Use of Personal Protection equipment by Moscow subway Passengers under Conditions of COVID-19 Pandemic

The Subway is the most important means of transport in Moscow. The active flows of passengers in the metro can contribute to the spread of infectious diseases with airborne and contact mechanisms of transmission, including the coronavirus infection COVID-19. The aim of the study was to assess the level of adherence to the use of personal protective equipment (facial masks, gloves) by passengers of the Moscow Subway. Materials and methods. A prospective study based on a visual assessment of passengers in a rolling stock of the Moscow subway, with division into cohorts of those using masks and gloves (K1), using only masks (K2), using masks in violation of the rules of use (K3) and not using personal protection equipment (K4) was conducted. Observations were carried out during the 42nd and 43rd weeks of 2020 in various subway clusters with a division in time into morning, afternoon and evening hours. Additionally, passengers were ranked into groups by occupation during the trip. Statistical processing included the identification of frequencies, their 95 % confidence intervals. To compare the significance of differences in the prevalence of features in paired groups, the methods of 4-field tables (χ2 Pearson) were used. Results and discussion. 18053 observations were validated, covering 61.3 % of stations. Men accounted for 54.7 % (9867). During the observation period, the following shares were established: K1 - 5.2 % (95 % CI 4.9-5.5), K2 - 51.9 % (95 % CI 51.2-52.7), K3 - 26.9 (95 % CI 26.2-27.6), K4 - 16 % (95 % CI 15.4-16.6). The level of adherence to the proper use of PPE is significantly lower among men. Land lines have the lowest proportion of passengers using PPE. Among passengers using electronic devices and paper media, a higher proportion of those wearing masks with violation of the rules of use, compared to passengers without activities, was established. Among passengers using electronic devices, the proportion of those using gloves is the lowest. Within two weeks of follow-up, a significant increase in the frequency of PPE use was revealed. © 2021 Russian Research Anti-Plague Institute. All rights reserved.

The Cases of COVID-19 and Measles Co-Infection in Children

Relevance. The rapid spread of new pathogens inevitably leads to the occurrence of joint circulation with already known infectious agents, leading to the development of mixed infections. The simultaneous circulation of the pandemic coronavirus SARS-CoV-2 with a highly contagious measles virus leads to the development of mixed infections in people who have not been sick or vaccinated against measles. Aims. Review cases of co-infection with measles and COVID-19 in Moscow. Material and methods. A retrospective study of cases of measles and COVID-19 co-infection in three children with a description of the epidemiological and clinical picture of the disease. Results. In all observed children, the manifestation of the disease was typical for measles, the diagnosis of COVID-19 was established based on a laboratory study carried out in a hospital, which gave reason to count. That the infection with SARS-CoV-2 occurred after the infection of children with measles. Conclusions. Different incubation periods can lead to several options for the development of co-infection. The similarity of clinical symptoms at the onset of the disease does not allow excluding a certain infection clinically, without laboratory verification. © Zvereva NN et al.

Clinical, laboratory-instrumental characteristics, course and therapy of pediatric multisystem inflammatory syndrome associated with COVID-19

The most severe manifestation of the new coronavirus infection COVID-19 in children is the multisystem inflammatory syndrome in children (MIS-C). A systematic review of foreign publications as of July 25, 2020 contains an analysis of the disease course in 662 children with this syndrome and is used for comparison with the data obtained. Objective of the research: to characterize clinical manifestation, results of laboratory and instrumental studies, therapy, outcomes and consequences of the COVID-19- associated MIS-C., based on the observation of patients hospitalized to Morozov Children's City Clinical Hospital and Children’s clinical hospital of infectious diseases № 6 from May 1 to September 15, 2020. Materials and methods: the pilot study included 32 children aged 9 months -15 years with COVID-19-associated MIS-C., verified based on WHO criteria (2020), including symptoms of Kawasaki disease (KD), arterial hypotension/shock, laboratory and instrumental signs of heart damage, signs of coagulopathy, gastrointestinal symptoms, increased inflammation markers, COVID-19 markers. Results: the median age of patients was 6 years, boys predominated among the patients (66%), all patients had antibodies to SARS-CoV-2 (31 children of the IgG class);MIS-C manifested itself as a combination of KD symptom complex (75% of patients) with arterial hypotension/shock (28%), neurological (50%), respiratory (41%), gastrointestinal (59%) symptoms;macrophage activation syndrome (MAS) was verified in 16% of patients. Therapy included intravenous immunoglobulin (75%), systemic glucocorticosteroids (88%), anticoagulants (91%), vasoactive/vasopressor support (31%). In 38% of cases treatment was performed in intensive care unit;one child died. According to echocardiography, 16% of patients had coronariitis, ectasia, and coronary arteries aneurysms. Conclusion: COVID-19-associated MIS-C is characterized by a severe course, cross-features with KD, shock syndrome with KD, MAS which requires intensive therapy and can cause acquired pathology of the cardiovascular system in children. Самым тяжелым проявлением новой коронавирусной инфекции COVID-19 у детей является ассоциированный с ней детский мультисистемный воспалительный синдром (ДМВС). Систематический обзор зарубежных публикаций по состоянию на 25 июля 2020 г. содержит анализ течения заболевания у 662 детей с данным синдромом и используется для сравнения с полученными данными. Цель исследования - характеристика клинической манифестации, результатов лабораторно-инструментальных исследований, терапии, исходов и последствий ДМВС, ассоциированного с COVID-19, основанная на наблюдении пациентов, госпитализированных в период с 1 мая по 15 сентября 2020 г. в Морозовскую ДГКБ и ДИКБ № 6 ДЗМ. Материалы и методы исследования: в пилотное исследование были включены 32 ребенка в возрасте 9 мес. - 15 лет с ДМВС, ассоциированным с COVID-19, верифицированным на основании критериев ВОЗ (2020), включающих симптомы болезни Кавасаки (БК), артериальную гипотензию/шок, лабораторно-инструментальные признаки поражения сердца, признаки коагулопатии, гастроинтестинальные симптомы, повышение маркеров воспаления, маркеры COVID-19. Результаты: медиана возраста больных составила 6 лет, среди больных преобладали мальчики (66%), у всех пациентов были обнаружены антитела к SARS-CoV-2 (у 31 ребенка класса IgG);ДМВС манифестировал в виде комбинации симптомокомплекса БК (75% больных) с артериальной гипотензией/шоком (28%), неврологическими (50%), респираторными (41%), гастроинтестинальными (59%) симптомами;у 16% пациентов был верифицирован синдром активации макрофагов (САМ). Терапия включала иммуноглобулин для внутривенного введения (75%), системные глюкокортикостероиды (88%), антикоагулянты (91%), вазоактивную/ вазопрессорную поддержку (31%). Лечение в 38% случаев проводилось в условиях отделения реанимации и интенсивной терапии;один ребенок погиб. У 16% по данным эхокардиографии были выявлены коронариит, эктазии, аневризмы коронарных артерий. Заключение: ДМВС, ассоциированный с COVID-19, характеризуется тяжелым течением, перекрестными чертами с БК, синдромом шока при БК, САМ, что требует проведения интенсивной терапии и может стать причиной приобретенной патологии сердечно-сосудистой системы у детей.