The article reviews the literature on community-acquired pneumonia. Own results of study on the features of clinical, laboratory, and instrumental manifestations of community-acquired pneumonia during epidemic of the new coronavirus infection of COVID-19 are given.

The article presents literature data on changes in labo­ratory parameters in new coronavirus infection COVID-19 and the results of our own researches. It was found that in the first three days after hospitalization, most patients had normocytosis, a normal number of lymphocytes. In the mild form, there were slightly more people with normal or with an increased number of leukocytes, granulocytes, but in moderate course, leukopenia, lymphopenia, granulocytosis and granulocytopenia, thrombocytosis, thrombocytopenia were registered more often. At the same time, in the mild form, there were more patients with an increased number of band neutrophils. In mild course, there were no individuals with an increased number of band neutrophils after 3 days in the hospital. Leukocytosis, lymphopenia, granulocytosis were no longer detected after 6 days in the hospital; during this period, the number of patients with leukopenia, thrombocytopenia also decreased significantly, most people had normocytosis. In patients with moderate-to-severe course, leukocytosis and leukopenia were observed for a longer period than with the mild course, even after 10 days in hospital. Most patients had normocytosis. By the sixth day of hospital stay, there were more individuals with granulocytosis (no such patients were registered at a later date), with an increased number of band neutrophils. After 6 days, there was greater number of patients with lymphocytosis, thrombocytosis and lymphocytopenia.

Актуальность. Ситуация в странах мира и Украине по поводу коронавирусной болезни COVID-19 остается очень напряженной. Медицинские учреждения, которые выделены для лечения больных с новой коронавирусной болезнью, работают с большой нагрузкой. Инфекционные отделения в некоторых медицинских учреждениях работают как диагностические. Цель исследования: с целью улучшения работы диагностических отделений исследовать структуру больных, которые поступали в данные отделения и проходили обследование и лечение. Материалы и методы. Были изучены данные журнала стационарных больных инфекционного отделения КНП «Киевская городская клиническая больница № 4», г. Киев, во время эпидемии коронавирусной инфекции COVID-19 за период март — июль 2020 г. Результаты. Среди госпитализированных больных преобладали работающие и неработающие, пенсионеры. После установления задачи работы инфекционного отделения как сортировочного в медицинском учреждении в отделение поступали преимущественно больные с подозрением на COVID-19, негоспитальной пневмонией (22,5 %) и подтвержденными случаями COVID-19. Среди госпитализированных большая доля больных с пневмонией была среди пенсионеров (66,7 %), медицинских работников (59,3 %), неработающих (53,6 %), работающих (55,7 %), а с тяжелой пневмонией — среди работников церкви (40 %), беременных (25 %), военнослужащих силовых структур (20 %), слушателей учебных заведений (18,2 %). Больший процент тяжелой пневмонии был у лиц в возрасте 71–100 лет и 21–40 лет. Также в отделение поступали больные с другой патологией, что требовало дополнительной нагрузки на лабораторию, ультразвуковое и рентгенологическое отделения для верификации диагноза (туберкулеза, негоспитальной пневмонии, острого нарушения мозгового кровообращения, ВИЧ-инфекции, бактериального эндокардита, саркоидоза и др.) и выявления осложнений (тромбоэмболии легочной артерии, миокардита и др.)

Literature and personal data on community-acquired pneumonia during the epidemic of a new coronavirus infection COVID-19 are presented. It was found that men and patients with moderately to severe form were treated for community-acquired pneumonia more often. The most common localizations were as follows (in descending frequency): bilateral multisegmental, right-sided lower lobe, left-sided lower lobe. Men as compared to women more often had the following localization of pneumonia: right-sided lower lobe pneumonia at the age of 20–30, 51–60; right-sided multisegmental in all age groups; left-sided lower lobe pneumonia at the age of 51–60, left-sided upper lobe pneumonia at the age of 20–50; left-sided multisegmental pneumonia in all age groups; slightly more frequent bilateral lower lobe pneumonia in different age groups; bilateral multisegmental pneumonia at the age of 20–30 and over 60. Conversely, the most common localization in women was as follows: right-sided lower lobe pneumonia at the age 31–50, right-sided upper lobe pneumonia at the age 20–30, left-sided lower lobe pneumonia at the age 20–50 and over 60, left-sided upper lobe pneumonia at the age over 60, bilateral lower lobe pneumonia at the age 31–40, bilateral multisegmental pneumonia at the age 41–60. Right-sided lower lobe pneumonia was equally often registered irrespective of gender in persons older than 60 years old. Right-sided upper lobe pneumonia was not registered in patients aged 31–40 and 41–50 years, and over 60 years old. The most frequent localization of pneumonia in mild form was left-sided lower lobe (35.3 %), right-si­ded lower lobe (20.6 %), and bilateral lower lobe (14.7 %). The least frequent were upper lobe localization of pneumonia in the right, left, and both lungs (2.94 % each), and left multisegmental pneumonia was not observed at all. The most frequent localization of pneumonia in the moderate form was the lower lobes of the right lung (29.4 %), left lung (18.3 %), and multisegmental in both lungs (28.8 %). It was least frequently registered in the upper lobe of the right lung (2.6 %), left lung (3.9 %) but was not registered in the upper lobes of both lungs. The most frequent localization of pneumonia in severe form was bilateral multisegmental (37.5 %). Right-sided multisegmental, left-sided lower lung and bilateral lower lung were the least common — 12.5 % for each. Subfebrile fever was registered more frequently in almost all localizations. More often normal or subfebrile temperature was registered in all localizations, except for right-sided upper lobe pneumonia, in which higher (febrile, pyretic) temperature was registered more often. In all localizations within three days after hospitalization most patients had normal leukocyte count, leukopenia was slightly more frequent in left-sided lower lobe pneumonia, leukocytosis — in the bilateral upper lobe, bilateral lower lobe, and right-sided upper lobe. In general, leukocytosis in community-acquired pneumonia was registered in 38.8 % of patients. In the first three days after hospitalization, a normal amount of lymphocytes was registered in the majority of patients, lymphopenia was observed in one-third of patients with right-sided upper and left-sided lower lobe localization.

The article presents the literature review data on the community-acquired pneumonia and the survey of patients with community-acquired pneumonia during the pandemic of the new coronavirus infection COVID-19. There are no changes in the rate of leukocytosis detection in patients with mild course of the di­sease within 10 days of hospital stay. There is a tendency to increase the proportion of people with a normal number of leukocytes and lymphocytes from day 4–6 of hospital treatment. Significantly, leukopenia was detected in 9.3 % of patients 1–3 days after hospitalization and was not observed in the future. Lymphopenia was registered in the first 1–6 days of hospital stay and was not observed from day 7–9. Granulocytosis was detected in 27.6 % of patients on day 1–3 in the hospital and in the following days their percentage decreased significantly; at the same time, the number of people with normal range of granulocytes increased significantly. Normal platelet counts were observed in most patients (93.8 %) on day 1–3 of hospital stay, and thrombocytopenia was recorded only in 6.3 % of individuals on day 1–3 after hospitalization. In moderate-to-severe form, 24.7 % of patients had leukocytosis on day 1–3 of hospital stay, and on day 7–9 of treatment, it was detected already in 28.8 % (p > 0.05). The majority of patients (66.7 %) had normocytosis in the first three days, and leukopenia was observed in 8.7 % of people on day 1–3. Significantly, the share of detected lymphocytosis increased, and lymphopenia — decreased from 4–6 days of hospital stay. Granulocytosis was registered in 23.2 % of patients on day 1–3 of hospital stay, followed by a significant decrease in the percentage of granulocytes from days 4–6. Band neutrophils were elevated in the first three days among 51.6 % of patients, and their percen­tage significantly decreased after the fourth day. Most individuals (77.3 %) had a normal platelet count on day 1–3 in the hospital, and thrombocytopenia at this time was found in 16.7 %. The majority of patients aged 20–30 years had a normal number of leukocytes (65.5 %), and 25.5 % had leukocytosis 1–3 days after hospitalization. Lymphocytosis in the first 3 days was registered among 9 % of people and then increased significantly, lymphopenia was observed in 31 % of patients on day 1–3 and subsequently decreased, granulocytosis — in 25 % of cases, elevated levels of band neutrophils — in 43.8 %, thrombocytosis — in 7.3 %, thrombocytopenia — in 10.9 %. Among patients aged 31–40 years in the first 3 days after hospitalization, leukocytosis was registered in 28 % of cases, leukocyte count was normal in 72 %, leukopenia was not detected, 48 % of patients had lymphopenia, 15.8 % — granulocytosis, levels of band neutrophils were elevated in 65.2 %, thrombocytosis was observed in 8 % of cases, thrombocytopenia — in 8 %. Most patients (66.7 %) aged 41–50 years on day 1–3 after hospitalization had normocytosis, 19 % — leukocytosis, 14.3 % — leukopenia, 14.3 % — lymphocytosis, 38.1 % — lymphopenia, 3 (25 %) people had granulocytosis, levels of band neutrophils were elevated in 65 % of cases, thrombocytosis was detected in 4.8 %, thrombocytopenia — in 28.5 %. Among patients aged 51–60 years in the first 3 days after hospitalization, the following indicators of complete blood count were found: 16.1 % of individuals had leukocytosis, number of leukocytes was normal in 83.9 % of cases, leukopenia was not detected, lymphocytosis was found in 16.1 % of people, lymphopenia — in 22.6 %, granulocytosis — in 20 %, elevated levels of band neutrophils — in 39.3 %, thrombocytosis — in 3.2 %, thrombocytopenia — in 16.2 %. Patients older than 60 years on days 1–3 after hospitalization had the following changes: 38.8 % — leukocytosis, white blood cell count was normal in 49 % of cases, 12.2 % of people had leukopenia, 12.2 % — lymphocytosis, 51.1 % — lymphopenia, granulocytosis was not observed, 25 % had granulocytopenia, 60 % — elevated levels of band neutrophils, 8.2 % — thrombocytosis, and 18.3 % — thrombocytopenia.