 – February 2022. Standard immunological parameters were analyzed like CD4+, CD8+ counts and immunoregulatory index for different patient’s subgroups. Statistical data processing was provided by SPSS 17 version (allowable error E = 5 %).   Results and discussion. The study demonstrated CD4+ and CD8+ reduction in HIV-infected with COVID-19. Late HIV-presenters didn’t display such phenomenon probably because of immune system exhaustion. COVID-19 itself in some cases could lead to immunodeficiency worsening due to depletion of T cell populations in HIV-patients on effective antiretroviral therapy.   Conclusion. Comprehension of different immunological characteristics in HIV / COVID-19 coinfected patients could improve therapeutic approaches for this challenging cohort.
SARS-CoV-2大流行现在是一个全球性的医疗和社会问题。对于它对某些易感亚群(如免疫功能低下患者)的影响知之甚少。因此,探索SARS-CoV-2感染对全球艾滋病毒阳性个体的影响仍有浓厚的兴趣。研究目的:分析HIV/COVID-19合并感染的死亡患者免疫学方面的情况。材料和方法。我们对258例患者的电子病历进行回顾性分析。所有合并感染艾滋病毒/ COVID-19的患者都住进了第二传染病医院,并于2020年5月至2022年2月死亡。分析不同亚组患者CD4+、CD8+计数及免疫调节指数等标准免疫学参数。统计数据采用SPSS 17版进行处理(允许误差E = 5%)。结果和讨论。该研究表明,感染COVID-19的艾滋病毒CD4+和CD8+减少。晚期hiv患者没有出现这种现象,可能是由于免疫系统的衰竭。在某些情况下,由于接受有效抗逆转录病毒治疗的艾滋病毒患者的T细胞群耗竭,COVID-19本身可能导致免疫缺陷恶化。结论。了解HIV / COVID-19合并感染患者的不同免疫学特征可以改善这一具有挑战性的队列的治疗方法。
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引用次数: 1
The burden of a new coronavirus infection in a Children’s multidisciplinary hospital in St. Petersburg 2020–2021 2020-2021年圣彼得堡儿童多学科医院新型冠状病毒感染负担
Pub Date : 2022-10-22 DOI: 10.22625/2072-6732-2022-14-3-80-95
E. Dondurei, V. Kondratev, L. N. Isankina, N. Y. Kaika, Yu. A. Gaist, V. V. Yesikov, I. Kosenko, V. A. Kaziakhmedov, K. V. Pshenisnov, O. V. Zabirova, S. Dvorak, L. Ivanova, O. Osipova, O. I. Afanasyeva, D. Lioznov
Objective: To describe the burden of COVID-19 in a children’s multidisciplinary hospital for two years of the pandemic, taking into account of age, severity of the disease, the spectrum of underlying conditions and the intensive care need.Methods: An assessment of 6048 cases of COVID-19 in patients under 18 years of age hospitalized from March 26, 2020 to December 31, 2021 was carried out. The diagnosis was confirmed by PCR on an outpatient basis or after hospitalization with the help of diagnostic kits registered in the Russian Federation. The features of the work of a children’s multidisciplinary hospital in new conditions, the dynamics of hospitalization, age characteristics and new coronavirus (CV) infection severity in the pandemic development process are presented. The analysis of the underlying condition’s structure depending on the severity of the disease, as well as the need and volume of therapy in the intensive care unit. The frequency and main characteristics of children’s multisystem inflammatory syndrome (MIS-C) in hospital conditions, long-term PCR positivity and its effect on the duration of inpatient treatment of children have been established.Results: The spread of SARS-COV-2 in St. Petersburg required a radical change in the work of the children’s multidisciplinary hospital. During the two years of the pandemic, four waves of hospitalization of children with new CV were revealed, differing in duration, intensity, and frequency of lung damage, but having no significant differences in the proportion of severe forms of the disease (1.7-2.8% of cases). Intensive therapy was required in 3.6% of cases, of which only 1/3 was due to the severe course of COVID-19 with a lung lesion volume of up to 100%. In 1/3 of cases, patients had risks of developing severe forms and in 1/3 – other pathology. Severe course of new CV was significantly more often accompanied by the need for respiratory support, anticoagulants and anti-inflammatory therapy. Contributing factors of severe forms and unfavorable outcomes were: pathology of the central nervous system, genetic diseases and malformations, obesity, as well as chronic bronchopulmonary pathology. Mortality in the hospital was recorded only among children with severe underlying conditions (0.1% of cases). D-MVS was registered significantly more often in boys (7 out of every 10 patients), accounting for 1.2% of cases of hospitalization of children with new CV over the entire period. Convalescent PCR-positivity in the outcome of COVID-19 was detected in 1/3 of children, significantly more often during the autumnwinter waves of the pandemic and among patients of high school age.Conclusion: New CV is gradually strengthening its position in the structure of acute respiratory pathology in children. Some of SARS-COV-2 infection cases is accompanied by extensive lung damage, as well as severe systemic inflammation independently or in the other infectious diseases structure, induction of the debut of vario
目的:考虑到年龄、疾病严重程度、基础疾病范围和重症监护需求,描述儿童多学科医院在大流行期间两年的COVID-19负担。方法:对2020年3月26日至2021年12月31日住院的6048例18岁以下新冠肺炎患者进行评估。该诊断是在门诊或住院后借助在俄罗斯联邦登记的诊断包通过聚合酶链反应确诊的。介绍了新形势下某儿童多学科医院的工作特点、住院动态、年龄特征和新冠病毒感染严重程度在疫情发展过程中的变化。根据疾病的严重程度,以及重症监护病房的治疗需求和治疗量,分析潜在疾病的结构。确定了儿童多系统炎症综合征(multiple system inflammatory syndrome, MIS-C)在医院条件下发生的频率和主要特征、长期PCR阳性及其对儿童住院时间的影响。结果:SARS-COV-2在圣彼得堡的传播要求儿童多学科医院的工作发生根本性变化。在大流行的两年中,发现了四波新CV儿童住院,在持续时间、强度和肺损伤频率上有所不同,但在严重形式的疾病比例上没有显著差异(1.7-2.8%的病例)。3.6%的病例需要强化治疗,其中只有1/3是由于COVID-19的严重病程,肺病变体积高达100%。在三分之一的病例中,患者有发展为严重形式的风险,三分之一的患者有其他病理。严重的新CV病程明显更常伴有需要呼吸支持、抗凝血和抗炎治疗。导致严重形式和不良结果的因素有:中枢神经系统病理、遗传疾病和畸形、肥胖以及慢性支气管肺病理。只有患有严重基础疾病的儿童在医院死亡(占病例的0.1%)。D-MVS在男孩中更常见(每10例患者中有7例),占整个期间新CV患儿住院病例的1.2%。在1/3的儿童中检测到COVID-19结果的恢复期pcr阳性,在秋冬季大流行期间和高中年龄患者中更为常见。结论:新CV在儿童急性呼吸病理结构中的地位正在逐渐加强。部分SARS-COV-2感染病例伴有广泛的肺损伤,以及独立或在其他传染病结构中出现的严重全身性炎症,不排除诱发各种躯体病理的首发。目前的数据证实,需要增加对不良呼吸道疾病结局高风险儿童的关注。所有严重的COVID-19儿童病例都需要采取个性化的方法,同时考虑到现有的背景疾病和可能的进程选择。misc应被认为是一种多种病因的感染性疾病框架内的全身性炎症反应综合征,与川崎病相鉴别,是全身性疾病的先兆。COVID-19结果的长期pcr阳性需要进一步研究,以解决治疗的必要性和性质,以防止感染在人群中进一步传播。
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引用次数: 1
Clinical and pathological analysis of deaths from different SARS-CoV-2 coronavirus genotypes 不同基因型SARS-CoV-2冠状病毒死亡病例的临床和病理分析
Pub Date : 2022-10-22 DOI: 10.22625/2072-6732-2022-14-3-96-104
M. Vashukova, V. Zinserling, N. Semenova, D. Baram, A. Fadeev, K. S. Komissarova, A. Komissarov, D. Lioznov
The genotype of the SARS-CoV-2 virus pathogen plays an important role in the epidemiological and clinical characteristics of a new coronovirus infection. There are no published data on the morphological features of lesions caused by different virus genotypes.The aim of the study was to evaluate clinical, laboratory and morphological changes depending on the genotype of the SARS-CoV-2 virus.Materials and methods. A retrospective analysis of the medical records of 39 patients with COVID-19 with a severe course of the disease, which ended in death, who were hospitalized at the St. Petersburg State Budgetary Infectious Diseases Clinical Hospital named after S.P. Botkin” in 20202022. Clinical and laboratory characteristics were assessed, including determination of the virus genotype, levels of leukocytes, lymphocytes, alanine aminotransferase, creatinine, ferritin, C-reactive protein, D-dimer, interleukin-6. Macro- and microscopic changes were assessed, including immunohistochemical examination of the lungs and other organs using sera to CD14 68, 163, type 1 and 3 collagen. The preparations were digitized on a Panoramic scanner, morphometric studies were carried out using the SlideViewer program, including the quantitative determination of the content of CD68+ macrophages in 12 cases.Results. In all patients, the disease was complicated by the development of pneumonia, the majority had concomitant diseases (94.6%). The average time of hospitalization was 19.0±1.6 days, the average time of stay in the intensive care unit was 7.7±1.2 days. The analysis, depending on the genotype of the SARS-CoV-2 virus, showed a statistical difference between the age of patients, the length of stay in the intensive care unit and the level of lymphocytes. Differences in the average duration of hospitalization, the level of laboratory parameters were not revealed. Histopathological picture in all examined was approximately the same. The content of CD68+ macrophages per unit area in different genotypes did not differ, but varied significantly within the same genotype.Conclusion. Thus, it was not possible to identify significant differences between the changes caused by different genotypes of the new coronavirus, which can probably be explained by the fact that mutations do not include genome regions that are relevant to virulence factors, although further research is needed.
SARS-CoV-2病毒病原基因型在新型冠状病毒感染的流行病学和临床特征中起重要作用。目前还没有关于不同病毒基因型引起的病变形态学特征的公开资料。该研究的目的是评估依赖于SARS-CoV-2病毒基因型的临床、实验室和形态学变化。材料和方法。回顾性分析了20202022年在以S.P. Botkin命名的圣彼得堡国家预算传染病临床医院住院的39名重症COVID-19患者的医疗记录,这些患者最终死亡。评估临床和实验室特征,包括测定病毒基因型、白细胞、淋巴细胞、丙氨酸转氨酶、肌酐、铁蛋白、c反应蛋白、d -二聚体、白细胞介素-6的水平。评估宏观和微观变化,包括使用血清对CD14、68、163、1型和3型胶原进行肺和其他器官的免疫组织化学检查。在全景扫描仪上数字化制备,使用SlideViewer程序进行形态学研究,包括定量测定12例CD68+巨噬细胞的含量。所有患者均并发肺炎,多数合并有其他疾病(94.6%)。平均住院时间19.0±1.6 d,重症监护病房平均住院时间7.7±1.2 d。根据SARS-CoV-2病毒的基因型进行的分析显示,患者的年龄、在重症监护病房的住院时间和淋巴细胞水平之间存在统计学差异。在平均住院时间、实验室参数水平上的差异未被揭示。所有检查的组织病理图像大致相同。不同基因型细胞单位面积CD68+巨噬细胞含量差异不显著,但同一基因型细胞单位面积CD68+巨噬细胞含量差异显著。因此,不可能确定新冠病毒不同基因型引起的变化之间的显着差异,这可能是由于突变不包括与毒力因子相关的基因组区域,尽管需要进一步研究。
{"title":"Clinical and pathological analysis of deaths from different SARS-CoV-2 coronavirus genotypes","authors":"M. Vashukova, V. Zinserling, N. Semenova, D. Baram, A. Fadeev, K. S. Komissarova, A. Komissarov, D. Lioznov","doi":"10.22625/2072-6732-2022-14-3-96-104","DOIUrl":"https://doi.org/10.22625/2072-6732-2022-14-3-96-104","url":null,"abstract":"The genotype of the SARS-CoV-2 virus pathogen plays an important role in the epidemiological and clinical characteristics of a new coronovirus infection. There are no published data on the morphological features of lesions caused by different virus genotypes.The aim of the study was to evaluate clinical, laboratory and morphological changes depending on the genotype of the SARS-CoV-2 virus.Materials and methods. A retrospective analysis of the medical records of 39 patients with COVID-19 with a severe course of the disease, which ended in death, who were hospitalized at the St. Petersburg State Budgetary Infectious Diseases Clinical Hospital named after S.P. Botkin” in 20202022. Clinical and laboratory characteristics were assessed, including determination of the virus genotype, levels of leukocytes, lymphocytes, alanine aminotransferase, creatinine, ferritin, C-reactive protein, D-dimer, interleukin-6. Macro- and microscopic changes were assessed, including immunohistochemical examination of the lungs and other organs using sera to CD14 68, 163, type 1 and 3 collagen. The preparations were digitized on a Panoramic scanner, morphometric studies were carried out using the SlideViewer program, including the quantitative determination of the content of CD68+ macrophages in 12 cases.Results. In all patients, the disease was complicated by the development of pneumonia, the majority had concomitant diseases (94.6%). The average time of hospitalization was 19.0±1.6 days, the average time of stay in the intensive care unit was 7.7±1.2 days. The analysis, depending on the genotype of the SARS-CoV-2 virus, showed a statistical difference between the age of patients, the length of stay in the intensive care unit and the level of lymphocytes. Differences in the average duration of hospitalization, the level of laboratory parameters were not revealed. Histopathological picture in all examined was approximately the same. The content of CD68+ macrophages per unit area in different genotypes did not differ, but varied significantly within the same genotype.Conclusion. Thus, it was not possible to identify significant differences between the changes caused by different genotypes of the new coronavirus, which can probably be explained by the fact that mutations do not include genome regions that are relevant to virulence factors, although further research is needed.","PeriodicalId":226950,"journal":{"name":"Journal Infectology","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127546560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Рroblems of PCR diagnostics OF COVID-19 PCR诊断COVID-19的Рroblems
Pub Date : 2022-10-22 DOI: 10.22625/2072-6732-2022-14-3-55-60
T. Grigorieva, M. Belopolskaya
To date, an adequate and timely assessment of the number of cases is the basis of effective measures aimed at preventing the spread of COVID-19 infection. Real-time reverse transcription polymerase chain reaction (RT-PCR) remains the gold standard for confirming COVID-19.The purpose of the work: to analyze the experience of the city virological center of the S.P. Botkin Clinical Infectious Diseases Hospital (Botkin Hospital) for the examination for the presence of SARS-CoV-2 coronavirus by PCR in the period from 2020 to 2022.Materials and methods. The systematization of PCR studies on COVID-19 for the period 2020-2022 was carried out. A total of 221,901 people were examined, positive results were obtained in 55,372 (24.95%). Among the contingents of the examined patients, patients who underwent inpatient treatment at the Botkin Hospital.Conclusions. This study analyzed the possible causes of false-positive and false-negative PCR results. The correlation of the number of positive results with the dynamics of detection of new cases of COVID-19 in St. Petersburg during the 2020-2022 pandemic is shown. It has been established that the proportion of patients examined more than 3 times during the period of hospitalization remains significant. This fact requires the closest attention, given the high cost and laboriousness of PCR studies.
迄今为止,对病例数量进行充分和及时的评估是采取有效措施防止COVID-19感染传播的基础。实时逆转录聚合酶链反应(RT-PCR)仍然是确诊COVID-19的金标准。工作目的:分析S.P. Botkin临床传染病医院(Botkin医院)市病毒学中心在2020 - 2022年期间用PCR检测SARS-CoV-2冠状病毒的经验。材料和方法。对2020-2022年2019冠状病毒病PCR研究进行了系统化研究。共检查221,901人,阳性结果55,372人(24.95%)。在接受检查的患者中,有在Botkin医院接受住院治疗的患者。本研究分析了PCR结果假阳性和假阴性的可能原因。图中显示了2020-2022年大流行期间,阳性结果数量与圣彼得堡新冠肺炎病例发现动态之间的相关性。已经确定,住院期间检查3次以上的患者比例仍然很大。考虑到PCR研究的高成本和费力性,这一事实需要密切关注。
{"title":"Рroblems of PCR diagnostics OF COVID-19","authors":"T. Grigorieva, M. Belopolskaya","doi":"10.22625/2072-6732-2022-14-3-55-60","DOIUrl":"https://doi.org/10.22625/2072-6732-2022-14-3-55-60","url":null,"abstract":"To date, an adequate and timely assessment of the number of cases is the basis of effective measures aimed at preventing the spread of COVID-19 infection. Real-time reverse transcription polymerase chain reaction (RT-PCR) remains the gold standard for confirming COVID-19.The purpose of the work: to analyze the experience of the city virological center of the S.P. Botkin Clinical Infectious Diseases Hospital (Botkin Hospital) for the examination for the presence of SARS-CoV-2 coronavirus by PCR in the period from 2020 to 2022.Materials and methods. The systematization of PCR studies on COVID-19 for the period 2020-2022 was carried out. A total of 221,901 people were examined, positive results were obtained in 55,372 (24.95%). Among the contingents of the examined patients, patients who underwent inpatient treatment at the Botkin Hospital.Conclusions. This study analyzed the possible causes of false-positive and false-negative PCR results. The correlation of the number of positive results with the dynamics of detection of new cases of COVID-19 in St. Petersburg during the 2020-2022 pandemic is shown. It has been established that the proportion of patients examined more than 3 times during the period of hospitalization remains significant. This fact requires the closest attention, given the high cost and laboriousness of PCR studies.","PeriodicalId":226950,"journal":{"name":"Journal Infectology","volume":"247 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132683006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of the impact of various risk factors on short-term and long-term outcomes in patients with COVID-19 on maintenance hemodialysis 各种危险因素对COVID-19维持性血液透析患者短期和长期结局的影响分析
Pub Date : 2022-10-22 DOI: 10.22625/2072-6732-2022-14-3-66-79
V. Suchkov, O. Klitsenko, K. K. Urtaeva, D. D. Avdoshina
Patients receiving renal replacement therapy (RRT) in the form of maintenance hemodialysis (MHD) belong to a group of particularly high risk of infection and the course of COVID-19. The new coronavirus infection also has a great impact on long-term outcomes.Materials and methods: A retrospective observational study included 510 patients on MHD, hospitalized from April 1, 2020 to April 01, 2021. The outcome of hospitalization was chosen as the primary endpoint of the study: discharge or 28day mortality. Death within 6 months after discharge and the development of complications related to COVID-19 during this period were considered as secondary endpoints. Data collection was carried out by analyzing electronic and archival medical records. Quantitative variables: age, duration of hospitalization, days in the intensive care unit, laboratory blood parameters: the level of D-Dimer, Glucose, Interleukin-6, Procalcitonin, Lymphocytes and Platelets, CRP, CPK, CPK-MB, LDH, Fibrinogen, Ferritin. Qualitative indicators: gender, ventilator, ARDS, the presence of diabetes, the presence of obesity, the presence of complications: cardiovascular, gastrointestinal, septic, macrothrombotic, stage of pneumonia. To identify statistically significant predictors of the risk of an event, the odds ratio (OR) method was used.Results: average age 57.8±14 years, men – 59.5%, average bed day 17.6±10.6 days. In concomitant diseases, diabetes mellitus was indicated in 24% of patients, obesity was registered in 4.3% of patients. Hospital mortality (28-day) in the total cohort of follow-up was 16.05%, in total with out-ofhospital mortality of 22%. Mortality in intensive care reached 62.7%, on ventilator more than 86%, with ARDS 94.3%. No statistical significance was revealed by gender and the presence of diabetes mellitus (DM) in concomitant diseases. When comparing short-term outcomes, the age groups over 65 differed statistically. The following laboratory blood parameters showed a significant difference (P<0.001): D-Dimer, Glucose, IL-6 lymphocytes, Leukocytes, Neutrophils, Platelets, LDH, Ferritin. The following odds ratios (OR) were obtained: ARDS (OR 143.78; 95% CI 33.4-616.2; p=0.0001), on ventilator (OR 57.96; 95% CI 23.1-144.5; p=0.0001), the presence of septic complications (OR 26.4; 95% CI 13.8-50; p=0.0001), the course of the disease is defined as severe (OR 25; 95% CI 12.9-48.2; p=0.0001), the course of the disease is defined as complicated (OR 11.6; 95% CI 6.8-19.7; p=0.0001), the presence of gastrointestinal complications (OR 6.5; 95% CI 2.28-18.4; p=0.0007), the presence of obesity (OR 2.57; 95% CI 1.0-6.5; p=0.039). Mortality of patients receiving two main treatment regimens T-1 and T-2 did not differ (15.8% vs 15.7%). Significant differences (p=0.0001) appeared when compared with the T-0 and T-4 schemes, in which mortality was recorded at 8.8% and 85.7%, respectively. When comparing long-term outcomes, the analysis did not reveal statistical significance by gen
接受维持性血液透析(MHD)形式的肾脏替代治疗(RRT)的患者属于感染和病程特别高的人群。新型冠状病毒感染对长期结果也有很大影响。材料和方法:一项回顾性观察性研究纳入了510例MHD患者,这些患者于2020年4月1日至2021年4月1日住院。住院结局被选为研究的主要终点:出院或28天死亡率。出院后6个月内的死亡以及在此期间与COVID-19相关的并发症的发生被视为次要终点。通过分析电子病历和档案病历进行数据收集。定量变量:年龄、住院时间、重症监护天数、血液学参数:d -二聚体、葡萄糖、白细胞介素-6、降钙素原、淋巴细胞和血小板、CRP、CPK、CPK- mb、LDH、纤维蛋白原、铁蛋白水平。定性指标:性别,呼吸机,急性呼吸窘迫综合征,有无糖尿病,有无肥胖,有无并发症:心血管,胃肠道,化脓性,大血栓形成,肺炎分期。为了确定具有统计学意义的事件风险预测因子,采用比值比(OR)方法。结果:平均年龄57.8±14岁,男性占59.5%,平均卧床时间17.6±10.6天。在合并疾病中,24%的患者有糖尿病,4.3%的患者有肥胖症。随访总队列的住院死亡率(28天)为16.05%,院外死亡率为22%。重症监护死亡率为62.7%,呼吸机死亡率超过86%,ARDS死亡率为94.3%。性别和合并疾病中是否存在糖尿病(DM)的差异无统计学意义。在比较短期结果时,65岁以上的年龄组在统计上存在差异。实验室血液指标:d -二聚体、葡萄糖、IL-6淋巴细胞、白细胞、中性粒细胞、血小板、乳酸脱氢酶、铁蛋白差异有统计学意义(P<0.001)。获得以下比值比(OR): ARDS (OR 143.78;95% ci 33.4-616.2;p=0.0001),呼吸机(OR 57.96;95% ci 23.1-144.5;p=0.0001),脓毒性并发症的存在(OR 26.4;95% ci 13.8-50;p=0.0001),病程定义为严重(OR 25;95% ci 12.9-48.2;p=0.0001),病程定义为复杂(OR 11.6;95% ci 6.8-19.7;p=0.0001),胃肠道并发症的存在(OR 6.5;95% ci 2.28-18.4;p=0.0007),肥胖的存在(OR 2.57;95% ci 1.0-6.5;p = 0.039)。接受两种主要治疗方案T-1和T-2的患者死亡率没有差异(15.8% vs 15.7%)。与T-0和T-4方案相比,出现了显著差异(p=0.0001), T-0和T-4方案的死亡率分别为8.8%和85.7%。当比较长期结果时,分析没有显示性别的统计学意义。统计差异是按年龄划分的。在实验室指标中,有并发症的幸存者的PCT水平较高。d -二聚体、血糖水平、IL-6、CRP在所有幸存者和死者之间存在显著差异(P<0.001)。以下指标的OR最高:存在胃肠道并发症(OR 7.7;95% ci 1.0-57.7;p=0.03),初始LDH血药浓度为622单位/l (OR 4.7;95% ci 1.63-13.63;p=0.0086),病程定义为复杂(OR 4.05;95% 1.97 - -8.33;p=0.003),病程定义为严重(OR 2.4;95% ci 1.17-5.0;p = 0.03)。结论:胃肠道并发症对程序性血液透析患者的短期和长期不良预后影响最大。对于铁蛋白、CRH、LDH等实验室标志物,获得了透析患者机会特征显著增加的阈值。在疫情的第一年,治疗主要是支持性的,旨在预防并发症,主要的隔离治疗方案对COVID-19结局的影响没有显着差异。
{"title":"Analysis of the impact of various risk factors on short-term and long-term outcomes in patients with COVID-19 on maintenance hemodialysis","authors":"V. Suchkov, O. Klitsenko, K. K. Urtaeva, D. D. Avdoshina","doi":"10.22625/2072-6732-2022-14-3-66-79","DOIUrl":"https://doi.org/10.22625/2072-6732-2022-14-3-66-79","url":null,"abstract":"Patients receiving renal replacement therapy (RRT) in the form of maintenance hemodialysis (MHD) belong to a group of particularly high risk of infection and the course of COVID-19. The new coronavirus infection also has a great impact on long-term outcomes.Materials and methods: A retrospective observational study included 510 patients on MHD, hospitalized from April 1, 2020 to April 01, 2021. The outcome of hospitalization was chosen as the primary endpoint of the study: discharge or 28day mortality. Death within 6 months after discharge and the development of complications related to COVID-19 during this period were considered as secondary endpoints. Data collection was carried out by analyzing electronic and archival medical records. Quantitative variables: age, duration of hospitalization, days in the intensive care unit, laboratory blood parameters: the level of D-Dimer, Glucose, Interleukin-6, Procalcitonin, Lymphocytes and Platelets, CRP, CPK, CPK-MB, LDH, Fibrinogen, Ferritin. Qualitative indicators: gender, ventilator, ARDS, the presence of diabetes, the presence of obesity, the presence of complications: cardiovascular, gastrointestinal, septic, macrothrombotic, stage of pneumonia. To identify statistically significant predictors of the risk of an event, the odds ratio (OR) method was used.Results: average age 57.8±14 years, men – 59.5%, average bed day 17.6±10.6 days. In concomitant diseases, diabetes mellitus was indicated in 24% of patients, obesity was registered in 4.3% of patients. Hospital mortality (28-day) in the total cohort of follow-up was 16.05%, in total with out-ofhospital mortality of 22%. Mortality in intensive care reached 62.7%, on ventilator more than 86%, with ARDS 94.3%. No statistical significance was revealed by gender and the presence of diabetes mellitus (DM) in concomitant diseases. When comparing short-term outcomes, the age groups over 65 differed statistically. The following laboratory blood parameters showed a significant difference (P<0.001): D-Dimer, Glucose, IL-6 lymphocytes, Leukocytes, Neutrophils, Platelets, LDH, Ferritin. The following odds ratios (OR) were obtained: ARDS (OR 143.78; 95% CI 33.4-616.2; p=0.0001), on ventilator (OR 57.96; 95% CI 23.1-144.5; p=0.0001), the presence of septic complications (OR 26.4; 95% CI 13.8-50; p=0.0001), the course of the disease is defined as severe (OR 25; 95% CI 12.9-48.2; p=0.0001), the course of the disease is defined as complicated (OR 11.6; 95% CI 6.8-19.7; p=0.0001), the presence of gastrointestinal complications (OR 6.5; 95% CI 2.28-18.4; p=0.0007), the presence of obesity (OR 2.57; 95% CI 1.0-6.5; p=0.039). Mortality of patients receiving two main treatment regimens T-1 and T-2 did not differ (15.8% vs 15.7%). Significant differences (p=0.0001) appeared when compared with the T-0 and T-4 schemes, in which mortality was recorded at 8.8% and 85.7%, respectively. When comparing long-term outcomes, the analysis did not reveal statistical significance by gen","PeriodicalId":226950,"journal":{"name":"Journal Infectology","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114705689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Infections and schizophrenia 感染和精神分裂症
Pub Date : 2022-10-22 DOI: 10.22625/2072-6732-2022-14-3-105-111
V. Orlova, I. Mikhailova, V. Zinserling
This paper provides a critical review of the literature, demonstrating a certain pathogenetic role of various infections, primarily viruses from the herpes and chlamydia groups, in the development and progression of schizophrenia, including published results of the authors’ own long-term studies.
本文对文献进行了批判性的回顾,证明了各种感染,主要是来自疱疹和衣原体群的病毒,在精神分裂症的发生和发展中具有一定的致病作用,包括作者自己长期研究的已发表结果。
{"title":"Infections and schizophrenia","authors":"V. Orlova, I. Mikhailova, V. Zinserling","doi":"10.22625/2072-6732-2022-14-3-105-111","DOIUrl":"https://doi.org/10.22625/2072-6732-2022-14-3-105-111","url":null,"abstract":"This paper provides a critical review of the literature, demonstrating a certain pathogenetic role of various infections, primarily viruses from the herpes and chlamydia groups, in the development and progression of schizophrenia, including published results of the authors’ own long-term studies.","PeriodicalId":226950,"journal":{"name":"Journal Infectology","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121092671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal Infectology
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