Prognostic criteria for the development of severe clinical forms of COVID-19 in medical organization workers

Employees of medical organizations are one of the risk groups for infection with a new coronavirus infection (COVID-19), including with the development of severe clinical forms. The aim of the study was to analyze the clinical manifestations of a new coronavirus infection in medical workers with the determination of laboratory markers for the development of severe COVID-19. Material and methods. The study included 186 medical workers who had COVID-19 in 2020. In 67 people (observation group), the disease occurred in the form of pneumonia, in 119 people (comparison group) - acute respiratory infection caused by SARS-CoV-2. In the acute period of the disease, a laboratory examination was carried out: a general clinical blood test, CD-typing of lymphocyte subpopulations, assessment of biochemical parameters, determination of parameters of the hemostasis system and cytokine levels. Using the binary logistic regression method, we have built multifactor models. To determine the threshold values of the indicators, we used ROC analysis. Statistical processing of materials was carried out using Microsoft Office 2016 and IBM SPSS Statistics (version 26). The differences were considered statistically significant at p<0.05. Results and discussion. The most frequent clinical manifestations of COVID-19 were: weakness, fever, myalgia, arthralgia, difficulty in nasal breathing, serous-mucous discharge from the nose, sore throat, cough, feeling of "tightness" in the chest, shortness of breath, headache, pain in the eyeballs, dizziness, anosmia, ageusia and dyspeptic manifestations in the form of diarrhea, nausea or vomiting. Markers associated with the development of severe pneumonia associated with COVID-19 have been identified. Threshold values of laboratory parameters for predicting the severe course of COVID-19 were determined: the number of platelets (less than 239x109/l), lymphocytes (less than 1.955x109/l), cytotoxic T-lymphocytes (less than 0.455x109/l), T-helper cells (less than 0.855x109/l), NK-cells (less than 0.205x109/l), ESR (more than 11.5 mm/h), LDH (more than 196 units/l), total protein (less than 71.55 g/l), D-dimer (more than 0.325 mcg/ml), CRP (more than 4.17 mg/l), IL-6 (more than 3.63 pg/l). Conclusion. The data obtained make it possible to predict the possibility of developing a severe variant of the COVID-19 course.Copyright © 2022 Infectious Diseases: News, Opinions, Training. All rights reserved.

Assessment of specific T-cell immunity in patients who have been ill and vaccinated against COVID-19.

Introduction. In the context of a pandemic of a new coronavirus infection (COVID-19), research on the peculiarities of the formation of an immune response to SARS-CoV-2 in patients who have been ill and vaccinated is of particular relevance. However, most studies are currently devoted to evaluating only the humoral link of immunity, and its cellular component remains insufficiently studied. The aim of the study was to evaluate the features of the formation and changes of the T-cell link of immunity in patients with a new coronavirus infection and vaccinated against this disease. Materials and methods. The study was performed on the basis of the clinical and diagnostic laboratory of the European Medical Center "UMMC-Health "LLC. Specific T-cell immunity was evaluated using ELISPOT technology. In the course of the study, 72 blood samples of employees of medical organizations were analyzed, including 26 from those who had a new coronavirus infection, 23 from persons who were intact according to COVID-19 before vaccination and 23 from the same employees after vaccination (<<Gam-Covid-Vac>>). In addition, each of the study participants was examined to determine specific class G antibodies (IgG) by solid-phase enzyme immunoassay using SARS-CoV-2-IgG-ELISA-BEST test systems (manufactured by VECTOR-BEST JSC). Results and discussion. In the group of patients (26 people), T-lymphocytes capable of specifically reacting to SARSCoV-2 antigens were detected in 100% of cases, even in individuals with IgG elimination. It should be noted that the response was more pronounced when meeting with M-and N-pepdids, compared with S-protein. 22 out of 23 COVID-19 intact individuals had no T-cell immunity to coronavirus infection before vaccination, but one employee had a response to 3 proteins-M, N, S, which indicates that he had previously encountered the SARS-CoV-2 virus. After vaccination with the drug "Gam-Covid-Vac", 22 (95.6%) employees revealed a T-cell response, while 21-only to S-protein, and an employee with a previously detected immune response-after vaccination, the response to M -, N-proteins remained almost at the same level, and the cellular response to S-peptide doubled. Conclusion. Thus, based on the results of the study, important materials were obtained on the peculiarities of the formation of a specific T-cell immune response to a new coronavirus infection. The obtained data provide a broader understanding of the immune response in new coronavirus infection in patients who have been ill and vaccinated and can be used in the future when planning preventive and anti-epidemic measures.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

Assessment of specific T-cell immunity in patients who have been ill and vaccinated against COVID-19.

Introduction. In the context of a pandemic of a new coronavirus infection (COVID-19), research on the peculiarities of the formation of an immune response to SARS-CoV-2 in patients who have been ill and vaccinated is of particular relevance. However, most studies are currently devoted to evaluating only the humoral link of immunity, and its cellular component remains insufficiently studied. The aim of the study was to evaluate the features of the formation and changes of the T-cell link of immunity in patients with a new coronavirus infection and vaccinated against this disease. Materials and methods. The study was performed on the basis of the clinical and diagnostic laboratory of the European Medical Center "UMMC-Health "LLC. Specific T-cell immunity was evaluated using ELISPOT technology. In the course of the study, 72 blood samples of employees of medical organizations were analyzed, including 26 from those who had a new coronavirus infection, 23 from persons who were intact according to COVID-19 before vaccination and 23 from the same employees after vaccination (<<Gam-Covid-Vac>>). In addition, each of the study participants was examined to determine specific class G antibodies (IgG) by solid-phase enzyme immunoassay using SARS-CoV-2-IgG-ELISA-BEST test systems (manufactured by VECTOR-BEST JSC). Results and discussion. In the group of patients (26 people), T-lymphocytes capable of specifically reacting to SARSCoV-2 antigens were detected in 100% of cases, even in individuals with IgG elimination. It should be noted that the response was more pronounced when meeting with M-and N-pepdids, compared with S-protein. 22 out of 23 COVID-19 intact individuals had no T-cell immunity to coronavirus infection before vaccination, but one employee had a response to 3 proteins-M, N, S, which indicates that he had previously encountered the SARS-CoV-2 virus. After vaccination with the drug "Gam-Covid-Vac", 22 (95.6%) employees revealed a T-cell response, while 21-only to S-protein, and an employee with a previously detected immune response-after vaccination, the response to M -, N-proteins remained almost at the same level, and the cellular response to S-peptide doubled. Conclusion. Thus, based on the results of the study, important materials were obtained on the peculiarities of the formation of a specific T-cell immune response to a new coronavirus infection. The obtained data provide a broader understanding of the immune response in new coronavirus infection in patients who have been ill and vaccinated and can be used in the future when planning preventive and anti-epidemic measures.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

From Monitoring the Commitment to Inoculations among Healthcare Workers during the COVID-19 Pandemic to Overcoming Communication Risks in the Process of Vaccination

Introduction: The epidemic process of the novel coronavirus disease (COVID-19) can be managed only through vaccination. Yet, despite the availability of effective immunobiological preparations, health administrators often face a negative attitude of the population, including healthcare professionals, to vaccination. Objective: To establish commitment of workers of health facilities to vaccination against COVID–19 during different periods of the pandemic using modern online resources and to justify the need to develop effective practices of dealing with communicative risks in the course of vaccination. Materials and methods: The study was conducted in several successive stages corresponding to five waves of the COVID-19 pandemic in the Russian Federation by means of an online survey of 5,304 health workers using Google Forms. We applied sociological and statistical methods of research. Results: We observed that the attitude to vaccination against COVID-19 among the employees of health institutions was ambiguous and changed over time demonstrating a gradual increase in adherence to inoculations. The potential risk group with a negative attitude towards vaccination included female nurses and workers of non-medical specialties with less than five years of work experience. An insufficient level of commitment to coronavirus vaccination among the personnel of health facilities has been also noted in other countries, which is a serious problem on a global scale hindering the victory over this novel infection. Conclusion: We assessed commitment to inoculations against COVID-19 among medical workers using modern online resources and found its inadequate level necessitating effective interventions aimed at awareness raising and training in modern practices of effective communications. © 2023, Federal Center for Hygiene and Epidemiology. All rights reserved.

Soft Skills as a Professional Platform in the Processes of Adaptation of Healthcare Workers to Crisis Situations

Introduction: Hospital employees have become one of the main risk groups for the novel coronavirus disease (COVID-19). In extreme conditions of the pandemic and over a short period of time, healthcare professionals were forced to repurpose their work, learn a significant amount of new information, and acquire novel professional competencies. Yet, the importance of supra-professional skills and competencies (so-called "soft skills”) for their job should not be underestimated, especially in crisis situations. Objective: To establish the role of soft skills in the adaptation of medical workers to severe conditions of the COVID-19 pan-demic. Materials and methods: We conducted an anonymous questionnaire-based survey of 638 hospital workers on the basis of the Google platform. The form containing two built-in scales was specially developed by the authors to assess the level of emotional intelligence (EQ) and adaptability of hospital employees under crisis conditions. Results: We found that most employees (78.7 %) had a moderate EQ level, while 13.0 % and 8.3 % had high and low EQ levels, respectively. We established that 100 % of the respondents with low EQ and 76.5 % of the respondents with moderate EQ had low adaptability;in the rest 23.5 % of the employees with moderate EQ, the level of adaptability was assessed as medium. Individuals with high EQ demonstrated medium (53.0 %) and high (44.6 %) levels of adaptability to the situation and only 2.4 % found it difficult to adapt to rapid changes. The estimated Spearman's correlation coefficient of 0.43 (p < 0.001) showed a moderate strength of correlation between the EQ level and adaptability. Conclusions: Highly developed soft skills contribute to better adaptation of employees to the new reality. Under current con-ditions, HR managers shall concentrate on introducing soft skills development training for healthcare professionals. © 2022, Federal Center for Hygiene and Epidemiology. All rights reserved.

Characteristic of Viral and Bacterial Contaminationin Objects of the Infection Hospital Environment of the Hospital for the Treatment of Patients with COVID-19 During the Pandemic Period

Relevance. Due to the COVID-19 pandemic a infectious diseases hospitals nationwide network has been deployed to treat patients infected with SARS-CoV-2. The principles of their formation with a strict division into «infectious» and «clean» zones, despite the epidemiological justification, lead to the formation of a dynamic artificially created closed ecosystem. In such an ecosystem, on the one hand, patients who undergo a wide range of invasive and aggressive therapeutic and diagnostic manipulations, and medical personnel stay for a long time, on the other hand, pathogens of a viral and bacterial nature that can adapt to hospital conditions and form resistant strains circulate. As a result, high risks of contamination of environmental objects of hospitals and patients themselves are created, which can lead to the development of exogenous nosocomial infection. Aims. To study the features of viral and bacterial contamination of objects in the hospital environment of the infectious diseases hospital for the treatment of patients infected with SARS-CoV-2 during the COVID-19 pandemic. Materials and methods. A study was conducted on 343 samples from the external environment of the infectious diseases hospital for COVID-19 patients' treatment during its planned work. Sample collection was performed during three days (Tuesday, Thursday, Sunday) at 20 unified sampling points: in the area where patients general hospital area as well as from the outer surface of personal protective equipment for medical personnel (overalls, gloves). The study used epidemiological (descriptive-evaluative and analytical), molecular genetic (SARS-CoV-2 PCR-RT, sequencing), bacteriological (isolation, cultivation and MALDI-TOF identification of bacterial cultures) methods. Statistical significance of differences was assessed by Fisher's point test (φ). Differences were considered significant at p≤0.05. Statistical data processing was carried out using the Microsoft Office 2010 application package, the online resource https://medstatistic. ru/, ST Statistica 10. Results. The study demonstrated a high level of viral and bacterial contamination of environmental objects in the intensive care unit of the infectious diseases hospital for COVID-19 patients treatment – 11.1%, incl. objects of the general hospital environment – 9.3% (doctor's workplace – 16.7%);patient location area – 13.9% (electric pump – 27.8%, mechanical ventilation, manipulation table – 16.7% each);the outer surface of personnel gloves – 21.1–38.9%;the outer surface of protective overalls for personnel – 44.4–50.0%. SARS-CoV-2 isolated from the objects of the external environment of the hospital belonged to the genetic variant B.1.617.1 DELTA, which corresponded to the epidemiological situation at sampling collection period. The opportunistic microflora structure was dominated by Enterococcus faecalis (38.1%), Klebsiella pneumoniaе (21.4%) and Escherichia coli (16.7%), which demonstrated a high level of resistance (to 3 or more groups of antibiotics). Conclusion. Initially, the main sources of the infectious diseases hospital environmental objects contamination with SARS-CoV-2 are most likely patients. Further contamination of the infectious diseases hospital environmental objects with viruses and opportunistic microflora occurs with the medical personnel direct participation. The current situation requires a review of approaches to the rules for disinfection, the PPE use and employees hands antiseptic treatment in infectious diseases hospital during the COVID-19 pandemic, as well as the length of staff work period length. © 2022, Numikom. All rights reserved.

COVID-19 Outbreak at Sports Club: Conditions of Occurrence and Causes of the Spread of Infection

Relevance. The new coronavirus infection (COVID-19), which appeared in late 2019 in China, has spread to almost all countries of the world in just a few months. The explosive nature of its spread was accompanied by the formation of large epidemic foci in organizations of various profiles, including leisure and sports. Aims. To establish the conditions and causes of the spread of SARS-CoV-2 among the members of one of the sports clubs based on an in-depth epidemiological analysis. Materials and methods. To study the features of the spread of the SARS-CoV-2 virus in a sports organization, the following documents were used previously developed by the authors and successfully tested in practice: «Act of epidemiological investigation of group and outbreak morbidity of new coronavirus infection (COVID-19) at an enterprise/organization/institution» and «Individual card of a patient with a new coronavirus infection (COVID-19) at the enterprise / organization/institution». In the process of epidemiological investigation, in order to detect SARS-CoV-2 RNA in PCR, a laboratory examination of sports club participants (sick and contact) was conducted, followed by genome-wide sequencing of isolated SARS-CoV-2 viruses on the basis of the Laboratory of Molecular Virology of the A. A. Smorodintsev Influenza Research Institute, which performs these types of studies. Results. Within 17 days, 26 cases of COVID- 19 were registered among the sports team members and staff from the support group (coaching staff, medical staff, administrators), which was 74.3% of their actual number. The majority of patients (76.9%) had mild acute respiratory infection, two (7.7%) had no symptoms, and four (15.4%) had interstitial pneumonia. Of the clinical manifestations of the disease, the most frequent were weakness, fever, headache, muscle and joint pain, difficulty in nasal breathing and serous-mucous discharge from the nose, sore throat, cough, shortness of breath, anosmia and dyspeptic manifestations in the form of diarrhea, nausea or vomiting. The occurrence of the outbreak was the result of the introduction of infection from the opposing team at the tournament. The leading factors that contributed to the spread of COVID-19 among sports club members were the admission to games and training of athletes with acute respiratory infections, prolonged close contact between players during training and competitions, violations in the use of personal protective equipment, compliance with hygiene and hand antiseptics, disinfection measures in the premises of sports institutions and defects in the implementation of the regulations for the examination of teams for SARS-CoV-2 during tournaments. Conclusion. Based on the results of the study, data were obtained on the features of the spread of SARS-CoV-2 in sports organizations, which can be used in conducting preventive and anti-epidemic measures in sports and leisure institutions. © 2022, Numikom. All rights reserved.

On the Issue of Evaluating the Effectiveness of Vaccination of Employees of Medical Organizations against COVID-19

Relevance. Active mass vaccination of the population against a new COVID-19 is being carried out on the territory of the Russian Federation, which is recognized as a priority strategy for the country's healthcare for the near and long-term periods. One of the main risk groups that are subject to priority vaccination is medical workers. Aims. To evaluate the effectiveness of vaccination of medical organizations ' employees against COVID-19 based on the results of a 6-month prospective follow-up. Materials and methods. The observation group consisted of 356 employees of a medical organization who were vaccinated against COVID-19 with the drug «Gam-Covid-Vac» from December 2020 to April 2021. The effectiveness of vaccination of employees was evaluated by the coefficient of IgG positivity to SARS-CoV-2 by solid-phase enzyme immunoassay 3 weeks after the first administration and 3–4 weeks after the second administration of the vaccine and then 1 time per month. Employees who were revaccinated after 5–6 months. After the initial vaccination, they were examined 10–14 days after the introduction of the first component «Gam-CovidVac». A total of 1921 serum samples were studied. A specific T-cell immune response was determined in two study participants without seroprotection after administration of two components of the «Gam-Covid-Vac» vaccine and eight employees with the elimination of IgG antibodies 4–5 months after vaccination using ELISPOT technology. In addition, 92 blood serum samples of 32 employees from the observation group were examined for specific antibodies to adenovirus by indirect enzyme immunoassay. From December 2020 to June 2021, the study participants were subjected to dynamic clinical observation, once a week they were examined by PCR to detect SARS-CoV-2 RNA in smears from the pharynx and nose (a total of 5696 samples). Results. After the completed course of immunization, the formation of both a humoral (in 99.4% of cases) and cellular immune response (100% among the studied samples) was confirmed. In the next 6 months after vaccination, cases of coronavirus infection were registered in 4.8% of those vaccinated, including 1 person – in the first month after vaccination and 16 – 3–5 months after vaccination. In all cases, the disease occurred in the form of an acute respiratory infection of mild or moderate severity and was characterized by a shorter period of virus isolation compared to similar data on the persistence of the virus in unvaccinated patients (15 days in vaccinated compared to 22 days in unvaccinated). It was found that the presence of immunity to adenovirus infection during vaccination with the drug «Gam-Covid-Vac» did not affect the possibility of forming an immune response to COVID-19. In the group of persons re-vaccinated with the first component of «Gam-Covid-Vac» after 5–6 months. after the initial vaccination, an immune response was received during the follow-up period. Conclusion. Thus, according to the results of the study, a high immunological and epidemiological effectiveness of vaccination against COVID-19 with the drug «Gam-Covid-Vac» was established in a group of medical workers, and the effectiveness and safety of the administration of a booster dose of the vaccine after primary vaccination was also shown. Keywords: coronavirus infection, COVID-19, vaccination, «Gam-Covid-Vac», medical workers, humoral and cellular immune response No conflict of interest to declare. © 2022, Numikom. All rights reserved.

RISKS OF BECOMING INFECTED WITH SARS-COV-2 FOR MEDICAL PERSONNEL IN A LARGE INDUSTRIAL CITY DURING THE PANDEMIC: COMPARATIVE ASSESSMENT

The COVID-19 pandemic has produced its effects on functioning of all the state institutions, the public healthcare sys-tem being a peculiar one among them. Medical personnel have become an unprotected population group that was actively involved into the epidemic process. Results produced by several studies indicate that relative risks to become infected with COVID-19 are by up to 11.6 times higher for medical personnel than in population at large. A share of medical personnel among patients with COVID-19 varies in different countries, from 4.2 % in China to 17.8 % in the USA. According to official statistics, in 2020 a share of medical personnel who became infected with COVID-19 in in-hospital foci amounted to 68.6 % in the RF regions located in the Urals and Siberian Federal Districts. High epidemic potential of the virus and intensive mass contacts between medical personnel and their patients make for rapid SARS-CoV-2 spread and infection among them. It is vital to examine all the range of risk factors that cause SARS-CoV-2 infection among medical personnel. The present study involved using “The map of epidemiological investigation focused on the incidence of the new coronavirus in-fection (COVID-19) in medical personnel”. The map was located on Google Cloud Platform. Overall, 613 medical workers from dif-ferent medical organizations took part in the research. We applied sociological, epidemiological and statistical research techniques. We established that work in an infectious diseases hospital increased a relative risk of SARS-CoV-2 infection by 1.8 times (RR = 1.78;95 % CI [1.65–1.93]). The total risk of SARS-CoV-2 infection was insignificant for workers employed at a medical organization that provided scheduled medical assistance to population (RR = 1.02;95 % CI [1.00–1.04]). However, certain factors created elevated risks of infection. Any contacts with COVID-19 patients who were close relatives, friends or neighbors were established to be significant (RR = 1.13;95 % CI [1.04–1.228]). The research results should be used when organizing work procedures and anti-epidemic activities in infectious diseases hospi-tals and medical organizations providing scheduled assistance to population. The focus should be on providing medical personnel with personal protective equipment as well as on calculating relevant duration of a work shift relying on the risk-based approach. © Smirnova S.S., Egorov I.А., Zhuikov N.N., Vyatkina L.G., Kharitonov А.N., Semenov А.V., Morova О.V., 2022

Multi-Level Monitoring of Vaccination Adherence of Various Population Groups in the Context of the COVID-19 Pandemic: Problematic Issues

Relevance. Despite significant progress in the prevention of many infectious diseases, a number of organizational issues remain in the area of special attention. One of them is to ensure the timeliness and completeness of vaccination coverage in the decreed age groups, which is possible only with a high level of public commitment to vaccination. During the pandemic of the new coronavirus infection (COVID-19), achieving a high level of vaccination coverage of the National Calendar of Preventive vaccinations is of particular relevance. Aim. Using state-of-the-art online resources, assess population vaccination adherence to develop effective communication risk management technologies for immunoprophylaxis in the COVID-19 pandemic. Materials and methods. To assess the commitment of various population groups and professional contingents of a large industrial city to vaccine prevention, a survey of 965 parents was conducted at the initial stage, and subsequently a survey of 2,632 employees of medical organizations, including 1,422 people in the period before the COVID-19 pandemic, 572 people in the «first wave» of the pandemic and 638 people in the «second wave». Instagram Facebook, Instagram, and VKontakte social networks were used to quickly obtain the necessary information (Google forms, corporate e-mails, WhatsApp, Telegram messengers, etc.). The work uses epidemiological, sociological and statistical methods of research. Results and discussion. When assessing the attitude of parents to vaccination, it was found that 78.8% of respondents were positive about vaccinations, 14.6% doubted their effectiveness and safety, and 6.6% denied their need. The main source of information that forms the attitude to vaccinations of parents was the opinion of medical professionals. In a survey of 1,422 employees, 190 people (13.3%) were identified, mainly from among the trained specialists, who themselves had a negative attitude to vaccination. When assessing the commitment of employees of medical organizations to the vaccination of a new coronavirus infection, the attitude to vaccination was ambiguous, especially in the group of secondary medical personnel and female employees of non-medical specialties, who are a potential risk group for forming a negative attitude to vaccinations and can act as «opinion leaders» on this issue for other categories of the population. Insufficient adherence to COVID-19 vaccine prevention has also been observed in other countries among various population groups, which is a serious problem on a global scale, hindering the fight against the pandemic of a new disease, which requires corrective measures. Conclusion. In this study, using modern online resources, a rapid assessment of the vaccination adherence of various population groups (parents and medical professionals) was carried out. It is shown that the use of modern technologies and software tools makes it possible to analyze a large array of data to solve problems of overcoming communication risks. The results obtained point to the need for prompt corrective measures in terms of the introduction of educational programs to increase adherence to vaccination, especially in groups at potential risk of the disease, including medical professionals, which is a priority for health care in all countries. © 2021, Numikom. All rights reserved.

ON REVEALING RISK GROUPS REGARDING EMOTIONAL BURN-OUT SYNDROME AMONG MEDICAL WORKERS DURING THE COVID-19 PANDEMIC

Medical workers have become a most affected population group during the pandemic of the new coronavirus infection (COVID-19). They were the first to start fighting against an unknown infection and at that stage their psychoemotional statedetermined not only correct evaluations of a situation but also relevant planning regarding control over it.Our research aim was to study the peculiarities of reacting to stress of medical organizations in an emergencyepidemic situation in order to reveal potential risk groups for developing emotional burnout syndrome.We applied our own author’s anonymous online poll available at Google platform to examine psychoemotional state ofmedical workers. The poll had a built-in “Scale of perceived stress-10” that included two sub-scales;one of them measureda subjectively perceived level of the situation strain and the other, the amounts of efforts made by medical workers to overcomeit. The poll was performed in November–December 2020;overall, 638 medical workers took part in it. They were ofdifferent age and sex and had different positions and working experience.We established great variability in individual levels of overstrain as per the stress perception sub-scale (Ех < 0;Ех = –0.59) with more “low” than “high” values as per this sub-scale (Аs > 0;Аs = 5.66). Having analyzed variabilityof values as per the stress overcoming sub-scale, we revealed that they were homogenous (Ех > 0;Ех = 3.98) with prevailing“high” values (Аs < 0;Аs = –6.97).Medical workers with their working experience being shorter than 5 years turned out to be a risk group with the mostdestructive reactions to long-term affecting stress factors at work and at home during the COVID-19 pandemic. Apart fromthem, high mental risks were also detected for workers who treated patients with COVID-19 as well as those who had previouslyhad the coronavirus infection.The research allowed obtaining actual data on psychoemotional state of medical workers during the COVID-19 pandemicand determining potential risk groups regarding developing emotional burnout syndrome. We substantiated the necessity toconstantly provide psychological trainings for medical workers with their focus on peculiarities of their reacting during the firstmeeting with destabilizing factors and with further adjustment of educational programs provided for potential risk groups © 2021, Health Risk Analysis. All Rights Reserved.

The incidence of covid-19 medical workers. The issues of biosafety and occupational risk factors

Relevance. During the pandemic of the new coronavirus infection (COVID-19), one of the most vulnerable and actively involved in the epidemic process categories of the population were medical workers. The study of the incidence of COVID-19 among medical workers, risk factors for infection and safety measures is an important area of research in modern conditions. The aim of the study is to assess the prevalence of COVID-19 among employees of medical organizations and occupational risk factors for infection in order to develop proposals for corrective measures. Materials and methods. To study the incidence of COVID-19 among employees of medical organizations, an anonymous online questionnaire developed by the authors was used, which was posted on the Google platform and distributed during the first wave of the pandemic among employees of medical organizations in several regions of the Russian Federation through corporate e-mail or specialized online resources adapted for health workers. The survey involved 1,872 medical workers of different genders, ages, positions and work experience. Results and discussion. Among the survey participants, 161 employees have already had a new coronavirus infection. In the majority (64.0%) of them, the disease occurred in the form of acute respiratory infection, in 28.6%-interstitial pneumonia, in 7.4% only the fact of isolation of the SARS-CoV-2 antigen without clinical manifestations of infection was documented. The most affected contingents were secondary and junior medical personnel, mainly hospital staff. The likelihood of infection in the workplace was increased by factors such as providing care to patients with confirmed COVID-19, participating in procedures related to aerosol generation, working with biomaterials of patients with COVID-19, contact with surfaces in the environment of a COVID-19 patient, ignorance of infectious safety issues due to lack of instruction before admission to work. When assessing the efficiency of personal protective equipment (PPE) when they are used in the process, it was found that the highest value for the prevention of infection COVID-19 had a PPE for face protection, respiratory and eye, and hand hygiene. At the same time, many employees are faced with the problem of an insufficient number of protective equipment in the workplace. When assessing the availability of SARS-CoV-2 testing to employees, it was found that only 77.4% of survey participants had the opportunity to be tested for coronavirus infection in a timely manner. Conclusion. Thus, for more effective protection of employees of medical organizations, it is necessary to have a sufficient number of personal protective equipment, especially for the face, respiratory organs and vision, the availability of hygienic hand treatment during work, regular instruction on infectious safety, using interactive forms of training, and the organization of screening examinations of previously unvaccinated and unvaccinated employees. © 2021, Numikom. All rights reserved.