Features of the new coronavirus COVID-19 infection in identical twins

The problem of the clinical course and principles of treatment for the new coronavirus infection COVID-19 remains the most debated issue. At the same time, reliable prognostic criteria that determine characteristics of the disease course and outcome have not been established. Taking it into consider...

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Main Authors: S. M. Yudina, V. V. Kiseleva, Tatyana S. Rusanova, I. A. Ivanova
Format: Article
Language:Russian
Published: Sankt-Peterburg : NIIÈM imeni Pastera 2022-07-01
Series:Инфекция и иммунитет
Subjects:
Online Access:https://iimmun.ru/iimm/article/viewFile/1868/1416
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author S. M. Yudina
V. V. Kiseleva
Tatyana S. Rusanova
I. A. Ivanova
author_facet S. M. Yudina
V. V. Kiseleva
Tatyana S. Rusanova
I. A. Ivanova
author_sort S. M. Yudina
collection DOAJ
description The problem of the clinical course and principles of treatment for the new coronavirus infection COVID-19 remains the most debated issue. At the same time, reliable prognostic criteria that determine characteristics of the disease course and outcome have not been established. Taking it into consideration, we present clinical cases of COVID-19 in identical twins. Patients A. and S., 39 years old, were admitted to the Regional Clinical Infectious Diseases Hospital. The patients were clinically diagnosed with COVID-19 coronavirus infection, verified, moderate form; bilateral polysegmental pneumonia of moderate severity, 1st degree respiratory failure. The course of COVID-19 coronavirus infection in identical twins markedly differed. Patient A. had peripheral blood lymphocytosis, slightly increased ESR, CRP, ferritin, IL-6, and D-dimer level. A paired twin brother (patient S.) had lymphopenia, ESR accelerated up to 20 mm/h, CRP pronouncedly increased up to 10 mg/ml, IL-6 up to 9,5 pg/ml, and D-dimer up to 750 ng/ml. Condition of the patient A. remained stable, on day 13th of treatment, the patient was discharged from the hospital. The condition of the patient S. on day 3rd of hospitalization deteriorated sharply. Considering the decrease in SpO2 level down to 88%, the damage of the lung parenchyma was more than 70%, resulting in the use of antibacterial drugs, anti-IL-6 monoclonal antibodies as well as selective reversible inhibitor of Janus-kinases 1 and 2. On day 16th of treatment, subjectively, the patient showed an improvement in general condition. During the next two days, the patients condition revealed marked positive dynamics on day 19th of hospital stay, the patient was discharged for rehabilitation. Thus, significant differences in the severity of the course of the new coronavirus infection in identical twins with similar medical history and lack of confounding comorbidities are most likely due to the initial dose of the viral load which was an important factor determining the development and course of infection.
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spelling doaj.art-ae4626a2766c48bea52b3caa7219b70d2022-12-22T03:46:13ZrusSankt-Peterburg : NIIÈM imeni PasteraИнфекция и иммунитет2220-76192313-73982022-07-0112356957410.15789/2220-7619-FOT-18681170Features of the new coronavirus COVID-19 infection in identical twinsS. M. Yudina0https://orcid.org/0000-0001-5074-9595V. V. Kiseleva1https://orcid.org/0000-0002-4138-7673Tatyana S. Rusanova2https://orcid.org/0000-0003-2566-798XI. A. Ivanova3https://orcid.org/0000-0002-7331-6255Kursk State Medical University of the Ministry of Health of the Russian FederationKursk State Medical University of the Ministry of Health of the Russian FederationKursk State Medical University of the Ministry of Health of the Russian FederationKursk State Medical University of the Ministry of Health of the Russian FederationThe problem of the clinical course and principles of treatment for the new coronavirus infection COVID-19 remains the most debated issue. At the same time, reliable prognostic criteria that determine characteristics of the disease course and outcome have not been established. Taking it into consideration, we present clinical cases of COVID-19 in identical twins. Patients A. and S., 39 years old, were admitted to the Regional Clinical Infectious Diseases Hospital. The patients were clinically diagnosed with COVID-19 coronavirus infection, verified, moderate form; bilateral polysegmental pneumonia of moderate severity, 1st degree respiratory failure. The course of COVID-19 coronavirus infection in identical twins markedly differed. Patient A. had peripheral blood lymphocytosis, slightly increased ESR, CRP, ferritin, IL-6, and D-dimer level. A paired twin brother (patient S.) had lymphopenia, ESR accelerated up to 20 mm/h, CRP pronouncedly increased up to 10 mg/ml, IL-6 up to 9,5 pg/ml, and D-dimer up to 750 ng/ml. Condition of the patient A. remained stable, on day 13th of treatment, the patient was discharged from the hospital. The condition of the patient S. on day 3rd of hospitalization deteriorated sharply. Considering the decrease in SpO2 level down to 88%, the damage of the lung parenchyma was more than 70%, resulting in the use of antibacterial drugs, anti-IL-6 monoclonal antibodies as well as selective reversible inhibitor of Janus-kinases 1 and 2. On day 16th of treatment, subjectively, the patient showed an improvement in general condition. During the next two days, the patients condition revealed marked positive dynamics on day 19th of hospital stay, the patient was discharged for rehabilitation. Thus, significant differences in the severity of the course of the new coronavirus infection in identical twins with similar medical history and lack of confounding comorbidities are most likely due to the initial dose of the viral load which was an important factor determining the development and course of infection.https://iimmun.ru/iimm/article/viewFile/1868/1416covid-19identical twinsclinical casecourse featurescovid-19 treatmentmonoclonal antibodies
spellingShingle S. M. Yudina
V. V. Kiseleva
Tatyana S. Rusanova
I. A. Ivanova
Features of the new coronavirus COVID-19 infection in identical twins
Инфекция и иммунитет
covid-19
identical twins
clinical case
course features
covid-19 treatment
monoclonal antibodies
title Features of the new coronavirus COVID-19 infection in identical twins
title_full Features of the new coronavirus COVID-19 infection in identical twins
title_fullStr Features of the new coronavirus COVID-19 infection in identical twins
title_full_unstemmed Features of the new coronavirus COVID-19 infection in identical twins
title_short Features of the new coronavirus COVID-19 infection in identical twins
title_sort features of the new coronavirus covid 19 infection in identical twins
topic covid-19
identical twins
clinical case
course features
covid-19 treatment
monoclonal antibodies
url https://iimmun.ru/iimm/article/viewFile/1868/1416
work_keys_str_mv AT smyudina featuresofthenewcoronaviruscovid19infectioninidenticaltwins
AT vvkiseleva featuresofthenewcoronaviruscovid19infectioninidenticaltwins
AT tatyanasrusanova featuresofthenewcoronaviruscovid19infectioninidenticaltwins
AT iaivanova featuresofthenewcoronaviruscovid19infectioninidenticaltwins