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

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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.

infectious diseases
pulmonary tuberculosis
surgical treatment
postoperative period
novel coronavirus infection
morphological study of surgical material

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  1. Vremennye metodicheskie rekomendatsii. Profilaktika, diagnostika i lechenie novoj koronavirusnoj infekii (COVID-19). Versija 10 (08.02.2021). M.: Minzdrav Rossii [Vremennye metodicheskie rekomendatsii. Profilaktika, diagnostika i lechenie novoi koronavirusnoi infekii (COVID-19). Versiya 10 (08.02.2021). M.: Minzdrav Rossii (in Russ.)].
  2. Gudima G.O., Haitov R.M., Kudlaj D.A. i dr. Molekuljarno-immunologicheskie aspekty diagnostiki, profilaktiki i lechenija koronavirusnoj infektsii. Immunologija. 2021; 42 (3): 198–210 [Gudima G.O., Khaitov R.M., Kudlay D.A. et al. Molecular immunological aspects of diagnostics, prevention and treatment of coronavirus infection. Immunologiya. 2021; 42 (3): 198–210 (in Russ.)]. DOI: 10.33029/0206-4952-2021-42-3-198-210
  3. Ekaterincheva O.L., Malkova A.M., Karev V.E. i dr. Osobennosti diagnostiki tuberkuleza na fone COVID-19. Zhurnal infektologii. 2021; 13 (1): 117–23 [Ekaterincheva O.L., Malkova A.M., Karev V.E. et al. Features of tuberculosis diagnosis in the COVID-19. Journal Infectology. 2021; 13 (1): 117–23 (in Russ.)]. DOI: 10.22625/2072-6732-2021-13-1-117-123
  4. Zajrat'jants O.V., Samsonova M.V., Mihaleva L.M. i dr. Atlas: patologicheskaja anatomija legkih pri COVID-19. M., 2020; 52 s. [Zairat’yants O.V., Samsonova M.V., Mikhaleva L.M. et al. Atlas: patologicheskaya anatomiya legkikh pri COVID-19. M., 2020; 52 p. (in Russ.)].
  5. Zvereva N.N., Sajfullin M.A., Rtischev A.Ju. i dr. Koronavirusnaja infektsija u detej. Pediatrija. 2020; 99 (2): 270–8 [Zvereva N.N., Sayfullin M.A., Rtishchev A.Yu. et al. Coronavirus infection in children. Pediatria. 2020; 99 (2): 270–8 (in Russ.)]. DOI: 10.24110/0031-403X-2020-99-2-270-278
  6. Samsonova M.V., Mihaleva L.M., Zajrat'jants O.V. i dr. Patologija legkih pri COVID-19 v Moskve. Arhiv patologii. 2020; 82 (4): 32–40 [Samsonova M.V., Mikhalyova L.M., Zairatyants O.V. et al. Lung Pathology of COVID-19 in Moscow. Arkhiv Patologii. 2020; 82 (4): 32–40 (in Russ.)]. DOI: 10.17116/patol20208204132
  7. Tsinzerling V.A., Vashukova M.A., Vasil'eva M.V. i dr. Voprosy patomorfogeneza novoj koronavirusnoj infektsii (COVID-19). Zhurnal infektologii. 2020; 12 (2): 5–11 [Zinserling V.A., Vashukova M.A., Vasilyeva M.V. et al. Issues of pathology of a new coronavirus infection CoVID-19. Journal Infectology. 2020; 12 (2): 5–11 (in Russ.)]. DOI: 10.22625/2072-6732-2020-12-2-5-11
  8. Ergeshov A.E., Ovsjankina E.S., Gubkina M.F. i dr. Osobennosti diagnostiki i techenija novoj koronavirusnoj infektsii u detej i podrostkov s tuberkulezom organov dyhanija. Vestnik TsNIIT. 2020; 4 (13): 43–9 [Ergeshov A.E., Ovsyankina E.S., Gubkina M.F. et al. The peculiarities of diagnosis and course of the novel coronavirus infection in children and adolescents with pulmonary TB. Vestnik TsNIIT. 2020; 4 (13): 43–9 (in Russ.)]. DOI: 10.7868/S2587667820040056
  9. Aguiar D., Lobrinus J.A., Shibler M. et al. Inside the lungs of COVID-19 disease. Int J Legal Med. 2020; 134 (4): 1271–4. DOI: 10.1007/s00414-020-02318-9
  10. Coronavirus disease 2019 (COVID-19). Situation report – 51. World Health Organization. Mode of access:
  11. Jain A. COVID-19 and lung pathology. Indian J Pathol Microbiol. 2020; 63 (2): 171–2. DOI: 10.4103/IJPM.IJPM_280_20
  12. Li H., Liu L., Zhang D. et al. SARS-CoV-2 and viral sepsis: observations and hypotheses. Lancet. 2020; 395 (10235): 1517–20. DOI: 10.1016/s0140-6736(20)30920-x
  13. Lu R., Zhao X., Li J. et al. Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020; 395 (10224): 565–74. DOI: 10.1016/s0140-6736(20)30251-8
  14. Malkova A., Kudlay D., Kudryavtsev I. et al. Immunogenetic Predictors of Severe COVID-19. Vaccines. 2021; 9: 211. DOI: 10.3390/vaccines9030211