Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 18 de 18
Filter
1.
Kliniceskaa Mikrobiologia i Antimikrobnaa Himioterapia ; JOUR(2):181-192, 24.
Article in Russian | Scopus | ID: covidwho-2091716

ABSTRACT

Objective. Development of local clinical protocols for antibacterial therapy of COVID-19-associated bacterial pneumonia in the therapeutic department of the city clinical hospital based on an analysis of the treatment process in patients with COVID-19-associated pneumonia. Materials and methods. A retrospective analysis of 1382 cases of hospitalization in the therapeutic department of patients with COVID-19-associated pneumonia for the period from 2020 to 2021 was carried out. The structure of etiotropic therapy, the frequency and timing of microbiological studies of the biomaterial, the manifestations of the main markers of bacterial infection during dynamic monitoring of clinical and laboratory parameters in patients prescribed antibiotic therapy, as well as statistics of the stay of patients in the therapeutic department of the hospital were assessed. Based on the results obtained in the course of microbiological studies, an assessment was made of the microbial landscape of the lower respiratory tract of patients with an analysis of the sensitivity of strains of the leading microflora to a wide range of antibiotics. Results. The study found that the dominant flora in COVID-19-associated pneumonia in hospitalized patients was gram-negative bacteria – K. pneumoniae, P. aeruginosa and A. baumannii – their proportion was more than 50%. Among K. pneumoniae strains, 89.4% were ESBL producers, 63.5% of the strains were resistant to carbapenems, which with a high probability allows them to be considered carbapenemase-producing strains. Among the strains of P. aeruginosa, the proportion of strains resistant to carbapenems and with a high degree of probability being strains – producers of carbapenemase was 41.1%. Among strains of Acinetobacter spp. these were 76.4%, and associated resistance to fluoroquinolones and aminoglycosides was also demonstrated. Gram-positive microorganisms were found in 34.3% of cases and were mainly represented by strains of S. aureus (74.9%), only 26.4% of strains of this pathogen were methicillin-resistant. Conclusions. Microbiological monitoring conducted in 2020–2021 revealed the presence, among the pathogens of viral-bacterial pneumonia, at an early stage of hospitalization, a significant proportion of gram-negative bacteria with resistance of the MDR and XDR types. Based on the obtained microbiological data, starting empirical schemes for antibacterial therapy of secondary viral and bacterial pneumonia, which complicated the course of a new coronavirus infection COVID-19 caused by the SARS-CoV-2 virus, were developed and proposed. © 2022, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. All rights reserved.

2.
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk ; 77(3):189-198, 2022.
Article in Russian | EMBASE | ID: covidwho-2081121

ABSTRACT

Background. The severe acute respiratory syndrome of the SARS-CoV-2 virus-mediated coronavirus disease 2019 (COVID-19) highlighted the central role of immunothrombosis. Severe endothelial damage with the release of unusually large multimers of von Willebrand factor (vWF) and subsequent consumption of ADAMTS-13 is described during severe COVID-19. The activation of innate immune cells among which neutrophils contribute to the formation of extracellular neutrophil traps (NETs) and to the release of myeloperoxidase (MPO) potentially contributing to the spread of inflammation and microvascular thrombosis. Objective - to evaluate the ability of vWF, ADAMTS-13 and MPO to predict in-hospital mortality in severe COVID-19 patients needing mechanical ventilation. Methods. We performed a one-center observational study of 79 severe COVID-19 patients entering intensive care unit for mechanical ventilation, examining vWF, ADAMTS-13 and MPO among other potential predictors for in-hospital death. Results. After multivariate analysis, vWF antigen (vWF:Ag) and MPO antigen (MPO:Ag) were finally the single two parameters which increasing values were independently associated with non-survival;vWF:Ag (U/dL): adjusted OR 3.360, 95% CI 1.562-7.228, p = 0.0019;MPO:Ag (ng/ml): adjusted OR 1.062, 95% CI 1.024-1.101, p = 0.0011. From these results a simplified mortality score was derived and patients categorized as having a score value higher or lower that the median value of the score: a high score value was associated with a lower cumulative survival rate (p < 0.0001), 50% of the cases being dead at day 13 post-hospital admission. Conclusions. In severe COVID-19 necessitating mechanical ventilation, increasing values of MPO activity and of vWF antigen tested at admission are associated with poor survival. Copyright © 2022 Izdatel'stvo Meditsina. All rights reserved.

3.
Obstetrics, Gynecology and Reproduction ; 16(3):228-243, 2022.
Article in Russian | EMBASE | ID: covidwho-1979784

ABSTRACT

Introduction. Currently, endothelial dysfunction caused by inflammation and immunothrombosisis considered as one of the crucial mechanisms in developing the SARS-CoV-2 virus-mediated coronavirus disease 2019 (COVID-19). A mass endothelial damage followed by release of untypical large quantity of von Willebrand factor (vWF) multimers and subsequent consumption of metalloproteinase ADAMTS-13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) is described during severe COVID-19. The activation of innate immune cells including neutrophils results in formation of neutrophil extracellular traps (NETs) and myeloperoxidase (MPO) release that, in turn, contributes to spread of inflammation and microvascular thrombosis. Aim: to evaluate a pathogenetic role and predictive significance for serum markers of inflammation, endothelial dysfunction and hemostatis activation such as vWF, ADAMTS-13 and MPO for in-hospital mortality in severe COVID-19 patients requiring mechanical lung ventilation. Materials and Methods. There was performed a single-center observational study with 129 severe COVID-19 patients on mechanical lung ventilation at the intensive care unit, by assessing serum in all subjects vWF, ADAMTS-13 as well as in 79 patients MPO level along with other potential predictors for in-hospital mortality. Results. A multivariate analysis revealed that increased serum level for vWF antigen (vWF:Ag) and MPO antigen (MPO:Ag) were significantly and independently related to high mortality probability: vWF:Ag (IU/ml) - adjusted odds ratio (OR) = 3.360;95 % confidence interval (95 % Cl) = 1.562-7,228 (р = 0,0019);MPO:Ag (ng/ml) - adjusted OR = 1.062;95 % = 1.024-1.101 (p = 0.0011). Such data allowed to obtained a simplified mortality score for categorizing patients as those having a higher or lower score compared with the median score level: a high score was associated with lower cumulative survival rate (p < 0.0001), with 50 % of the cases linked to lethal outcome on day 13 post-hospital admission. Conclusion. Severe COVID-19 patients requiring mechanical lung ventilation were found to have elevated level of serum MPO activity and vWF correlating with poor survival.

4.
Obstetrics, Gynecology and Reproduction ; 15(6):726-737, 2021.
Article in English | Scopus | ID: covidwho-1703937

ABSTRACT

A novel coronavirus (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) is largely associated with various coagulopathies, which can lead to either bleeding and thrombocytopenia or hypercoagulation and thrombosis. Thrombohemorrhagic complications also could accompany the development of cancer process. In addition, circulating inflammatory biomarkers such as fibrin, D-dimer, P-selectin and von Willebrand factor (vWF) typical to both coronavirus infection and malignancy process are of special interest. In this review, we discuss potential interplay between COVID-19 and cancer related to endothelial dysfunction, platelets, and systemic inflammatory response syndrome. Most importantly, patients should be treated in early stage of the disease process when elevated levels of fibrinogen, D-dimer, vWF, and P-selectin are observed. The level of these markers will rise rapidly upon disease progression, followed by a cytokine storm, would evidence about a poor prognosis. © 2021 IRBIS LLC. All Rights Reserved.

5.
Obstetrics, Gynecology and Reproduction ; 15(6):639-657, 2021.
Article in Russian | Scopus | ID: covidwho-1698694

ABSTRACT

As shown by numerous studies conducted during the pandemic, the severe course of COVID-19 is accompanied by multiple organ failure. Cytokine storm, hypercoagulation, complement hyperactivation and other arms comprise the overall picture of the pathogenesis of the severe disease course. The frequent diagnosis of multiple microvascular thrombosis in lung, heart, and kidneys, as well as the presence of platelet-fibrin thrombi there and signs of terminal organ damage, suggest a possible involvement of thrombotic microangiopathy (TMA) in the development of multiple organ failure. In this regard, it is especially important to timely diagnose TMA and start pathogenetic therapy. These measures can significantly reduce mortality due to the novel disease. Heparins and direct oral anticoagulants are the mainstay for prevention and treatment of venous thromboembolism in patients with COVID-19, but their effectiveness in the presence of TMA is questionable. It has been proven that anticoagulants use in critically ill patients with COVID-19 for prevention of large vessel thrombosis is effective, but their role in the prevention of microthrombosis is not clear. Here we review the currently available information on thrombotic microangiopathy, as well as a review of literature data describing TMA-like conditions in COVID-19, discuss potential pathophysiology of the condition development and proposed therapeutic approaches. © Obstetrics, Gynecology and Reproduction 2021.

6.
Infektsionnye Bolezni ; 19(3):5-13, 2021.
Article in Russian | Scopus | ID: covidwho-1614429

ABSTRACT

We evaluated humoral immunity (presence of specific IgM and IgG) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare professionals providing inpatient care for individuals with COVID-19. Objective. To detected and measure the level of anti-SARS-CoV-2 antibodies in healthcare professionals and to identify how many of them contacted with COVID-19 patients, including those who had asymptomatic or subclinical disease. Materials and methods. Anti-SARS-CoV-2 antibodies were detected using enzyme-linked immunosorbent assay (ELISA) with the ‘SARS-CoV-2-ELISA-Vector’ kit for IgG (State research Center of Virology and Biotechnology ‘Vector’) and ‘SARS-CoV-2-IgG- ELISA-BEST’ and ‘SARS-CoV-2-IgМ-ELISA-BEST’ kits for IgM and IgG (Vector-Best LLC). Samples were collected in several healthcare institutions of Moscow and in G.N.Gabrichevskiy Moscow Research Institute of Epidemiology and Microbiology. A total of 24,373 serum specimens from 74 healthcare institutions were tested. All study participants filled in special questionnaires. Results. Among 24,373 healthcare professionals tested in this study, 5,382 people were IgG-positive to SARS-CoV-2 (seroprevalence index 22.1%). The seropositivity rate was 21.5% in senior medical staff, 22.2% in nursing professionals, and 22.8% in medical assistants/technicians. We found that the proportion of SARS-CoV-2 seropositive individuals had changed over time, gradually increasing from 17.9% in April 2020 to 37.6% in December 2020. The proportion of SARS-CoV-2 seropositive people doubled among senior medical staff and nursing professionals during the year. The proportion of individuals with asymptomatic or subclinical COVID-19 was 13.8%. Conclusion. The methodological approaches used in this study allowed us to assess the humoral immunity to SARS-CoV-2 among healthcare professionals in Moscow. Our findings can be used for further improvement of anti-epidemic measures in healthcare institutions. © 2021, Dynasty Publishing House. All rights reserved.

7.
Obstetrics, Gynecology and Reproduction ; 15(5):499-514, 2021.
Article in English | Scopus | ID: covidwho-1551949

ABSTRACT

The rate of thrombosis and disseminated intravascular coagulation (DIC) has been increasing in COVID-19 patients. Key features related to such condition include minimal or no risk of bleeding, moderate thrombocytopenia, high plasma fibrinogen as well as increased complement components level in the areas of thrombotic microangiopathy. The clinical picture is not typical for classic DIC. This review systematizes the pathogenetic mechanisms of hypercoagulation in sepsis and its extreme forms in patients with COVID-19. The latter consist of the thrombosis-related immune mechanisms, the complement activation, the macrophage activation syndrome, the formation of antiphospholipid antibodies, the hyperferritinemia, and the dysregulation of the renin-angiotensin system. Taking into consideration the pathogenetic mechanisms, the biomarkers had been identified related to the prognosis of the disease development. Patients with pre-existing cardiovascular disease and other risk factors, including obesity, diabetes, hypertension, and aging pose the peak risk of dying from COVID-19. We also summarize new data on platelet and endothelial dysfunction, immunothrombosis, and, as a result, thrombotic storm as essential components of COVID-19 severe features. © 2021 Obstetrics, Gynecology and Reproduction. All rights reserved.

8.
Obstetrics, Gynecology and Reproduction ; 15(3):313-320, 2021.
Article in English | EMBASE | ID: covidwho-1527054

ABSTRACT

The novel coronavirus epidemic is characterized by high rates of morbidity and relatively high mortality. Laboratory test results in patients include leukopenia, an increase in liver function tests and ferritin levels reaching hundreds, and sometimes thousands of units. These data remind us about the macrophage activation syndrome (MAC). Secondary hemophagocytic lymphohistiocytosis syndrome, MAC, which pathogenesis is based on a defect in the mechanisms of T-cell cytotoxicity and decreased level of natural killer cells associated with the defect in the perforin-encoding gene as well as hyperproduction of a number of cytokines - interleukin (IL)-1β, tumor necrosis factor-α, etc. by T-lymphocytes and histiocytes, indirectly leading to the activation of macrophages and production of proinflammatory cytokines, in particular IL-6 hyperproduction. MAC is one of "hyperferritinemic syndromes". These disorders have similar clinical and laboratory manifestations, and they also respond to similar treatments, suggesting that hyperferritinemia may be involved in the overall pathogenesis and is characterized by elevated ferritin level and cytokine storm. Despite the fact that data on the immune and inflammatory status in patients with COVID-19 have only started to appear, it is already clear that hyperinflammation and coagulopathy affect the disease severity and increase the risk of death in patients infected with SARS-CoV-2. Hence, understanding the pathogenesis of the novel coronavirus infection can help in its early diagnostics and treatment.

9.
Obstetrics, Gynecology and Reproduction ; 15(4):404-414, 2021.
Article in Russian | EMBASE | ID: covidwho-1449370

ABSTRACT

Antiphospholipid syndrome (APS) is an autoimmune process that increases the risk of arterial and venous thrombosis. The mechanism of damage to the central nervous system (CNS) can be not only due to thrombosis, but also antiphospholipid antibodies (APA) circulating in the peripheral blood. The latter can damage the cerebral vascular endothelium, alter the resistance of the blood-brain barrier and penetrate into the central nervous system, exerting a damaging effect on astroglia and neurons, as evidenced by the release of neurospecific proteins into the peripheral bloodstream. The role of APS in developing cerebral ischemia, migraine, epilepsy, chorea, transverse myelitis, multiple sclerosis, cognitive impairment and mental disorders, as well as the peripheral nervous system is described. It should also be noted about a role of APS for emerging neurological disorders in COVID-19, enabled apart from thrombogenesis due to APA via 2 potential mechanisms - molecular mimicry and neoepitope formation. Further study of the APS pathogenesis and interdisciplinary interaction are necessary to develop effective methods for patient management.

10.
Obstetrics, Gynecology and Reproduction ; 15(4):335-350, 2021.
Article in English | EMBASE | ID: covidwho-1449369

ABSTRACT

Numerous studies have proven a close relationship between inflammatory diseases and the state of hypercoagulability. In fact, thromboembolic complications represent one of the main causes of disability and mortality in acute and chronic inflammatory diseases, cancer and obstetric complications. Despite this, the processes of hemostasis and immune responses have long been considered separately;currently, work is underway to identify the molecular basis for a relationship between such systems. It has been identified that various pro-inflammatory stimuli are capable of triggering a coagulation cascade, which in turn modulates inflammatory responses. Neutrophil extracellular traps (NETs) are the networks of histones of extracellular DNA generated by neutrophils in response to inflammatory stimuli. The hemostasis is activated against infection in order to minimize the spread of infection and, if possible, inactivate the infectious agent. Another molecular network is based on fibrin. Over the last 10 years, there has been accumulated a whole body of evidence that NETs and fibrin are able to form a united network within a thrombus, stabilizing each other. Similarities and molecular cross-reactions are also present in the processes of fibrinolysis and lysis of NETs. Both NETs and von Willebrand factor (vWF) are involved in thrombosis as well as inflammation. During the development of these conditions, a series of events occurs in the microvascular network, including endothelial activation, NETs formation, vWF secretion, adhesion, aggregation, and activation of blood cells. The activity of vWF multimers is regulated by the specific metalloproteinase ADAMTS-13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13). Studies have shown that interactions between NETs and vWF can lead to arterial and venous thrombosis and inflammation. In addition, the contents released from activated neutrophils or NETs result in decreased ADAMTS-13 activity, which can occur in both thrombotic microangiopathies and acute ischemic stroke. Recently, NETs have been envisioned as a cause of endothelial damage and immunothrombosis in COVID-19. In addition, vWF and ADAMTS-13 levels predict COVID-19 mortality. In this review, we summarize the biological characteristics and interactions of NETs, vWF, and ADAMTS-13, the effect of NETs on hemostasis regulation and discuss their role in thrombotic conditions, sepsis, COVID-19, and obstetric complications.

11.
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk ; 76(3):268-278, 2021.
Article in Russian | EMBASE | ID: covidwho-1411069

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a viral infection that, in severe course, leads to the development of a cytokine storm, systemic inflammatory response and coagulopathy. Unlike other sepsis-associated disseminated intravascular coagulopathy, COVID-19 induced coagulopathy is realized mainly in thrombosis. Researchers around the world are currently developing adequate diagnostic, monitoring and anticoagulant therapy approaches to safely and effectively manage patients with severe COVID-19. The need to develop laboratory monitoring is due to the fact that 20% of patients have changes in hemostasis indicators, while in patients with a severe form of the disease, they are present in 100% of cases. In case of deaths from COVID-19, there is an increase in the concentration of D-dimer and fibrinogen degradation products. Thus, the severity of hemostasis disorders has an important prognostic value. Anticoagulant therapy is included in the list of all recommendations as an effective means of reducing mortality from COVID-19. The questions of the recommended groups and doses of anticoagulant drugs are still open. The approach to the choice of an anticoagulant should be based not only on risk factors, characteristics of the course of the disease, anamnesis, but also on the wishes of the patient during long-term therapy at the post-hospital stage.

12.
Obstetrics, Gynecology and Reproduction ; 15(3):295-312, 2021.
Article in Russian | EMBASE | ID: covidwho-1344586

ABSTRACT

Our knowledge regarding chemical structure and properties of heparin and its derivatives, including biological properties in blood plasma, on the cell surface and while interacting with receptors, has been progressively growing. New insights are followed by the expansion of therapeutic opportunities and indications for the use of heparins. There are prerequisites for the creation of new generation drugs with modified properties that reduce a bleeding risk while applied for a non-anticoagulant goal. The non-anticoagulant heparin properties allow to consider it as a candidate for pathogenetic treatment of patients with COVID-19. This review focuses on the anticoagulant and non-anticoagulant heparin properties as well as the underlying molecular mechanisms.

13.
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk ; 75(1):83-92, 2020.
Article in Russian | EMBASE | ID: covidwho-1244381

ABSTRACT

The rapid spread of COVID-19 and the large number of cases put a significant burden on the health systems of any developed country. Specialists in natural disasters and military medicine should be involved in the provision of medical care and observance of anti-epidemic measures. In some countries, including Italy, they were involved only after the situation was dramatically worsening with many clinical units and hospitals overloaded by infected patients. To curb the spread of COVID-19, most countries declared a state of emergency, and unprecedented measures have been taken to strengthen quarantine in suspected or positive symptomatic subjects. Nevertheless, the crisis associated with the unexpectedly global scale and tragedy of the pandemic and the inconsistency of actions of both society and individuals and specialized medical services, lead to insufficient effectiveness of the measures taken in a number of regions. In the present day, it is vital for every person to change its mindset ― relying on personal responsibility to comply with all recommendations of quarantine and anti-epidemic measures, and to reorganize departments and resources of medical institutions at all levels in order to withstand the spread of infection and at the same time provide all those in need with the necessary and appropriate medical care. Particular attention should be paid to the obstetric care service, given that even in “normal” times, the obstetric hospital is an area of increased responsibility for the life and health of mother and child and future mankind. Fulfillment of existing orders, instructions of national and regional committees, international and national protocols and clinical protocols should undoubtedly lead to a positive result, but this requires additional training of medical personnel at all levels. The purpose of this review is to propose quick key strategies for reassessing the maternity and neonatal wards/ hospitals based on the experience of health systems and organizations which faced the spread of this new coronavirus;this advice may be applied along with binding tight instructions in obstetric hospitals in order to proactively respond to a likely wave of growth in COVID-19.

14.
Obstetrics, Gynecology and Reproduction ; 14(3):314-326, 2020.
Article in Russian | EMBASE | ID: covidwho-903105

ABSTRACT

Recently, it has been increasingly apparent that sepsis and septic shock become a pressing issue. Over the last decade, incidence rate of sepsis in obstetrics and gynecology has been increased by more than 2-fold. Here we review clinical forms of septic conditions, risk factors, pathogenesis of sepsis and septic shock, as well as major pathogens resulting in septic conditions. Special attention is paid to neonatal sepsis. The relationship between septic shock and viral infections is considered in the context of the novel coronavirus infection (COVID-19) pandemic caused by SARS-CoV-2. Impaired hemostasis is discussed in patients with septic shock, including those with disseminated intravascular coagulation (DIC). An importance of assessing ADAMTS-13 level to refine disease prognosis is discussed.

15.
Obstetrics, Gynecology and Reproduction ; 14(2):132-147, 2020.
Article in English | EMBASE | ID: covidwho-842276

ABSTRACT

The pandemic of a novel coronavirus infection COVID-19 has become a real challenge to the mankind and medical community and has raised a number of medical and social issues. Based on the currently available information on COVID-19 clinical cases, it follows that COVID-19 patients in critical condition exhibit a clinical picture of disseminated intravascular coagulation (DIC), septic shock with developing multiple organ failure, which justifies use of anticoagulant therapy in COVID-19 patients. In addition to isolating virus RNA from biological material and polymerase chain reaction diagnostics, use of simple and easily accessible laboratory blood markers is necessary for management of COVID-19 patients. If the activation of coagulation processes is sufficient enough, consumption of platelets and blood clotting factors can be diagnosed by laboratory methods as prolongation of routine blood clotting tests and increasing thrombocytopenia. Hyperfibrinogenemia, increased D-dimer level, prolonged prothrombin time, thrombocytopenia, lymphopenia, leukocytopenia, increased concentration of interleukin-6 and ferritin are observed in most COVID-19 patients. The degree of increase in these changes correlates with severity of the inflammatory process and serves as a prognostically unfavorable sign. Here we discuss value of laboratory monitoring playing an essential role in such pathological crisis that contributes to patient screening, diagnosis as well as further monitoring, treatment and rehabilitation.

16.
Obstetrics, Gynecology and Reproduction ; 14(2):123-131, 2020.
Article in English | EMBASE | ID: covidwho-841175

ABSTRACT

COVID-19 is an infectious disease caused by the beta-coronavirus SARS-CoV-2 that in 2020 has spread worldwide. In most severe patients, the clinical picture begins with respiratory failure further deteriorating up to multiple organ failure. Development of coagulopathy is the most adverse prognostic. Analyzing currently available clinical data revealed that 71.4 % and 0.6 % of survivors and fatal cases, respectively, demonstrated signs of overt disseminated intravascular coagulation (DIC). Monitoring D-dimer level, prothrombin time, platelet count and fibrinogen content is important for determining indications for treatment and hospitalization in COVID-19 patients. In case such parameters deteriorate, a more pro-active “aggressive” intensive care should be applied. Low molecular weight heparin (LMWH) should be administered to all patients with diagnosed COVID-19 infection (including non-critical patients) requiring hospitalization, but having no contraindications to LMWH.

17.
Obstetrics, Gynecology and Reproduction ; 14(2):229-238, 2020.
Article in Russian | Scopus | ID: covidwho-831744

ABSTRACT

Zika virus (ZIKV) is an arthropod-borne virus (arbovirus) in the genus Flavivirus and the Flaviviridae family. In 1947 and 1948 ZIKV was first isolated from a nonhuman primate as well as from mosquitoes in Africa, respectively. For half a century, ZIKV infections in human were sporadic prior to 2015-2016 pandemic spreading. Transmission of ZIKV from mother to fetus can occur in any trimester of pregnancy, even if mother was an asymptomatic carrier. The clinical signs of ZIKV infection are nonspecific and can be misdiagnosed as some other infectious diseases, especially those caused by arboviruses such as Dengue and Chikungunya. ZIKV infection was solely associated with mild illness prior to the large French Polynesian and Brazil outbreaks, when severe neurological complications, Guillain-Barre syndrome and dramatically increased rate of severe congenital malformations (including microcephaly) were reported. The adaptation of ZIKV to an urban cycle in endemic areas suggests that the incidence of ZIKV infections may be underestimated. The pandemic of novel coronavirus infection (COVID-19) demonstrates that lessons from ZIKV pandemic propagation has not been learned properly. © 2020 Universidad de Antioquia. All rights reserved.

18.
Annals of the Russian academy of medical sciences / Вестник Российской академии медицинских наук ; 75(1):83-92, 2020.
Article | WHO COVID | ID: covidwho-71763

ABSTRACT

The rapid spread of COVID-19 and the large number of cases put a significant burden on the health systems of any developed country. Specialists in natural disasters and military medicine should be involved in the provision of medical care and observance of anti-epidemic measures. In some countries, including Italy, they were involved only after the situation was dramatically worsening with many clinical units and hospitals overloaded by infected patients. To curb the spread of COVID-19, most countries declared a state of emergency, and unprecedented measures have been taken to strengthen quarantine in suspected or positive symptomatic subjects. Nevertheless, the crisis associated with the unexpectedly global scale and tragedy of the pandemic and the inconsistency of actions of both society and individuals and specialized medical services, lead to insufficient effectiveness of the measures taken in a number of regions. In the present day, it is vital for every person to change its mindset ― relying on personal responsibility to comply with all recommendations of quarantine and anti-epidemic measures, and to reorganize departments and resources of medical institutions at all levels in order to withstand the spread of infection and at the same time provide all those in need with the necessary and appropriate medical care. Particular attention should be paid to the obstetric care service, given that even in normal times, the obstetric hospital is an area of increased responsibility for the life and health of mother and child and future mankind. Fulfillment of existing orders, instructions of national and regional committees, international and national protocols and clinical protocols should undoubtedly lead to a positive result, but this requires additional training of medical personnel at all levels. The purpose of this review is to propose quick key strategies for reassessing the maternity and neonatal wards/ hospitals based on the experience of health systems and organizations which faced the spread of this new coronavirus;this advice may be applied along with binding tight instructions in obstetric hospitals in order to proactively respond to a likely wave of growth in COVID-19. ;Актуальность. Быстрое распространение COVID-19 и большое количество заболевших накладывает значительную нагрузку на системы здравоохранения развитых государств. Ð’ ряде стран к оказанию медицинской помощи и соблюдению противоэпидемических мероприятий привлекаются специалисты по стихийным бедствиям и военной медицине, однако в некоторых странах, в том числе в Италии, они были задействованы после того, как многие клинические подразделения и стационары были перегружены. Для сдерживания распространения COVID-19 большинство стран объявили чрезвычайное положение, были приняты беспрецедентные меры по усилению карантинных мероприятий. Тем не менее кризис, связанный с неожиданно глобальным масштабом и трагичностью пандемии, и несогласованность действий как общества и отдельных граждан, так и специализированных медицинских служб приводят к недостаточной эффективности проводимых мероприятий в ряде регионов. Особое внимание следует уделить службе родовспоможения, учитывая, что и в спокойное время акушерский с ‚ационар является зоной повышенной ответственности за жизнь и здоровье матери и ребенка. Исполнение действующих приказов, указаний национальных и региональных комитетов, международных/национальных и клинических протоколов, несомненно, приведет к положительному результату, но требует дополнительного обучения и тренировки медицинского персонала всех уровней. Цель обзора ― предложить ключевые стратегии, основываясь на опыте регионов, ранее столкнувшихся с распространением нового коронавируса, которые могут быть быстро применены наряду с обязательными к исполнению действующими приказами и распоряжениями в акушерских стационарах, чтобы превентивно отреагировать на вероятную волну роста заболеваемости и носительства COVID-19.

SELECTION OF CITATIONS
SEARCH DETAIL