ABSTRACT
In December 2022, the Council of Experts was held. It purpose was to determine the place of virus-neutralizing monoclonal antibodies (NMA) in the ethiotropic treatment of COVID-19 in vulnerable categories of patients. The main issues were identified and their solutions were proposed. At the first visit of pregnant women due to COVID-19, proactive identification of risk factors and early prescription of NMA are recommended, preferably - with published safety data in this category of patients (casirivimab + imdevimab). In patients with oncological and other chronic (rheumatology, pulmonology, gastroenterology) diseases, prophylactic use of NMA is recommended. regardless of the severity of the disease. For patients with chronic pathology regardless of the severity of the disease an early prescription of ethiotropic therapy must be provided, combating the long-term circulation of the virus. To solve the problem of late treatment prescription, it is necessary to: use rapid tests, prescribe NMA if indicated, even if the patient presents late, introduce digital technologies to transfer information about COVID-19 cases between healthcare institutions (HI), create call centers for primary triage of patients, daily hospitals to reduce the burden on the HI. The issue of NMA using related to changes in their activity against new variants of SARS-CoV-2 remains relevant. Among the proposed solutions are: priority of indications over information about the activity of NMA, the diversification of the choice of NMA in HI, taking into account clinical experience, indications for use and prognosis of NMA activity, the use of combined forms of NMA (for example, casirivimab + imdevimab) or a combination of NMA with other means of ethiotropic therapy.Copyright © 2023, Dynasty Publishing House. All rights reserved.
ABSTRACT
Esophagoplasty in patients with esophageal cancer remains an extremely high-risk operation. This is due not only to the invasiveness of the operation, but also to the need for adequate blood supply to the gastric tube moved to the posterior mediastinum. The course of a new coronavirus infection is characterized by a high risk of thrombotic and thromboembolic complications, including after surgical interventions. The aim is to present a clinical observation of the development of a lethal complication of esophagoplasty - gastric graft necrosis in a convalescent patient with a new coronavirus infection COVID-19.Copyright © 2022 GEOTAR Media. All rights reserved.
ABSTRACT
Esophagoplasty in patients with esophageal cancer remains an extremely high-risk operation. This is due not only to the invasiveness of the operation, but also to the need for adequate blood supply to the gastric tube moved to the posterior mediastinum. The course of a new coronavirus infection is characterized by a high risk of thrombotic and thromboembolic complications, including after surgical interventions. The aim is to present a clinical observation of the development of a lethal complication of esophagoplasty - gastric graft necrosis in a convalescent patient with a new coronavirus infection COVID-19.Copyright © 2022 GEOTAR Media. All rights reserved.
ABSTRACT
Esophagoplasty in patients with esophageal cancer remains an extremely high-risk operation. This is due not only to the invasiveness of the operation, but also to the need for adequate blood supply to the gastric tube moved to the posterior mediastinum. The course of a new coronavirus infection is characterized by a high risk of thrombotic and thromboembolic complications, including after surgical interventions. The aim is to present a clinical observation of the development of a lethal complication of esophagoplasty - gastric graft necrosis in a convalescent patient with a new coronavirus infection COVID-19.Copyright © 2022 GEOTAR Media. All rights reserved.
ABSTRACT
Effectiveness of the inclusion of reamberin in the complex rehabilitation of patients suffering of pneumonia caused by SARS-CoV-2 was evaluated at the outpatient stage. The data of 162 patients who received the rehabilitation treatment including, in addition to pharmacological benefits, exercise therapy and vacuum labile massage, were analyzed. In addition, patients of the main group (n = 82) received reamberin (1.5%, intravenously in a volume of 500 mL) for 10 days. The biochemical parameters of blood were studied in dynamics, and the blood oxygenation was monitored by the Stange and Genchi tests and the pulse oximetry. The quality of life was assessed in terms of the SF-36 questionnaire. The inclusion of reamberin in the complex rehabilitation contributed to improvement of the main biochemical parameters of blood (the levels of aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transpeptidase decreased 1.2, 1.7, and 1.9 times, respectively, p0.5) and caused a more pronounced increase in the external respiration function (on the average by 8.4 sec according to the Stange test and by 9.1 sec according to the Genchi test), which was accompanied by positive trends in the quality of life indicators (according to the SF-36 questionnaire) in terms of physical functioning (by 5.1 points) and general health status (by 3.76 points. The obtained clinical and laboratory data, together with good tolerance of the drug, allow us to recommend the inclusion of reamberin in rehabilitation regimens for patients with pneumonia caused by SARS-CoV-2. Copyright © 2022 Izdatel'stvo Meditsina. All rights reserved.
ABSTRACT
Despite the increased salience of infectious disease risk due to the COVID-19 pandemic, two recent surveys of the business and scientific communities have found a continued belief in the prominence of environmental risks. In particular, failure to take action on climate change was seen as a highly likely risk whose impacts would become locked-in barring an immediate global response. These expert opinions are consistent with a growing body of evidence and give us insight into the priorities of global thought leaders who study and respond to risk. Given this alignment in priorities, we argue for the importance of integrating climate and environmental action into responses to emerging threats.
ABSTRACT
After the outbreak of COVID-19 pandemic in Bulgaria, the government has declared "state of emergency" (from March 13th, 2020) and took instant and decisive measures, including suspension of all educational activities, ban on access to all public places, installation of checkpoints on entrance-exit roads of the regional centers, to prevent the spread of the infection. The aim of this article is to evaluate the effectiveness of the "state of emergency" on the air quality improvement. In particular, an interrupted time series modelling approach is employed to test if a significant change in the level and the trend of the pollutant time series has occurred after the "state of emergency" measure. The case study regards the city of Stara Zagora, Bulgaria and focuses on the comparison of the period before (January 1st - March 12th, 2020) and after (March 13th - December 15th, 2020) the state of emergency. After adjusting by meteorology and Sunday effect, the results confirm for negative and significant effect in the level for NO2 and SO2 immediately after the state of emergency and positive and significant trend only for NO2. For the remaining PM10 series of data, it is not possible to conclude that the intervention was helpful in improving air quality. These results are reasonable due to the stay-at-home order has certainly lowered road traffic on the one hand, thus reducing the main emission source connected to N02 concentrations and on the other hand increase PM;0 concentrations because in Stara Zagora city, solid fuel heating is the main source for PM. © 2022 American Institute of Physics Inc.. All rights reserved.
ABSTRACT
The aim of the study was to evaluate the effectiveness of including remaxol in the medical rehabilitation of elderly and senior patients with COVID-19-associated pneumonia and changes in liver enzyme activity. Material and methods: 116 patients (56 men and 60 women) were examined. All patients underwent a complex of medical rehabilitation on an outpatient basis on the 10–12th day after discharge from the hospital and in the presence of 2 negative results of PCR tests for SARS-CoV-2, which included, in addition to the recommended measures (drug therapy and exercise therapy), vacuum labile massage according to the author's methodology and a course of hepatoprotective drugs. Depending on the latter, the patients were divided into two groups: I — the main group (n=60) — received remaxol in the drug treatment regimen: 400 ml, intravenously, drip, in a course of 10 days, II – comparison (n=56) — ademetionine: 400 ml, intravenously, drip, in 0.9% saline, in a course 10 days. Before rehabilitation and at its end, the following tests were carried out: Stange and Genchi tests;quality of life was assessed using the SF-36 questionnaire. Laboratory studies included determination of the following indicators levels: ALT, AST, their ratio, alkaline phosphatase, GGT, total and direct bilirubin, LDH, albumin and total protein levels. Results. The inclusion of hepatoprotectors in the medical rehabilitation of the patients of this group contributes to a decrease in cytolytic and cholestatic syndromes, which is more pronounced in patients who received remaxol: (a decrease in AST by 1.5 times (from 35.4±1.4 to 23.5±l), and ALT — by 1.8 times (from 38.7±1.3 to 21.5±0.4 IU/l), as well as normalization of bilirubin metabolism: a decrease of total bilirubin by 2.1 times (from 32.1± 0.6 to 14.8±0.9 µmol/l) and of direct — by 2.5 times (from 7.1±0.6 to 2.8±0.1 µmol/l). A pronounced increase in resistance to hypoxia was noted during the therapy with the drug (according to Stange and Genche), which contributed to an improvement in psychophysiological indicators of patients’ quality of life (according to the SF-36 questionnaire). The obtained results, along with the safety of the drug, allow us to recommend its use in patients with this pathology.
ABSTRACT
The COVID-19 pandemic has a significant impact not only on the economies of countries but also on global migration processes. The article contains the results of a study conducted in Saint Petersburg in 2020-2021. In the introduction, economic and social consequences of the COVID-19 pandemic for international migrants are demonstrated, and the research task related to the analysis of the main predictors of migrant vulnerability in current conditions is identified. The next part of the article contains the academic literature review on the impact of the COVID-19 pandemic on migration. As a theoretical framework for the study, a typology of migrant vulnerability is proposed, which assumes individual, structural and situational forms of vulnerability. The main methods of research, in addition to analyzing statistics, published research data, and legal documents, include expert interviews and in-depth interviews with migrants. The results of the study are presented in the following thematic blocks. (1) The legal status of international migrants. The lack of an official legal status of a migrant is a key predictor of vulnerability to the consequences of the COVID-19 pandemic. (2) Access of international migrants to health services. Many migrants do not receive medical care during the pandemic, which negatively affects not only the health of migrants, but also the epidemiological situation in general. (3) Professional risks of international migrants. Significant difficulties in the labor market are associated with informal relations with employers. In addition, the pandemic mainly affected employment in the service sectors, where migrants are mostly represented. (4) The housing conditions of migrants. The housing conditions of migrants are characterized by a higher population density, which makes it difficult to ensure social distancing;thereby migrants are more vulnerable to the COVID-19 infection and at the same time pose an epidemic threat to others. (5) The public attitudes towards international migrants. Respondents among migrants claim that during the pandemic they faced an increase in xenophobia. (6) The education of migrants' children. Many children often do not have technical opportunities for online education;in addition, the low level of education and poor Russian language skills of their parents make home education difficult since online classes require the support of adult family members. (7) Social support for international migrants. Social support for migrants is fragmented;there is no systematic approach to reducing the social vulnerability of the migration community during the pandemic. The conclusion contains key findings and recommendations based on the study results. It is emphasized that the social vulnerability of migrants affects not only the social situation of migrants themselves but also the host society, which is especially important to take into account in the situation of the COVID-19 pandemic.
ABSTRACT
BACKGROUND. The presence and drug correction of arterial hypertension (AH) with inhibitors of the renin-angiotensin system (RAS), as well as chronic kidney disease (CKD) and its role in the regulation of RAS, can significantly affect the condition of a person with COVID-19. OBJECTIVE: to study the features of the functional state of the kidneys in patients with grade 1-2 hypertension who have fallen ill with COVID-19. PATIENTS AND METHODS. A subanalysis of patients with CKD, participants in the BIRCOV study (ARB, ACEi, DRi in COVID-19) is presented: 112 outpatient patients with grade 1-2 hypertension, 83 of whom had CKD. The participants were divided into groups receiving ACE inhibitors (group 1 - 39 %), ARBs (group 2 - 32 %), or a direct renin inhibitor (PIR) (group 3 - 29 %) as the main therapy of hypertension. The value of blood pressure, eGFR, albuminuria level were analyzed at the debut of COVID-19 and at 2, 4, 12, 24 weeks from the onset of the disease. RESULTS. In the first two weeks of COVID-19, there was a decrease in blood pressure with a gradual return to baseline values in patients of group 1 and group 3 (to a lesser extent). The use of ACE inhibitors in the treatment of hypertension increased the risk of withdrawal compared to PIR and ARBs due to COVID-19. In patients with CKD, higher values of mean blood pressure were obtained with similar dynamics. A synchronous decrease in eGFR and systolic blood pressure has been documented, more pronounced in patients with CKD, especially when taking aCEI. The decrease in eGFR correlated with the stage of CKD. With stable renal function in patients with CKD during the first 12 weeks of COVID-19, the urine albumin/creatinine ratio (UAC) increased without further normalization. By the second week of the disease, eGFR decreased with a reciprocal increase in the level of uric acid in the blood. The use of dexamethasone was accompanied by a decrease in eGFR in CKD stages 3b-4. CONCLUSION. When taking ACE inhibitors, the effect of lowering blood pressure was comparable to a double block of RAS: ACE inhibitors + ARBs. © 2022 Educational Autonomous Non-Profit Organization Nephrology. All right reserved.
ABSTRACT
The first patients with SARS-CoV-2 infection were registered in Kabardino-Balkar Republic (KBR) in the end of March 2020, when Hospital No 1 at the Center for AIDS and Infectious Diseases was completely equipped for the admission of COVID-19 patients. Objective. To assess clinical and laboratory characteristics of patients with severe and extremely severe COVID-19 treated in the intensive care unit of Hospital No 1 in Nalchik in 2020-2021. Patients and methods. A total of 283 patients were treated in the intensive care unit (ICU) during this year. More that one-third of patients (41.3%) died;most of them were male. The majority of patients in the ICU were between 61 and 70 years of age;the majority of deaths were registered among patients aged 71 to 80 years. One hundred and seventy-three individuals in the ICU required non-invasive or invasive ventilation;105 of them (60.7%) died. Two hundred and fifty-two patients (89%) had severe concomitant diseases. The disease severity was also determined by advanced lung damage (more than 50%) in 143 patients (50.5%). Patients were examined and treated in accordance with temporary guidelines (effective at that time). Results. The most common causes of death among patients treated for COVID-9 in the ICU were pulmonary embolism (n=50;42.75%), sepsis (n=19;16.2%), and acute respiratory failure (n=17;14.5%). © 2021, Dynasty Publishing House. All rights reserved.
ABSTRACT
Life on land depends on the health and sustainability of ecosystems. Rapid and extensive human impact, however, has resulted in depletion and degradation of biological diversity at extraordinarily high rates. The COVID-19 pandemic brought into stark relief the fragility of the web of life, the importance of the relationship between people and nature, and the risk of disease spillover from wildlife to humans. Responses to the pandemic highlight the significance of governance mechanisms and the imperative for intentional investment in the health of the planet. This chapter explains the evolution and potential futures of biodiversity governance and analyzes the interactions among the existing legal regime for biodiversity, the Sustainable Development Goals, and the Post-2020 Global Biodiversity Framework. It draws lessons from the successes and challenges of past governance efforts and explores future paths that promote planetary and human health. © 2022 selection and editorial matter, Thomas G. Weiss and Rorden Wilkinson;individual chapters, the contributors.
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COVID-19 pandemic changed dramatically people’s attitude toward outdoor recreation as a counterpoint to the notorious “stay-at-home” measures. Eco trails, the forest flora and fauna provide multiple opportunities for open-air experience, beautiful landscapes and freedom to move around, yet keeping the necessary physical distancing. The main goal of this study is to explore the shift in tourists’ attitudes to move away from traditional mass types of tourism to forest-based activities like hiking on trails and footpaths. Additionally, the paper focuses on the availability and maintenance of eco trails, and possibilities to further develop their product for weekend breaks to appeal to urban tourists. The empirical research reveals the perceptions of Bulgarian tourists towards the role of eco trails as an escape from the lockdowns. © 14th International Scientific Conference WoodEMA 2021 - The Response of the Forest-Based Sector to Changes in the Global Economy, Proceedings. All rights reserved.
ABSTRACT
In the context of the dynamic conditions since the beginning of the pandemic, the objective of this article is to explore the changes in the export of Bulgaria. The focus is on two categories: consumption goods and intermediate goods. My approach is based on the examination of the latest available data for trade value. It is combined with a review of relevant publications of international organizations and the academia. The results suggest disruptions in the Bulgarian export of both observed categories since the outbreak of the new virus. Based on early data, the article can be useful to provide initial indication for the variations in export in the first three quarters of 2020. The implications of the outcomes may be limited by the uncertainty of the pandemic and possible unexpected changes in the international trade environment. © 2021, University of National and World Economy. All rights reserved.
ABSTRACT
The new COVID-19 disease caused by the SARS-CoV-2 coronavirus spread across the entire planet within a few months. In this context, restrictive measures were introduced: in order to ensure food security during the quarantine period, a number of countries restricted or banned the export of vegetables. This has disrupted trade between countries that has been established for many years and has led to an increase in prices for vegetables and a shortage of them in importing countries. Already in February, imports of vegetables from China decreased by 11% in physical terms compared to the same period last year. According to experts, the decline in world trade will be 13-32% by the end of the year. As a result of closing businesses and shutting down businesses, almost half of the world's working people may lose their income. The emerging global crisis will also affect the agro-industrial sector. According to research results, due to a decrease in household income, consumption of fresh vegetable products is reduced. To restore their economies as quickly as possible, countries are developing programs to support businesses and citizens. Under favorable circumstances, the world economy may partially recover in 2021. The support measures introduced by the EEU member states are considered. The problems faced by Russian vegetable producer and the actions already taken to combat them are described, and additional options for their solution are suggested. In particular, the market of organic agriculture is considered, and forecasts are given for the future of its development.
ABSTRACT
The Novel Human Coronavirus (SARS-CoV-2) also well-known as COVID-19 is the greatest public health challenge of the 21st century. The aims of this article were to provide data analytic of the COVID-19 cases in Bulgaria and to modeling their spread using SIR (Susceptible-Infected-Recovered) model. We used the covid19.analytics package from the statistical software R in extracting time-series data of COVID-19 in Bulgaria (dating March 8, 2020 to November 24, 2020), in presenting the data analysis as well as forecast the maximum number of infected people, peak time and the basic reproduction number based on SIR model. As per SIR model, the maximum number of infected people is reached after 61 days of starting of COVID-19 pandemic in Bulgaria (around May 13, 2020) with about 1.298446e+05 infections. The basic reproduction number R0 was found to 1.46, which means that on average an infectious individual infects 1.46 susceptible individuals during his infection period. We believe that performed data analytics of COVID-19 cases in Bulgaria and the obtained results of the SIR model will help government of Bulgaria when restricting the spread of the virus. © 2020 Academic Publications
ABSTRACT
Background: Our multicentric study explores the potential relationship between time perception, level of distress and fear of infection with COVID-19 in cancer patients undergoing chemotherapy. Methods: Perception of time was assessed in 300 cancer patients with solid tumors by evaluating each subjects’ prospective estimation of how fast one minute passed compared to the actual time. The median value (25 sec) of time perception was used to group cases into two categories of fast and slow perception of time. The National Comprehensive Cancer Network Distress Thermometer was used to evaluate levels of distress on a scale from 0 to 10. Patients scoring 4 or above were 173 (57.7%) and were regarded as having high levels of distress. Analogical thermometer was created for the fear of COVID-19 infection. Results: Significantly more patients were distressed in the presence of COVID-19 than historically controls. Patients with lung, breast and colon cancer were most distressed and worried about possible COVID-19 infection. Median value of both thermometers was 5. The pattern of the time perception distributions significantly changed over levels of distress and fear of COVID-19 infection (both p<0.05). There were significant negative correlations between time perception and values of Distress and COVID-19 thermometers (rho=-0.341 and rho=-0.169) and positive correlation between values of both thermometers (rho=0.601). Patients with a fast perception of time had significantly higher levels of distress (5.4±3.1) and fear from COVID-19 (5.3±3.3) infection than patients with a slow perception of time (3.2±2.8 and 4.2±3.2;respectively, both p<0.05). Moreover, in a multivariate analysis of covariance, time estimation, was significantly related to the reported values of both thermometers (V = 0.13, F (2, 297) = 21.2, p <0.001). Conclusions: Significantly more patients with cancer disease experienced distress in the presence of possible COVID-19 infection. Perception of time is a novel potent indicator for high levels of distress and fear of COVID-19 infection in cancer patients. Legal entity responsible for the study: Medical University of Varna. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.