FEATURES OF THE COURSE OF PSEUDOMEMBRANOUS COLITIS IN PATIENTS INFECTED WITH SARS-COV-2

In the context of the COVID-19 pandemic, intestinal lesions associated with this disease are a serious problem. Purpose: to analyze and identify the features of the course of pseudomembranous colitis in patients infected with SARS-CoV-2. Material and methods. The analysis was carried out on the basis of questionnaires, including information on the course and treatment of COVID-19, comorbidity, clinical symptoms of pseudomembranous colitis, results of colonoscopy, fecal ELISA for C. difficile toxins. Results and conclusion. 396 questionnaires of patients hospitalized with COVID-19 complicated by pseudomembranous colitis were analyzed. The maximum number of patients (36%) was recorded at the age of 60-69 years; women (65%) predominated in the structure of patients. The onset of symptoms of intestinal dyspepsia, in most cases (67%), was observed on the 10-20th day from the onset of COVID-19, and in 78,5% of cases, a recurrent course of colitis was observed. In 81% of cases, pseudomembranous colitis developed against the background of antibiotic therapy, and in 67% of cases, its development was combined with the appointment of proton pump inhibitors. Mortality from pseudomembranous colitis against the background of SARS-CoV-2 was very high (25,5%) and increased with increasing age of the patient, reaching a maximum (51,7%) in the group of patients over 80 years old. In 99%, the cause of deaths was the development of multiple organ failure against the background of concomitant pathology. Severe course of viral pneumonia in deceased patients was observed only in 17% of cases, which indicates the leading role of intestinal damage in the development of multiple organ failure syndrome in patients with pseudomembranous colitis against the background of infection with the SARS-CoV-2 virus.

coronavirus infection, pseudomembranous colitis, antibiotic therapy, increased intestinal permeability, dysbiosis