Značaj ultrazvučnog merenja veličine jetre i slezine u dijagnostici komorbiditeta malarije i COVID-19
Sažetak
Uvod/Cilj. Sa izbijanjem pandemije bolesti korona virusa 2019 [coronavirus disease 2019 – (COVID-19)], zapaženi su i bolesnici koji su imali malariju i COVID-19 istovremeno. Hepatosplenomegalija je karakteristična i skoro uvek prisutna kod bolesnika sa malarijom (bez pridruženog COVID-19). Značajno povećanje veličine jetre i slezine jasno ukazuje na mogući razvoj teškog oblika malarije. Cilj rada bio je da se utvrdi uticaj COVID-19 na veličinu jetre i slezine kod obolelih od malarije. Metode. Istraživanje je sprovedeno dok su autori radili u srpskoj Vojnoj bolnici misije United Nations Multidimensional Integrated Stabilization Mission (MINUSCA-UN) u Bangiju, Centralnoafrička Republika. Analizirani su podaci 1 710 pacijenata, koji su podvrgnuti ultrazvučnom pregledu abdomena, kojim su mereni prečnici jetre i slezine. Ukupan broj pregledanih pacijenata podeljen je u četiri grupe: 816 kontrolnih pacijenata bez malarije (K grupa), 480 bolesnika sa aktivnom malarijom (M+), 353 onih koji su imali malariju u poslednjih 2-6 meseci (Mpast) i 61 bolesnik sa aktivnom malarijom i manifestacijama COVID-19 (M+Cov+). Rezultati. Jetra je bila značajno veća u M+, Mpast i M+Cov+ grupama, u poređenju sa K grupom. Statistički značajno povećanje slezine primećeno je samo u M+ grupi ali ne i u M+Cov+ grupi, u poređenju sa K grupom. Zaključak. Kod bolesnika sa koinfekcijom korona 2 virusom izazivačem teškog akutnog respiratornog sindroma i Plasmodium malariae nema uvećanja slezine. To znači da se kod bolesnika sa jasnom splenomegalijom može već u prvim satima hospitalizacije, u fazi čekanja na rezultate testa lančane reakcije polimeraze, sa velikom verovatnoćom ukazati na odsustvo COVID-19.
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