Кафедра дитячих інфекційних хвороб

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    Effect of degalactosylated bovine glycoprotein formulations MAF and M сapsules on lymphopenia and clinical outcomes in hospitalized COVID-19 patients: a randomized clinical trial
    (2024-05) Gavrylov, Anatoliy; Inui, Toshio; Kruglova, Oksana; Martynenko, Olga; Martynenk, Kostiantyn; Tieroshyn, Vadym; Kubo, Kentaro; Yamakage, Hajime; Kutsyn, Borys; Kubashko, Alla; Veklych, Zoryana; Terashima, Yurika; Mette, Martin; Kutsyna, Galyna
    Background Targeting mucosal immunity of the gut, which is known to provide antigen processing, while avoiding excessive or unnecessary inflammation, was tested as a way to modulate COVID-19 severity. Methods Randomized open-label trial in 204 adults hospitalized with non-critical COVID-19 who received for 14 days in addition to standard of care (SOC) degalactosylated bovine glycoproteins formulations of either MAF capsules (MAF group) or M capsules (M group) or SOC only (control group). Results Median recovery time when patients did not require supplemental oxygen was 6 days in both study groups compared to 9 days in the control (MAF vs. control; P=0.020 and M vs. control; P=0.004). A greater reduction in mortality was seen in the MAF group compared to the control by day 14 (8.3% vs. 1.6%; P=0.121) and by day 29 (15.3% vs. 3.2%; P=0.020), and similarly in the M group by day 14 (8.3% vs. 2.9%; P=0.276) and by day 29 (15.3% vs. 2.9%; P=0.017). The proportion of those who had baseline absolute lymphocyte count (ALC) lower than 0.8×109 /L was 13/63 (20.6%), 17/69 (24.6%), and 18/72 (25.0%) of patients in MAF, M, and control group respectively. Day 29 mortality among these lymphopenic patients was three times higher than for the intent-to-treat population (21% vs. 7%) and consisted in above subgroups: 2/13 (15%), 2/17 (12%), and 6/18 (33%) of patients. The decreased mortality in both study subgroups correlated with greater ALC restoration above 0.8×109/L level seen on day 14 in 91% (11/12) and 87.5% (14/16) of survivors in MAF and M subgroups respectively compared to 53.3% (8/15) of survivors in control subgroup. Incidences of any ALC decrease below the baseline level on day 14 occurred in 25.4% of patients in the MAF group and 29.0% of patients in the M group compared to 45.8% in control and ALC depletion by ≥50% from the baseline level consisted of 7.9%, 5.8%, and 15.3% of cases in these groups respectively. Conclusion This study showed that both study agents prevented ALC depletion and accelerated its restoration, which is believed to be one of the mechanisms of improved crucial clinical outcomes in hospitalized COVID-19 patients.
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    Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms
    (2024-05-04) Gavrylov, Anatoliy; Citarella, B.W.; Kartsonaki, C.; Ibáñez-Prada, E.D.; Zoufaly, A.; Zucman, D.
    Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4 % presented with RS, while 13.6 % had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7 % vs RS: 37.5 %). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1 % vs. RS 32.0 %), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83–0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders.
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    Сучасні методи лабораторно-інструментальної діагностики інфекційних захворювань у дітей
    (2024-05-23) Ольховська, Ольга Миколаївна; Колесник, Яна Володимирівна; Слєпченко, Маргарита Юріївна; Гаврилов, Анатолій Вікторович; Міщенко, В.А.
    Сучасні методи лабораторно-інструментальної діагностики інфекційних захворювань у дітей. Метод. вказ. для здобувачів вищої медичної освіти та лікарів-інтернів
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    Історія кафедри інфекційних хвороб харківського національного медичного університету в подіях і персоналіях. Погляд крізь століття
    (2023-11-21) Капустник, Валерій Андрійович; Юрко, Катерина Володимирівна; Козько, Володимир Миколайович; Градиль, Григорій Іванович; Меркулова, Ніна Федірівна; Ткаченко, Віталій Григорович; Соломенник, Ганна Олегівна; Могилинець, Олена Іванівна
    Висвітлено основні події та персоналії в історії кафедри інфекційних хвороб Харківського національного медичного університету за 100 років її існування.
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    Патогістологія печінки як основа морфологічної діагностики хронічного гепатита С: запалення та дистрофія
    (2023-08) Юрко, Катерина Володимирівна; Щасна, Ія Олексіївна; Cоломенник, Ганна Олегівна; Гаврилов, Анатолій Вікторович
    У статті розглядаються питання клінічної морфології печінки при хронічному гепатиті С. Приділено увагу таким патологічним процесам, як запалення та дистрофія. Саме вони є передумовою подальшого розвитку некрозу та фіброзу печінки, які визначають тяжкість хронічного гепатиту С і зумовлюють несприятливі наслідки хвороби. Визначення ступеня запально-некротичного процесу є однією з діагностичних задач під час ведення пацієнта з даною патологією.
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    Значення відносного рівня лімфоцитів у прогнозуванні активації латентної форми герпесвірусної інфекції в дітей хворих на ротавірусний гастроентерит
    (Науково-практична конференція "Мечниковські читання – 2023", 2023-11-03) Слєпченко, Маргарита Юріївна; Колесник, Яна Володимирівна; Ольховська, Ольга Миколаївна
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    Liver injury in hospitalized patients with COVID-19: An International observational cohort study
    (2023-09-13) Gavrylov, Anatoliy; Tieroshyn, Vadym; Vijayaraghavan, B.K.T.; Bishnu, S.; Baruch, J.; Zayyad, H.; Zucman, D.
    Background. Using a large dataset, we evaluated prevalence and severity of alterations in liver enzymes in COVID-19 and association with patient-centred outcomes. Methods. We included hospitalized patients with confirmed or suspected SARS-CoV-2 infection from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) database. Key exposure was baseline liver enzymes (AST, ALT, bilirubin). Patients were assigned Liver Injury Classification score based on 3 components of enzymes at admission: Normal; Stage I) Liver injury: any component between 1-3x upper limit of normal (ULN); Stage II) Severe liver injury: any component ≥3x ULN. Outcomes were hospital mortality, utilization of selected resources, complications, and durations of hospital and ICU stay. Analyses used logistic regression with associations expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI). Results. Of 17,531 included patients, 46.2% (8099) and 8.2% (1430) of patients had stage 1 and 2 liver injury respectively. Compared to normal, stages 1 and 2 were associated with higher odds of mortality (OR 1.53 [1.37–1.71]; OR 2.50 [2.10–2.96]), ICU admission (OR 1.63 [1.48–1.79]; OR 1.90 [1.62–2.23]), and invasive mechanical ventilation (OR 1.43 [1.27–1.70]; OR 1.95 (1.55–2.45). Stages 1 and 2 were also associated with higher odds of developing sepsis (OR 1.38 [1.27–1.50]; OR 1.46 [1.25–1.70]), acute kidney injury (OR 1.13 [1.00–1.27]; OR 1.59 [1.32–1.91]), and acute respiratory distress syndrome (OR 1.38 [1.22–1.55]; OR 1.80 [1.49–2.17]). Conclusions. Liver enzyme abnormalities are common among COVID-19 patients and associated with worse outcomes.
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    Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19
    (2023-08) Gavrylov, Anatoliy; Tieroshyn, Vadym; Wainstein, M.; Spyrison, Nicholas; Dai, Danyang; Ghadimi, Moji; Chávez-Iñiguez, Jonathan S.; Rizo-Topete, Lilia; Citarella, Barbara Wanjiru; Merson, Laura; Pole, Jason D.; Claure-Del, Granado Rolando; Johnson, David W.; Shrapnel, Sally
    Introduction: Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population. Methods: This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay. Results: Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity. Conclusions: AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes.
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    Кореляційні зв’язки рівня гемоглобіну з клінічними проявами ротавірусного гастроентериту у дітей
    (2023-02-15) Слєпченко, Маргарита Юріївна; Ткалич, Дар'я Юріївна; Майстренко, Ярослава Юріївна
    Виявлені достовірні кореляції підтверджують, що рівень гемоглобіну залежить від цифр температурної реакції, та може розглядатись як один з маркерів важкості перебігу РВІ у дітей.
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    Ріст захворюванності на стрептококову інфекцію у Європі
    (2023-02-15) Слєпченко, Маргарита Юріївна; Ткалич, Дар'я Юріївна; Майстренко, Ярослава Юріївна
    Широке впровадження у практичну діяльність діагностичних шкал бета-гемолітичного стрептококу групи А (БГСА), таких як шкала МакАйзека, FeverPAIN критерії, шкала Центора, експрес тест на БГСА, сприятимете контролю за антибіотикорезистентністю штамів БГСА.