Septic cavernous sinus thrombosis in a patient with COVID-19.

The cavernous sinus is one of the dural venous sinuses which plays an important role in venous outflow from the brain and eye sockets and in the regulation of intracranial circulation. We report a case of septic cavernous sinus thrombosis in a female patient with COVID-19. The disease often results in alterations of blood rheology, thrombosis in different organs, and septic complications. This article aims to raise awareness of healthcare professionals about the characteristics of COVID-19 that might cause septic cavernous sinus thrombosis in patients with severe comorbidities. Laboratory testing revealed severe comorbidities, including diabetes mellitus and liver cirrhosis caused by hepatitis C. They manifested with an impaired protein production in the liver and coagulation disorders. Systemic effects of SARS-CoV-2 on the vascular endothelium aggravated preexisting coagulation disorders and led to hemorrhage into retrobulbar tissue and clinical signs of septic cavernous sinus thrombosis, including swelling of the eyelids, bilateral exophthalmos, and ophthalmoplegia, followed by necrosis of the facial skin.Copyright © 2022, Dynasty Publishing House. All rights reserved.

Infectious Morbidity in Closed Long-Term Care Facilities in the «Pre-COVID Stage»

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.

[Clinical cases of complicated diverticulitis against the background of severe course COVID-19. Case report].

Two clinical cases of perforation of a previously undiagnosed colon diverticulum in patients with coronavirus infection caused by the SARS-CoV-2 virus treated at the Hospital №1 of Nalchik. Both patients were elderly, overweight, had a lot of chronic concomitant diseases. Patients received hormone therapy and were targeted: the first patient twice (tocilizumab on the first day of hospitalization and olokizumab on the 7th day of inpatient treatment). The second patient received levilimab on the 3rd day of his stay in the hospital. A short time after targeting, both patients developed acute diffuse abdominal pain, the patients were transferred to the surgical department and operated on. During the operation, both patients were found to have previously undiagnosed diverticular disease, complicated by diverticular perforation and peritonitis on the background of immunosuppression. Both patients died. Thus, when using targeted therapy for patients with COVID-19, it is necessary to take into account that they may have previously undiagnosed chronic diseases that can cause fatal complications against the background of immunosuppression.

Septic cavernous sinus thrombosis in a patient with COVID-19.

The cavernous sinus is one of the dural venous sinuses which plays an important role in venous outflow from the brain and eye sockets and in the regulation of intracranial circulation. We report a case of septic cavernous sinus thrombosis in a female patient with COVID-19. The disease often results in alterations of blood rheology, thrombosis in different organs, and septic complications. This article aims to raise awareness of healthcare professionals about the characteristics of COVID-19 that might cause septic cavernous sinus thrombosis in patients with severe comorbidities. Laboratory testing revealed severe comorbidities, including diabetes mellitus and liver cirrhosis caused by hepatitis C. They manifested with an impaired protein production in the liver and coagulation disorders. Systemic effects of SARS-CoV-2 on the vascular endothelium aggravated preexisting coagulation disorders and led to hemorrhage into retrobulbar tissue and clinical signs of septic cavernous sinus thrombosis, including swelling of the eyelids, bilateral exophthalmos, and ophthalmoplegia, followed by necrosis of the facial skin.Copyright © 2022, Dynasty Publishing House. All rights reserved.

Clinical and laboratory characteristic of patients with COVID-19 and meningococcal co-infection.

Objective. To analyze clinical and laboratory characteristics of patients with COVID-19 and meningococcal co-infection. Patients and methods. We analyzed cases of mixed infection caused by SARS-CoV-2 and meningococci in 8 patients treated in Moscow Multidisciplinary Clinical Center 'Kommunarka.' We used mass spectrometry for microbiological examination followed by culturing in accordance with the results of examination. All patients were tested positive for COVID-19 by PCR and meningococcal infection by bacteriological method. Results. Patients were admitted to hospital on average 5.88 +/- 4.2 days after COVID-19 onset. Two patients had moderate disease, whereas 6 patients had severe disease and were admitted to the intensive care unit. Study participants presented with different forms of meningococcal infection, including nasopharyngitis (n = 1), meningitis (n = 1), pneumonia (n = 2), menin-gococcemia (n = 3), and mixed form meningitis and meningococcemia (n = 1). Fatal outcome was observed in 37.5% of cases. Conclusion. The problem of meningococcal infection remains highly relevant during the COVID-19 pandemic. So-infection is characterized by an increase in the proportion of rare forms (pneumonia), which requires special attention of clinicians. The implementation of mass spectrometry will allow early detection of meningococcal infection in patients with rare forms and timely initiation of adequate and optimal therapy. Copyright © 2022.

Clinical and laboratory characteristic of patients with COVID-19 and meningococcal co-infection

Objective. To analyze clinical and laboratory characteristics of patients with COVID-19 and meningococcal co-infection. Patients and methods. We analyzed cases of mixed infection caused by SARS-CoV-2 and meningococci in 8 patients treated in Moscow Multidisciplinary Clinical Center 'Kommunarka.' We used mass spectrometry for microbiological examination followed by culturing in accordance with the results of examination. All patients were tested positive for COVID-19 by PCR and meningococcal infection by bacteriological method. Results. Patients were admitted to hospital on average 5.88 +/- 4.2 days after COVID-19 onset. Two patients had moderate disease, whereas 6 patients had severe disease and were admitted to the intensive care unit. Study participants presented with different forms of meningococcal infection, including nasopharyngitis (n = 1), meningitis (n = 1), pneumonia (n = 2), menin-gococcemia (n = 3), and mixed form meningitis and meningococcemia (n = 1). Fatal outcome was observed in 37.5% of cases. Conclusion. The problem of meningococcal infection remains highly relevant during the COVID-19 pandemic. So-infection is characterized by an increase in the proportion of rare forms (pneumonia), which requires special attention of clinicians. The implementation of mass spectrometry will allow early detection of meningococcal infection in patients with rare forms and timely initiation of adequate and optimal therapy. Copyright © 2022.

Epidemic Outbreak of COVID-19 in Foreign Closed Long-Term Care Facilities

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.

Efficacy and Safety of Peptide Vaccine in Prevention of SARS-CoV-2 Infection: Prospective Study among Healthcare Professionals

The pandemic caused by the new coronavirus infection remains the topical health issue and constitutes serious threat to the entire world. Nowadays, active immunization against new type of coronavirus infection continues in Russian Federation and in all other countries. Vaccination is the crucial component in comprehensive program for COVID-19 prevention and control. Mass immunization of population can prevent both admissions and hospitalization in conditions of high incidence of COVID-19 and thereby reduce the burden on the health system. Despite the remaining complications in combating the SARS-CoV-2 pandemic, preventive vaccination is by far the most effective method for protection against this infection Clinical studies on the efficacy of various preventive vaccinations in different regions of the world are extremely relevant especially under conditions of the emergency use authorization for vaccines against new coronavirus infection, the changing epidemiological situation, and the wide variability of different types of vaccines. All countries will need continuously updated data on vaccine efficacy to address new challenges such as weakening post-vaccine protection, new SARS-CoV-2 strains, and need for other preventive measures to mitigate the pandemic.

Serotonin adipate in intensive therapy of patients with severe covid-19

In this article, we discuss the history of discovery of serotonin deficiency and therapy for it. We described the experience of using serotonin adipate as a part of comprehensive intensive therapy for severe COVID-19. We also describe treatment outcome of a 52-year-old female patient treated in the intensive care unit of the Clinical Hospital for Infectious Diseases No 2 with a diagnosis of community-acquired polysegmental pneumonia, confirmed COVID-19, and functional intestinal obstruction. Her condition was complicated by infectious and toxic dilated cardiomyopathy of mixed origin (caused by both coronavirus itself and substrates of enterogenic endotoxicosis) and hemodynamic instability manifesting itself with arterial hypotension that required micro-injections of norepinephrine. The comprehensive treatment aimed to eliminate growing endotoxicosis caused by intestinal insufficiency, so we had to adjust her intensive therapy by adding serotonin adipate to the treatment scheme. Good treatment outcome of this patient was ensured by an improved strategy of intensive therapy that included a drug restoring and stimulating functions of smooth muscles. Later, the patient was transferred to the specialized department, recovered, and discharged from hospital. © 2021, Dynasty Publishing House. All rights reserved.

New opportunities of antiinflammatory therapy in comprehensive treatment for covid-19

Antiviral and antiinflammatory drugs used in patients with COVID-19 are currently showing multiple side effects. This necessitates the search for effective and safe medications for the prevention and treatment of COVID-19. Objective. Тo evaluate the experience of using ammonium glycyrrhizinate (AG), an antiinflammatory drug, in comprehensive treatment of adult patients hospitalized with moderate COVID-19. Patients and methods. This observational study included 172 patients;123 of them received AG in addition to standard therapy (experimental group), whereas 49 individuals received only standard therapy (control group). During the follow-up period, we performed daily monitoring of physical parameters, severity of each symptom, and overall condition using the NEWS scale. Results. Patients in the experimental group demonstrated faster improvement and normalization of their NEWS score compared to controls: the proportion of individuals with NEWS score 0 (day/night) on day 8 was significantly higher among those receiving AG than among controls (35% vs 16%;р = 0.016). Therapy with AG ensured rapid normalization of important parameters, including oxygen saturation (SpO2 ≥96%) and respiratory rate. Patients in the experimental group started sputum production early (on day 3), and already by day 7–8 had this symptom subsided. Individuals receiving AG developed wheezing significantly earlier than controls;moreover, there was a trend to faster resolution of this symptom in the experimental group than in the control group. A total of 45% and 11% of patients in the experimental group required infusion therapy and administration of at least 3 antibacterial drugs, respectively;these proportions were lower than those in the control group (67% and 31%, respectively;p = 0.008, р = 0.006). Conclusion. The inclusion of AG in the treatment scheme for patients with moderate COVID-19 ensured earlier recovery, resolution of clinical symptoms, and restoration of the drainage function of the lungs. AG increased the efficacy of comprehensive therapy, reducing the need to increase its intensity, and had a positive effect on the disease prognosis. © 2021, Dynasty Publishing House. All rights reserved.

Recombinant interferons in comprehensive therapy for new coronavirus infection

The second decade of the 21st century has brought us a new coronavirus infection, SARS-CoV-2, which affects not only animals (livestock, companion animals, birds), but also people, causing severe disease in them (COVID-19) with various clinical variants: From upper respiratory tract lesions to sepsis and thromboembolism. Coronaviruses are known to suppress the production of IFN-I. Therefore, administration of IFN-I is a promising strategy for early treatment and prevention of COVID-19. In the Russian Federation, treatment of COVID-19 in children is performed in accordance with the recommendations of the Ministry of Health of Russia and depends on the clinical form of the disease. Mild and moderate forms of the disease, observed in the majority of children, are treated according to the protocols for managing ARVI, bronchitis, bronchiolitis, and pneumonia in children. However, the fact that non-severe COVID-19 shares clinical manifestations with other infections caused by respiratory viruses and herpesviruses (including cytomegalovirus, HHV6A/B, and Epstein-Barr virus), as well as recently increased proportion of mixed viral infections necessitate (until the etiological diagnosis is confirmed) the administration of drugs recommended for the treatment of seasonal ARVI (including intranasal forms of IFN-α, etc.). Such therapeutic tactics often ensures faster improvement and symptom elimination. We report a case of mixed respiratory infection caused by two viruses (SARS-CoV-2 and Epstein–Barr virus) in a child. Early treatment with recombinant interferon-α2b with taurine resulted in fever alleviation and normalization of child’s condition by the moment of transfer to a specialized department. © 2020, Dynasty Publishing House. All rights reserved.