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Background. The COVID-19 pandemic has become a substantial global health crisis, unparalleled in world history. Infection dynamics can have specific characteristics in different countries due to social, economic, climatic, or geographic factors. Aim(s): to study features of SARS-CoV-2 collective immunity among the Armenian population. Materials and methods. A cross-sectional, randomized study of collective immunity was carried out according to a program developed by Rospotrebnadzor and the St. Petersburg Pasteur Institute, taking into account WHO recommendations. The study was approved by the ethics committees of the National Center for Infectious Diseases (Armenia) and the St. Petersburg Pasteur Institute (Russia). A volunteer cohort was formed (N = 6057), randomized by age and region. The study's analysis included: shares and distributions of antibodies (Abs) to nucleocapsid (Nc) antigen (Ag) and receptor binding domain (RBD) S-1 Ag in the cohort;and quantitative determination of these Abs by ELISA. During the survey, a history of vaccination was indicated by 4395 people. Results. Overall seropositivity formed in the whole cohort (by April 14, 2022) was 98.6% (95% CI: 98.1-98.7). It did not depend on age, place of residence, or occupation. When quantifying Nc and RBD Abs, the proportions of volunteers with Nc Ab levels of 1-17 BAU/ml and RBD Ab levels of 22.6-220 BAU/ml were the smallest, amounting to 6.9% (95% CI: 6.2-7.5) and 20.4% (95% CI: 19.4-21.4), respectively. With increasing serum concentrations (Nc > 667 BAU/ml, RBD > 450 BAU/ml), the proportions of individuals with the corresponding levels were 20.2% for Nc (95% CI: 19.2-21.3) and 54.2% for RBD (95% CI: 52.9-55.5). Vaccination coverage was 72.6% (95% CI: 71.5-73.7). The most frequently used were Sinopharm/BIBP (32.4%), AZD1222 (22.3%), and Gam-COVID-Vac (21%). The remaining vaccines (CoronaVac, mRNA-1273, BNT162b2, CoviVac) were used by 24.3% of vaccinated individuals. When summing vaccines by platform, it was found that: vector vaccines were used in 40.34% (95% CI: 33.57-42.39) of cases;whole-virion vaccines were used in 26.83% (95% CI: 24.76-32.20);and mRNA vaccines were used in 6.33% (95% CI: 4.84-8.91). Conclusion. The epidemic situation in Armenia by April 2022 was characterized by a high level of collective immunity, independent of age or regional factors. Vector and whole-virion vaccines have been used most widely.Copyright © Popova A.Yu. et al., 2023.
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According to current data, SARS-CoV-2 virus has the ability to cause multi-organ pathology, leading to acute damage of various organs and systems and long-term consequences characterized by polymorphic symptoms. Recently, a high incidence of invasive mycoses, particularly mucormycosis - COVID-M, has been noted among the COVID-19 complications. The predisposing factor for the development of this pathology is diabetes mellitus, immunodeficiency states, and prolonged use of high doses of glucocorticosteroids. Mucormycosis is characterized by severe clinical manifestations and high lethality, and timely diagnostics of this pathology often represents a difficult problem. The aim of this study was to analyze a clinical case of rhino-orbital mucormycosis in convalescent COVID-19 patient. In the study, there was used mucopurulent nasal discharge from the patient previously hospitalized with a severe novel coronavirus infection. Here, we describe the methodology allowing to isolate and identify a pure mold fungus culture from the biomaterial using methods of routine bacteriology and MALDI-ToF mass spectrometry. Direct microscopy examination of nasal cavity discharge revealed branched non-septic hyphae with a characteristic branching angle, allowing to preliminarily diagnose invasive mucormycosis. Growth of mycelial fungus colony was observed by using Sabouraud's medium with potassium tellurite. Microscopy of the pure culture revealed branching mycelium without septa, broad, with irregular thickness, unsegregated hyphae, and sporangia with a typical column specific to mucormycetes. Analysis of the obtained mass spectra allowed to establish the microbial species identity as Lichtheimia corymbifera. The latter along with other members of the order Mucorales, are known to cause mucormycosis. As a result of antifungal treatment (Amphotericin B) and timely surgical intervention, the patient was discharged from the hospital with prominent clinical improvement and no complaints during further outpatient follow-up period. The analysis of this clinical case showed the lack of alertness in some clinical diagnostic laboratories to detect pathogens of invasive mycoses. To avoid errors, while making a diagnosis, attention should be paid not only to detection of fungal spores in clinical material, but also take into account the structure of mycelium underlying major difference between yeast-like fungi, higher and lower molds. The isolation and identification of a pure pathogen culture allows to confidently verify the diagnosis, timely correct the treatment tactics and monitor circulation of mycotic agents to prevent occurrence of mycoses in most vulnerable patients cohorts.
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Despite all efforts of the world community, the COVID-19 pandemic remains one of the main epidemiological challenges of our time. Even with its widespread distribution, the infection may have certain local features due to social, geographic, and climatic factors. Objective(s): to study collective immunity to SARS-CoV-2 in the population of the Republic of Tajikistan. A cross-sectional, randomized study of herd immunity was carried out according to a program developed by Rospotrebnadzor and the St. Petersburg Pasteur Institute, taking into account WHO recommendations. The ethics committees of the corresponding entities approved the study: Tajik Ministry of Health and Social Protection;and the St. Petersburg Pasteur Institute (Russia). Based on questionnaire results, 4,022 people were selected, representing 0.15% (95% CI: 0.14-0.15) of the total population randomized by age and region. In subsequent laboratory analysis, 3682 people took part. The distribution and quantitative content of antibodies (Abs) to viral nucleocapsid (N Ag) and receptor binding domain (RBD Ag) were determined by ELISA. When questioned, a history of SARS-CoV-2 vaccination was indicated by 69.7% (95% CI: 68.2-71.2) of the volunteer cohort. Vector vaccines were most frequently used (50.6%;95% CI: 48.7-52.5), with whole-virion inactivated preparations in second place (23.0%: 95% CI: 21.4-26.6) and mRNA vaccines in third place (21.0%;95% CI:19.4-22.6). The cohort (n = 3682) featured 27.5% men and 72.5% women. The overall seroprevalence was 98.5% (95% CI: 97.7-99.2) in men and 99.4% (95% CI: 99.0-99.6) in women (differences statistically insignificant). Overall seroprevalence in the cohort was 99.2% (95% CI: 98.8-99.4) and ranged from 97.2 to 100% in certain subgroups. Asymptomatic seropositivity in the whole cohort was 98.4% (95% CI: 97.6-99.1). As a result of a mandatory vaccination program introduced in Tajikistan under a COVID-19 Emergency Project, the level of herd immunity among vaccinated individuals reached 99.5% (95% CI: 99.1-99.7), which is similar to the level reached in the cohort as a whole. The epidemic situation that developed in Tajikistan by mid-March 2022 was characterized by an almost absolute level of herd immunity, as evidenced by an absence of detected overt COVID-19 cases since the end of February (2022).Copyright © Popova A.Yu. et al., 2023 The article can be used under the Creative Commons Attribution 4.0 License.
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Computed tomography has become the main method of early diagnostics of COVID-19 during the pandemic of the novel coronavirus infection. Based on results of computed tomography of the chest it is possible to diagnose viral pneumonia associated with COVIS-19, to quickly assess the lung damage volume and severity of changes, to perform quick routing of patients and to start antiviral treatment. Hence, 2020 was associated with a rapid increase in the number of computed tomography examinations with corresponding changes in the structure of X-ray diagnostics. The aim of the current study was to evaluate the impact of the pandemic of the novel coronavirus infection on the structure of X-ray diagnostics and collective doses from medical exposure in the Russian Federation in 2019-2020. The study was based on the results of analysis of the federal state statistical surveillance forms 3-DOZ and 30 as well as on the data on Covid-19 morbidity in the regions of the Russian Federation. The results of the study indicate that there were no significant changes in the structure of X-ray diagnostics in 2020 compared to 2019 except for the increase in the number of computed tomography examinations. Their contribution to the total number of X-ray examinations has increased to 8,2% in 2020 compared to 4,6% in 2019. Contribution of other imaging modalities to the total number of X-ray examinations has not changed significantly. In 2020 the number of X-ray examinations decreased by 20% in average, varying from 6% for diagnostic nuclear medicine to 42% for interventional examinations. At the same time, the number of computed tomography examinations has rapidly increased by 60%. The structure of collective dose from medical exposure has significantly changed in 2020. Contribution of computed tomography to the collective dose in 2020 accounted for to 74% compared to 57% in 2019. Contribution of other imaging modalities has decreased by the factor of 1,5-2. Contribution of radiography examinations has decreased to 10,5% compared to 19% in 2019. Collective doses have correspondingly decreased by 20-30% for all imaging modalities except for computed tomography. Collective dose from computed tomography has increased by 71% compared to 2019. The number of all X-ray examinations in the Russian Federation has decreased by 12%: from 294 million in 2019 to 258 million in 2020. Collective dose from medical exposure has rapidly increased in 2020 by 30% to 115 thousand man.-Sv compared to 88 thousand man.-Sv in 2019. In average, in regions of the Russian Federation in 2020 each second computed tomography examination has been performed as a part of COVID-19 diagnostics with 2,3 computed tomography examinations per person infected with COVID.Copyright © 2022, Saint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev. All rights reserved.
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Introduction. It is necessary to establish peculiarities and regularities of COVID-19 infection;this task requires further research on how to formalize and build spatial-temporal models of the infection spread. This article focuses on determining non-infectious factors that can modify the epidemic process caused by the COVID-19 coronavirus for further substantiation of integrated solutions that are necessary to ensure sanitary-epidemiological welfare of the RF population. Materials and methods. Our study involved analyzing regularities of regional differentiation in parameters introduced into mathematical models. These models described how the epidemic process developed in RF regions depending on modifying non-infectious factors identified by modelling the dynamics of spread of SARS-CoV-2 delta strain. These modifying factors included anti-epidemic activities;sanitary-epidemiological, sociodemographic, and economic conditions in a region;weather and climate;public healthcare systems and people's lifestyles in RF regions over 2020–2021. The dynamics of the epidemic process was modelled by using the conventional SIR-model. Relationships between parameters introduced into the model of the epidemic process and modifying regional conditions were examined by using correlation-regression analysis. Results. The modelling made it possible to identify priority risk factors that modified COVID-19 spread authentically (p<0.05) and explained regional differences in intensity of contagion, recovery and lethality. We established that population coverage with vaccination, especially among people aged 31–40 years, had the greatest authentic positive influence on the decline of reproduction index (R0) of the virus (r=–0.37). An increase in monthly average temperatures in autumn and winter as well as over a year made for people moving faster from the susceptible to infected category (r=0.21–0.22). Growing sun insolation over a year, especially in summer, resulted in slower movement of susceptible people into the infected category (r=–0.02–(–0.23)). Next, several sanitary-epidemiological indicators authentically made the infection spread faster;they were improper working conditions (not conforming to the safety standards as per physical indicators) and ambient air quality in settlement not corresponding to the hygienic standards as per chemical indicators and noise (r=0.29–0.24). Recovery took longer in regions where alcohol consumption was comparatively higher (r=–0.32). Limitations. The limitations of the study include modelling the epidemic process using the standard SIR model;limited set of indicators and period of analysis. Conclusions. The existing regional differentiation in development of specific stages in the epidemic process related to the COVID-19 delta strain occurs due to complex interactions and influence exerted by modifying factors that create a certain multi-level and multi-component system. This system is able to transform the epidemic process either potentiating it or slowing it down. © 2022 Izdatel'stvo Meditsina. All rights reserved.
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PCR tests are known to give the most accurate results, but are not suitable for mass testing. This article suggests the use of data extraction to diagnose Covid-19. For this purpose, data from rapid antigen tests, external signs of infection and general blood count are processed. The result is that the reliability of antigen tests increases from 50% to over 72%. The future development of the system is to generate a hypothesis about the likelihood of complex application of Covid-19. PCR tests are known to give the most accurate results, but are not suitable for mass testing. © 2022 IEEE.
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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.
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Computed tomography has become the main method of early diagnostics of COVID-19 during the pandemic of the novel coronavirus infection. Based on results of computed tomography of the chest it is possible to diagnose viral pneumonia associated with COVIS-19, to quickly assess the lung damage volume and severity of changes, to perform quick routing of patients and to start antiviral treatment. Hence, 2020 was associated with a rapid increase in the number of computed tomography examinations with corresponding changes in the structure of X-ray diagnostics. The aim of the current study was to evaluate the impact of the pandemic of the novel coronavirus infection on the structure of X-ray diagnostics and collective doses from medical exposure in the Russian Federation in 2019-2020. The study was based on the results of analysis of the federal state statistical surveillance forms 3-DOZ and 30 as well as on the data on Covid-19 morbidity in the regions of the Russian Federation. The results of the study indicate that there were no significant changes in the structure of X-ray diagnostics in 2020 compared to 2019 except for the increase in the number of computed tomography examinations. Their contribution to the total number of X-ray examinations has increased to 8,2% in 2020 compared to 4,6% in 2019. Contribution of other imaging modalities to the total number of X-ray examinations has not changed significantly. In 2020 the number of X-ray examinations decreased by 20% in average, varying from 6% for diagnostic nuclear medicine to 42% for interventional examinations. At the same time, the number of computed tomography examinations has rapidly increased by 60%. The structure of collective dose from medical exposure has significantly changed in 2020. Contribution of computed tomography to the collective dose in 2020 accounted for to 74% compared to 57% in 2019. Contribution of other imaging modalities has decreased by the factor of 1,5-2. Contribution of radiography examinations has decreased to 10,5% compared to 19% in 2019. Collective doses have correspondingly decreased by 20-30% for all imaging modalities except for computed tomography. Collective dose from computed tomography has increased by 71% compared to 2019. The number of all X-ray examinations in the Russian Federation has decreased by 12%: from 294 million in 2019 to 258 million in 2020. Collective dose from medical exposure has rapidly increased in 2020 by 30% to 115 thousand man.-Sv compared to 88 thousand man.-Sv in 2019. In average, in regions of the Russian Federation in 2020 each second computed tomography examination has been performed as a part of COVID-19 diagnostics with 2,3 computed tomography examinations per person infected with COVID. Copyright © 2022, Saint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev. All rights reserved.
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In the conditions of the existing pandemic, that affects both the physical and psychological health of people, it can be pre-dicted with a high degree of probability an outbreak in mental disorders and stress-associated mental illnesses, including depression. The problem of the relationship between depression and cardiac diseases, in particular coronary heart disease (CHD), has been studied by native and foreign scientists for several decades. Various mechanisms have been found and con-tinue to be studied, indicating that the presence of depression can affect more or less on the course of coronary heart disease and even become a predictor of new cardiac events. Dysfunction of the autonomic nervous system with changes in heart rate variability, hyperactivity of the hypothalamic-pituitary-adrenal axis and associated hypercortisolemia, disorders of serotonergic signal transmission pathways, high aggregation response and increased platelet activity, continuous increase of proinflamma-tory cytokines ((IL17A, IL6, TNFa and IL12p70) in patients’ plasma – such mechanisms probably underlie the correlation between depression and an increased risk of cardiovascular complications and cardiac death. The review includes some features of depression and its influence on various forms of coronary heart disease, particularly in different age and gender groups. In view of the ongoing COVID-19 pandemic, this theme seems to be relevant and requires targeted study. Probably it is necessary to conduct clinical researches, to create registers for a detailed assessment of the mutual influence of depression and coronary heart disease in existing conditions. Perhaps, the results of such work will contribute not only to the early detec-tion and treatment of depression, but also to the development of new ways in primary and secondary prevention of coronary heart disease and its acute forms. © 2022, Remedium Group Ltd. All rights reserved.
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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.
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Objective: To study the seroprevalence of SARS-CoV-2 antibodies (AB) in children in the 2nd year of the COVID-19 pandemic in Russia. Materials and methods: Prospective cohort study. The seroprevalence research was conducted among 3670 children aged 1 to 17 y/o from 26 modelling regions of Russia (that have been participating earlier in the five stages of seromonitoring during 2020-2021). The serological testing was carried out in December, 2021. The work was carried out according to a unified methodology set by the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being with the Pasteur Institute of Epidemiology and Microbiology (Saint Petersburg, Russia). The plasma was obtained from 3 ml of venous blood, in which the level of AB to nucleocapsid (NC), and the SARS-CoV-2 receptor-binding domain (RBD) was determined by immunoferment method using reagents for qualitative and quantitative analysis. Results: The analysis of AB seroprevalence to NC and RBD showed the statistically significant increase in the share of seropositivity to RBD in children of all modelling regions (p<0.05). The most seropositive volunteers contained low levels of AB: 31.3-125.6 BAU/ml NC and 22.6-220 BAU/ml RBD. An increase in the level of AB to NC and RBD was accompanied by a decrease in the percentage of seropositive patients. Evaluating the contribution of children to the level of humoral immunity, convalescents (had been ill shortly before the examination), the «anamnesis» (had been ill at previous stages of seromonitoring) and asymptomatic (had been asymptomatically ill) groups were distinguished. The maximum contribution was made by children with asymptomatic cases of COVID-19 in anamnesis: In 82.3% (95% CI 81.1-83.6), of which 76.9% (95% CI 75.5-78.3) AB detected to RBD. The contribution of children of two other groups to the overall level of humoral immunity was 33 times less. Conclusion: Statistically significant predominance of AB to RBD above AB to NC and their main contribution to the level of humoral immunity to SARS-CоV-2 (p<0.001).
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Introduction. The development of SARS-COV-2 (COVID-19) pandemic creates certain analytical challenges with respect to both examining the spread of the disease itself and investigating reasons and regularities in the epidemic propagation under different conditions. This article dwells on the least examined issue related to the necessity to establish peculiarities and reasons for occurring differences in the coronavirus infection spread in RF regions with different socioeconomic and social-hygienic status. This is necessary for substantiating relevant actions, which are to compensate for preventable modifying influence exerted by environmental factors and lifestyle-related ones. Materials and methods. The study involved analyzing regularities in regional differentiation of parameters in a classic SIR model describing the epidemic process in RF regions. We analyzed data on more than two hundred fifty various indicators describing levels of infection, vaccination, hospital admission and mortality among population collected in 85 RF regions in 2020–2021. All the data were taken as average values over a week. Results. We assessed parameters of mathematical models for RF regions. The assessments gave grounds for analyzing peculiar development of the epidemic process and for detecting basic regularities in the territorial distribution of parameters describing rates of infection, recovery and mortality rate and the basic reproductive number for SARS-COV-2 virus. Limitations. The results are limited by data aggregation performed only at a regional level and a simplified model of the developing epidemic process applied in the present study. Another limitation is insufficient coverage of environmental factors reflecting peculiarities in the infection spread. The latter is considered a promising trend in future research. Conclusion. The study made it possible to trace basic peculiarities and regularities in the spread of the disease and to spot out regions where the epidemic process was the most acute and accompanied with the highest burdens on regional social security services. These trends and regularities indicate to the occurring regional differentiation detected at various stages in the development of epidemic process of the new coronavirus infection (COVID-19) spread due to the Delta strain caused by complex interactions and influence exerted by modifying factors creating a certain multi-level and multi-component structure. © 2022 Izdatel'stvo Meditsina. All rights reserved.
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BACKGROUND AND AIMS: The current strategy to fight against the COVID-19 pandemic involves active patient vaccination. Patients with renal and autoimmune diseases are in high risk for severe COVID-19 infection [1]. Therefore they should be prioritized for vaccination. Immunoglobulin A nephropathy (IgAN) is one of the most common primary glomerulonephritis triggered by mucous membrane alteration;however, there is a discussion about vaccination-caused IgA flare [2]. The immunological nature of IgAN and misleading information in public sources leaves patients skeptical about whether to get vaccinated [3]. The study aimed to investigate the impact of SARS-CoV-2 vaccination on the clinical course of IgA nephropathy. METHOD: Adult patients treated in Pauls Stradins Clinical University Hospital with morphologically proven IgAN were included in the study. Patients with secondary IgAN were excluded. Evaluation of clinical and laboratory markers was performed on inclusion visit and on the second visit 6 months later. SARS-CoV-2 vaccination type and status were noted on both visits. Estimated GFR was calculated with CKD-EPI creatinine-cystatin equation. IBM SPSS Statistics version 27 and Microsoft Excel 10 were used for data analysis. RESULTS: The study involved 54 patients, 36 were unvaccinated and 18 were fully vaccinated. A significant difference between the two groups was observed by baseline proteinuria. Other differences were not observed. Fourteen patients were vaccinated with mRNA vaccine, 13 with Comirnaty and 1 with Spikevax, and four patients were vaccinated with Vaxzevria vector vaccine. The differences between the two groups are shown in Table 1. During study period, two patients had COVID-19 infection;a patient in the vaccinated group had COVID-19 prior to vaccination. CONCLUSION: SARS-CoV-2 vaccination did not affect the clinical course of IgA nephropathy. Our study results indicate that SARS-CoV-2 vaccination in IgA nephropathy patients was safe regarding renal function and disease activity markers. (Table Presented).
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Purpose: To describe clinical characteristics of patients positive simultaneously for RdRp, N and E genes of SARS-CoV-2 and to analyse dynamics of symptoms and Ct values in the interval from day 0 to day 10 after symptoms onset. Materials and methods: Retrospective analysis of data obtained on the day of specimen collection from 1044 individuals was carried out. Detection of RdRp, E and N genes of SARS-CoV-2 was conducted by RT-PCR. Only patients positive for all three genes were included. Results: Out of all patients, 47.8% were female, and 52.2% were male with a median age of 60 years, and the elder (>50 years) population constituted 71.5%. The most common comorbidities were cardiovascular disease (44.5%), diabetes mellitus (11.0%), and chronic pulmonary disease (8.6%). The prevalent symptoms at the time of specimen collection were fever (74.7%), cough (67.1%), and dyspnea (39.6%). Fever and cough were leading symptoms in the time interval between zero and the tenth day since the onset of COVID-19. A linear trend for dry cough and dyspnea, with a daily increase of 2.2% and 2.3%, respectively, was observed. Dry cough was the primary discriminator in distinguishing mild and moderate infection. Gradual increase of Ct values of all genes was observed from day 0 to day 10, and day 3 was essential for separating two time intervals. Conclusions: Flu-like symptoms were leading over the study period. Male sex, older age, cardiovascular disease, diabetes mellitus, and chronic pulmonary disease were risk factors for infection. Cough, age over 65 years and male sex in the group 33-63 years were predictors of more severe disease.
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Objective. Detection of additional factors favoring progression of COVID-19 and developing lethal outcomes in hospitalized patients. Materials and methods. Analysis of 98 medical records of lethal cases of patients that underwent hospitalization with diagnosis of COVID-19 associated pneumonia of two in-patient facilities of the Amur oblast and Khabarovsk krai was performed. Two groups were formed: first included medical records of patients hospitalized in severe condition (n = 52) and second group included patients with state of moderate severity (n = 46). Length of hospitalization stay, time from admission to the medical facility to progression of the disease, time from hospitalization to death and bacterial pathogens species composition isolated from lungs tissue autopsy material were analyzed. Statistical assessment of obtained data was performed with StatSoft Statistica 12.0. Results. Majority of patients of 1st and 2nd groups (66.7 ± 6.80% and 69.6 ± 6.78%) were hospitalized on fourth day of the COVID-19 clinical manifestations onset or later. Two thirds of patients hospitalized in severe condition progressed to critical health status on 1st–3rd day of hospitalization. Majority of second group patients (65.2 ± 7.02%) deteriorated from moderate severity to severe health condition on 4th–14th day of hospital stay. Bacteriological assessment analysis of autopsy material revealed that material obtained from first group showed more frequent absence of bacterial flora growth compared with second group both in the Amur oblast (44.4 ± 9.74% и 29.4 ± 11.39%) and in the Khabarovsk krai (в 40.0 ± 10.0% and 27.6 ± 8.45% of cases). Klebsiella pneumoniae (57.7 ± 5.86%) and Candida spp. (18.3 ± 4.59%) were revealed more frequently in the structure of diagnosed pathogens. Substantial proportion of pathogens (81.7 ± 4.59%) were isolated in autopsy material of patients which hospital stay was 4 days and longer. Prolonged hospital stay was associated with more frequent detection of K. pneumoniae and Candida spp. in patients that suffered from COVID-19 pneumonia and eventually died from the disease. With duration of hospitalization of 4 days and longer Acinetobacter baumannii – an extremely virulent pathogen with natural drug resistance was isolated from autopsy material. Conclusion. Factors influencing unfavorable outcomes of COVID-19 include signs of secondary bacterial infection as well as detection of aggressive drug-resistant bacterial microflora that most likely had nosocomial origin due to prolonged hospitalization. © 2021, Dynasty Publishing House. All rights reserved.
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INTRODUCTION: Chronic prostatitis (CP) has long been considered one of the common causes of male infertility. The influence of therapy for CP on spermatogenesis is well studied. However, recently, especially in the era of the new coronavirus infection (COVID-19), much attention has been paid to the effects of cytokines on the pathogenesis of the inflammatory process, and their impact on male fertility. AIM: To study the effect of a complex of natural antimicrobial peptides and cytokines (Superlymph) on ejaculate, MAR test, oxidative stress (OS), and sperm DNA fragmentation (SDF) in men with infertility and a history of CP. In some patients, the level of cytokines before and after treatment was determined. MATERIALS AND METHODS: A total of 583 infertile men with a history of CP, aged 18-75 years, were screened according to the inclusion/ exclusion criteria. In group I, patients received antioxidant stimulation of spermatogenesis (triovit, trental, mexidol) in combination with a complex of natural antimicrobial peptides and cytokines (Superlymph) one suppository 25 IU at night for 20 days for 1-3 weeks and for 6-8 weeks for 2 months. In group II, antioxidant stimulation of spermatogenesis was prescribed along with suppositories for the prevention of CP for 2 months. The evaluated criteria included sperm analysis, MAR test, oxidative stress in spermatozoa (reactive oxygen species (ROS)) and SDF. The levels of seminal plasma cytokines were also measured before and after treatment in 32 patients using the Bio-Plex Pro panel for the simultaneous determination of 17 human cytokines, the Human Cytokine 17-plex Assay. Statistica-10 software was used for statistical analysis (p<0.05). RESULTS: Of 135 eligible patients, results were collected from 125 men (mean age 31.7 +/- 13.4 years). In group I, there was a more pronounced increase in motility by 42.3%, a decrease in the MAR-test level by 64.7%, oxidative stress in spermatozoa by 56.1%, and SDF by 25.6%, compared to group II (30.4 %, 10.5%, 45.7%, 21.9%), respectively. All these changes were significant with the exception of a decrease in the level of SDF. In group I, there was a predominant increase in the activity of anti-inflammatory cytokines (IL-4, 10, 13), a decrease in the level of pro-inflammatory cytokines ((IL-2, 12). In group II, there was a significant decrease in both pro-inflammatory (IL-2, 6, 8), and anti-inflammatory cytokines (IL-4). The remaining changes were insignificant. Among mild side effects, there were a change in the color of the sclera in 4 (3.2%), anal pain in 3 (2.4%), a decrease in libido in 2 (1.6%) patients. No differences between groups in the frequency of side effects were recorded (p>0.05). CONCLUSION: Antioxidant stimulation of spermatogenesis in infertile men and CP is an effective and safe. The addition of a complex of natural antimicrobial peptides and cytokines (Superlymph) leads to a more profound increase in sperm motility, a decrease in the MAR-test, oxidative stress in sperm cells, which potentiates the effects of therapy. The use of Superlymph is accompanied by a more pronounced positive effect on pathospermia, an increase in anti-inflammatory and a decrease in pro-inflammatory cytokines. In the contrary, in control group, where patients received antioxidant stimulation of spermatogenesis, only a decrease in the level of main cytokines was observed. The effect of a complex of natural antimicrobial peptides and cytokines (Superlymph) on the level of SDF, as well as the relationship with fertility and childbirth rates, requires further study.
ABSTRACT
The aim of the study was to assess the seroprevalence to the SARS-CoV-2 nucleocapsid in the population of the Nizhny Novgorod region against the background of COVID-19. Materials and methods. The work was carried out according to a unified methodology developed by Rospotrebnadzor with the participation of the St. Pasteur. The selection of volunteers for the study was carried out by the method of questioning and randomization. The exclusion criterion was active COVID-19 infection at the time of the survey. A total of 2829 volunteers were surveyed, divided into seven age groups. Venous blood samples were taken from all volunteers from EDTA vacutainers. In the blood plasma, the content of specific IgG to the SARS-CoV-2 nucleocapsid was determined by the enzyme immunoassay. Results. The population level of immunity to SARS-CoV-2 among the surveyed volunteers was 8,4% (95% CI 7,4–9,5). The largest proportion of seroprevalent persons was found among children aged 1–6 years — 15,9% (95% CI 8,2–26,7), the smallest in the group of volunteers aged 18–29 years — 6,0% (95% CI 3,8–8,9). During 3-stage serological monitoring, the proportion of seroprevalent volunteers increased to 22,5% (95% CI 20,3–24,9)%, or almost 2 times from the initial level (p<0,05). of the population of the Semenovsky district (22,7% (95% CI 10,9–41,8)), the smallest — in the city of Dzerzhinsk (2,4% (95% CI 0,5–7,1)%) Among convalescents after COVID-19, specific antibodies were detected in 47,2% (95% CI 30,5–69,6), which is 5,6 times higher than the average for the population. Among those who had verified contact with patients, specific IgG were detected in 17,6% (95% CI 12,9–23,5), which is 2,1 times higher than the average for the population. Among asymptomatic persons who had a positive PCR result, 53,3% (95% CI 30,5–86,6) were seropositive, which is 6,3 times higher than the average for the population. Of 225 seropositive people, 188 (88,4% (95% CI 76,6–101,6)) had the disease asymptomatic. Conclusion. The relatively low proportion of seroprevalent persons among the population may indicate a significant risk of further development of the epidemic process caused by COVID-19 in the territory of the Nizhny Novgorod region. © 2021,HIV Infection and Immunosuppressive Disorders. All Rights Reserved.
ABSTRACT
Introduction. The first pandemic in the 21st century, caused by the pathogenic representative of the coronavirus SARS-CoV-2, began in the Chinese city of Wuhan, where the first outbreak of coronavirus pneumonia was recorded in December 2019. The disease spread so quickly around the world that already on February 11, 2020, WHO was forced to declare a pandemic of the “coronavirus disease 2019” COVID-19. The first case of COVID-19 in the Stavropol Territory was registered on March 20, 2020, and three weeks later, starting from the 15th week of the year, a steady increase in the incidence began, which lasted until the 52nd week. During the study period, the incidence increased from 21.1 to 28.3 per hundred thousand of the population. Growth 1.3 times. Purpose: to determine the dynamics of population immunity among the population of the Stavropol Territory in 2020-2021. during the period of an epidemic increase in the incidence of COVID-19. Materials and methods. The SARS-CoV-2 study was carried out according to a unified methodology within the framework of the program for assessing the population immunity of the population of the Russian Federation, developed by Rospotrebnadzor with the participation of the St. Pasteur. In total, 2688 people were examined, divided into 7 age groups. In the examined individuals, the level of specific IgG to the SARS-CoV-2 nucleocapsid was determined by the enzyme immunoassay. Results. The level of seroprevalence among residents of the Stavropol Territory was 9.8%. The largest proportion of seropositive individuals was found in the age groups 1-6 and 7-13 years old (19.2% and 19.7%, respectively). Seroprevalence had no gender differences and ranged from 9.3% to 10.8%. When assessing the distribution of the proportion of seropositive persons in different geographic territories of the region, it was found that the maximum proportion was found in the Kochubeevsky district (23.1%), the minimum in Kislovodsk (7.7%). Among convalescents, the content of specific antibodies to SARS-CoV-2 was noted in 73.3%, which is 7.8 times higher than the average population level. When conducting seromonitoring in the 2nd half of 2020, a 10-fold increase in seroprevalence was recorded, accompanied by a decrease in incidence from the 5th week of 2021. Among asymptomatic volunteers in whom SARS-CoV-2 RNA was detected by the polymerase chain reaction, antibody titers to viruses were found in 78.6%, which corresponds to the seroprevalence of convalescents. The proportion of seropositive persons among those who have come into contact with CO-VID-19 patients was 16.4%, (1.8 times higher than the average for the population). Out of 262 seroprevalent volunteers, the asymptomatic form of SARS-CoV-2 was detected in 92% of the examined, which indicates a significant role of the number of asymptomatic forms of infection in the epidemic process of COVID-19. Conclusion. The results of assessing the population immunity of the population of the Stavropol Territory indicate that it has not yet reached the threshold level at which a decrease in the intensity of the COVID-19 epidemic process can be expected. © 2021 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
Introduction. Direct influence of novel coronavirus infection (COVID-19) on male fertility is still unproven. However, through prolonged fever, hypoxia, systemic inflammation and other yet incompletely described factors this disease may apparently cause not only “long COVID” syndrome, but also transitory non-specific impairment of spermatogenesis. The study objective is to evaluate the effectiveness of administration of Russian complex with unique composition BESTFertil in case of decreased fertility and asthenic syndrome in males after new coronavirus infection. Materials and methods. We performed a non-blinded randomized prospective controlled trial which included 60 male patients with a history of COVID-19 not earlier than 6 months prior to enrollment from couples planning to have children. Patients were included if they had pre-disease semen analysis results available. They were divided into two equal groups. Group 1 (main group) received BESTFertil complex for 12 weeks, while Group 2 (comparison group) received no additional treatment. At baseline and 12-week follow-up all patients underwent semen analysis, MAR test, sperm DNA fragmentation test, serum sex hormone profiling and completed the “Asthenic condition scale” questionnaire. Student's t-test, Wilcoxon test, Mann-Whitney U-test and McNemar test were used for statistical analysis. Results. When comparing retrospective and baseline values we found no critical influence of COVID-19 on semen param- eters, though a moderate decrease of percentage of sperm with progressive motility could be observed (40.5 % vs 30 %, p = 0.008). Group 1 had a stronger tendency toward recovery of semen parameters. Patients receiving BESTFertil had median total motile sperm count increased from 48.5 million to 76.8 million (p = 0.032), while in comparison group it increased from 39.8 million to 49.2 million (p = 0.317). BESTFertil antioxidant complex had no negative influence on endocrine profile. Moreover, there was a statistically significant decrease of sperm DNA fragmentation index from 21.2 to 13.9 % (p = 0.007) in Group 1. Lower rate of asthenic symptoms was observed in Group 1 which received BESTFertil. Conclusion. Men with a recent history of COVID-19 had a moderate decrease of surrogate fertility markers, most prob- ably due to non-specific mechanisms. Patients receiving BESTFertil had a more pronounced recovery of semen parame- ters and improvement in post-COVID asthenic syndrome. © 2021 ABC-press Publishing House. All Rights Reserved.
ABSTRACT
The results of the joint work of a panel of experts from Rospotrebnadzor and healthcare professionals of the Republic of Uzbekistan on organizing activities to counter the spread of the SARS-CoV-2 virus are described in the paper. The goal of the study was to determine the main driving forces of COVID-19 spread in the Republic of Uzbekistan and develop an action plan to reduce the incidence of coronavirus infection caused by the SARS-CoV-2 virus. Materials and methods. The organization of work in 14 health care institutions in Tashkent and Samarkand, as well as in Tashkent and Samarkand Regions, was analyzed: in 7 laboratories, 6 hospitals and 1 polyclinic. The routes for the movement of personnel, the demarcation of green and red zones, the features of disinfection and the use of personal protective equipment were studied. Attention is drawn to the diagnosis of COVID-19, the use of therapy aimed at reducing the period of virus shedding, the criteria for lifting quarantine restrictions for patients. Results and discussion. The main factors in the organization of work of institutions that contribute to the spread of COVID-19 among medical personnel and the population have been identified: the lack of equipped gateways between the red and green zones with the accessibility of adequate disinfection, the wrong choice of personal protective equipment, monitoring of contact persons for 10 days, discharge from hospitals based on clinical improvement. The incorrect use of antiviral therapy, the lack of differentiated approaches to the selection of optimal regimens have been noted. Proposals are formulated for organizing the work of healthcare institutions, taking into account the requirements of biological safety. The introduction of targeted measures in addition to those previously adopted has led to a significant improvement in the epidemic situation: the total number of active cases in the Republic of Uzbekistan, despite the increase in testing volumes, decreased from 3,686 people on August 23 to 2335 on October 27. Towards December 20, 2020, 97 % of patients recovered completely. All diagnostic triage centers in the Republic of Uzbekistan are closed due to the absence of patients with COVID-19, most of the country's medical institutions previously re-profiled for patients with coronavirus infection have returned to the routine operations. © 2021 Russian Research Anti-Plague Institute. All rights reserved.