The first experience in the surgical treatment of pulmonary tuberculosis in patients who have experienced COVID-19

DOI: https://doi.org/10.29296/25877305-2021-07-09
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Issue: 
7
Year: 
2021

Professor A. Ergeshov, MD; Professor M. Bagirov, MD; E. Krasnikova, MD; Professor L. Lepekha,
BD Central Research Institute of Tuberculosis, Moscow

The paper presents the first experience in the surgical treatment of pulmonary tuberculosis (PT) in 19 (14 and 5) patients who had the novel coronavirus infection (NCI) in the pre- and postoperative periods, respectively). A comparative analysis was carried out in 11 patients with newly diagnosed PT who had been receiving anti-tuberculosis therapy (ATT) for 3-12 months and had experienced mild and moderate NCI before surgery and in 16 similar patients who did not have NCI. In patients with new-onset PT who had been receiving ATT for no more than 2 months, the high activity of tuberculosis inflammation in both groups was associated with the progression of tuberculosis and correlated with the detection of multiple or extensively drug resistant Mycobacterium tuberculosis (MDR/XDR MBT) in the surgical material. Both groups showed no differences in the duration of surgery, the amount of intraoperative blood loss, the duration and volume of exudation, the postoperative leakiness of the operated lung, and the total duration of drainage. The results of a morphological study of the surgical material point to the fact the histological pattern of caseous necrotic foci and the structural and functional state of their surrounding lung parenchyma suggests in most cases that the inflammatory process exhibits a low or moderate activity that is equally pronounced in both observation groups and independent of NCI experienced during ATT. The high activity of the process is characteristic of patients with an exacerbation of chronic tuberculosis, among whom MDR/XDR MBT was detected in the surgical material. There was no reactivation of the tuberculosis process in patients who continuously received ATT and successfully underwent surgical interventions for disseminated tuberculosis, in those who fell ill with COVID-19 in the late postoperative period. Thus, NCI is not a significant risk factor for the progression of the tuberculosis process in patients receiving ATT.
Keywords: 
phthisiology
infectious diseases
pulmonary tuberculosis
surgical treatment
postoperative period
novel coronavirus infection
COVID-19
morphological study of surgical material

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