INVESTIGATION OF AUTOPSY MATERIAL IN SEAR CH OF VIRAL ETIOLOGY OF FATAL PNEUMONIAS IN KHABAROVSK IN 2023–2024

Recent years' research demonstrates a shift in the etiology of lower respiratory tract infections from bacterial to viral. Identifying pathogens in post-mortem (autopsy) material can provide a more accurate etiological cause of fatal pneumonias.

Objective: To conduct a comparative analysis of the species composition of viral pathogens identified in autopsy samples from patients of different age groups with fatal outcomes of community-acquired pneumonia in Khabarovsk in 2023-2024.

Materials and Methods: The material for analysis consisted of the results of examining 140 autopsy samples performed in 2023 and 155 samples studied in 2024. The search focused on identifying DNA-RNA of 11 respiratory viral pathogens and four viruses causing opportunistic diseases. The study was conducted using the polymerase chain reaction (PCR) method with reagents from domestic manufacturers.

Results and Discussion. When searching for 11 DNA-RNA respiratory viral pathogens, they were isolated in 46.43% of cases in 2023 (65 DNA-RNA pathogens from 140 samples), and almost twice less frequently in 2024 – in 27.74% of cases (43 DNA-RNA pathogens from 155 samples). A decrease in the frequency of isolation was noted in 2024 for 10 out of 11 respiratory viruses, including a 1.7-fold decrease for SARS-CoV-2 (from 15.71% to 9.03%). Influenza A/H1N1 virus and respiratory syncytial virus were not registered in 2024 (in 2023, their proportions were 7.14% and 3.57%, respectively). The replacement of the departed influenza A/H1N1 virus with influenza A/H3N2 virus was established (from 0.71% in 2023 to 7.74% in 2024). A 1.6-fold decrease in the frequency of detection of the group of viruses causing opportunistic diseases was also noted (from 27.14% in 2023 to 16.77% in 2024). In 2024, among individuals with fatal outcomes, the most vulnerable to viral pathogens were the younger age group (0 to 2 years) and individuals over 60 years old. Among infants aged 0-2 years, the highest total detection rate of viral pathogens was observed (78.57%) with the isolation of 7 types of viruses, including influenza A/H3N2, rhinovirus (7.14% each), SARSCoV-2, seasonal coronaviruses (3.57% each), as well as opportunistic disease viruses (cytomegalovirus, human herpesvirus 6, and Epstein-Barr virus – 57.15%). In individuals over 60 years old, the total proportion of detected viral pathogens was 34.15% with the isolation of 8 types of viruses. In this age group, the highest frequency of isolation of influenza A/H3N2 and SARS-CoV-2 viruses was noted (12.2% each).

Conclusion. The research results justify the need for continued monitoring of viral agents of fatal pneumonia.

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