Assessment of clinical data and the species composition of pathogens in the upper respiratory tract of patients with COVID-19 and determination of sensitivity to essential etiotropic drugs

Objective. To comparatively analyze the clinical and microbiological data of outpatients with COVID-19 who took a bacteriophage-based drug and who did not.

Subjects and methods. The investigation involved 42 outpatients with COVID-19 who were divided into two groups: a study group of 30 patients who received standard therapy for COVID-19, as well as an oral bacteriophage-based drug (15 ml thrice a day for 10 days); a control group of 12 patients who had only the standard COVID-19 therapy. After 10 days of therapy, the clinical manifestations of the disease were comparatively evaluated in the examined groups. A repeated study of the material for bacterial microflora to assess the eradication of the pathogenic microflora in the respiratory tract was conducted on day 21 after the start of therapy.

Results. Klebsiella pneumoniae (77%), Staphylococcus aureus (17%), and streptococci (Streptococcus agalactiae and Streptococcus pyogenes) (6%) were identified in the structure of bacterial pathogens in patients with COVID-19. Microbiological monitoring revealed multidrug-resistant K. pneumoniae in 50% of the patients; that sensitive to antibiotics in 26.7% of cases and that sensitive to a bacteriophage in 100%. The investigation results showed that the use of a polyvalent K. pneumoniae bacteriophage in patients with COVID-19 to prevent bacterial complications contributed to a significant (p < 0.001) elimination of K. pneumoniae. The pathogen isolation rate in the study group decreased significantly (p < 0.001). Thus, the use of phage therapy in combination with etiotropic therapy can be recommended to prevent bacterial complications in patients with COVID-19.