ABSTRACT
Relevance. Elderly people have become the fastest growing segment of the global population over the past few decades. The number of people over the working age in Russia, and with them citizens living in closed long-term care facilities (CLTFS), is growing. Residents of these organizations belong to the risk group, and CLTFS have a number of characteristics that turn these institutions into a unique environment for the spread of infectious diseases. Aims. To analyze the CLTFS residents infectious morbidity in the "pre-covid stage" (according to literature sources). A scientific review of research in Russian and English using information portals and platforms has been carried out eLIBRARY.ru, Web of Science, PubMed, Google Academy and Scopus for the period 1981-2022. The search was carried out by keywords. Information about the most frequent infectious diseases affecting residents of closed long-term care institutions was the criterion for inclusion in the sample of publications. Out of 16171 initially identified articles, 61 publications were selected after initial analysis. Conclusions. According to various estimates, the leading infectious diseases in CLTFS were: acute respiratory infections, pneumonia, urinary tract infections, skin and mucous infections, acute intestinal infections. The article describes pathogens and their prevalence in CLTFS including pathogens with multiple drug resistance (MDR), describes the resistance of bacteria to antimicrobial drugs formation problem in these organizations, as well as development of certain diseases risk factors. Studies conducted in various CLTFS in Europe, Russia, the USA, and Asia indicate a high prevalence of infectious diseases among their residents, high colonization of residents with antimicrobial-resistant pathogens, as well as the infection transmission probability from the CLTFS and its spread to other long-term care institutions and medical and preventive organizations. © 2023, Numikom. All rights reserved.
ABSTRACT
Infectious diseases, due to their epidemic potential, are capable of global spread, they are unpredictable, and their effective control is possible only on a planetary scale. In no other field of medicine, such radical and often unpredictable changes occur in a short time in the form of the elimination of individual diseases, the identification of a large number of previously unknown and the return of already forgotten diseases, a significant change in the pathogenesis and clinical symptoms of a significant number of them. Under these conditions, these changes often create problems for the health authorities and the public, ahead of their ability to recognize and respond in a timely manner to the emergence of epidemics and the transformation of pathological manifestations. Significant recent scientific progress has only slightly clarified our knowledge of the biological and genetic diversity of pathogens. Until now, the entire spectrum of infectious pathology remains unclear, and its numerous manifestations often take even experienced specialists by surprise. Evidence of our limited knowledge and ability to control the situation is the ongoing COVID-19 pandemic for three years now, the increasingly frequent detection of "new" infections, the return of infections declared defeated, evidence of the role of infectious factors in the etiology of many other human diseases.Copyright © 2023 Izdatel'stvo Meditsina. All rights reserved.
ABSTRACT
Infectious diseases, due to their epidemic potential, are capable of global spread, they are unpredictable, and their effective control is possible only on a planetary scale. In no other field of medicine, such radical and often unpredictable changes occur in a short time in the form of the elimination of individual diseases, the identification of a large number of previously unknown and the return of already forgotten diseases, a significant change in the pathogenesis and clinical symptoms of a significant number of them. Under these conditions, these changes often create problems for the health authorities and the public, ahead of their ability to recognize and respond in a timely manner to the emergence of epidemics and the transformation of pathological manifestations. Significant recent scientific progress has only slightly clarified our knowledge of the biological and genetic diversity of pathogens. Until now, the entire spectrum of infectious pathology remains unclear, and its numerous manifestations often take even experienced specialists by surprise. Evidence of our limited knowledge and ability to control the situation is the ongoing COVID-19 pandemic for three years now, the increasingly frequent detection of "new" infections, the return of infections declared defeated, evidence of the role of infectious factors in the etiology of many other human diseases.Copyright © 2023 Izdatel'stvo Meditsina. All rights reserved.
ABSTRACT
Background: Residents of long-term care facilities are at higher risk of the severe course and outcomes of COVID-19. Objective: To describe the epidemiological situation and risk factors for severe COVID-19 in nursing homes in the world and Russia. Materials and methods: We reviewed Russian and English-language papers published in March 2020 to October 2022 and found in such resources as eLIBRARY.ru, Web of Science, PubMed, Google Academy, and Scopus using the following keywords: long-term care facilities, nursing homes, COVID-19 morbidity in nursing homes, COVID-19 mortality in nursing homes, and COVID-19 risk factors in nursing homes. Availability of information on morbidity and mortality among residents and employees of long-term care facilities in Russia, Europe and the USA and about the risk factors for severe course and adverse outcomes of COVID-19 was the inclusion criterion. Of 1,013 articles initially identified, 40 publications were included in the review. Results: The analysis of the worldwide epidemiological situation has shown that COVID-19 incidence and mortality rates in nursing homes fluctuate, and, as of October 2022, cases of the disease among residents, including multiple cases within a facility, were still registered. In most countries, the highest incidence of COVID-19 in long-term care facilities was observed in January – March 2022, while the lowest was noted in May – July 2021. The number of deaths has decreased significantly over time and remains low. Risk factors for a severe course and death from the novel coronavirus disease include age, male sex, and concomitant diseases. We established, however, that disease severity was also affected by the staff-to-resident ratio, availability of paid sick leave of the personnel, patient isolation opportunities, division of the working area, type of ownership (private), and COVID-19 incidence rates in the local community. Conclusion: We have analyzed the epidemiological situation and risk factors for severe COVID-19 in long-term care facilities at the national and global levels. As of October 2022, the novel coronavirus disease remains a challenge for nursing facilities. The severity of the infection is influenced by personal characteristics of patients and external factors related to the residential care facility. © 2023.
ABSTRACT
Over the two years of the novel coronavirus infection (COVID-19) pandemic, there has been an evolution of views in various fields of medicine, which has led to a powerful development of scientific research in the field of epidemiology, clinic, diagnosis and therapy of COVID-19. This article discusses the evolution of views and approaches to the study of the clinic and therapy of COVID-19. The symptoms and aggravation of the course of cardiovascular diseases with COVID-19 have been established. The main strategy for organizing surgical care for patients with COVID-19 is indicated. The main criteria for the treatment of COVID-19, the need to prescribe SGCS on an individual basis, and the need to search for new methods of anti-inflammatory therapy for COVID-19, one of which may be the use of alkylating drugs in ultra-low doses, are described. Copyright © 2022 Izdatel'stvo Meditsina. All rights reserved.
ABSTRACT
Background. The COVID-19 pandemic has exposed health problems, but at the same time has become a powerful impetus for the development of new scientific research in the field of epidemiology, clinic of infectious diseases, diagnostics, bioinformatics and digital methods. On the basis of the Central Research Institute of Epidemiology of Rospotrebnadzor, new unique test systems for the detection of SARS-CoV-2 RNA based on real-time PCR based on loop isothermal amplification (IT) technology have been developed, which allows you to examine samples 3-4 times faster than those developed previously. The Central Research Institute of Epidemiology of Rospotrebnadzor has developed and put into operation the Russian Platform for Aggregation of Information on Virus Genomes (VGARus). The VGARus database contains information about the nucleotide sequences of the SARS-CoV-2 viruses and their mutations, and the SOLAR Integration Platform has been created to quickly transfer the results of PCR studies to all interested citizens of the Russian Federation. Aims - to study the manifestations of the epidemic process of COVID-19 and the prevalence of genovariants of the SARS-CoV-2 virus in the Russian Federation. Methods. A retrospective epidemiological analysis of the incidence of COVID-19 was carried out from March 30, 2020 to May 17, 2022 in the Russian Federation. The database was formed on the basis of the materials of the Rospotrebnadzor report form No. 970 "Information on cases of infectious diseases in persons with suspected new coronavirus infection", data from the WHO, the domestic information portal Stopkoronavirus.rf and the Yandex DataLens data visualization and analysis service were used, information on SARS-CoV-2 genovariants in the VGARus database. Results. When analyzing the manifestations of the COVID-19 epidemic process in the Russian Federation for 2020-2022. Two stages have been identified. The first stage was characterized by the rapid spread of the SARS-CoV-2 virus from megacities to other regions of the country and the use of non-specific prevention measures. The beginning of the second was due to the evolution of the SARS-CoV-2 virus and a change in its biological properties, followed by a change in the prevailing genovariants on the territory of the Russian Federation. Conclusion. As a result of the study, it was found that with each subsequent increase in the incidence of COVID-19, there was a decrease in the severity of the course and the proportion of pneumonia in the structure of the clinical forms of the disease. Copyright © 2022 Izdatel'stvo Meditsina. All rights reserved.
ABSTRACT
Objective. Of particular interest is the incidence of COVID-19 in closed groups, in institutions, in particular, in nursing homes, geriatric centers, veterans' homes and neuropsychiatric boarding schools. Methods. Analysis and description of COVID-19 foci in closed long-term care facilities was carried out using literature sources from the MEDLINE medical information database using the PubMed electronic search engine, using the search query CARE HOME OR NURSING HOME OR LONG-TERM CARE FACILITY AND COVID-19 AND OUTBREAK. The share of sick people as a percentage of the total number of residents and individual employees was considered only in those publications that described the outbreak of COVID-19 in a single institution. The absence of data on the number of hospitalizations and deaths, symptoms, and data on the time frame of the outbreak was not an exclusion criterion, but their presence was taken into account in the analysis. We selected mainly publications where people with a positive PCR test for SARS-CoV-2 RNA were considered to be ill with COVID-19. However, it is worth considering that the authors describe outbreaks during the first rise in the incidence of COVID-19 in the world, when there was a shortage of test systems for a new coronavirus infection. Results. An overview of the incidence of COVID-19 in the world in closed long-term care institutions is presented. It has been shown that residents of closed communities are elderly people with many concomitant diseases, in connection with which a severe course of COVID-19 and high mortality are often noted. Conclusion. Convictions about the need to strengthen the quality of anti-epidemic measures in closed long-term care institutions, which are at risk, are summarized. © Akimkin VG, et al.
ABSTRACT
Background. The ongoing pandemic of the novel coronavirus infection (COVID-19) draws attention to the significance of molecular and genetic monitoring of the SARS-CoV-2 spread among the population of the Russian Federation. The aim of the study was to analyze the dynamics of circulation of SARS-CoV-2 genetic variants in Russia. Materials and methods. The analysis of the circulation dynamics for SARS-CoV-2 genetic variants in Russia was carried out, covering the period from 28/12/2020 to 26/6/2022. The analysis included the data from Rospotrebnadzor Report No. 970 "Information about Infectious Diseases in Individuals with Suspected Novel Coronavirus Infection" and the Virus Genome Aggregator of Russia (VGARus). The presence of SARS-CoV-2 RNA was confirmed by the real-time reverse transcription polymerase chain reaction. The primer panels developed at the Central Research Institute of Epidemiology were used for amplification of genomic fragments and the subsequent sequencing. Results and discussion. Using the Russian VGARus platform developed by the Central Research Institute of Epidemiology, we received the data on mutational variability of SARS-CoV-2. By monitoring the circulation of SARS-CoV-2 genetic variants in Russia from 28/12/2020 to 26/6/2022, we found that Delta and Omicron genetic variants prevailed at different stages of the epidemic. Conclusion. The data of molecular and genetic studies are an essential component of epidemiological surveillance, being critically important for making executive decisions aimed at prevention of further spread of SARS-CoV-2 and laying the groundwork for creating new vaccines. © 2022, Central Research Institute for Epidemiology. All rights reserved.
ABSTRACT
Over the two years of the novel coronavirus infection (COVID-19) pandemic, there has been an evolution of views in various fields of medicine, which has led to a powerful development of scientific research in the field of epidemiology, clinic, diagnosis and therapy of COVID-19. The article highlights the evolution of views and approaches to the study of the epidemiology and radiology of COVID-19. The data of molecular genetic studies are shown, which are the most important component of epidemiological surveillance. The study of the manifestations of the COVID-19 epidemic process made it possible to distinguish two stages in the development of the epidemiological situation in the Russian Federation. At the first stage of the epidemic, two rises in the incidence rate of the population were recorded, regulated by social and natural factors. The second stage of the epidemic was due to a change in the biological properties of the SARS-CoV-2 virus, followed by a change in the prevailing genovariants (Alpha, Delta and Omicron). At the second stage of the epidemic, three rises in the incidence of the population were recorded. The general principles for the use of radiodiagnosis methods, which are used primarily to detect lung damage in COVID-19, are given. With the accumulation of experience, a natural change in ideas about the algorithms for the use of visualization technologies has occurred. Copyright © 2022 Izdatel'stvo Meditsina. All rights reserved.
ABSTRACT
Annualy, SARS occupy a leading position in terms of morbidity and the magnitude of the economic damage caused both in the world and in the Russian Federation. Currently, the most widespread pandemics are caused by the influenza A (H1N1) pdm09 virus and the new SARS-CoV-2 coronavirus, which occupy a common ecological niche and require studying the manifestations of the epidemic process of ARVI for further development of measures to improve epidemiological surveillance of this group of infections. Aim of the study was to investigate the current manifestations of the epidemic process of ARVI and influenza, including in the context of a new coronavirus infection (COVID–19) pandemic, on the territory of Russia and in Moscow. Materials and methods. The assessment of the long-term dynamics of the incidence of ARVI and influenza (from 1999 to 2021), as well as its age structure in the territory of the Russian Federation and in Moscow, was carried out. The main sources of information were: WHO: «The situation with COVID-19 in the European region», the domestic information portal Stopkoronavirus.rf, as well as data from Federal State Statistical Observation forms No. 2 and No. 6. Results. During the period 2013–2019, a strong positive correlation was revealed between the incidence rates of ARVI in the Russian Federation and Moscow (p = 0.8, with p < 0.05), which became negative with the spread of SARS-CoV-2: in the country, the incidence rate of ARVI increased by 11.5% in 2020 and 15.6% in 2021., in Moscow there was a decrease of 45.1% than the average in Russia, which could be due to the quality of differential diagnosis of ARVI and COVID-19. In 2021 the incidence rate of influenza decreased by more than 2 times in all Federal Districts of the country, with the exception of the capital region, where it became the maximum-65.9 per 100 thousand population in 2021 (against 14.1 in 2019). In the age structure of influenza incidence, as well as ARVI, for the period from 2019 to 2021. the child population prevailed with the highest rates in the age groups of 1–2 years and 3–6 years. As the circulation of SARS-Cov-2 decreased to 15–19%, the activity of influenza viruses and other pathogens of the ARVI group increased (from 0.7–3.0% during the developed pandemic to 5.6–6.6% at the stage of its decline), which indicates a pronounced interference of pathogens detected at the global level in the system of Global Hospital Surveillance for flu. Conclusion. The forecast for the upcoming epidemic season 2022–2023 largely depends on the spread of the new coronavirus SARS-CoV-2, as well as its variability and the emergence of new variants. Nevertheless, there may be a significant increase in the incidence caused by the influenza A(H1N1)pdm09 virus, whose high activity was recorded in the current epidemic season in a number of countries in the Southern hemisphere. © 2022, Numikom. All rights reserved.
ABSTRACT
New coronavirus infection (COVID-19) is highly contagious viral disease caused by SARS-CoV-2 leading to the pandemic. The autopsy of COVID-19 patients often showed features of previous brain diseases including neurodegeneration, previous strokes, demyelinating diseases and atherosclerosis. Patients with acute cerebrovascular accidents and severe COVID-19 had higher numbers of lethality in comparison to non-severe course of infection without cerebrovascular accidents. A comparative analysis of morphological changes in lungs of deceased patients who died in different periods of first clinical symptoms is to be conducted. Objective. Description of pathomorphological changes in deceased patients during the period of reconvalescence. Patients and methods. The analysis of 15 fatal cases which took place in Botkin Hospital with the diagnosis of ischemic stroke and new coronavirus infection in the previous 2-4 months has been held. Macro and microscope examination of brain, lungs, brachiocephalic arteries, kidneys and liver has been carried out. Results. All patients had morphological features of ischemic damage of grey matter in the brain. Beside necrosis of neurocytes with diffuse infiltration in the grey matter, hematoxylin cycles were found, in some cases they were placed in a perivascular way in choroid plexus. Also 5 patients suffered a myocardial infarction up to 3 days. 10 patients had structures disorganisation in areas of lung parenchyma with hystoacrchitectonic changes because of the fibrosis. Alveoli in some places collaborated mostly with single airway clearance. The fact that most patients had lung hemosiderosis can prove coronavirus infection suffered earlier with microcirculatory bed damage. Conclusion. Thus, morphological changes seen in the period of reconvalescence of COVID-19 is a result of pathomorphosis of changes described earlier for acute period of coronavirus infection and affect not only lungs, but also other organs and tissues. This proves systematic characteristic of the infection.
ABSTRACT
This article presents the results of scientific research on the epidemiological features of the new coronavirus infection (COVID-19) and the molecular genetic characteristics of SARS-CoV-2 virus genovariants, based on the experience of the Central Research Institute of Epidemiology of the Federal Service for Oversight of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor).
ABSTRACT
Background. The ongoing pandemic of a new coronavirus infection (COVID-19) determines the relevance of the analysis of epidemiological patterns of SARS-CoV-2 spread among the population of the Russian Federation. Aim — study of the manifestations of the epidemic process of COVID-19 in the Russian Federation in 2020–2022. Materials and methods. A retrospective epidemiological analysis of the incidence of COVID-19 in the Russian Federation was carried out from 03/30/2020 to 04/24/2022. The data from the Rospotrebnadzor report No. 970 “Information on cases of infectious diseases in persons with suspected new coronavirus infection”, information portal Stopcoronavirus.rf, etc. were used. The presence of SARS-CoV-2 RNA was confirmed by real-time RT-PCR. Results and discussion. The analysis of the manifestations of the epidemic process of COVID-19 in the Russian Federation in 2020–2022 showed the presence of two stages which differed depending on the influence of the biological factor and the ongoing anti-epidemic measures. There was a pronounced trend in the development of the epidemic process, starting from megacities (Moscow, Moscow region and St. Petersburg), which are major transport hubs and centers of migration activity of the population, to the regions of the Russian Federation. The SARS-CoV-2 pathogenicity has been shown to decrease with each subsequent cycle of the rise in the incidence of COVID-19 against the background of the increased contagiousness of the virus. Conclusion. As a result of the study, risk areas (megacities) and risk groups were identified. © 2022, Central Research Institute for Epidemiology. All rights reserved.
ABSTRACT
SARS-CoV-2 is the cause of COVID-19, which has a serious effect on the lower respiratory system. COVID-19 causes bilateral pneumonia and acute respiratory syndrome. Smell disorders are important diagnostic symptoms of COVID-19. This symptom is detected in about 90 % of cases. Anosmia may be the first or even the only symptom and may appear before other symptoms of SARS-CoV-2 infection. In the context of the COVID-19 epidemic, anosmia can be considered a clinical diagnostic criterion when laboratory tests are not available. The sense of smell is one of the most important senses needed to gain information about the environment. Anosmia can occur in both COVID-19 and allergic rhinitis (AR), which can make it difficult to detect the origin of these symptoms and make a diagnosis in the context of the COVID-19 pandemic. Research results indicate AR is not an aggravating factor for COVID-19. Comorbidity of AR does not affect the reduction of the sense of smell in patients with COVID-19. Patients with AR are recommended to use antihistamines and intranasal corticosteroids for relief of symptoms. Control of AR symptoms can help prevent the spread of SARS-CoV-2 infection. It can be assumed that both local and oral corticosteroids at COVID-19 can be regarded as effective in the treatment of olfactory dysfunction. To restore the sense of smell in patients with AR and COVID-19, experts recommend regular olfactory training, which, at the moment, is the only modern scientifically based therapy for restoring post-viral loss of smell. The use of face masks and respirators during a pandemic aims to minimize exposure to allergens and the SARS-CoV-2 virus. However, prolonged wearing of masks and respirators makes breathing even more difficult with rhinitis caused by AR or COVID-19, which reduces the quality of life and worsens the clinical picture.
ABSTRACT
Infectious diseases caused by fungi (mycoses) are one of the significant problems of modern medicine Worldwide, more than 300 million people suffer from severe and chronic mycoses, 25 million patients are at risk of disability or death. Due to changes in treatment strategies and the wider use of antifungal prevention in recent years, the epidemiology of fungal infections has changed and has become particularly relevant due to a significant increase in cases of invasive mycoses. Deep, visceral mycoses, sometimes associated with HIV infection, oncohematological pathology, organ transplantation, nursing of newborns, have become more frequent, while the role of fungi that were previously considered apatogenic increases. In the context of the COVID-19 pandemic, risk factors for these infections continue to increase, and therefore it is likely that the incidence of fungal infections, including those associated as nosocomial, will increase in the coming years. The increasing role of fungi in the etiology of hospital infections, the introduction into clinical practice of a significant number of new drugs was inevitably accompanied by the formation of resistance of fungi to antimycotics. According to literature data, the rate of emergence of pathogenic fungi resistant to a limited number of widely used antifungal agents is unprecedented. Thus, in modern conditions associated with the increase in resistance of pathogenic fungi, the key measures should be aimed at developing optimal strategies for containing resistance to antifungal drugs.
ABSTRACT
During the COVID-19 pandemic, many infection foci were registered in dormitories. Therefore, it is critical to have a clear understanding of the effectiveness of antiepidemic measures (AEMs) that appear to be one of the most important method to prevent the spread of the virus. Objective. To provide a scientific rationale for AEMs used to prevent the spread of COVID-19 in dormitories. Materials and methods. We compared the epidemic process in 5 representative COVID-19 foci, depending on AEMs initiated at these foci. The t-test was used to check the statistical hypothesis (p ≤ 0.05). Results. The epidemiological analysis demonstrated that the severity of COVID-19 epidemic process correlated with the effectiveness of AEMs. Absence of AEMs during focus formation promoted rapid spread of the virus among residents on all floors of the dormitory. The epidemic process in these dormitories was characterized by a chronic course with a high incidence rate. The implementation of a complex of AEMs when first COVID-19 cases were registered prevented the formation of a large infection focus and facilitated its timely isolation. Conclusion. Our findings suggest that AEMs are the main measures to limit focal incidence of COVID-19 in the dormitories of Moscow.
ABSTRACT
The paper presents an original method for solving the problem of finding a connection between the course of the epidemic and socio-economic, demographic and climatic factors. The method was applied to solve this problem for 110 countries of the world using a set of corresponding curves of the COVID-19 growth rate for the period from January 2020 to August 2021. Hierarchical agglomerative clustering was applied. Four large clusters with uniform curves were identified – 11, 39, 17 and 13 countries, respectively. Another 30 countries were not included in any cluster. Using machine learning methods, we identified the differences in socio-economic, demographic and geographical and climatic indicators in the selected clusters of countries of the world. The most important indicators by which the clusters differ from each other are amplitude of temperatures throughout the year, high-tech exports, Gini coefficient, size of the urban population and the general population, index of net barter terms of trade, population growth, average January tempera-ture, territory (land area), number of deaths due to natural disasters, birth rate, coastline length, oil reserves, population in urban agglomerations with a population of more than 1 million etc. This approach (the use of clustering in combination with classification by methods of logical-statistical analysis) has not been used by anyone before. The found patterns will make it possible to more accurately predict the epidemiological process in countries belonging to different clusters. Sup-plementing this approach with autoregressive models will automate the forecast and improve its accuracy. © 2022, The Belarusian State University. All rights reserved.
ABSTRACT
INTRODUCTION: Currently, a significant number of patients with COVID-19 require inpatient treatment. At the same time, predictors of hospitalization are still stable, including in persons with concomitant pathology. AIM: Assessment of factors affecting the probability of hospitalization of COVID-19 patients with concomitant pathology and the development of a prognostic model based on them. MATERIALS AND METHODS: An observational retrospective cohort study of 74 314 patients with COVID-19 with various comorbidities was carried out in the period from March to November 2020 in the Russian Federation. RESULTS: Based on 16 factors, including age, gender, place of diagnosis, fever, rhinitis, loss of taste, shortness of breath, concomitant diseases of the cardiovascular, bronchopulmonary system, oncological, endocrine diseases in patients included in the study, a prognostic model was developed. The need for inpatient treatment of patients with COVID-19 and comorbidities was determined. CONCLUSION: The constructed predictive model has demonstrated sufficient efficiency to assess the likelihood of hospitalization of patients with COVID-19 by medical specialists.
Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/therapy , SARS-CoV-2 , Prognosis , Retrospective Studies , Hospitalization , Risk FactorsABSTRACT
Relevance. The COVID-19 pandemic is still making adjustments to the modern realities of both healthcare and society as a whole. The incidence of COVID-19 in children and adolescents is becoming more and more urgent. At the end of January 2022, in Moscow, the number of registered cases of SARS-CoV-2 infection in minors increased 14 times (from 2,000 to 28,000), and the number of hospitalizations increased 10 times, to 120 people per day. During the pandemic, local outbreaks of COVID-19 remain relevant, especially in organized groups. Aim. Description of a local outbreak of COVID-19 in an organized educational group of common residence, preventive measures and characteristics of the infection. Materials and methods. The results of the examination of the focus of COVID-19, medical records of hospitalized patients, regulatory documents, and literary sources were used. A descriptive epidemiological method was used. Statistical data processing was not carried out due to the small sample size. Results. In the spring of 2021, an outbreak of COVID-19 was registered in one specialized educational and methodological center in Moscow with ten victims. The center is located in a five-story brick building designed for the teaching and living of pupils. When registering the first case of COVID-19 in a specialized educational and methodological center, an operating mode was established on the principle of an observatory. Nine children were hospitalized and one teenager was treated for scrap in Moscow. All hospitalized patients underwent computed tomography of the chest organs, no changes in the lungs were noted, which is a significant difference compared to adults, in whom in most cases the SARS-Cov-2 virus enters the lungs. All patients in the hospital received antiviral therapy (Umifenovir 200 mg orally 4 times a day, 5 days), decongestants, local antiseptics, antihistamines were used according to indications. At discharge, all adolescents had positive results for COVID-19 according to the results of PCR swabs from the nasopharynx and oropharynx, and therefore, with an improvement in their general condition, they were transferred for further observation to the observational rehabilitation center COVID-19 «Krylatskiye kholmy». Conclusions. Living in communal dormitories and learning at the place of residence involves close contacts at home and during classes, which predetermines a high risk of infection with the SARS-Cov-2 virus and the occurrence of foci. Promptly carried out anti-epidemic measures make it possible to interrupt the chain of infections in the outbreak. Compared to adults, adolescents experienced fewer and less severe symptoms of COVID-19. Although in most cases, children do not get severely ill from COVID-19 as adults, they can play an important role in the transmission of the infection and in the formation of its outbreak. © Mazankova LN, et al.
ABSTRACT
Objective. To analyze clinical and laboratory characteristics of COVID-19 in children with comorbidities admitted to the intensive care unit (ICU). Patients and methods. This study included 155 infants/children aged 1 month to 18 years with confirmed COVID-19 who were admitted to the ICU No. 2 of Z.A. Bashlyaeva Children's City Clinical Hospital, Moscow Healthcare Department between March 2020 and June 2021. The diagnosis was confirmed by epidemiological, clinical, and laboratory data. Results. Thirty-six out of 155 patients admitted to the ICU (23.2 ± 3.4%) had no comorbidities. Comorbidities were detected in 119 children (76.8±3.4%) with severe COVID-19, which manifested as multisystem inflammatory syndrome in children (MIS-C) (n = 16;13.4 ± 2.7%), CT 1-2 pneumonia (n = 25;21 ± 3.3%), CT 2-3 pneumonia (n = 7;5.9 ± 1.9%), and CT 3-4 pneumonia (n = 19;16 ± 3.0%). Viral pneumonia with MIS-C was observed in 10 children (8.4 ± 2.2%). Six patients (3.9 ± 1.6%) were diagnosed with generalized bacterial infection, which aggravated the course of COVID-19. Conclusion. A total of 76.8% of children in our study were found to have some comorbidities, which is a risk factor for severe COVID-19. The most common comorbidities included nervous system diseases, metabolic disorders (such as obesity), concomitant infectious diseases, etc. So far, the information on the effects of different comorbidities on the course of COVID-19 in children is limited, which necessitated the analysis of COVID-19 course in this cohort of patients.