The association of hair loss and coronavirus infection COVID-19 – facts and hypotheses

The main manifestations of COVID-19 are primarily interstitial pneumonia and respiratory failure. No less than 20% of patients have variable skin rashes, which try to be interpreted as markers and predictors of the peculiarities of the course of coronavirus infection. In addition, hair loss is a characteristic manifestation of COVID-19, and the salivary follicles are regarded as a target for SARS-CoV-2. The most common variants of alopecia in patients with a new coronavirus infection or vaccine-induced alopecia are acute telogenic, nondescript, and androgenetic alopecia. This review provides information on the most common variants of hair loss in patients with SARS-CoV-2 infection, the features of their manifestations, and possible mechanisms of development. Acute telogenic hair loss is the most common variant of SARS-CoV-2-induced alopecia, is characteristic of patients with subacute course of COVID-19 and can be combined with trichodynia, anosmia and aguvia, which are markers of nervous system damage. Given the variability in the time of onset after infection, a heterogeneous pathogenesis of alopecia can be assumed. Nested alo-pecia after COVID-19 is often a relapse of the disease, its severity and frequency do not correlate with the severity of the infectious disease, and its prevalence in women indicates the importance of hormonal factors in its development. Androgenetic alopecia may be a predictor of high risk of infection, severe course, and recurrence of COVID-19. The first two variants of alopecia may be associated with COVID-19 vaccination, and the latter is a predictor of inadequate immune response to vaccine administration. The mechanisms of the damaging effects of SARS-CoV-2 on hair follicles have not been fully deciphered and are most likely complex, with different leading links in different types of hair loss. Deciphering these mechanisms may provide prerequisites for understanding the mechanisms of COVID-19 damage to other tissues and organs. © Smirnova I.O. 2023.

The association of hair loss and coronavirus infection COVID-19 – facts and hypotheses

The main manifestations of COVID-19 are primarily interstitial pneumonia and respiratory failure. No less than 20% of patients have variable skin rashes, which try to be interpreted as markers and predictors of the peculiarities of the course of coronavirus infection. In addition, hair loss is a characteristic manifestation of COVID-19, and the salivary follicles are regarded as a target for SARS-CoV-2. The most common variants of alopecia in patients with a new coronavirus infection or vaccine-induced alopecia are acute telogenic, nondescript, and androgenetic alopecia. This review provides information on the most common variants of hair loss in patients with SARS-CoV-2 infection, the features of their manifestations, and possible mechanisms of development. Acute telogenic hair loss is the most common variant of SARS-CoV-2-induced alopecia, is characteristic of patients with subacute course of COVID-19 and can be combined with trichodynia, anosmia and aguvia, which are markers of nervous system damage. Given the variability in the time of onset after infection, a heterogeneous pathogenesis of alopecia can be assumed. Nested alo-pecia after COVID-19 is often a relapse of the disease, its severity and frequency do not correlate with the severity of the infectious disease, and its prevalence in women indicates the importance of hormonal factors in its development. Androgenetic alopecia may be a predictor of high risk of infection, severe course, and recurrence of COVID-19. The first two variants of alopecia may be associated with COVID-19 vaccination, and the latter is a predictor of inadequate immune response to vaccine administration. The mechanisms of the damaging effects of SARS-CoV-2 on hair follicles have not been fully deciphered and are most likely complex, with different leading links in different types of hair loss. Deciphering these mechanisms may provide prerequisites for understanding the mechanisms of COVID-19 damage to other tissues and organs. © Smirnova I.O. 2023.

Analysis of the World Fleet Capacities in the Context of the Northern Sea Route with Help of the EDAS Methodology

The relevance of the world fleet capacities' analysis, with an emphasis on the container transport, as well as the use of the promising opportunities of the Northern Sea Route (NSR) is acquiring a global meaning. The influence and dominance of the maritime powers in this market is no longer traditional and does not directly depend on classical factors. As a result of the crisis economic trends caused by the Covid-19 pandemic, as well as the continuous search for a cost optimization and complex cargo transportation strategies that include new opportunities and directions are coming to the fore. The purpose of this study is to investigate the position of the largest players in the sea freight market with the intensification of the NSR navigation. This article based on the analysis of the best strategic alternatives using the EDAS methodology. The proposed multi-criteria model demonstrates that the strategic choice of leading cargo carriers is based on focusing not only on the key indicators of maritime transport, but also on the complex nature of their strategy. © 2022 The Authors. Published by ELSEVIER B.V.

IMPACT OF THE COVID-19 PANDEMIC ON THE DIGITAL TRANSFORMATION OF CRIMINAL JUSTICE

A common trend in the development of criminal proceedings over the last decade has been the penetration of modern digital technology. To a certain extent, the digitalisation of criminal proceedings has been a natural consequence of a qualitative change in crime and an increase in the number of offences committed through the use of modern technology. However, the degree of digitalisation of the criminal process varies considerably from state to state. The COVID-19 pandemic that has engulfed the world has severely challenged courts and law enforcement agencies. The criminal justice system has been confronted with unforeseen challenges and new procedural tools have to be found to address them. The resolution of the contradiction between social distance and the right of citizens to access to justice forced courts to use modern information technology more frequently. However, the pandemic has also revealed organisational and regulatory difficulties that make their use difficult. The authors believe that further scientific development of the problems of digitalization of criminal proceedings will contribute to the smooth administration of justice in criminal cases, even in emergency situations and special regimes. The article analyses prospective directions of digitalization which will contribute to the optimization of criminal proceedings. These directions include application of digital technologies for detection and investigation of crimes, criminal evidence, optimization of routine processes in criminal proceedings and use of artificial intelligence in making procedural decisions. The authors emphasise that the main factor limiting the use of digital technology is the significant lag in the regulatory framework that does not allow the use of a particular technology in the due process of law. The authors propose to regulate by law the issue of determining the reasonableness of the duration of court proceedings, taking into account the epidemiological situation. In conclusion, we substantiate a system of conditions, the fulfilment of which will be a prerequisite for the productive digitalisation of Russian criminal procedure in the post-pandemic era. Key issues are suggested for further constructive scientific discussion, the results of which should be reflected in legislation.

Features of informatization of the criminal process in the context of the pandemic: New challenges

The article analyses the features of the application of the current criminal procedural legislation in practice in the context of the new coronavirus infection (COVID-19) after recognizing it as a disease that poses a danger to others, the Decree of the Presidium of the Supreme Court of the Russian Federation of April 08, 2020 and Reviews on certain issues of judicial practice related to the application of legislation and measures to counter the spread of the new coronavirus infection in the Russian Federation of April 21, 2020 and April 30, 2020. However, the difficulties that have arisen in law enforcement practice, also assessed in the article, indicate that criminal procedural legislation will be adjusted in the near future since the number of Decisions of the Presidium and the Plenum of the Supreme Court of the Russian Federation are not sufficient to eliminate ambiguities and contradictions in the Code of Criminal Procedure of the Russian Federation. In particular, the article reflects such key problems as the emerging system of procedural decisions at the pre-trial and trial stages in a pandemic, the possibility of considering not only criminal cases but also case materials using videoconferencing systems as well as the prevailing and optimal understanding by law enforcement agencies of the category “urgency” of such consideration. The authors pay special attention to the absence in the Code of Criminal Procedure of the Russian Federation of the concepts introduced by paragraph “m” Art. 7 of the Constitution of the Russian Federation such as “information technologies” and “digital data turnover”. The results of the study make it possible to formulate proposals for improving criminal procedural regulation in terms of the described problems. © 2021 Saint Petersburg State University. All Rights Reserved.

Clinical outcomes of patients with COVID-19 admitted for respiratory support to the intensive care units in Russia

Aim. To evaluate mortality and risk factors for death in patients with COVID-19 who required admission to intensive care units (ICU) for respiratory support in Russia.Material and methods. In a retrospective study, we collected medical records of the consecutive ICU patients submitted by the local COVID-19 hospitals across Russia to the Federal Center at the Sechenov University (Moscow) betweenMarch 16 to May 3, 2020. All patients have completed their hospital stay (death or recovery). Diagnosis of SARS-CoV-2 pneumonia was established both by polymerase chain reaction (PCR) and CT. In patients with inconclusive or negative results of PCR, the SARS-CoV-2 pneumonia was defined as severe acute respiratory infection with typical CT findings and no other obvious aetiology. We used Cox proportional hazards regression model adjusted for age, sex and other risk factors to estimate hazard ratios (HR) and 95% confidence intervals (CI).Results. We studied 1522 ICU patients with SARS-CoV-2 induced acute respiratory distress syndrome (ARDS), including 864 males and 658 females at the median age of 62 years. Nine hundred twenty two records (60.1%) were submitted from Moscow and Moscow province, and 600 records (39.4%) were received from the hospitals located in 70 regions of Russia. SARS-CoV-2 was verified by PCR in 995 (65.4%) patients. Among 1522 patients enrolled in the study,995 patients (65.4%) died, and 527 (34.6%) patients recovered. The most common causes of death were ARDS (93.2%), cardiovascular events (3.7%) and pulmonary embolism (1.0%). The mortality rate was low in patients with less severe pneumonia requiring oxygen therapy (10.1%). However, it increased significantly in patients who were placed on noninvasive or invasive ventilation (36.8% and 76.5%, respectively). Risk of death increased with age, and in males older than 50 years it was significantly higher than in females of similar age. In a unvariate analysis, arterial hypertension, coronary artery disease (CAD), history of stroke, atrial fibrillation, type 2 diabetes, obesity and malignancies were associated with an increased risk of death. However, only CAD (HR1.257, 95% CI 1.064-1.485, p=0.007), type 2 diabetes (HR1.300, 95% CI 1.131-1.494, p<0.0001) and obesity (HR1.347,95% CI 1.166-1.556, p<0.0001) retained statistical signicance in multiple factor analysis.Conclusion. In ICU patients with COVID-19, severity ofARDS (i.e. requirement in mechanical ventilation), age, malegender, CAD, obesity and type 2 diabetes were associatedwith a higher risk of death. Цель. Изучение летальности и факторов рискасмерти больных с COVID-19, госпитализированных для респираторной поддержки в отделения реанимации и интенсивной терапии(ОРИТ) лечебных учреждений Российской Федерации.Материал и методы. Ретроспективноеисследование было выполнено в Федеральномдистанционном консультативном центре анестезиологии и реаниматологии для взрослыхпациентов с COVID-19 на базе Первого МГМУим. И.М. Сеченова. В исследование включаливсех пациентов с известными исходами (смертьот любых причин или выздоровление) SARS-CoV-2 пневмонии, осложнившейся острым респираторным дистресс синдромом (ОРДС),которые были проконсультированы с 16 мартапо 3 мая 2020 г. Факторы риска смерти анализировали с помощью многофакторной регрессионной модели Кокса.Результаты. В исследование были включены 1522 пациента, 864 (56,8%) мужчины и 658(43,2%) женщин. Медиана возраста - 62 года.922 (60,6%) больных находились в ОРИТ стационаров Москвы и Московской области, 600(39,4%) - лечебных учреждений в 70 регионахРоссийской Федерации. У 995 (65,4%) больных диагноз SARS-CoV-2 инфекции был подтвержден с помощью ПЦР. Умерли 995 (65,4%)пациентов, выжили 527 (34,6%). Основнымипричинами смерти были ОРДС (93,2%), сердечно-сосудистые осложнения (3,7%) и тромбоэмболия легочной артерии (1,0%).Летальность была низкой у пациентов, находившихся на оксигенотерапии (10,1%), изначительно повышалась у больных, которыхприходилось переводить на неинвазивную(36,8%) или инвазивную (76,5%) вентиляциюлегких. Риск смерти увеличивался с возрастоми в возрастных группах старше 50 лет у мужчинбыл достоверно выше, чем у женщин. В однофакторных моделях заболеваниями, ассоциировавшимися с развитием летального исхода,были артериальная гипертония, ИБС, инсульт,фибрилляция предсердий, сахарный диабет 2типа, ожирение и солидные опухоли, однако вмногофакторной модели, построенной по всемпризнакам с коррекцией по полу и возрасту,статистическое значение сохранили толькоИБС (отношение рисков [ОР] 1,257, 95% доверительный интервал [ДИ] 1,064-1,485,p=0,007), сахарный диабет 2 типа (ОР 1,300,95% ДИ 1,131-1,494, p<0,0001) и ожирение(ОР 1,347, 95% ДИ 1,166-1,556, p<0,0001).Заключение. Основными факторами рискасмерти больных с COVID-19, переведенных вОРИТ для респираторной поддержки, былитяжесть ОРДС, прежде всего необходимость вИВЛ, пожилой возраст, мужской пол, а такжеИБС, ожирение и сахарный диабет 2 типа.