ABSTRACT
The relationship between the incidence of COVID-19 in pregnant women who have had a coronavirus infection at different gestational ages and the health status of paired neonates is of great interest. However, no sufficient convincing data fully reflecting features of subsequent neonatal period, the state of the immune system in this category of children, affecting characteristics of postnatal period have been accumulated. Based on this, it underlies the relevance of the current study aimed at investigating parameters of clinical and immunological state of neonatal health after paired mothers recovered from COVID-19 at different gestational ages. The prospective study included 131 women and 132 children. The main group consisted of women (n = 61) who had COVID-19 during pregnancy and paired newborns (n = 62) at gestational age (GA) of 37-41 weeks, the comparison group - women without laboratory-confirmed COVID-19 during pregnancy (n = 70) and paired newborns (n = 70) of similar gestational age. While analyzing the anamnesis of the patients, no significant differences in somatic and obstetric-gynecological diseases were found. Analyzing course of pregnancy revealed that low molecular weight heparins were significantly more often applied in the main group. The term and frequency of delivery by caesarean section in pregnant women in the main group did not significant differ from that of the control group. No significant difference in the frequency of causes accounting for the severity of the condition of neonates in paired mothers with COVID-19 at different trimester of gestation was found. Investigating lymphocyte subset composition, neutrophil phagocytic activity, and IgG class antibodies specific to SARS-CoV-2 was carried out. It was found that lymphocyte subset profile in newborns from paired mothers with COVID-19 at different trimesters of gestation differed only in the level of NK cells (CD56+) in children born to mothers recovered from COVID-19 in the first trimester. In this study, in general, no severe perinatal outcomes in newborns from paired mothers with COVID-19 during pregnancy were documented. No cases of moderate or severe maternal COVID-19 were observed. Therefore, further prospective studies are needed to assess an impact of COVID-19 severity on maternal and fetal birth outcomes and clarify optimal management of pregnant women in such cases.
ABSTRACT
There is a description of two clinical cases of a new coronavirus infection COVID-19 in patients with a history of heart transplantation. Patients who receive immunosuppressants for life are at risk of developing infectious diseases. This requires the vigilance of doctors, especially in the face of a pandemic of a new coronavirus infection. Adequate and timely started therapy increases the effectiveness of treatment and reduces the risk of complications. The complex participation of different specialists is necessary to determine the tactics of treatment, correct pathogenetic and suppressive therapy.Copyright © 2021 Sovero Press Publishing House. All rights reserved.
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The purpose of this review is to analyze the data of scientific articles on medicines indicated as etiotropic and approved for outpatient use within the framework of temporary methodological recommendations for the prevention, diagnosis and treatment of a new coronavirus infection in the Russian Federation. Material and methods. A systematic search of literature was carried out on the databases MEDLINE, PubMed, Cochrane Library, GHL, OpenGrey, ICTRP and ClinicalTrials.gov until April 2021. 37 779 articles were indexed in the ScienceDirect database (keywords: SARS-CoV-2), of which (pre-press) - 2023 (2), 2022 (69), published in 2021 (19 642 articles), in 2020 (12,966 articles). The search was carried out using the following keywords: Favipiravir - 1622 publications, Umifenovir - 387 publications, which indicates a high interest in the problem of new coronavirus infection in general and its drug (etiotropic) therapy, in particular. Results. The conducted analysis demonstrates that drugs based on favipiravir have a larger number of studies proving its effectiveness in different clinical groups of patients with COVID-19, while it is important to note the breadth of the geography of published works, which allows us to speak about the reproducibility of the results. Drugs from this group have a direct antiviral effect with the studied target of action (i.e., most likely, the principle of etiotropic therapy is implemented). Conclusion. The search for new drugs, as well as the expansion of information about the mechanisms of action of previously known molecules, is the basis for the development of COVID-19 therapy regimens with maximum efficiency and safety.Copyright © 2021 Sovero Press Publishing House. All rights reserved.
ABSTRACT
The pandemic of coronavirus infection is characterized by a low percentage of complications and severe forms in sick children compared to the adult population. However, there have been described cases of severe clinical course of COVID-19 in children with comorbidities among which is obesity. The aim of this study was to analyze the severe course of a new coronavirus infection paralleled with morbid obesity in a pediatric patient. Materials and methods. All accompanying patient medical documentation was examined. Results and discussion. From the anamnesis of life it is known that the patient was long time complained of intensively increased body weight, on which she repeatedly underwent examinations. In 2018, hypothalamic pubertal syndrome was diagnosed for the first time, for which the patient received hypoglycemic and antihypertensive drugs, hepatoprotectors on an ongoing basis. In the epidemiological anamnesis, the intrafamilial COVID-19 contact with mother was established. The main disease began acutely with a rise in body temperature up to 39-39.5degreeC, cough and weakness. During the first week of illness, the patient did not seek medical help and receive self-treatment, but the positive effect was not achieved. Saturation measurement showed low oxygen level (SpO2 71%). In this regard, the patient underwent chest computed tomography, which revealed a bilateral interstitial polysegmental lung lesion with signs of consolidation. After emergency hospitalization, the patient was prescribed empiric antibiotic therapy, anti-inflammatory and antithrombotic treatment, as well as respiratory support. A positive PCR result of a throat and nasal swab for SARS-CoV-2 was obtained in the hospital. Due to a poor response to therapy, the patient was transferred to a respiratory hospital. At the time of hospitalization, the condition was considered severe due to severe respiratory failure and premorbidity. The range of treatments included oxygenotherapy, antibacterial and anticoagulation therapy, as well as surfactant and the nucleoside analogue Remdesivir. During treatment, the clinical picture gained a positive trend, and after 6 days of hospitalization the patient no longer needed respiratory support. According to the results of repeated computed tomography, bilateral interstitial polysegmental pneumonia was diagnosed with damage to the lung tissue up to 95%. The patient remained stable and showed no signs of respiratory failure during the following days of hospitalization. On the 20th day of ilness, the patient was discharged from hospital with full clinical recovery. Conclusion. This clinical case demonstrates the role of premorbid background in aggravating the clinical picture of a new coronavirus infection in a child. Careful study of anamnestic characteristics is necessary in patients of any age, even with an uncomplicated disease course.Copyright © 2023 Saint Petersburg Pasteur Institute. All rights reserved.
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Background: Glycogen Storage Disease Ia (GSDIa) and Ib (GSDIb) are inborn errors of carbohydrate metabolism due to a deficiency of glucose-6-phosphatase (G6Pase) or glucose-6-phosphate translocase (G6PT), respectively. Consuming prescribed amounts of uncooked cornstarch (UCCS) to prevent hypoglycemia is the standard of care for GSDIa and GSDIb. Patients followed in our GSD Program are admitted to the hospital annually for evaluation of their metabolic control by measuring glucose and lactate levels and revising treatment regimens accordingly. Lack of bed space due to the COVID-19 pandemic has created a need for alternate markers of metabolic control as lactate measurements are unreliable in the outpatient setting. This research aims to identify alternative biomarkers to show degree of metabolic control in individuals with GSDI. Method(s): A retrospective chart review was conducted on 45 adults and children with GSDI using data from January 1, 2014 toMay 6, 2021. Plasma alanine and free carnitine levels were compared with laboratory reference ranges. Results from the three tests were not available on every subject. Plasma alanine was evaluated on 24 subjects (16-GSDIa, 8-GSDIb) and free carnitine was evaluated on 25 subjects (17-GSDIa, 8-GSDIb). Result(s): Alanine levels in subjects with GSDIa ranged from 378 to 786 umol/L, while alanine levels in subjects with GSDIb ranged from 254 to 506 umol/L (reference range = 103-528 umol/L). Free carnitine levels ranged from26 to 72 umol/L in subjects with GSDIa and from 44 to 90 umol/L in subjects with GSDIb (reference range = 19-55 umol/L). Conclusion(s): Our analysis showed that plasma alanine and free carnitine have potential to be used as biomarkers of metabolic control. For plasma alanine, there seemed to be differences between subjects with GSDIa and GSDIb, as the majority of subjects with GSDIa had elevations in plasma alanine, while subjects with GSDIb did not. Elevated plasma alanine levels indicate lactic acidosis. For GSDIb, we hypothesize that there may be some type of G6Pase enzyme activity that occurs outside of the endoplasmic reticulum. When looking at both groups, free carnitine levels were mostly elevated. This indicates that there could be inhibition of fatty acid oxidation.Copyright © 2022 Elsevier Inc. All rights reserved.
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Objective. To assess level and the structure of systemic antibiotic consumption in Russia over the period 2017 to 2021. Materials and methods. Data were collected and analysed in compliance with the standard protocol of the World Health Organization Regional Office for Europe by the means of ATC/DDD methodology for J01 group - antibacterials for systemic use. Consumption was calculated for outpatients and inpatients separately as a number of DDDs per 1000 inhabitants per day (DID) for the main classes of antibiotics and the agents with the highest or the most diverse consumption levels for the given period of time, and was based on the data of wholesale purchases and public tenders. Results. Antibiotic consumption in Russia in 2017, 2018, 2019, 2020, and 2021 was 16.6 DID, 14.3 DID, 14.8 DID, 19 DID, and 15.7 DID respectively. Penicillins, macrolides and lincosamides, and quinolones had the highest levels of consumption in outpatients. Prominent increase in outpatient consumption of antibacterials in 2020 was related to three agents: azithromycin, levofloxacin and ceftriaxone. Cephalosporins (mainly III-V generations), quinolones and penicillins had the highest levels of consumption in inpatients. Hospital consumption of meropenem, tigecycline, and vancomycin increased and amikacin and ciprofloxacin decreased over the duration of the study. Conclusions. Levels of systemic antibiotic consumption in Russia for the period 2017 to 2019 were relatively low and consistent with the average means for European Union and European Economic Area countries. The steep increase in consumption in 2020 was probably due to the wide use of antibiotics for the management of COVID-19 patients. The results of the study can be of value for the development of targeted national antibiotic stewardship programs and awareness campaigns as well as for the analysis of trends of emergence and spread of antibiotic resistance.Copyright © 2022, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. All rights reserved.
ABSTRACT
The pandemic of coronavirus infection is characterized by a low percentage of complications and severe forms in sick children compared to the adult population. However, there have been described cases of severe clinical course of COVID-19 in children with comorbidities among which is obesity. The aim of this study was to analyze the severe course of a new coronavirus infection paralleled with morbid obesity in a pediatric patient. Materials and methods. All accompanying patient medical documentation was examined. Results and discussion. From the anamnesis of life it is known that the patient was long time complained of intensively increased body weight, on which she repeatedly underwent examinations. In 2018, hypothalamic pubertal syndrome was diagnosed for the first time, for which the patient received hypoglycemic and antihypertensive drugs, hepatoprotectors on an ongoing basis. In the epidemiological anamnesis, the intrafamilial COVID-19 contact with mother was established. The main disease began acutely with a rise in body temperature up to 39–39.5°C, cough and weakness. During the first week of illness, the patient did not seek medical help and receive self-treatment, but the positive effect was not achieved. Saturation measurement showed low oxygen level (SpO2 71%). In this regard, the patient underwent chest computed tomography, which revealed a bilateral interstitial polysegmental lung lesion with signs of consolidation. After emergency hospitalization, the patient was prescribed empiric antibiotic therapy, anti-inflammatory and antithrombotic treatment, as well as respiratory support. A positive PCR result of a throat and nasal swab for SARS-CoV-2 was obtained in the hospital. Due to a poor response to therapy, the patient was transferred to a respiratory hospital. At the time of hospitalization, the condition was considered severe due to severe respiratory failure and premorbidity. The range of treatments included oxygenotherapy, antibacterial and anticoagulation therapy, as well as surfactant and the nucleoside analogue Remdesivir. During treatment, the clinical picture gained a positive trend, and after 6 days of hospitalization the patient no longer needed respiratory support. According to the results of repeated computed tomography, bilateral interstitial polysegmental pneumonia was diagnosed with damage to the lung tissue up to 95%. The patient remained stable and showed no signs of respiratory failure during the following days of hospitalization. On the 20th day of ilness, the patient was discharged from hospital with full clinical recovery. Conclusion. This clinical case demonstrates the role of premorbid background in aggravating the clinical picture of a new coronavirus infection in a child. Careful study of anamnestic characteristics is necessary in patients of any age, even with an uncomplicated disease course. © 2023 Saint Petersburg Pasteur Institute. All rights reserved.
ABSTRACT
Over the last decade, the introduction of new antifungal drugs and diagnostic procedures has improved the prognosis of hematological patients with invasive fungal disease (IFD), primarily invasive aspergillosis. Despite effective antifungal prophylaxis against the most common IFD caused by Aspergillus spp., rates of IFD due to rare pathogens being resistant to most antifungal drugs, including mucormycosis have been increased. The main group of patients having a high risk of mucormycosis is deeply immunocompromised patients who received chemotherapy for acute leukemia, patients undergoing allogeneic bone marrow transplantation, or treated with corticosteroids for graft-versushost disease. Currently, the urgency of this complication is significantly higher due to COVID-19 pandemic and extensive use of corticosteroids for the treatment of COVID-19. Despite the fact that the criteria for the diagnosis of IFD EORTC/MSG 2008 and 2020 have been developed and implemented into practice in most countries, mucormycosis still remains a difficult-to-diagnose IFD, where the factor of rapid diagnosis is a main factor of treatment success. Medications available for the treatment of IFD include polyenes, triazoles, and echinocandins. For a long time, the drug of choice for the treatment of mucormycosis was liposomal amphotericin B. However, a new effective drug has been approved for the treatment of both mucormycosis and IFD, caused by multiple pathogens - isavuconazole. This review presents new data on the epidemiology of mucormycosis, diagnosis approaches and current international treatment guidelines.Copyright © 2021, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. All rights reserved.
ABSTRACT
The risk of severe type I diabetes mellitus in children with new coronavirus infection (COVID-19) is extremely high, which is associated, with a high risk of intracranial hypertension, cerebral edema and multiple organ dysfunction, syndrome. On the example of a clinical case, the features of the course of diabetic ketoacidosis and. intensive care measures in children with COVID-19 were considered. The main data of the history and clinical and laboratory examination are reflected, specialattention is paid to the applied aspects of therapy, it was noted that with a severe course of a new coronavirus infection and diabetic ketoacidosis, the risk of developing cerebral injury, acute kidney injury and. thromboembolic complications is quite high, which, may require artificial lung ventilation, for the purpose of cerebral protection, renal replacement therapy and. the use of anticoagulants. The new coronavirus infection is a risk factor for the severe course of diabetic ketoacidosis in children with type I diabetes, regardless of the age of the child, which is the basis for clinicalalertness in order to timely identify and treat potential life-threatening complications.Copyright © 2022 Authors. All rights reserved.
ABSTRACT
Clinical Infectious Diseases Hospital. S.P. Botkin has been providing assistance to pregnant women and newborns suffering from COVID-19 since the beginning of the pandemic. In the period from April 2020 to April 2022, 550 newborns born to mothers suffering from COVID-19 of varying severity were observed in the hospital, of which 52 children had a registered diagnosis of COVID-19 (the SARS-CoV-2 virus was identified in a swab from the nasopharynx of a newborn using PCR). In this paper, an analysis of the pathological changes identified in this category of newborns was carried out, the issues of the influence of the covid status of the mother and the duration of stay with her on the child's condition were studied. Analysis of the results of the work revealed a relationship between the duration of the period of stay of a newborn with a mother with an active form of COVID-19 and the severity of the disease in newborns. According to our clinical observations, the vertical route of transmission of the virus seems highly probable. Newborns who have had COVID-19 or have perinatal contact with SARS-CoV-2 are subject to dynamic observation. It is necessary to determine the order, timing and scope of dispensary observation for the timely detection of pathological changes in this category of children.Copyright © 2022 Authors. All rights reserved.
ABSTRACT
Clinical Infectious Diseases Hospital. S.P. Botkin has been providing assistance to pregnant women and newborns suffering from COVID-19 since the beginning of the pandemic. In the period from April 2020 to April 2022, 550 newborns born to mothers suffering from COVID-19 of varying severity were observed in the hospital, of which 52 children had a registered diagnosis of COVID-19 (the SARS-CoV-2 virus was identified in a swab from the nasopharynx of a newborn using PCR). In this paper, an analysis of the pathological changes identified in this category of newborns was carried out, the issues of the influence of the covid status of the mother and the duration of stay with her on the child's condition were studied. Analysis of the results of the work revealed a relationship between the duration of the period of stay of a newborn with a mother with an active form of COVID-19 and the severity of the disease in newborns. According to our clinical observations, the vertical route of transmission of the virus seems highly probable. Newborns who have had COVID-19 or have perinatal contact with SARS-CoV-2 are subject to dynamic observation. It is necessary to determine the order, timing and scope of dispensary observation for the timely detection of pathological changes in this category of children.Copyright © 2022 Authors. All rights reserved.
ABSTRACT
Clinical Infectious Diseases Hospital. S.P. Botkin has been providing assistance to pregnant women and newborns suffering from COVID-19 since the beginning of the pandemic. In the period from April 2020 to April 2022, 550 newborns born to mothers suffering from COVID-19 of varying severity were observed in the hospital, of which 52 children had a registered diagnosis of COVID-19 (the SARS-CoV-2 virus was identified in a swab from the nasopharynx of a newborn using PCR). In this paper, an analysis of the pathological changes identified in this category of newborns was carried out, the issues of the influence of the covid status of the mother and the duration of stay with her on the child's condition were studied. Analysis of the results of the work revealed a relationship between the duration of the period of stay of a newborn with a mother with an active form of COVID-19 and the severity of the disease in newborns. According to our clinical observations, the vertical route of transmission of the virus seems highly probable. Newborns who have had COVID-19 or have perinatal contact with SARS-CoV-2 are subject to dynamic observation. It is necessary to determine the order, timing and scope of dispensary observation for the timely detection of pathological changes in this category of children. © 2022 Authors. All rights reserved.
ABSTRACT
Clinical Infectious Diseases Hospital. S.P. Botkin has been providing assistance to pregnant women and newborns suffering from COVID-19 since the beginning of the pandemic. In the period from April 2020 to April 2022, 550 newborns born to mothers suffering from COVID-19 of varying severity were observed in the hospital, of which 52 children had a registered diagnosis of COVID-19 (the SARS-CoV-2 virus was identified in a swab from the nasopharynx of a newborn using PCR). In this paper, an analysis of the pathological changes identified in this category of newborns was carried out, the issues of the influence of the covid status of the mother and the duration of stay with her on the child's condition were studied. Analysis of the results of the work revealed a relationship between the duration of the period of stay of a newborn with a mother with an active form of COVID-19 and the severity of the disease in newborns. According to our clinical observations, the vertical route of transmission of the virus seems highly probable. Newborns who have had COVID-19 or have perinatal contact with SARS-CoV-2 are subject to dynamic observation. It is necessary to determine the order, timing and scope of dispensary observation for the timely detection of pathological changes in this category of children. © 2022 Authors. All rights reserved.
ABSTRACT
SARS-CoV-2 pandemic is now a global medical and social problem. Little is known about its impact on some vulnerable subgroups, such as immunocompromised patients. Therefore, there is still a strong interest in exploring the impact of SARS- CoV-2 infection among HIV-positive individuals worldwide. Aim of the study: to analyze immunological aspects of the deceased, patients with HIV/COVID-19 coinfection. Materials and. methods. We provided retrospective analysis of 258 patient's electronic medical records. All patients were admitted, to the Infectious diseases hospital N2 with HIV/COVID-19 coinfection and died in May 2020 - February 2022. Standard, immunological parameters were analyzed, like CD4+, CD8+ counts and. immunoregulatory index for different patient's subgroups. Statistical data processing was provided by SPSS 17 version (allowable error E=5%). Results and. discussion. The study demonstrated. CD4+ and CD8+ reduction in HIV-infected with COVID-19. Late HIV-presenters didn't display such phenomenon probably because of immune system, exhaustion. COVID-19 itself in some cases could, lead, to immunodeficiency worsening due to depletion of T cell populations in HIV-patients on effective antiretroviral therapy. Conclusion. Comprehension, of different immunological characteristics in HIV/COVID-19 coinfected patients could, improve therapeutic approaches for this challenging cohort.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
SARS-CoV-2 pandemic is now a global medical and social problem. Little is known about its impact on some vulnerable subgroups, such as immunocompromised patients. Therefore, there is still a strong interest in exploring the impact of SARS- CoV-2 infection among HIV-positive individuals worldwide. Aim of the study: to analyze immunological aspects of the deceased, patients with HIV/COVID-19 coinfection. Materials and. methods. We provided retrospective analysis of 258 patient's electronic medical records. All patients were admitted, to the Infectious diseases hospital N2 with HIV/COVID-19 coinfection and died in May 2020 — February 2022. Standard, immunological parameters were analyzed, like CD4+, CD8+ counts and. immunoregulatory index for different patient's subgroups. Statistical data processing was provided by SPSS 17 version (allowable error E=5%). Results and. discussion. The study demonstrated. CD4+ and CD8+ reduction in HIV-infected with COVID-19. Late HIV-presenters didn't display such phenomenon probably because of immune system, exhaustion. COVID-19 itself in some cases could, lead, to immunodeficiency worsening due to depletion of T cell populations in HIV-patients on effective antiretroviral therapy. Conclusion. Comprehension, of different immunological characteristics in HIV/COVID-19 coinfected patients could, improve therapeutic approaches for this challenging cohort. © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
SARS-CoV-2 pandemic is now a global medical and social problem. Little is known about its impact on some vulnerable subgroups, such as immunocompromised patients. Therefore, there is still a strong interest in exploring the impact of SARS- CoV-2 infection among HIV-positive individuals worldwide. Aim of the study: to analyze immunological aspects of the deceased, patients with HIV/COVID-19 coinfection. Materials and. methods. We provided retrospective analysis of 258 patient's electronic medical records. All patients were admitted, to the Infectious diseases hospital N2 with HIV/COVID-19 coinfection and died in May 2020 - February 2022. Standard, immunological parameters were analyzed, like CD4+, CD8+ counts and. immunoregulatory index for different patient's subgroups. Statistical data processing was provided by SPSS 17 version (allowable error E=5%). Results and. discussion. The study demonstrated. CD4+ and CD8+ reduction in HIV-infected with COVID-19. Late HIV-presenters didn't display such phenomenon probably because of immune system, exhaustion. COVID-19 itself in some cases could, lead, to immunodeficiency worsening due to depletion of T cell populations in HIV-patients on effective antiretroviral therapy. Conclusion. Comprehension, of different immunological characteristics in HIV/COVID-19 coinfected patients could, improve therapeutic approaches for this challenging cohort.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
Despite the rapid accumulation of facts about the humoral immune response in COVID-19, there are still no evidence-based answers to questions about the factors influencing the level and duration of the detection period of antibodies to SARS-CoV-2 in the blood. Objective(s): To assess the prevalence, clinical and demographic associations of IgG antibodies to RBD of the SARSCoV-2 spike protein at different times after COVID-19. Materials and methods. Residents of the Altai region of Russia, Caucasians aged 20-93 years, who had COVID-19 from May 2020 to February 2021 (n = 314), took part in a onetime observational study. The level of antibodies in the blood was measured by enzyme-linked immunosorbent assay 1-14 months after the onset of the clinical manifestation of CO-VID-19. Results. Anti-RBD IgG antibodies of the SARS-CoV-2 spike protein were detected in 86.9% of the study participants. The dependence of the antibody titer on the duration of the period after COVID-19 was not revealed. The antibody titer was positively correlated with the complication of CO-VID-19 pneumonia and the volume of lung tissue lesions. The presence of pneumonia COVID-19 and the volume of lung tissue lesions are positively associated with age. Age positively correlated with antibody titer regardless of the pneumonia COVID-19 in the anamnesis. Conclusion. IgG antibodies to RBD of the SARS-CoV-2 spike protein are present in most of the COVID-19 patients. The titer of these antibodies in adults depends on age, complications of pneumonia COVID-19, and probably persists up to 14 months after the first symptoms of infection appear.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
Despite the rapid accumulation of facts about the humoral immune response in COVID-19, there are still no evidence-based answers to questions about the factors influencing the level and duration of the detection period of antibodies to SARS-CoV-2 in the blood. Objective(s): To assess the prevalence, clinical and demographic associations of IgG antibodies to RBD of the SARSCoV-2 spike protein at different times after COVID-19. Materials and methods. Residents of the Altai region of Russia, Caucasians aged 20-93 years, who had COVID-19 from May 2020 to February 2021 (n = 314), took part in a onetime observational study. The level of antibodies in the blood was measured by enzyme-linked immunosorbent assay 1-14 months after the onset of the clinical manifestation of CO-VID-19. Results. Anti-RBD IgG antibodies of the SARS-CoV-2 spike protein were detected in 86.9% of the study participants. The dependence of the antibody titer on the duration of the period after COVID-19 was not revealed. The antibody titer was positively correlated with the complication of CO-VID-19 pneumonia and the volume of lung tissue lesions. The presence of pneumonia COVID-19 and the volume of lung tissue lesions are positively associated with age. Age positively correlated with antibody titer regardless of the pneumonia COVID-19 in the anamnesis. Conclusion. IgG antibodies to RBD of the SARS-CoV-2 spike protein are present in most of the COVID-19 patients. The titer of these antibodies in adults depends on age, complications of pneumonia COVID-19, and probably persists up to 14 months after the first symptoms of infection appear.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
ABSTRACT
We present the results of a prospective multicenter study of risk factors, etiology, clinical features, and treatment outcomes for mucormycosis in patients with COVID-19 (COVID-M) in the Russian Federation. The study included 60 adult patients with COVID-M. To analyze risk factors for COVID-M, we conducted a case-control study. The control group included 60 adult patients with COVID-19 without mucormycosis. To analyze the clinical manifestations of COVID-M, we created a control group of hematological patients with mucormycosis examined in 2011-2020. In patients with COVID-19, the risk of developing mucormycosis was significantly increased with diabetes mellitus (OR=49) and overweight (OR=4,75), as well as with the use of high (>=100 mg per day for prednisolone) doses of glucocorticosteroids (OR= 4,762), especially >=10 days (OR=25,4). The main localization of mucormycosis in patients with CO-VID-19 was the paranasal sinuses (95%) and the orbit (68%). Involvement of >=2 organs was identified in 70% of patients. The main causative agents of mucormycosis were Rhizopus arrhizus (43%) and unidentified mucormycetes (36%). 90-days overall survival of patients with mucormycosis and COVID-19 - 71%. The stay in the ICU (p=0,01), the use of mechanical ventilation (p=0,0481), the presence of CVC (p=0,049), CNS damage (p=0,016) and >= 2 organs (p=0,048) significantly worsened the prognosis of the disease. The best prognosis was in patients who received antifungal therapy (p=0,03875) and surgical treatment (p=0,046).Copyright © 2022 Authors. All rights reserved.
ABSTRACT
We present the results of a prospective multicenter study of risk factors, etiology, clinical features, and treatment outcomes for mucormycosis in patients with COVID-19 (COVID-M) in the Russian Federation. The study included 60 adult patients with COVID-M. To analyze risk factors for COVID-M, we conducted a case-control study. The control group included 60 adult patients with COVID-19 without mucormycosis. To analyze the clinical manifestations of COVID-M, we created a control group of hematological patients with mucormycosis examined in 2011–2020. In patients with COVID-19, the risk of developing mucormycosis was significantly increased with diabetes mellitus (OR=49) and overweight (OR=4,75), as well as with the use of high (≥100 mg per day for prednisolone) doses of glucocorticosteroids (OR= 4,762), especially ≥10 days (OR=25,4). The main localization of mucormycosis in patients with CO-VID-19 was the paranasal sinuses (95%) and the orbit (68%). Involvement of ≥2 organs was identified in 70% of patients. The main causative agents of mucormycosis were Rhizopus arrhizus (43%) and unidentified mucormycetes (36%). 90-days overall survival of patients with mucormycosis and COVID-19 – 71%. The stay in the ICU (p=0,01), the use of mechanical ventilation (p=0,0481), the presence of CVC (p=0,049), CNS damage (p=0,016) and ≥ 2 organs (p=0,048) significantly worsened the prognosis of the disease. The best prognosis was in patients who received antifungal therapy (p=0,03875) and surgical treatment (p=0,046). © 2022 Authors. All rights reserved.