The aim of the work – to conduct clinical and pathomorphological analysis of deaths from COVID-19 in 2020. Materials and methods. We analyzed 41 case histories and results of pathological-anatomical examination of patients who were died of COVID-19 during 2020. Results. The lethal outcome of COVID-19 disease was recorded at day 22 (16; 27) of the disease. Among the dead, there is a high percentage of men (73.2 %), early old age and middle old age patients (75.6 %) with comorbid pathology (92.7 %). Early lung damage with COVID-19 in the deceased was determined by pronounced interstitial and interstitial-alveolar edema, the presence of erythrocyte stasis in the pulmonary microvessels, blood clots and hypoperfusion leukocyte stasis, as well as the presence of erythrocytes in the alveoli. Bilateral polysegmental subtotal viral pneumonia in 90.2 % of dead patients was characterized by significant edema and thickening of the alveolar walls with their moderate infiltration by lymphocytes, focal peribronchial and perivascular inflammatory polymorphonuclear infiltration, multiple and small exfoliated alveolar epithelium (87.8 %), as well as metaplasia of a few alveolocytes preserved on the luminal surface of the alveoli (82.9 %). Every tenth person who died of COVID-19 had signs of secondary bacterial microflora. In 85.4 % of patients who died on day 22–27 of the disease focal or sublobar pneumofibrosis was diagnosed. In those who died due to COVID-19, multiorgan failure was characterized by focal necrosis of the renal tubular epithelium (73.2 %), focal lymphocytic-leukocyte infiltration (12.2 %) and renal microvascular thrombosis (17.1 %), focal centro-lobular necrosis (90.2 %) and focal lymphocytic-leukocyte infiltration of lobes (7.3 %) of the liver. Thrombotic complications were confirmed in 22.0 % of deceased patients: ischemic cerebral infarction, transmural myocardial infarction, pulmonary embolism, deep vein thrombosis of the lower extremities under the pathology. These thrombotic complications were not diagnosed during life in all patients. The majority of deaths due to COVID-19 had morphological signs of chronic cardiovascular pathology. Ischemic heart disease and hypertension during the life of patients were not diagnosed in all cases. Conclusions. Early lung damage in COVID-19 in the deceased was determined by pronounced interstitial-alveolar edema, blood clots and leukocyte stasis in microvessels, less often – the presence of “hyaline membranes”. In 90.2 % of the dead patients bilateral polysegmental subtotal pneumonia with edema and lymphocytic infiltration of the pulmonary interstitium, inflammatory peribronchial and perivascular focal polymorphonuclear infiltrates, foci of atelectasis and dyscryphaseses was found. In 9.7 % of patients bilateral subtotal viral-bacterial fibrinous-purulent bronchopneumonia developed. In those who died on the 22nd–27th day of the disease focal pneumofibrosis was determined. Pathomorphologically, thrombotic complications, which were not diagnosed in all patients during their lifetime, were confirmed in 22.0 % of deceased patients. Most deaths from COVID-19 had morphological signs of chronic cardiovascular disease.

Aim. The aim of the work was to determine the role of polymorphism of the interleukin-10 gene (rs 1800872) in the course of herpes zoster in adults. Materials and methods. 50 adult patients with herpes zoster were included into the study. The clinical course of the disease and development of the certain nature of complications were analyzed depending on the genetic polymorphism of the interleukin-10 gene. Statistical data processing was performed with using the formed patient database in the program STATISTICA for Windows 13 (StatSoft Inc., № JPZ804I382130ARCN10-J). Results. It was established that genotype TT of the IL-10 gene (rs 1800872) was recorded in 30 (60.0 %) patients with herpes zoster versus 14 (35.0 %) healthy people from the control group (P = 0.02), which confirmed the significance of the gene polymorphism IL-10 in reactivation of the varicella zoster virus and the manifestation of shingles. Analysis of the polymorphism of the IL-10 gene depending on the clinical form and the severity of shingle showed that genotype TT was significantly more frequently recorded in patients with severe course disease (86.7 % vs. 48.6 %, P = 0.01), however, did not influenced on the formation of certain clinical forms of the disease (P > 0.05). In patients with herpes zoster polymorphism of the IL-10 gene (rs 1800872) influenced the severity of the course of the disease, namely, the TT genotype was associated with a severe course of the disease (P = 0.01) and the development of neurological complications (P = 0.03), which were represented by meningitis (6), Ramsey-Hunt syndrome (3) and the subsequent formation of postherpetic neuralgia (3), as well as of ophthalmic nature (P = 0.0001), which were represented by herpetic blepharoconjunctivitis (16), keratouveitis (3), iridocyclitis (1), subconjunctival hemorrhages (1). Unlike the TT genotype, genotype TG of the IL-10 gene (rs 1800872) was associated with the development of complications with the addition of secondary bacterial microflora (χ 2 = 4.5, P = 0.03), the incidence of which did not depend on the severity of herpes zoster (P > 0.05). Conclusions. In patients with herpes zoster, the TT-genotype of the IL-10 gene (rs 1800872) was associated with reactivation of the varicella zoster virus and development of a severe disease course, with formation of neurological (χ 2 = 4.75, P = 0.03) and ophthalmic (χ 2 = 14.75, P = 0.0001) complications. The TG genotype of the IL-10 gene (rs 1800872) is associated with the development of complications associated with the addition of secondary bacterial microflora (χ 2 = 4.5, P = 0.03).

Aim. The aim of our work is to establish the prognostic significance of demographic indicators and the Charlson comorbidity index (CCI) in oxygen-dependent patients with coronavirus disease (COVID-19). Material and methods. The research included 211 oxygen-dependent patients with COVID-19: I group – 94 patients who recovered; II group – 117 patients, the disease ended fatally. We used the WHO age classification when analyzing the age structure of patients. The Charlson comorbidity index was calculated for each patient. The patients were divided into groups Statistical data processing was carried out in the program Statistica for Windows 13 (StatSoft Inc., No. JPZ804I382130ARCN10-J). Results. It was established that the median age of the ІІ group patients was higher (P < 0.001) than patients the I in group. Elderly patients were more often registered in the ІІ group than among patients in group I (25.6 % vs. 8.5 %, P = 0.001). Middle-aged patients were more often registered in the І group than among patients in the II group (34.0 % vs. 19.4 %, P = 0.02). According to the result of the ROC analysis, the prognostic value of the age of the patients was established, namely, under conditions of age >66 years (AUC = 0.636, Р = 0.002), the probability of a fatal outcome of COVID-19 was significant. Analysis of the influence of comorbid conditions on the risk of COVID-19 fatal outcome in oxygen-dependent patients according to the CCI showed that the absence of comorbid pathology was more common among patients of group I than among patients of group II (12.8 % vs. 2.6 %, P = 0.004). The level of CCI in patients of the II group significantly exceeded the corresponding indicator of the patients of the I group (P < 0.01), who recovered. According to the obtained result of the ROC analysis, the prognostic value of this indicator was established, namely under the conditions of the CCI index >5 in oxygen-dependent patients with COVID-19 (AUC = 0.652, P < 0.001) the probability of fatal outcome of the disease was significant. Conclusions. In oxygen-dependent patients with COVID-19, patient age and comorbidity are associated with disease outcome. Under conditions of age >66 years (AUC = 0.636, P = 0.002) and the Charlson comorbidity index >5, the probability of a fatal outcome of the disease is significant (AUC = 0.652, P < 0.001).

Measles is a highly contagious acute infectious disease of viral etiology. Thanks to the widespread use of measles vaccine in the European Region in the early 2000s, WHO set a goal to achieve measles elimination. An essential feature of measles during the period of elimination was the predominance of cases among adults.The purpose of the work is to analyze the literature data on the peculiarities of the current course of measles in adults.According to the WHO, in 2017-2018 in Europe, including Ukraine, there was a significant increase in the number of people with measles. The rise in the incidence of measles in modern conditions is characterized by a change in the genotypes of circulating viruses. The data of modern medical literature show that a significant feature of measles outbreaks in recent years is the predominance of cases among adults, the incidence of measles among medical workers who were vaccinated against measles. The clinical picture of measles in adults remains typical; however, unlike measles in children, it is characterized by a greater incidence of complications.The development of pneumonia and encephalitis is the most severe and life-threatening. Pneumonia is a frequent complication of measles in adults over 20 years of age, the incidence of which in adults, according to different studies, ranges from 14 to 66 %, but the most patients need oxygen therapy. The risk of measles encephalitis occurs during the rash onset and mortality rate depends on the age of patients in this complication: 25 % in adults versus 5 % in children. In adult patients with measles, liver damage is recorded much more often than in children, with the prevalence of cytolytic syndrome, sometimes with the development of jaundice, but is characterized by a benign clinical course. In the literature, there are reports of enteritis and pancreatitis development in patients with measles. Data on the course of measles in pregnant women warrant special attention due to such adverse effects as abortions, premature births, and stillbirths. Measles is a controlled infection, therefore vaccination, including adults, is the main focus in the fight against this disease. Conclusions.In modern conditions, there is a high incidence of measles in adults, primarily due to the low level of community immunity. The prevalence of adults among measles patients is an important feature of this infection outbreak in recent years. The clinical picture of measles in adults retains typical symptoms, but the course is characterized by a high risk of a wide range of complications, the most severe of which are pneumonia and measles encephalitis. It is possible to achieve success in the fight against measles through the effective vaccination coverage. Сучасний перебіг кору в дорослих (огляд літератури)Ю. Ю. Рябоконь, С. О. Білокобила, О. В. Рябоконь Кір -висококонтагіозне гостре інфекційне захворювання вірусної етіології. Завдяки широкому застосуванню вакцинації проти кору в Європейському регіоні на початку 2000-х років ВООЗ поставила за мету елімінацію кору...

The aim was to analyze spectrum of comorbid pathology and age structure of oxygen-dependent patients with severe coronavirus disease 2019 (COVID-19) depending on outcomes of the disease. Materials and methods. The study included 85 oxygen-dependent patients with severe COVID-19. The patients were divided into groups: I – 70 patients with recovery; II – 15 patients in whom the disease was fatal. Statistical data processing was performed in the program Statistica for Windows 13 (StatSoft Inc., No. JPZ804I382130ARCN10-J). Results. Among the patients with fatal outcomes of the disease, elderly and senile were dominated – 93.3 % (14 of 15) versus 67.1 % (47 of 70) among patients who recovered (P < 0.05). Analysis of comorbid pathology structure in oxygen-dependent patients with severe COVID-19 showed that patients who died more often had hypertension (93.3 % vs. 30.0 %, P < 0.001), postinfarction cardiosclerosis (26.7 % vs. 2.9 %, P < 0.001), rhythm disturbance as persistent atrial fibrillation (20.0 % vs. 1.4 %, P < 0.01) as compared to those who survived. The patients of group II were more commonly diagnosed with chronic kidney disease (20.0 % vs. 4.3 %, P < 0.05) as the comorbid pathology. The presence of ischemic stroke in COVID-19 infection influenced the disease outcome (20.0 % vs. 4.3 %, P < 0.05). Fatal outcomes in the patients with COVID-19 were associated with a combination of 3 or more comorbid conditions in 46.7 % versus 17.4 % among oxygen-dependent survivors with severe disease (P < 0.01). Conclusions. Elderly and senile oxygen-dependent patients are more likely to die from severe COVID-19 (P < 0.05). Comorbid hypertension, postinfarction cardiosclerosis, arrhythmia in the form of persistent atrial fibrillation, chronic kidney disease and ischemic stroke or the combination of 3 or more comorbid conditions listed are more common among patients with COVID-19 who died (P < 0.05) as compared to survivors.