Functional features of the cardiovascular system in COVID-19 children

The functional state of the cardiovascular system of children aged 8-12 years who underwent COVID-19 was studied. It has been shown that one of the mechanisms of functional disorders in the cardiovascular system in the period from 3 to 6 months after suffering COVID-19 is considered a syndrome of autonomic dysfunction. The manifestations of autonomic dysfunction in children are hypertensive changes in the cardiovascular system in the absence of pronounced clinical manifestations, the presence of functional tension of regulatory systems, unsatisfactory functional status, decreased rates of increase in heart rate power in response to load, low values of sympathetic regulation mechanisms and centralization of the cardiovascular system regulation circuit, a large proportion of the influence of the peripheral regulation circuit. Conclusion. One of the pathogenetic mechanisms for reducing the functional parameters of the cardiovascular system in children who have had a coronavirus infection is endothelial dysfunction syndrome.

Public attitudes to Sputnik V vaccination against the novel COVID 19 infection the role of the socialdemographic characteristics and pandemic COVID-19 individual experience issues and their implementation as the targets for brief psychosocial intervention

Introduction: Vaccination has proved to be an effective tool in decreasing infectious diseases incidence and their mortality rate. Negative public vaccine attitude can significantly undermine efforts to combat the pandemic that makes vaccine hesitancy one of the WHO main concerns Objectives: Examination of the relationships in population between vaccine attributes and COVID-19 personal experience, social and demographic characteristics Methods: Cohort cross-sectional study of the population attitude to vaccination against coronavirus infection COVID-19 was performed online during the first 2 months of mass vaccination in Russia, using the special designed questionnaire assessing social demographic variables, COVID-19 related factors, and preferable sources of information about COVID-19 vaccines. 4977 participants in the age from 18 to 81 years were enrolled in the study to vaccination against coronavirus infection COVID-19 was performed online during the first 2 months of mass vaccination in Russia, using the special designed questionnaire assessing social demographic variables, COVID-19 related factors, and preferable sources of information about COVID-19 vaccines . Result(s): 34.2% of respondents consider vaccination useful. 31.1% - doubt its effectiveness. 9.9% - consider vaccination unnecessary. 12.2% - dangerous. indifference to vaccination was formed in 7.4% of respondents. They indicated that they do not plan to be vaccinated. 32.3%. postpones their decision until more remote data on the results and effectiveness of vaccination are obtained - 34.0%. were vaccinated at the time of the study - 11.6%. Conclusion(s): Attitude towards vaccination depends on age, gender, education, fear of possible complications, coronaphobia. Young people are less focused on vaccination than middle-aged and older people.

Post-covid syndrome: psychoneurological disorders in focus

The outbreak of the novel coronavirus infection pandemic has spread all over the world millions of people have been recovered from it that makes necessary the research of their health status after the acute infection phase. The accumulated data about previous coronavirus epidemics showed their prolonged impacton the nervous system with the manifestation of mental and neurological symptoms. Specialists from different countries from the beginning of the pandemic have revealed typical symptoms in patients recovered from coronavirus infection with negative tests still complained on residual respiratory, gastroenterological and psychoneurological symptoms that manifested with asthenic, cognitive, dissomnic and affective disorders, anosmia and changes in taste preferences. No correlation between infection severity and symptoms set in the reconvalescence period has been found. Different countries have been used different terms to describe it like prolonged, long, chronic covid.The leading medical centers have made their impact in this problem analysis During the two recent years a big international research base, including the data from electronic medical histories has been accumulated concerning COVID 19 reconvalescents health status. WHO has presented the postcovid 19 syndrome work definition, in its structure psychoneurological symptoms such as asthenia, anxiety-depressive and cognitive disorders, insomnia play an important role. The healthcare provision for the patients with postcovid syndrome remains the issue needed further elaboration, the most promising treatment plan seems the combination of pharma-cotherapy with psychosocial interventions. Tofizopam as a drug with anxiolytic, secondary precognitive and aniastenic effects can be recommended for the postocovid syndrome psychoneurological symptoms. © 2022, Remedium Group Ltd. All rights reserved.

Mental ecology in the structure of the COVID-19 pandemic (review)

Currently, sufficient data are available on the negative impact of the COVID-19 pandemic and its socio-economic consequences on human mental health and the mental ecology in general. The success of public health strategies to cope with pandemics is largely determined by psychological factors and the mental values prevailing in the community at large. The present review systematized the psychological response features of various social, professional, and national representatives during the COVID-19 period within the framework of the main mental ecology provisions. The review methodology was based on the World Health Organization documents and open sources of the Scopus and Web of Science databases on the population's mental health under COVID-19 pandemic conditions. A significant increase in adaptive and anxiety-depressive disorders was noted during the COVID-19 pandemic. Among the specific mental phenomena associated with the pandemic, coronaphobia, COVID-19-stress syndrome, covid-dissidence manifestations with the involvement of conspiracy theories, and mythological thinking were identified. The negative infodemia impact on the mental ecology, as well as the adherence to anti-epidemic measures and readiness for vaccination, were also established. Negative trends were demonstrated in communities where the maximum infection and death risk were associated with low adherence to the epidemiological measures and refusal to vaccination. It was revealed that belonging to certain social or professional groups largely determines a person's behavior in relation to a new coronavirus infection within the framework of accepted social norms. Based on the analysis of a large domestic and international data number on the impact of the COVID-19 pandemic emergency on the human psyche, its significant adverse contribution to the overall mental ecology was noted. The necessity of developing special therapeutic and psycho-prophylactic programs aimed at coping with the stress pandemic impact and treatment of affective disorders, countering infodemia, and strengthening behavioral patterns to maintain mental health and personal well-being is substantiated. © Authors, 2022.

VACCINATION AGAINST COVID-19 FOR HEMATOLOGIC PATIENTS: A REVIEW OF CLINICAL GUIDELINES

Introduction. The COVID-19 pandemic has led to the need to accelerate the development of vaccines targeting SARS-CoV-2. A large number of researchers have already confirmed that patients with cancer have a high risk of mortality from COVID-19. Hematologic diseases and the therapy of these diseases are very heterogeneous, therefore it is expected that the immune response to infection or vaccination will be more variable in this cohort of patients. Accordingly, questions arise regarding the safety and efficacy of vaccines in the context of immune changes caused either by the hematological disease itself or by the therapy that is administered to the patient. Aim - to summarize the current understanding of the efficacy and safety of vaccination against the SARS-CoV-2 in patients with hemoblastosis and other hematological diseases. Basic information. Legalized COVID-19 vaccines are safe and effective for the general population. Given the high mortality rate among patients with hematological diseases, which is ten times higher than the mortality rate in the general population, vaccination is a priority for this group of patients. The current lack of clinical trial data on the effectiveness and safety of vaccines against COVID-19 in hematological patients raises a large number of questions among specialists and patients. This is also due to the fact that for most of the approved vaccines-immunocompromised patients were not included in the phase III clinical trials. Thus, most patients with hematological diseases could not participate in these studies, and therefore the effectiveness and safety of vaccines against the causative agent of COVID-19 have not been thoroughly studied in this group. Current recommendations for vaccination against COVID-19 in hematological patients are based on expert opinion, including past experience of immunizing these patients against other viral infections. Conclusions. Vaccination of patients with hematological diseases and their environment (medical staff, relatives, caregivers) is one of the necessary methods to prevent high mortality from a new coronavirus infection during the COVID-19 pandemic.

Final Results of CHRONOS19 Observational Study in Patients with Hematologic Disease and COVID-19 in Russia

Background: Research on the impact of COVID-19 on different patient populations has been of great value for the optimization of patient care since the start of the SARS-CoV-2 pandemic. Earlier, we reported the interim analysis of the immediate outcomes in patients (pts) with hematologic (hem) disease and COVID-19. Long-term results of the CHRONOS19 registry are now available. Methods: CHRONOS19 is an observational prospective cohort study among adult pts ((≥18 years) with hem diseases (malignant or non-malignant) and laboratory-confirmed or suspected (based on clinical symptoms and/or CT) COVID-19 in Russia. Data from 15 centers all over the country were collected on a web-based platform in a de-identified manner at 30, 90, and 180 days after COVID-19 was diagnosed. The primary endpoint was 30-day all-cause mortality. Secondary outcomes included COVID-19 complications, rate of ICU admission and mechanical ventilation, outcomes of hem disease in SARS-CoV-2 infected pts, overall survival, and risk factors for disease severity and mortality. Results: As of July 30, 2021, 666 pts were enrolled (females / males [n (%)]: 317 (48%) / 349 (52%);median [range] age: 56 [18-90] years. Disease types (malignant/non-malignant [n (%)]): 618 (93%) / 48 (7%), including AML 115 (17%), MM 113 (17%), NHL 106 (16%), CML / CMPD 92 (14%), ALL 52 (8%), CLL 50 (8%), MDS 25 (4%), HCL 23 (3%), HL 21 (3%), AA 16 (2%), APL 11 (2%), others 42 (6%);among them induction phase / remission / relapse or refractory / NA in 237 (35%) / 231 (35%) / 152 (23%) / 46 (7%) pts. Concomitant conditions were reported in 385 (58%) pts: cardiovascular 254 (66%), diabetes 76 (20%), obesity 57 (15%), pulmonary 41 (11%), chronic renal 44 (11%) or hepatic 33 (9%) disease, other 90 (23%). At a median follow-up of 7,5(1-19) months, 618 pts were evaluable for the primary outcome. Thirty-day all-cause mortality was 16% (100 pts died). Death due to COVID-19 complications occurred in 82 pts, 14 pts died due to progression of hem disease. Overall, 217 (33%) pts had severe disease, COVID-19 complications were detected in 458 (70%) pts, the most common were pneumonia in 425 (93%) pts, respiratory failure in 252 (55%) pts, multiple organ failure in 56 (12%) pts, cytokine storm in 52 (11%) pts, ARDS in 47 (10%) pts, and sepsis in 44 (10%) pts. The rate of ICU admission was 23% (145 pts) with high mortality in this group of pts (77%), 111 (17%) pts required mechanical ventilation, among them only 5 (4.5%) pts survived. Treatment of hem disease was changed, interrupted, or discontinued in 395 (60%) pts with a median delay of 4 weeks. At 30 days, the rate of relapse / progression of hem disease was 5% / 8% (24 / 40 of 517 evaluable pts). At the longer follow-up (90 and 180 days), relapse / progression occurred in another 9 / 23 pts. At the data cutoff, the median overall survival was not reached. Antibody detection was performed in 253 pts: 211 (84%) pts had IgG to SARS-CoV-2. In a univariate analysis, older age (> 60 years), myelotoxic agranulocytosis, transfusion dependence, diabetes among comorbidities, ARDS and other complications, except CRS, ICU and mechanical ventilation (Fig. 1) were associated with higher risks of mortality (p<0.05). The final results of the CHRONOS19 study will be presented. Conclusions: Patients with hem disease and COVID-19 have higher mortality than a general population with SARS-CoV-2 infection, predominantly due to COVID-19 complications. The longer-term follow-up did not reveal any concerns in terms of hem disease outcomes. [Formula presented] Disclosures: Vorobyev: Janssen, Roche, Sanofi, Takeda, Biocad, Abbvie: Other: Advisory Boards, Speakers Bureau;Astellas, Novartis, AstraZeneca: Speakers Bureau. Chelysheva: Pharmstandart: Speakers Bureau;Pfizer: Speakers Bureau;Bristol Myers Squibb: Speakers Bureau;Novartis Pharma: Speakers Bureau.

[Time perspective perception specific and maladaptation in elderly under uncertainty conditions during pandemic emergency.]

The purpose of the study - to determine the specifics of experiencing psychological stress, the time perspective and symptoms of adaptation disorders in older people in a pandemic emergency compared to the active adult population. At the first stage, 587 people were examined using the PSM-25 scale, then 100 respondents with maladaptive stress levels (sum ≥155 points) were selected. The main group consisted of 50 people aged 60 to 74 years (average age 65±2,7 years), 50 people aged 18 to 44 years (average age 32±3,8 years) were included in comparison group, who were examined with using the SCL-90-R questionnaire for assessing psychopathological symptoms and the ZTPI questionnaire for assessing the perception of time perspective. The presence of adaptation disorders in both groups was revealed. In the elderly group, the activation of the perception of the positive past was established, which can be an adaptive resource, and the greater severity of the fatalistic perception of the present, which causes passive overcoming with stress and narrows the adaptive capabilities of the elderly. The results of the study make it possible to identify potential «targets» of psychotherapeutic work with the population in conditions of pandemic stress, taking into account the age factor.

Treatment outcomes and antibody immunity to SARS-CoV-2 in patients with hematological malignancies

Background: Since SARS-CoV-2 infection heavily affects vulnerable populations including those with immune suppression, it is of special value to study clinical course, treatment outcomes, and immunity in patients (pts) with hematological (hem) malignancies. Methods: CHRONOS19 is an ongoing observational study in adult pts (≥18 years) with hem diseases (malignant or non-malignant) and COVID-19 in Russia. This web-based registry collected de-identified data from 15 centers all over the country at 30, 90, and 180 days after lab-confirmed or suspected (based on CT and/or clinical symptoms) COVID-19 diagnosis. The primary endpoint was 30-day all-cause mortality. Results: As of data cut-off on April 14, 2021, 626 pts were enrolled in the study;562 were eligible for primary endpoint assessment, n (%): M/F 271 (48%) / 291 (52%), median age 56 [18-90] years, malignant disease in 516 (92%) pts, among them induction phase / relapse or refractory / remission / NA in 180 (35%) / 120 (23%) / 187 (36%) / 29 (6%) pts. Thirty-day all-cause mortality in pts with hem malignancies was 19%;83% of deaths were due to COVID-19 complications. No increase of hem disease relapse rate after COVID-19 was observed at Day 90 or Day 180, although 180-day data was still not mature at the time of analysis. IgG to SARS-CoV-2 was detected in 84% of pts with hem malignancies (167/199). The highest rate of detected antibody immunity was found in pts with chronic myeloproliferative neoplasms (100%;13/13), HL (100%;12/12), and multiple myeloma (97%;34/35), the lowest – in pts with CLL (62%;8/13) and NHL (60%;6/10 and 56%;10/18 for low-grade and high-grade lymphoma, respectively). igG detection rate in CD20+ lymphoma (60%) was significantly lower than in HL or T-cell lymphoma (p=0.004). Pts with ECOG 0-2 throughout the disease had a high rate of antibody immunity (90%;104/116) vs. those with ECOG 3-4 at the time of COVID-19 diagnosis (77.5%;31/40) or with worsening of ECOG to 3-4 during the disease (78%;36/46). Five cases of SARS-CoV-2 re-infection were described. Conclusions: Pts with hem malignancies and COVID-19 have higher mortality than the general population. Low post-disease antibody immunity to SARS-CoV-2 and cases of re-infection may justify vaccination of these pts and warrant further research. Clinical trial identification: NCT04422470. Legal entity responsible for the study: National Research Center for Hematology. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Outcomes in patients with acute leukaemia and covid-19: Results of subgroup analysis of chronos19 registry

Background: Patients (pts) with acute leukemia (AL) are at high risk of COVID-19 severe and lethal course. Intensive chemotherapy and immunosuppression in these patients are the possible causes of high mortality. Emerging data on risk factors and outcomes in this vulnerable patient population is aimed to support strategies of their medical care. Aims: To evaluate treatment outcomes and risk factors in pts with AL and COVID-19 in a real-world setting. Methods: CHRONOS19 [NCT04422470] is an ongoing nationwide observational cohort study of adult (≥18 y) pts with hematologic disease (both malignant and non-malignant) and lab-confirmed or suspected (based on clinical and/or CT findings) COVID-19. We performed a subgroup analysis of pts with AL and COVID-19. Primary objective was to evaluate treatment outcomes and identify risk factors associated with higher mortality in this group of pts. Primary endpoint was 30-day all-cause mortality. Long-term follow-up was performed at 90 and 180 days. Data from 14 centers was collected on a web-based platform and managed in a deidentified manner. Results: As of data cutoff on January 27, 2021, 575 pts were included in the registry, 132 of them with AL were eligible for primary endpoint assessment n(%): AML - 86(65%), ALL - 37(28%), APL - 9(7%);M/F 55(42%)/77(58%), median age 45 [18-79] years, induction phase/R/R/ treatment in remission 49(37%)/27(21%)/ 54(42%), agranulocytosis in 55(42%) pts, 68(53%) pts were transfusion dependent, comorbidities - in 58(45%) pts. Complications developed in 98(74%) pts: pneumonia (71%), sepsis (9%), CRS (8%), ARDS (6%). One-third of pts had severe COVID-19, 30% were admitted to ICU, 26% required mechanical ventilation. We performed comparative analysis of characteristics between a group of pts with AL and other hematologic diseases (lymphomas, chronic leukemia, multiple myeloma, and other malignant and non-malignant diseases): pts with AL had significantly more frequent agranulocytosis (42% vs 20%, p<0,001), transfusion dependence (53% vs 33%, p<0,001), and a higher rate of admission to ICU (30% vs 20%, p=0,036). All-cause mortality at 30 days was 24% in pts with AL vs. 15% in pts with other hematologic diseases (p=0,03);70% of deaths were due to COVID- 19 complications in pts with AL. At 90 days, one additional death due to COVID-19 occurred. At 180 days, 5 more deaths due to leukemia progression were registered. Risk factors that were significantly associated with overall survival (OS) are listed in Table 1. In multivariate analysis, ICU + mechanical ventilation, HR, 70.258 (19.5-270.0) and age >60 years HR, 3.340 (1.08-10.9) were the most significant risk factors of death. Overall, AL were associated with a higher risk of death, HR, 2.40 (1.28-4.51), compared to less aggressive diseases (CML, CLL, MM, lymphomas, non-malignant), HR, 0.54 (0.37-0.80). COVID-19 affected treatment of AL in 65% of pts, 58% experienced treatment delay for a median of 4 [1-10] weeks. In 11 of 103 (10,7%) pts with AL early relapse/refractory disease was detected, but the association of relapses with affected treatment is unknown. COVID-19 re-infection was described in 2 patients. Summary/Conclusion: Thirty-day all-cause mortality was significantly higher in SARS-CoV-2-infected pts with AL than in those with other hematologic diseases. Longer-term follow-up (180 days) for AL outcomes and OS will be presented.

EXPERIENCE OF HAEMATOLOGICAL OBSERVATORY WARD DURING COVID-10 PANDEMIC

Introduction. The SARS-CoV-2 infection (COronaVlrus Disease 2019, COVID-19) usually progresses uncomplicated in an acute respiratory form but causes frequent severe illness in oncohaematological patients. Aim analysis of the management and efficacy of medical aid at a haematology clinic during the COVID-19 pandemic. Patients. The clinic admitted 2,130 patients in April 20 November 20, 2020, with 920 of them triaged into observatory wards. At the time of admission, 907 (98.5 %) patients were SARS-CoV-2 RNA-negative, with 13 hospitalised without nasopharyngeal swab tests. Patient nosology: 235 (25.5 %) lymphoma, 152 (16.5 %) multiple myeloma, 131 (14.2 %) acute leucaemia, 86 (9.3 %) haemophilia, 35 (4 %) Gaucher's disease, 17 (1.8 %) Waldenstrom macroglobulinemia, 16 (1.7 %) aplastic anaemia, 153 (16.6 %) various surgical diseases, 81 (8.8 %) other haematological diseases and 14 (1.6 %) were bone marrow donors. Results. Among the 920 patients admitted to the observatory, 139 (15 %) were severe and 653 (71 %) had a moderate condition. Fever was reported in 124 (13.5 %) patients at admission. Chest computed tomography (CT) was performed in 809 patients, with recent lung inflammation detected in 121 (15 %) cases. Twenty four (2.6 %) patients were revealed SARS-CoV-2-positive, with 20 diagnoses PCR-verified and four in chest CT. Ten patients were diagnosed positive in routine examination or at a specialty unit as fever aggravated. Thus, a two -staged SARS-CoV-2 screening with PCR and chest CT allowed an extra 2.6 % detection of COVID-19 cases despite negative tests at admission. Conclusion. The observatory management has reduced the likelihood of nosocomial COVID-19 and ensured a continued supply of specialty medical aid.

The impact of life hardiness, attachment style and personality profile on ptsd vulnerability manifestation in breast cancer patients undergone successful surgical treatment

IntroductionPTSD manifestation is determined by facing extreme life threatening experience going beyond our stress coping skills. The diagnosis of the serious illness like cancer or SARS-2 COVID 19 can be considered as one of the PTSD risk factors. In our clinical practice we have to distinguish the patients groups vulnerable to comorbid PTSD as well as define the psychological factors like good life hardiness, adaptive internal illness image or specific personality profile that can help to cope with disease stress and should be strengthen with psychosocial interventions.ObjectivesAfter screening with PTSD Trauma Screening Questionnaire and an expert clinical interview aimed to verify the PTSD diagnosis according to ICD-10 criteria 97 breast cancer patients were enrolled in the study, 46 with comorbid PTSD, 51 well coped with stressMethodsSemi-structured interview, Hardiness Survey questionnaire,Experiences in Close Relationships-Revised (ECR-R) Adult Attachment questionnaire,Impact of Event Scale-R – IES-R, the questionnaire of the internal disease model, Ego-structure test by G. Ammon(ISTA),.ResultsThe correlation analysis revealed negative correlation between PTSD diagnosis and hardiness, especially its Involvement, Control, Risk acceptance sub-scales and with the Traumatic event impact score. Deficient-destructive ISTA personality profile had a positive correlation with PTSD and traumatic Impact scores, the strongest correlation were with deficient aggression(r=0,698, p=0.01), destructive anxiety (r=0,674, p=0,01), and deficient internal and external demarcation (r=0,678, p=0,01). The adaptive internal illness image types had a negative correlation with PTSDConclusionsHardiness, maladaptive illness images types and destructive-deficient personality dimension should be the main targets for psychotherapy in comorbid PTSD treatment and preventionKeywordlife hardiness ptsd breast cancer internal image of the illness construct anxiety social support

COVID-19 and hematologic diseases: Risk factors and longterm follow-up of CHRONOS19 Registry

Background: Pts with hem diseases are at high risk of COVID-19 severe course and mortality. Emerging data on risk factors and outcomes in this patient population is of great value for developing strategies of medical care. Methods: CHRONOS19 is an ongoing nationwide observational cohort study of adult (≥18 y) pts with hem disease (both malignant and nonmalignant) and lab-confirmed or suspected (clinical symptoms and/or CT) COVID-19. Primary objective was to evaluate treatment outcomes. Primary endpoint was 30-day allcause mortality. Long-term follow-up was performed at 90 and 180 days. Data from 14 centers was collected on a web platform and managed in a deidentified manner. Results: As of data cutoff on January 27, 2021, 575 pts were included in the registry, 486 of them eligible for primary endpoint assessment, n(%): M/F 243(50%)/243(50%), median age 56 [18-90], malignant disease in 452(93%) pts, induction phase/R/R/remission 160(33%)/120(25%)/206(42%). MTA in 93(19%) pts, 158(33%) were transfusion dependent, comorbidities in 278(57%) pts. Complications in 335(69%) pts: pneumonia (67%), CRS (8%), ARDS (7%), sepsis (6%). One-third of pts had severe COVID-19, 25% were admitted to ICU, 20% required mechanical ventilation. All-cause mortality at 30 days - 17%;80% due to COVID19 complications. At 90 days, there were 14 new deaths: 6 (43%) due to hem disease progression. Risk factors significantly associated with OS are listed in Tab 1. In multivariate analysis - ICU+mechanical ventilation, HR, 53.3 (29.1-97.8). Acute leukemias were associated with higher risk of death, HR, 2.40 (1.28-4.51), less aggressive diseases (CML, CLL, MM, nonmalignant) - with lower risk of death, HR, 0.54 (0.37-0.80). No association between time of COVID-19 diagnosis (Apr-Aug vs. Sep-Jan) and risk of death. COVID-19 affected treatment of hem disease in 65% of pts, 58% experienced treatment delay for a median of 4[1-10] weeks. Relapse rate on Day 30 and 90 - 4%, disease progression on Day 90 detected in 13(7%) pts;180-day data was not mature at the time of analysis. Several cases of COVID-19 re-infection were described. Conclusions: Thirty-day allcause mortality in pts with hem disease was higher than in general population with COVID19. Longer-term follow-up (180 days) for hem disease outcomes and OS will be presented. Univariate analysis of factors associated with lower OS.

[Pandemic COVID-19 and mental disorders international experience and therapeutic approaches]. / Psikhicheskie narusheniya, svyazannye s pandemiei COVID-19 (mezhdunarodnyi opyt i podkhody k terapii).

The article considers the COVID-19 pandemic impact on the population mental health, the main psychogenic and somatogenic mental disorders associated with COVID-19 are distinguished. The comorbid PTSD clinical features are described. The mental health risk factors for health workers are presented. The psychotherapeutic and psychopharmaceutical approaches are proposed.

Specifications of the COVID-19 infection in children

First encountered in the 2019 COVID-19 virus has a high transmission capacity, and children are not spared. Therefore, we set a goal, referring to the experience of the countries in which the infection spread the earliest and widest, to make a summary of the characteristics of COVID-19 in the pediatric population. Of course, the most significant thing is the variation in the clinical manifestation, the correct assessment of the clinical risk of lung damage, as well as the laboratory and imaging methods of examination that support a reliable diagnosis. The therapy section of the article describes all the possible strategies for therapeutic behavior. Despite the rapidly growing theoretical information and shared clinical experience, the article could be a foundation on which to add and expand theoretical and practical knowledge.

[Pandemic and mental adjustment disorders. Therapy options]. / Pandemiya i adaptatsionnye trevozhnye rasstroistva: vozmozhnosti terapii.

The article considers the main triggers of adjustment and anxiety disorders in the time of pandemic that brings significant changes in all life dimensions with the high uncertainty level. The article highlights a role of coronavirus infodemic in the development of anxiety disorders. The main targets for cognitive, emotional and behavioral interventions are suggested. Recommendations for anxiety adjustment disorders psychopharmacotherapy with the use of tranquillizers as treatment of choice are given. Prevention measures for medical doctors working in conditions of pandemic are proposed.