Assessing the effectiveness of screening for malignant neoplasms during the COVID-19 epidemic

Medical checkups are a systemic preventive measure aimed at identifying chronic non-communicable diseases and their risk factors contributing to premature mortality in our country. One of the most important tasks of the checkups is screening to detect malignant neoplasms (MN). Unfortunately, preliminary analysis has shown that one of the typical problems in the activities of primary healthcare organizations is the lack of developed schemes of patient routing as part of cancer screening at the level of both the constituent entities of the Russian Federation and individual healthcare organizations. Objective. To evaluate the screening effectiveness in the Chuvash Republic, Moscow and Sakhalin regions in primary detection of cervix, colorectal, and breast cancer. Material and methods. We used data obtained from Statistical Reporting Form No. 12 "Information on the Number of Diseases Reg-istered in Patients Residing in the Service Area of a Healthcare Organization", Branch Statistical Reporting Form No. 131/o for 2019, 2020, 2021 and the first half of 2022 in the Chuvash Republic, Moscow and Sakhalin regions. Regional legal acts regulating the routing of patients for preventive activities were analyzed. Results. In the studied constituent entities of the Russian Federation, there was a decrease in the proportion of newly diagnosed cancers both in general and during the COVID-19 pandemic. The most significant decrease (14.1%) was observed between 2019 and 2020 in the Sakhalin region. Analysis of healthcare-related regulatory acts of executive authorities of three constituent entities of the Russian Federation, regulating the organization of medical care to the adult population for cancer diseases in health-care organizations, showed their compliance with the Medical Care Procedure to the adult population for cancer diseases, and also revealed some defects hampering accurate statistical records of the revealed diseases. Conclusion. The suspension of routine medical care in the studied subjects of the Russian Federation in connection with the COVID-19 pandemic significantly affected the initial detection of malignant neoplasms. Copyright © L.YU. DROZDOVA, E.S. IVANOVA, V.A. EGOROV, YU.S. RAKOVSKAYA.

Increasing Population Adherence to Vaccination: Evaluation and a Systematic Approach to Implementation

Relevance. The problem of vaccine hesitancy is becoming even more urgent in the light of the coronavirus pandemic, which acted as an impetus for increasing public skepticism about vaccination. In 2019, the WHO declared vaccine hesitancy as one of the global health threats. Aims. The purpose of the research is a comprehensive analysis of the factors that cause vaccine hesitancy in Russian Federation, followed by recommendations for increasing population adherence to vaccination. Materials & Methods. Statistical, factual analysis of the research objects, as well as a qualitative and quantitative analysis of open sources data carried out. The main sources of information were anti-vaccination messages on social networks and the media, information from anti-vaccination communities on Vkontakte, official websites and social networks of relevant federal executive authorities of the Russian Federation. Results. Communication space. Social networks are the main source of dissemination of false information about vaccination. The most active platforms for the dissemination of anti-vaccination messages on social networks are Odnoklassniki and Vkontakte. Semantic analysis. Anti-vaccination rhetoric on Facebook, Instagram, Vkontakte, Odnoklassniki, Telegram, Twitter, Tik Tok, You Tube, Live Journal, the media, and forums is generally similar. As the object of anti-vaccination rhetoric, the words “vaccines”, “vaccination”, “vaccinations” most often appear in posts. Such rhetoric is more directed towards childhood vaccinations. The target audience of anti-vaccination propaganda is parents. The target audience. The sample of the target audience of the doubting population, compiled on the basis of social network Vkontakte users, amounted to 90,937 people. A significant part of the doubting population is represented by women (85%). As a result, the average age of target audience representative is 35.4 years. Major part of the audience is married – 83.1% of the total sample. Almost a third (24.1%) of the Russian audience of the anti-vaccination movement are residents of the Central Federal District. Influence groups. The activity of key influence groups members is characterized by a high level of cohesion within the anti-vaccination movement, which is manifested in mutual reposts of information, joint actions, live broadcasts and announcing the events of “comrades-in-arms”. Among the main motives for participating in the anti-vaccination movement are commercial interests in promoting services and products that are alternative to vaccination, as well as attracting the attention of the audience. It is important to note that the most active representatives of the anti-vaccination movement, for the most part, do not have a medical education. Measures to increase adherence. The state policy in relation to increasing the population adherence to population, as well as the activities of the pro-vaccination movement representatives, play an important role in strengthening the public's confidence in immunization. As part of increasing adherence to vaccination, a wide range of methods and means of informational impact on citizens is used-separate information portals, social networking, face-to-face educational events, special projects, organization of hotlines on vaccine prevention. Conclusions. Solving the problem of vaccine hesitancy under the influence of the anti-vaccination movement activities, rhetoric in the media and social networks, distrust of the state and the healthcare system, and personal perception of vaccination risks require an integrated approach to organizing measures for increasing adherence at the federal and regional levels. The immunization system development should be carried out by changing the regulatory legal framework in order to effectively implement such activities at all levels of the country's health care system. © 2022, Numikom. All rights reserved.

Public commitment to the implementation of recommendations to limit the spread of new coronavirus infection in the Russian Federation in the autumn-winter period 2020—2021

The most important measure to reduce the negative impact of the COVID-19 pandemic is the implementation of recommendations aimed at reducing the transmission of the virus, such as adherence to the self-isolation regime for certain groups of the population, social distance, the use of protective face masks, gloves, reducing the number of visits to public places, public transport, etc. Purpose of the study. Evaluate adherence to compliance with recommendations to limit the spread of new coronavirus infection in Russia and certain regions in the autumn-winter period of 2020—2021 based on an online survey. Material and methods. National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of Russia from November 2020 to February 2021 conducted an all-Russian online survey «Study of the impact of restrictions due to COVID-19 on the lifestyle of the population». Participants are adult Russians aged 18 and over. Results. The survey involved 5537 people from 62 regions of Russia. The largest number of respondents was from Moscow (n=1157), Ulyanovsk Oblast (n=735), Irkutsk Oblast (n=595), Omsk Oblast (n=452) and the Komi Republic (n=408). The average age of the respondents was 40.7±12.2 years. As measures to limit the spread of the new coronavirus infection, 97.3% of respondents used masks, 87.3% — often washed their hands, 71.1% — observed social distance, the least common measure (42.9%) was the use of gloves. Respondents with higher or incomplete higher education were more likely to follow the recommended COVID-19 prevention measures, with the exception of the use of gloves (n=11 257, 38.9%). Certain regional differences in adherence to the recommended measures were identified, which could be due to the peculiarities of the epidemiological situation and the imposed restrictions. Conclusion. In the whole country and in a number of regions in the autumn-winter period 2020—2021 there is a high commitment to adherence to preventive measures aimed at limiting the spread of COVID-19, but regional differences exist. © 2022, Media Sphera Publishing Group. All rights reserved.

The outpatient medical care in patients with chronic diseases under dispensary supervision in the conditions of the COVID19 pandemic. Temporary guidelines. Version 2

The aim of these guidelines is to provide primary care physicians with scientifically based algorithms for the implementation of dispensary monitoring in patients with chronic noncommunicable diseases in the conditions of the new coronavirus infection (COVID19) pandemic, including the use of telemedicine technologies. The organization and conduct of highquality medical followup are the most important tasks aimed at both reducing the risks of developing complications of chronic noncommunicable diseases and reducing overall mortality, especially in the current conditions of the COVID19 pandemic. The guidelines contain clinical aspects of dispensary followup, general principles of tactics for managing patients with various chronic noncommunicable diseases in COVID19 conditions, in addition, brief checklists with options for interviewing patients with various chronic noncommunicable diseases are presented, topical aspects of the interaction of drugs used in the treatment of chronic noncommunicable diseases with antiviral drugs are considered. The guidelines are intended for general practitioners, district therapists, general practitioners (family doctors), as well as doctors of other specialties providing primary health care. © 2022 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved.

Restrictive measures during COVID-19 pandemic and sleep quality in spring 2020: Russian national online survey of the Russian population in spring 2020

Introduction: Good sleep is an important determinant of health. Poor sleep quality is associated with poor health outcomes. Restrictive measures introduced due to the COVID-19 pandemic in the spring 2020 have led to unprecedented changes in human lives worldwide warranting research on different aspects of the influence of restrictive measures on human health and behavior. Aim: To study associations between the restrictive measures during COVID-19 pandemic and sleep characteristics in Russia. Moreover, we studied factors associated with changes in sleep patterns.

ОГРАНИЧИТЕЛЬНЫЕ МЕРЫ ВО ВРЕМЯ ПАНДЕМИИ COVID-19 И КАЧЕСТВО СНА: ОНЛАЙН-ОПРОС НАСЕЛЕНИЯ РОССИИ ВЕСНОЙ 2020 ГОДА

Введение: Сон - важный компонент образа жизни, низкое качеÑ

SARS-CoV-2 infection in kidney transplant recipients

The study aimed to assess the clinical course and risk factors for adverse outcomes, as well as the treatment options for COVID-19 in renal transplant recipient (RTR). Patients and methods: a retrospective study included 279 RTRs (M 60.9%, age 49.9±10.9 years), infected with SARS-CoV-2 from 01.04.2020 to 30.11.2020. After confirmation of COVID-19 by PCR and chest CT, MMF/Aza were canceled. In severe cases, the CNI dose was minimized while that of CS was increased. Observation endpoints: hospital discharge/recovery or death. Results: SARS-CoV-2 was identified in 84.2% of RTRs. In almost 90% of patients, the COVID-19 was confirmed by CT data. Duration after transplantation at the time of infection was 54.0 (14.0;108.0) months, in 17.6% of cases it was 6 months or less. 223/79.9% RTRs were treated in the hospital. The period from the onset of the disease to the hospitalization was 6.8±4.5 days. Severe lung damage (>50%) occurred in 43.1% RTRs;45.3% of patients required respiratory support. Hospital mortality was 13.9%, overall mortality was 11.1%. The most common cause of death (93.5%) was acute respiratory distress syndrome (ARDS). The risk factors associated with an unfavorable outcome were a high comorbidity index, the severity of the pulmonary lesion, the degree of graft dysfunction at the onset of the disease, decreased SpO2 and the use of mechanical ventilation, as well as anemia, leukocytosis, lymphocytopenia, and hypoalbuminemia, increased levels of creatinine, AST, CRP, LDH, and D-dimer, interleukin-6 and procalcitonin. Scr during the course of the disease increased from 171.6±78.0 μM to 221.5±121.3 μM (p<0.01) with no signs of acute rejection. In 2 recipients with severe graft failure at the time of infection with SARS-CoV-2, HD was resumed from the moment of hospitalization. We were unable to identify the effect of hydroxychloroquine on the outcome of COVID-19. At the same time, mortality in patients with hydroxychloroquine use was higher than in recipients treated with immunobiological drugs: 25.6% and 11.4%, respectively, p<0.02. When immunomodulators were combined with dexamethasone, mortality decreased to 4.8%. The independent factors of adverse outcome were high levels of procalcitonin (p<0.019) and mechanical ventilation (p<0.001). Conclusion: COVID-19 in RTRs is characterized by a severe course and high mortality, which necessitates hospitalization of the majority of infected patients. An increase in procalcitonin levels and the need for mechanical ventilation were independent predictors of an unfavorable outcome of COVID-19. © 2021 JSC Vidal Rus. All rights reserved.

COVID-19 in solid organ transplant recipients: initial report from national multicenter observational study "ROKKOR-recipieni"

We herein present our initial report from «ROKKOR-recipient», a national multicenter observational study. The prevalence, risk factors, clinical manifestations and outcomes ofthe novel coronavirus disease 2019 (COVID-19) in solid organ transplant recipients receiving immunosuppressive therapy were investigated. The study enrolled 251 COVID-19 patients (220 kidney recipients, 7 liver recipients, 1 liver-kidney recipient, and 23 heart recipients). The subjects came from 20 regions in Russia. The symptoms, clinical presentation, imaging and lab test results, therapy and outcomes of COVID-19 were described. It was established that solid organ transplant recipients with COVID-19 have a higher risk of developing adverse events. Predictors of adverse events include associated cardiovascular diseases, pulmonary diseases, diabetes, and kidney failure. Symptoms of the disease include dyspnea, rash and catarrhal signs, as well as initial low blood oxygen saturation (SpO₂ <92%), leukocytosis (white blood cell count >10 х 10⁹/L), elevated creatinine levels (>130 mumol/L) and a marked decrease in glomerular filtration rate, requiring hemodialysis. Performing organ transplant surgery in COVID-19 does not increase the risk of adverse events but could save the lives of waitlisted terminally ill patients. В статье представлены первые результаты национального многоцентрового исследования «РОККОР-реципиент», имевшего целью изучить распространенность, факторы риска, клинические проявления и исходы новой коронавирусной инфекции (COVID-19) у реципиентов солидных органов, получающих иммуносупрессивную терапию. В исследование включен 251 пациент (220 реципиентов почки, 7 реципиентов печени, 1 реципиент печени и почки, 23 реципиента сердца) из 20 регионов России c COVID-19. Описаны симптомы, клинические проявления, результаты инструментальных и лабораторных обследований, терапия и исходы коронавирусной инфекции. Выявлено, что наличие трансплантированного органа повышает риск нежелательных событий на фоне COVID-19, предикторами которых являются сопутствующие сердечно-сосудистые, легочные заболевания, сахарный диабет и почечная недостаточность, наличие в качестве симптомов манифестации заболевания одышки, сыпи и катаральных явлений, а также исходно низкая сатурация кислорода (SpO₂ <92%), лейкоцитоз более 10 х 10⁹/л, повышение уровней креатинина более 130 мкмоль/л и значимое снижение скорости клубочковой фильтрации, требующее проведения гемодиализа. Выполнение трансплантации органов на фоне пандемии COVID-19 не повышает риск развития нежелательных событий у реципиентов, но позволяет спасти жизни больных с терминальными заболеваниями, включенных в лист ожидания.

Interim guidelines: "Outpatient care for patients with chronic diseases subject to outpatient care in the context of the COVID-19 pandemic"

Consensus of experts of the Russian Society for Prevention of Noncommunicable Diseases, S.P. Botkin National Society for Advanced Medical Training, Profile Commission on Therapy and General Medical Practice of the Ministry of Health of Russia and Profile Commission on Medical Prevention of the Ministry of Health of Russia. Консенсус экспертов Российского общества профилактики неинфекционных заболеваний, Национального общества усовершенствования врачей имени С.П. Боткина, Профильной комиссии по терапии и общей врачебной практике Минздрава России и Профильной комиссии по медицинской профилактике Минздрава России.