ABSTRACT
Objective. To evaluate the effectiveness of the detection of malignant neoplasms (MNPs) when implementing secondary preventive measures against cancer in municipal healthcare facilities during the COVID-19 pandemic. Material and methods. The model of the Volga Federal District (VFD) of Russia was used to conduct analytical and statistical studies of the rates of active detection of MNPs in the municipal healthcare facilities in 2019-2020. The demographic indicators and state statistics data, which were publicly available on the Internet, on the official websites of the territorial health authorities, oncology dispensaries of the VFD subjects, were comparatively analyzed. A database (State Registration Certificate of the Russian Federation under No. 2021621834/01.09.21) was used to evaluate the effectiveness of secondary preventive measures against cancer during the COVID-19 pandemic in 2020. Results. Compared to 2019, the COVID-19 pandemic caused a 2.1% expansion in the network of patients' examination rooms mainly due to an increase in the number of male rooms by 5.6% and mixed-type rooms by 6.3%. The number of mid-level healthcare workers that provided the functioning of patients' examination rooms rose by 5.2%;the proportion of specialists trained in the area of oncology decreased by 20% (85% in 2019 and 68.1% in 2020). The introduction of restrictive measures determined a statistically significant (p<0.05) decline in the proportion of people who had undergone a primary medical examination in the male (32.9%), female (35.6%), and general (34.7%) populations. The mean frequency of detected MNPs in 2019 and 2020 was 0.91 and 0.76, respectively (a 16.5% decrease). There was an increase in the incidence of lung cancer (LC) (a 4.2% increase) and a reduction in that of breast cancer (BC) (a 56.6% decrease). A comparative assessment of changes in the rate of active detection of MNPs in healthcare facilities at all health levels revealed a negative increase in its mean value in 2020 versus 2019 for colorectal cancer (CRC) (-25.6%), LC (-25.0% ), BC (-11.6%), cervical cancer (CC) (-12.4%), and prostate cancer (PC) (-2.1%). The prognosis of the number of actively detected MNP cases during the pandemic shows that, provided that the effectiveness of MNP detection rates remains the same as in 2019;there were no CRC (n = about 1100 cases), LC (n=1050), BC (n=1470), CC (n=300), and PC (n=300) cases in the VFD in 2020. An analysis of the effectiveness of secondary preventive measures against LC and BC in the VFD showed that among the number of newly diagnosed cases of a disease in 2019, there were LC (92.3%) and BC (75.1%) cases in the municipal healthcare facilities;there were LC (100%) and BC (60.9%) cases during the COVID-19 pandemic. Conclusion. The COVID-19 pandemic led to a decline in the number of participants in preventive activities. Considering the uneven territorial spread of COVID-19, the development of a methodology for the preventive measures adapted to a pandemic, mainly in the municipal healthcare facilities, is an extremely important area of preventive healthcare activities.Copyright © 2022, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
The restrictive social distancing strategy during the COVID-19 pandemic in the healthcare system has led to a reduction in measures for the active detection of malignant neoplasms (MNs). Objective. To evaluate the impact of a temporary stop the measures for the secondary prevention of MNs on the frequency of detected cases of the disease during preventive medical examinations (PMEs). Materials and methods. The efficiency of active MN detectability in 2020 versus the pre-COVID-19 period (2018-2019) was com-paratively analyzed in 17 regions of the Central Federal District (CFD) of Russia. Information on the coverage of the population with PMEs and on the frequency of detected cancer cases when using fluorographic, mammographic, and cytological studies was obtained from the study of the data contained in the information project <<Passport of an Oncology Dispensary>> of the P.A. Herzen Moscow Oncology Research Institute, as well as those available in the public domain on the Internet and on the official websites of regional health authorities. Results. The comparative analysis of the results of PMEs did not reveal significant differences in their efficiency in the studied regions of the Central Federal District of Russia in 2018 and 2019. Compared to the pre-COVID-19 period in 2020, there was a sta-tistically significant decline in the population coverage with primary care, which was 33.2+/-2.3% among both sexes (p<0.01), 25.8+/-2.3 for males (p<0.05) and 39.7+/-3.0% females (p<0.01). The frequency of detected cancer cases was 1.0 in the general population, 0.6 for males and 1.2 for females. There was an increase in the number of detected cases during fluorographic (+27.1%) and mammographic (+22.9%) studies and a decrease in the proportion of cytologically detected MNs (-33.2%). At the same time, due to a decline in the number of the surveyed population in 2020, there was a decrease in the number of detected cancer cases of the lung (-34.8%), breast (-37.1%), as well as tumors diagnosed cytologically (-65.9%). Conclusion. This investigation may suggest that at least 1.065 lung cancer cases and 1.875 breast ones were not diagnosed due to the temporary reduction in PMEs in the regions studied.Copyright © 2021, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
The restrictive social distancing strategy during the COVID-19 pandemic in the healthcare system has led to a reduction in measures for the active detection of malignant neoplasms (MNs). Objective. To evaluate the impact of a temporary stop the measures for the secondary prevention of MNs on the frequency of detected cases of the disease during preventive medical examinations (PMEs). Materials and methods. The efficiency of active MN detectability in 2020 versus the pre-COVID-19 period (2018—2019) was com-paratively analyzed in 17 regions of the Central Federal District (CFD) of Russia. Information on the coverage of the population with PMEs and on the frequency of detected cancer cases when using fluorographic, mammographic, and cytological studies was obtained from the study of the data contained in the information project «Passport of an Oncology Dispensary» of the P.A. Herzen Moscow Oncology Research Institute, as well as those available in the public domain on the Internet and on the official websites of regional health authorities. Results. The comparative analysis of the results of PMEs did not reveal significant differences in their efficiency in the studied regions of the Central Federal District of Russia in 2018 and 2019. Compared to the pre-COVID-19 period in 2020, there was a sta-tistically significant decline in the population coverage with primary care, which was 33.2±2.3% among both sexes (p<0.01), 25.8±2.3 for males (p<0.05) and 39.7±3.0% females (p<0.01). The frequency of detected cancer cases was 1.0 ‰ in the general population, 0.6‰ for males and 1.2‰ for females. There was an increase in the number of detected cases during fluorographic (+27.1%) and mammographic (+22.9%) studies and a decrease in the proportion of cytologically detected MNs (–33.2%). At the same time, due to a decline in the number of the surveyed population in 2020, there was a decrease in the number of detected cancer cases of the lung (–34.8%), breast (–37.1%), as well as tumors diagnosed cytologically (–65.9%). Conclusion. This investigation may suggest that at least 1.065 lung cancer cases and 1.875 breast ones were not diagnosed due to the temporary reduction in PMEs in the regions studied. © 2021, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
Objective. To evaluate the effectiveness of the detection of malignant neoplasms (MNPs) when implementing secondary preventive measures against cancer in municipal healthcare facilities during the COVID-19 pandemic. Material and methods. The model of the Volga Federal District (VFD) of Russia was used to conduct analytical and statistical studies of the rates of active detection of MNPs in the municipal healthcare facilities in 2019-2020. The demographic indicators and state statistics data, which were publicly available on the Internet, on the official websites of the territorial health authorities, oncology dispensaries of the VFD subjects, were comparatively analyzed. A database (State Registration Certificate of the Russian Federation under No. 2021621834/01.09.21) was used to evaluate the effectiveness of secondary preventive measures against cancer during the COVID-19 pandemic in 2020. Results. Compared to 2019, the COVID-19 pandemic caused a 2.1% expansion in the network of patients’ examination rooms mainly due to an increase in the number of male rooms by 5.6% and mixed-type rooms by 6.3%. The number of mid-level healthcare workers that provided the functioning of patients’ examination rooms rose by 5.2%;the proportion of specialists trained in the area of oncology decreased by 20% (85% in 2019 and 68.1% in 2020). The introduction of restrictive measures determined a statistically significant (p<0.05) decline in the proportion of people who had undergone a primary medical examination in the male (32.9%), female (35.6%), and general (34.7%) populations. The mean frequency of detected MNPs in 2019 and 2020 was 0.91‰ and 0.76‰, respectively (a 16.5% decrease). There was an increase in the incidence of lung cancer (LC) (a 4.2% increase) and a reduction in that of breast cancer (BC) (a 56.6% decrease). A comparative assessment of changes in the rate of active detection of MNPs in healthcare facilities at all health levels revealed a negative increase in its mean value in 2020 versus 2019 for colorectal cancer (CRC) (–25.6%), LC (–25.0% ), BC (–11.6%), cervical cancer (CC) (–12.4%), and prostate cancer (PC) (–2.1%). The prognosis of the number of actively detected MNP cases during the pandemic shows that, provided that the effectiveness of MNP detection rates remains the same as in 2019;there were no CRC (n = about 1100 cases), LC (n=1050), BC (n=1470), CC (n=300), and PC (n=300) cases in the VFD in 2020. An analysis of the effectiveness of secondary preventive measures against LC and BC in the VFD showed that among the number of newly diagnosed cases of a disease in 2019, there were LC (92.3%) and BC (75.1%) cases in the municipal healthcare facilities;there were LC (100%) and BC (60.9%) cases during the COVID-19 pandemic. Conclusion. The COVID-19 pandemic led to a decline in the number of participants in preventive activities. Considering the uneven territorial spread of COVID-19, the development of a methodology for the preventive measures adapted to a pandemic, mainly in the municipal healthcare facilities, is an extremely important area of preventive healthcare activities. © 2022, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
Since the emergence of the SARS-CoV-2 virus in late 2019, vaccines against the COVID-19 infection have been under development using different approaches. At present, protective immunity factors against COVID-19 infection are not completely characterized. Of the four structural proteins of coronavirus, the spike protein (S) and the nucleocapsid protein (N) are most widely expressed in viral infections and elicit the antibody response. Antibody-dependent enhancement (ADE) presents a problem for developing a vaccine against SARS-CoV. It was shown in animal studies that SARS-CoV-1 vaccines containing recombinant S-protein or DNA-vaccine expressed S-protein led to pulmonary immunopathology after infection with SARS virus. Antibodies to the coronavirus S-protein produced by the human immune system in response to infection may contribute to the penetration of SARS-CoV into monocytes and macrophages through the Fc-gamma receptor (Fc gamma R) and may aggravate the course of infection. The demonstration of ADE with coronavirus infection raises fundamental questions regarding the development of vaccines against the SARS-CoV-2 virus and the use of passive prophylaxis or treatment with virus-specific monoclonal antibodies. Evaluation of the mechanisms of immunopathology, including the responses of immunoglobulins and cytokines to vaccines, and tests for antigen-antibody complexes after infection and vaccination can help address these issues.