As a result of the analysis of bibliographic sources, important information was elucidated regarding the clinical manifestations and management of patients with tuberculosis associated with COVID-19 infection. The similarity of the clinical manifestations of these two diseases was confirmed along with the importance of investigations by the presence of “ground glass” opacities for the diagnosis of COVID-19 infection. The increased mortality among patients suffering from co-infection TB/COVID-19 was argued by the presence of cardiovascular and endocrine comorbidities.

No abstract

The study included 24 patients, which formed the baseline group — 12 patients with pulmonary tuberculosis in combination with COVID-19 infection and the control group — 12 patients with pulmonary tuberculosis. There were studied the leukocyte formula, the content of CD3, CD4, CD8 lymphocytes, the content of NO2-+NO3- total and its metabolites. The obtained results showed that in patients with pulmonary tuberculosis and COVID-19 there is a pronounced decrease of lymphocytes and an unexpressed shift of the leukocyte formula to the left. The lymphocyte content decreases due to CD3 lymphocytes and their subpopulation of CD4 (helper) lymphocytes. The CD4/CD8 immunoregulatory index demonstrates a stimulation of immunological reactivity in patients with pulmonary tuberculosis and depression of immunological reactivity in patients with pulmonary tuberculosis in combination with COVID-19 infection and a pronounced suppression of the production content of NO2-+NO3- total and its metabolites (NO2- and NO3-).

Detection consists in the use of measures for the early identifi cation of suspects and requires radiological examination of the chest in patients from the high-risk groups, endangered contingents and groups designed by the pneumophthisiologists. The aim was to compare the particularities of patients from endangered contingents and high risk groups to optimize the early detection of tuberculosis. A retrospective, selective research was conducted on 166 patients distributed in the study group which included 48 cases from endangered contingents and the comparative group with 118 patients from high risk groups registered in Chisinau in 2018. Peculiarities of patients from endangered contingents was age younger 34 years, urban residence, completed level of the education, favorable socio-economic particularities, negative microbiological state and of those from high-risk groups: age older 45 years, social vulnerability, behaviors with risk, epidemiological factors, administrative barriers in accessing healthcare and positive microbiological status. Conclusion: despite the standard manmanagement, the patients from the endangered contingents have been successfully treated compared to the high risk groups, which demonstrates the need for a personalized approach to patients with aggravating characteristics.

In order to study the particularities of T lymphocyte content depending on the indicators of oxidative stress and antioxidant activity, in patients with pulmonary tuberculosis in association with COVID-19 coinfection, 42 patients were examined, of which: a) baseline - 21 patients with pulmonary tuberculosis and co-infection COVID-19, b) control group - 21 patients with pulmonary tuberculosis. At the patients included in the study, there were determined the leukocyte formula, the level of CD3, CD4, CD8 lymphocytes, the oxidative stress reaction as well as the antioxidant activity. As a result, it was determined that at patients with tuberculosis and COVID-19 coinfection: as the content of lymphocytes, and in particular, T lymphocytes decreases at patients with pulmonary tuberculosis and COVID-19 co-infection, the degree of oxidative damage of proteins and the predisposition of lipoproteins to oxidation increases significantly according to the data of the AOPP marker and the indicator of malonic dialdehyde of oxidative stress (malonic dialdehyde - DAM), which indicates the severity of oxidative stress reactions at these patients. The total antioxidant activity, determined by the ATS method at patients with pulmonary tuberculosis and COVID-19 co-infection, was significantly reduced, and according to the CUPRAC method it increased significantly as the content of lymphocytes and, in particular, lymphocytes decreased. The enzyme superoxide dismutase (SOD), catalase and the activity of the antioxidant protein ceruloplasmin at patients with pulmonary tuberculosis and COVID19 decreased significantly as the content of lymphocytes and, in particular, T lymphocytes decreased. Thus, the parameters of oxidative stress and antioxidant activity can be considered potential biomarkers markers of the evolution of pulmonary tuberculosis in association with COVID-19 infection.