Role of antiviral therapy in respiratory infections in children: Analysis of clinical and laboratory observations.

Objective. To evaluate the efficacy of therapy for acute respiratory viral infections (ARVIs) in children with antiviral medications: inosine pranobex (Groprinosin, Gedeon Richter) and Kagocel (Kagocel, Niarmedic Pharma LLC) in comparison with symptomatic treatment without etiotropic agents based on clinical and laboratory parameters. Patients and methods. The clinical and laboratory observation was conducted in an outpatient setting in the pre-COVID-19 period between 2018 and 2020. Acute respiratory infections were diagnosed using licensed testing systems by multiplex polymerase chain reaction (PCR) with detection of nucleic acid viral genomes: influenza, rhinovirus, respiratory syncytial virus, metapneumovirus, parainfluenza, seasonal coronaviruses, adenoviruses, and bocavirus). A total of 151 children aged 3 to 15 years were examined and monitored in dynamics, with 78.7% of positive and 21.3% of negative results detected by PCR in the nasopharyngeal and oropharyngeal swabs. The patients were randomized into three groups depending on the antiviral medication prescribed: group 1 (53 children) received Groprinosin;group 2 (52 children) received Kagocel;group 3 (control, 46 children) received only symptomatic therapy without antiviral agents. Results. The study demonstrated a significant positive effect in patients in group 1 treated with Groprinosin (n = 53). At the end of therapy for both mono- and mixed infections, there were 95.8% of negative results (according to PCR diagnosis, that is, the absence of viral genome). In children in group 2 (n = 52) treated with Kagocel, the absence of viral nucleic acids (NAs) was observed less frequently (in 77.3% of cases). In children in group 3 (n = 46) who did not receive etiotropic antiviral therapy, there were only 40.3% of negative results after the end of treatment, and viral NAs were detected in 59.7% of patients. In this case, a 5-day course of Groprinosin was prescribed, after which the PCR results became negative in all patients. Therefore, children with recurrent respiratory infections, mixed infections, and herpesvirus infections require longer therapy. Additionally, a high frequency of ARVI complications was noted in group 3 (5 (10.9%) patients, where otitis was observed in 1 case, sinusitis - in 2 cases, bronchitis - in 2 cases), whereas 1 (1.8%) patient taking Groprinosin had otitis, and 1 (1.9%) patient taking Kagocel had pneumonia. Conclusion. This study was the first to investigate antibody titers to respiratory viruses in dynamics at 3, 6 and 12 months after the onset of ARVI. It showed that the development of antibodies to respiratory viruses is very unstable and does not occur in all patients. Antibodies almost disappeared by the third month after ARVI and were no longer detectable by the sixth month. After 12 months, patients suffered a new ARVI and developed the corresponding antibodies. This information will be especially relevant in conditions of the rise in the incidence of ARVIs, as well as the COVID-19 pandemic observed in recent years.Copyright © 2022, Voprosy Prakticheskoi Pediatrii. All rights reserved.

Rhino- and Rs-Viruses in the Covid-19 Pandemic

Acute respiratory viral infections are distributed across the globe and are the most numerous human diseases caused by several hundreds of diverse viruses. Human rhinovirus is one of the most common respiratory pathogens worldwide, causing more than half of all acute respiratory viral infection cases. Seasonal human coronaviruses account for 10-15% of common cold cases;respiratory syncytial (RS) virus is the most common cause of respiratory hospitalization in infants;influenza viruses, adenoviruses, human parainfluenza virus, metapneumoviruses, and some other pathogens are also widespread. It is believed that viral common colds are mostly self-limited, causing mild infections that usually resolve within 8-10 days. However, the role of common seasonal respiratory viruses in total respiratory morbidity should not be underestimated. It turned out that during extraordinary conditions of pandemics, they behave differently. This was clearly demonstrated in the last 2009 influenza pandemic. Whereas some viruses lost relevance under the burden of a new aggressive pandemic strain, others, e.g., rhinovirus, continued to fight for existence and not only circulated along with the pandemic pathogen, but delayed its spread in some cases. For instance, the data from some European countries pointed out that the circulation of the H1N1pdm09 influenza A pandemic virus was interrupted by the annual rhinovirus outbreak. Ten years after the H1N1pdm09 influenza pandemic, a new virus outbreak emerged - the COVID-19 pandemic has begun. This pandemic, caused by the SARS-CoV-2 virus, has disrupted well-established pathogenetic and epidemiological relationships. The level of circulation of many respiratory pathogens has changed dramatically. For instance, global influenza activity has been at a much lower level than expected for the second year from now. In many regions of the world, the flu season has not been started yet. But what is interesting is that rhinoviruses together with RS-virus again showed their unique ability to compete with highly pathogenic and aggressive pathogens. Along with profoundly reduced circulation of many other seasonal respiratory viruses, rhinovirus, and RS-virus are the most frequently detected viruses. In this review, we have brought together the main biological characteristics of such genetically distinct viruses such as rhinovirus, influenza A virus, RS-virus, and SARS-CoV-2. We focused on their main similarities and discrepancies in the attempt to understand why they behave so differently in extreme pandemic conditions as well as what allows rhinoviruses and RS-viruses to coexist with SARS-CoV-2, which in turn almost fully replaced the influenza virus.

EPIDEMIOLOGY AND COURSE OF INFECTIOUS DISEASES DURING THE COVID-19 PANDEMIC. REPORT 2. INTERFERENCE ENGAGED BETWEEN SARS-CoV-2 AND ACUTE RESPIRATORY VIRAL INFECTIONS

Currently, the disease caused by the new coronavirus (COVID-19) and the possibility of co-infection with SARS-CoV-2 and other pathogens in the current epidemic situation continues to be of particular interest. The review, based on the analysis of literature and own materials, outlines the features of the relationship between SARS-CoV-2 and pathogens of acute respiratory viral infections (ARVI). Particular attention is paid to the combined course of COVID-19 and influenza, a comparative characteristic of the severity of the clinical picture. An assessment of the epidemic situation against the backdrop of the COVID-19 pandemic in foreign countries and the Russian Federation (RF) revealed the pres-ence of the phenomenon of SARS-CoV-2 interference with other viral respiratory agents, based on the facts of a sharp suppression of the circulation of influenza viruses, respiratory syncytial virus (RSV) and other ARVI pathogens during the period of active spread of pandemic coronavirus. The main epidemiological indicators of the course of coronavirus infection were compared and the contribution of various pathogens to the etiology of acute respiratory viral infections during the development of the second wave of COVID-19 in the RF was assessed. It was noted that the decrease in the number of new cases by 11.4 and deaths by 2.1 times due to COVID-19 at 6 and 13 weeks in 2022 occurred with unchanged laboratory detection of the influenza virus (0.8%) and an increase in the frequency detection of pathogens of other SARS. The results of observations showed that against the background of a decrease in the incidence of COVID-19, there was no increase in the proportion of diagnosed cases of infections caused by other pathogens, especially influenza. The re-sults obtained confirm the need to ensure effective epidemiological surveillance and additional application of pathogen identification methods for monitoring various ARVI, which can significantly affect the approach to differential diagnosis, patient management tactics and the decision on appropriate preventive measures.

Role of antiviral therapy in respiratory infections in children: Analysis of clinical and laboratory observations.

Objective. To evaluate the efficacy of therapy for acute respiratory viral infections (ARVIs) in children with antiviral medications: inosine pranobex (Groprinosin, Gedeon Richter) and Kagocel (Kagocel, Niarmedic Pharma LLC) in comparison with symptomatic treatment without etiotropic agents based on clinical and laboratory parameters. Patients and methods. The clinical and laboratory observation was conducted in an outpatient setting in the pre-COVID-19 period between 2018 and 2020. Acute respiratory infections were diagnosed using licensed testing systems by multiplex polymerase chain reaction (PCR) with detection of nucleic acid viral genomes: influenza, rhinovirus, respiratory syncytial virus, metapneumovirus, parainfluenza, seasonal coronaviruses, adenoviruses, and bocavirus). A total of 151 children aged 3 to 15 years were examined and monitored in dynamics, with 78.7% of positive and 21.3% of negative results detected by PCR in the nasopharyngeal and oropharyngeal swabs. The patients were randomized into three groups depending on the antiviral medication prescribed: group 1 (53 children) received Groprinosin;group 2 (52 children) received Kagocel;group 3 (control, 46 children) received only symptomatic therapy without antiviral agents. Results. The study demonstrated a significant positive effect in patients in group 1 treated with Groprinosin (n = 53). At the end of therapy for both mono- and mixed infections, there were 95.8% of negative results (according to PCR diagnosis, that is, the absence of viral genome). In children in group 2 (n = 52) treated with Kagocel, the absence of viral nucleic acids (NAs) was observed less frequently (in 77.3% of cases). In children in group 3 (n = 46) who did not receive etiotropic antiviral therapy, there were only 40.3% of negative results after the end of treatment, and viral NAs were detected in 59.7% of patients. In this case, a 5-day course of Groprinosin was prescribed, after which the PCR results became negative in all patients. Therefore, children with recurrent respiratory infections, mixed infections, and herpesvirus infections require longer therapy. Additionally, a high frequency of ARVI complications was noted in group 3 (5 (10.9%) patients, where otitis was observed in 1 case, sinusitis - in 2 cases, bronchitis - in 2 cases), whereas 1 (1.8%) patient taking Groprinosin had otitis, and 1 (1.9%) patient taking Kagocel had pneumonia. Conclusion. This study was the first to investigate antibody titers to respiratory viruses in dynamics at 3, 6 and 12 months after the onset of ARVI. It showed that the development of antibodies to respiratory viruses is very unstable and does not occur in all patients. Antibodies almost disappeared by the third month after ARVI and were no longer detectable by the sixth month. After 12 months, patients suffered a new ARVI and developed the corresponding antibodies. This information will be especially relevant in conditions of the rise in the incidence of ARVIs, as well as the COVID-19 pandemic observed in recent years.Copyright © 2022, Voprosy Prakticheskoi Pediatrii. All rights reserved.

Differences in the structure of infectious morbidity of the population during the first and second half of 2020 in st. petersburg

This chapter focuses on the comparative statistical analysis of the incidence of acute respiratory viral infections (ARVI), new coronavirus infection Covid-19 and community-acquired pneumonia in one of the administrative districts of St. Petersburg. It was found that the total number of people with ARVI, new coronavirus infection Covid-19 and community acquired pneumonia observed in pediatric and adult clinics had two "waves". In the structure of the incidence of Covid-19 in the first "wave", adult patients prevailed. During the second "wave" of the rise in the incidence of Covid-19, the proportion of children doubled to 12.9%. The increased infectious morbidity required the involvement of additional medical personnel, transport, as well as the introduction of new organizational technologies for providing medical care to the population. The data of regular statistical observation became the basis for making operational management decisions for the organization of medical care for the population in the context of an epidemic rise in morbidity. © ISTE Ltd 2022.

EPIDEMIOLOGY AND COURSE OF INFECTIOUS DISEASES DURING THE COVID-19 PANDEMIC. REPORT 2. INTERFERENCE ENGAGED BETWEEN SARS-CoV-2 AND ACUTE RESPIRATORY VIRAL INFECTIONS.

Currently, the disease caused by the new coronavirus (COVID-19) and the possibility of co-infection with SARS-CoV-2 and other pathogens in the current epidemic situation continues to be of particular interest. The review, based on the analysis of literature and own materials, outlines the features of the relationship between SARS-CoV-2 and pathogens of acute respiratory viral infections (ARVI). Particular attention is paid to the combined course of COVID-19 and influenza, a comparative characteristic of the severity of the clinical picture. An assessment of the epidemic situation against the backdrop of the COVID-19 pandemic in foreign countries and the Russian Federation (RF) revealed the presence of the phenomenon of SARS-CoV-2 interference with other viral respiratory agents, based on the facts of a sharp suppression of the circulation of influenza viruses, respiratory syncytial virus (RSV) and other ARVI pathogens during the period of active spread of pandemic coronavirus. The main epidemiological indicators of the course of coronavirus infection were compared and the contribution of various pathogens to the etiology of acute respiratory viral infections during the development of the second wave of COVID-19 in the RF was assessed. It was noted that the decrease in the number of new cases by 11.4 and deaths by 2.1 times due to COVID-19 at 6 and 13 weeks in 2022 occurred with unchanged laboratory detection of the influenza virus (0.8%) and an increase in the frequency detection of pathogens of other SARS. The results of observations showed that against the background of a decrease in the incidence of COVID-19, there was no increase in the proportion of diagnosed cases of infections caused by other pathogens, especially influenza. The results obtained confirm the need to ensure effective epidemiological surveillance and additional application of pathogen identification methods for monitoring various ARVI, which can significantly affect the approach to differential diagnosis, patient management tactics and the decision on appropriate preventive measures.Copyright © 2022 Saint Petersburg Pasteur Institute. All rights reserved.

Respiratory viral infections and their role in human cardiovascular diseases

Acute respiratory viral infections are the most common human diseases. Symptoms of the infection vary from a slight cold to critical condition requiring artificial lung ventilation and support of cardiovascular system. Main risk factors of severe disease include high viral load, co-infection with other pathogens, age from 0 to 2 years and older than 65 years, and immunodeficiency. Cardiac manifestations of the infection are usually caused by indirect effects due to inflammatory reaction resulting in systemic increase in proinflammatory cytokines, so called cytokine storm. However, there have been reports on the identification of respiratory viruses isolated directly from the myocardial tissue, or testing of viral RNA in the myocardium using real-time polymerase chain reaction. This review discusses the direct and indirect effects of respiratory viral infections on causing cardiovascular complications. The authors discuss the similarities and differences of the immunopathogenic mechanisms associated with COVID-19, influenza infection, as well as diseases caused by enteroviruses, respiratory syncytial viruses, metapneumoviruses, and parainfluenza viruses. © 2022 Tomsk State University. All rights reserved.

EPIDEMIOLOGY AND COURSE OF INFECTIOUS DISEASES DURING THE COVID-19 PANDEMIC. REPORT 2. INTERFERENCE ENGAGED BETWEEN SARS-CoV-2 AND ACUTE RESPIRATORY VIRAL INFECTIONS.

Currently, the disease caused by the new coronavirus (COVID-19) and the possibility of co-infection with SARS-CoV-2 and other pathogens in the current epidemic situation continues to be of particular interest. The review, based on the analysis of literature and own materials, outlines the features of the relationship between SARS-CoV-2 and pathogens of acute respiratory viral infections (ARVI). Particular attention is paid to the combined course of COVID-19 and influenza, a comparative characteristic of the severity of the clinical picture. An assessment of the epidemic situation against the backdrop of the COVID-19 pandemic in foreign countries and the Russian Federation (RF) revealed the presence of the phenomenon of SARS-CoV-2 interference with other viral respiratory agents, based on the facts of a sharp suppression of the circulation of influenza viruses, respiratory syncytial virus (RSV) and other ARVI pathogens during the period of active spread of pandemic coronavirus. The main epidemiological indicators of the course of coronavirus infection were compared and the contribution of various pathogens to the etiology of acute respiratory viral infections during the development of the second wave of COVID-19 in the RF was assessed. It was noted that the decrease in the number of new cases by 11.4 and deaths by 2.1 times due to COVID-19 at 6 and 13 weeks in 2022 occurred with unchanged laboratory detection of the influenza virus (0.8%) and an increase in the frequency detection of pathogens of other SARS. The results of observations showed that against the background of a decrease in the incidence of COVID-19, there was no increase in the proportion of diagnosed cases of infections caused by other pathogens, especially influenza. The results obtained confirm the need to ensure effective epidemiological surveillance and additional application of pathogen identification methods for monitoring various ARVI, which can significantly affect the approach to differential diagnosis, patient management tactics and the decision on appropriate preventive measures. Copyright © 2022 Saint Petersburg Pasteur Institute. All rights reserved.

The Contribution of Viruses to the Structure of Acute Respiratory Diseases in the Population of Yakutsk in 2019-2020

The aim of the study was to identify the viral etiology of acute respiratory diseases in patients hospitalized to the infectious hospitals in Yakutsk. Methods: nasal and pharyngeal swabs were obtained from the examined patients. The presence of the genetic material of the respiratory viruses was determined by real-time PCR. Results: During the study, 178 patients admitted to the infectious hospitals in Yakutsk from November 2019 to April 2020 were selected according to the inclusion criteria. 99/178 (55.6%) samples were positive for at least one of the studied viruses, 79/178 (44.4%) samples were negative. Respiratory syncytial virus;rhinoviruses;metapneumovirus;parainfluenza viruses of types 1, 2, 3 and 4;coronaviruses NL-63, 229E, HKU-1 and OC-43;adenoviruses groups B, C and E;bokavirus, as well as influenza A and influenza B viruses were identified. The results of the study are necessary to improve and optimize diagnostic tactics, for control and prevention of respiratory viral infections.

EPIDEMIOLOGY AND COURSE OF INFECTIOUS DISEASES DURING THE COVID-19 PANDEMIC. REPORT 2. INTERFERENCE ENGAGED BETWEEN SARS-CoV-2 AND ACUTE RESPIRATORY VIRAL INFECTIONS

Currently, the disease caused by the new coronavirus (COVID-19) and the possibility of co-infection with SARS-CoV-2 and other pathogens in the current epidemic situation continues to be of particular interest. The review, based on the analysis of literature and own materials, outlines the features of the relationship between SARS-CoV-2 and pathogens of acute respiratory viral infections (ARVI). Particular attention is paid to the combined course of COVID-19 and influenza, a comparative characteristic of the severity of the clinical picture. An assessment of the epidemic situation against the backdrop of the COVID-19 pandemic in foreign countries and the Russian Federation (RF) revealed the presence of the phenomenon of SARS-CoV-2 interference with other viral respiratory agents, based on the facts of a sharp suppression of the circulation of influenza viruses, respiratory syncytial virus (RSV) and other ARVI pathogens during the period of active spread of pandemic coronavirus. The main epidemiological indicators of the course of coronavirus infection were compared and the contribution of various pathogens to the etiology of acute respiratory viral infections during the development of the second wave of COVID-19 in the RF was assessed. It was noted that the decrease in the number of new cases by 11.4 and deaths by 2.1 times due to COVID-19 at 6 and 13 weeks in 2022 occurred with unchanged laboratory detection of the influenza virus (0.8%) and an increase in the frequency detection of pathogens of other SARS. The results of observations showed that against the background of a decrease in the incidence of COVID-19, there was no increase in the proportion of diagnosed cases of infections caused by other pathogens, especially influenza. The results obtained confirm the need to ensure effective epidemiological surveillance and additional application of pathogen identification methods for monitoring various ARVI, which can significantly affect the approach to differential diagnosis, patient management tactics and the decision on appropriate preventive measures. Copyright © 2022 Saint Petersburg Pasteur Institute. All rights reserved.

Evaluation of the efficacy and safety of interferon alpha-2b in the prevention of acute respiratory infections (including COVID-19) among children in Uzbekistan

Objective. To study the preventive efficacy and safety of interferon alpha-2b (IFN-alpha2b) with antioxidants against acute respiratory viral infections (ARVI) among children in Uzbekistan during the COVID-19 pandemic. Patients and methods. An open-label prospective observational study included 300 first-grade pupils (age 6-7 years) from schools in Tashkent (Uzbekistan). Children were evenly divided into three groups: the first and second (study) groups from different schools received IFN-alpha2b (Viferon gel for external and local use, 36,000 IU/g);the third group (control) did not receive the medication. The main criteria for assessing the effectiveness of prevention were the incidence of ARVI within 3 months after inclusion in the study, duration and severity of clinical symptoms of the disease, and the frequency of adverse events associated with the use of the study medication. Results. Observation after 30 to 90 days from the beginning of treatment showed a statistically significant increase in the proportion of ARVI cases in the control group compared to the study groups where Viferon gel was used. The average duration of the febrile period in children with ARVI in the first group was the lowest and amounted to 3.1 +/- 0.4 days, in the second group - 3.8 +/- 0.5 days, in the third group - 5.4 +/- 1.1 days (p1-3 = 0.002 and p2-3 = 0.003, Mann-Whitney U test with adjustment to multiple comparisons). Also, the duration of intoxication symptoms and catarrhal phenomena in children with ARVI in the groups receiving IFN-alpha2b was significantly shorter than in the control group. No cases of COVID-19 were registered in the study groups during the entire period of observation, while in the control group, markers of infection were detected in 30 children. There were no adverse events associated with the administration of IFN-alpha2b (Viferon gel for external and local use 36,000 IU/g). Conclusion. In children who received IFN-alpha2b with antioxidants, a statistically significant decrease in ARVI episodes was found, as well as rapid relief of intoxication symptoms and catarrhal phenomena in the event of disease. The pronounced effectiveness and the absence of adverse events give reason to recommend the use of Viferon gel for the prevention of acute respiratory viral infections, as well as COVID-19 in children. Copyright © 2022, Dynasty Publishing House. All rights reserved.

Complex therapy recovered after infectious diseases

Introduction. At the present time, the incidence of acute respiratory viral infections (ARVI) remains at a high level. Some patients who have undergone ARVI and COVID-19 have been disturbed by astheno-neurotic syndrome and chronic fatigue syndrome for quite a long time. Aim. To study the efficacy and safety dietary supplement treatment in the rehabilitation of patients recovered after acute respiratory viral infections. Materials and methods. We have examined 50 patients diagnosed with acute respiratory viral infections (38 people) and COVID-19 (12 people). Age of patients: from 25 years to 60 years old, average age 35 ± 11.84 years old. All patients were randomized into two study groups: the first group (25 people) received a biologically active food supplement and the second group (25 people) did not receive such complex. Сomplex was prescribed to the participants of the first group in amount of two capsules once a day. The course of therapy was 14 days. Before and after taking, all patients were assessed for shortness of breath on the MRC scale, depression on the Beck scale, chronic fatigue syndrome on the FAS scale, and the level of C-reactive protein (CRP) was assessed as well. Results. In the course of the observation, no significant difference between the groups was recorded in the dynamics of the state of assessment for dyspnea, depression and hemoglobin level. The average level of CRP before taking in the first group was 4.4 mg/l (from 0 to 22 mg/l), in the second – 3.8 mg/l (from 0 to 14 mg/l). When comparing the dynamics in the first group, there was more pronounced decrease in the level of CRP. In the first group, decrease in manifestations of pathological fatigue was revealed, characterized by decrease in FAS scores compared to the control group, where the number of scores, on the contrary, increased. Conclusions. Сomplex has a corrective effect on astheno-neurotic symptoms after suffering from acute respiratory viral infections or post-COVID syndrome. © 2022, Remedium Group Ltd. All rights reserved.

RHINO- AND RS-VIRUSES IN THE COVID-19 PANDEMIC.

Acute respiratory viral infections are distributed across the globe and are the most numerous human diseases caused by several hundreds of diverse viruses. Human rhinovirus is one of the most common respiratory pathogens worldwide, causing more than half of all acute respiratory viral infection cases. Seasonal human coronaviruses account for 10 -15% of common cold cases;respiratory syncytial (RS) virus is the most common cause of respiratory hospitalization in infants;influenza viruses, adenoviruses, human parainfluenza virus, metapneumoviruses, and some other pathogens are also widespread. It is believed that viral common colds are mostly self-limited, causing mild infections that usually resolve within 8–10 days. However, the role of common seasonal respiratory viruses in total respiratory morbidity should not be underestimated. It turned out that during extraordinary conditions of pandemics, they behave differently. This was clearly demonstrated in the last 2009 influenza pandemic. Whereas some viruses lost relevance under the burden of a new aggressive pandemic strain, others, e.g., rhinovirus, continued to fight for existence and not only circulated along with the pandemic pathogen, but delayed its spread in some cases. For instance, the data from some European countries pointed out that the circulation of the H1N1pdm09 influenza A pandemic virus was interrupted by the annual rhinovirus outbreak. Ten years after the H1N1pdm09 influenza pandemic, a new virus outbreak emerged - the COVID-19 pandemic has begun. This pandemic, caused by the SARS-CoV-2 virus, has disrupted well-established pathogenetic and epidemiological relationships. The level of circulation of many respiratory pathogens has changed dramatically. For instance, global influenza activity has been at a much lower level than expected for the second year from now. In many regions of the world, the flu season has not been started yet. But what is interesting is that rhinoviruses together with RS-virus again showed their unique ability to compete with highly pathogenic and aggressive pathogens. Along with profoundly reduced circulation of many other seasonal respiratory viruses, rhinovirus, and RS-virus are the most frequently detected viruses. In this review, we have brought together the main biological characteristics of such genetically distinct viruses such as rhinovirus, influenza A virus, RS-virus, and SARS-CoV-2. We focused on their main similarities and discrepancies in the attempt to understand why they behave so differently in extreme pandemic conditions as well as what allows rhinoviruses and RSviruses to coexist with SARS-CoV-2, which in turn almost fully replaced the influenza virus. (English) [ FROM AUTHOR] Острые респираторные вирусные инфекции являются самыми многочисленными заболеваниями человека, с развитием которых связывают несколько сотен различных вирусов. Один из наиболее распространенных на планете респираторных патогенов -это риновирус человека, который является причиной более половины всех случаев острых респираторных вирусных инфекций;на долю сезонных коронавирусов человека приходится 10–15% простудных заболеваний;респираторно-синцитиальный (РС) вирус -наиболее частая причина госпитализации младенцев с респираторными заболеваниями;также широко распространены вирусы гриппа, аденовирусы, вирус парагриппа человека и метапневмовирусы. Считается, что вирусные простудные заболевания-это в основном самостоятельно купирующиеся, легко протекающие инфекции, которые обычно проходят в течение 8–10 дней. Однако не стоит недооценивать роль обычных сезонных респираторных вирусов в общей массе респираторных патогенов. Оказалось, что в экстраординарных условиях пандемий они ведут себя по-разному. Это было очень четко продемонстрировано в последнюю пандемию гриппа 2009 г. Если одни вирусы под гнетом агрессивного пандемического штамма сдали свои позиции, то другие, и ярким тому примером может служить риновирус,- продолжали активно бороться за существование и не только циркулировали наравне с пандемическим патогеном, но и в ряде случаев задерживали его распространение. Так происходило, например, в ряде европейских стран, где наступление пандемического вируса гриппа H1N1pdm09 было приостановлено начавшейся ежегодной осенней вспышкой риновирусной инфекции. Спустя десять лет от начала пандемии гриппа H1N1pdm09 разразилась пандемия COVID-19, вызванная новым коронавирусом SARS-CoV-2. Эта пандемия нарушила устоявшиеся эпидемиологические и патогенетические взаимосвязи. Уровень циркуляции многих респираторных патогенов значительно изменился. Например, глобальная активность гриппа уже второй год находится на гораздо более низком уровне, чем ожидалось. Вомногих регионах мира сезон гриппа так и не начался. Но что интересно: риновирусы, а с ними и РС-вирус, снова проявили свою уникальную способность конкурировать с высокопатогенными и агрессивными возбудителями. При значительном сокращении циркуляции мн ¾Ð³Ð¸Ñ… сезонных респираторных вирусов, именно риновирус и РС-вирус оказались наиболее часто обнаруживаемыми вирусами. Ð’ настоящем обзоре мы свели воедино основные биологические характеристики таких генетически удаленных вирусов, как риновирус, вирус гриппа А, РС-вирус и SARS-CoV-2, в попытке понять, что их объединяет и разделяет, почему так по-разному они ведут себя в экстремальных пандемических условиях и что позволяет риновирусам и РС-вирусам сосуществовать с SARSCoV-2, который, в свою очередь, почти полностью вытеснил вирус гриппа. (Russian) [ FROM AUTHOR] Copyright of Russian Journal of Infection & Immunity is the property of National Electronic-Information Consortium and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The Main Risks of an Еpidemic Emergency Associated with New Respiratory Viruses

Relevance. The conceptual task of epidemiological surveillance as part of the sanitary protection of the territory of the Russian Federation (RF) from the importation and spread of diseases that pose a danger to the population at the present stage is to identify potential risks of a sanitary and еpidemic emergency and prompt response if they occur. Epidemic manifestations of diseases caused by new respiratory viruses, in most cases, cause a crisis in public health, which indicates the need for a comprehensive study of the features of their course, determination of criteria for the potential risk of an emergency of an еpidemic nature, which will make it possible to timely organize a complex of anti-epidemic (preventive) measures. Aim. Study, systematize and stratify the features of the atypical course of the epidemic process of acute respiratory viral infections caused by new variants of the pathogen in a city with a population of more than one million people. Materials and methods. The study used retrospective data on infectious morbidity in different age groups from government reports for the period 2015–2020, data from annual forms No. 2 of the federal state statistical observation for the period 2009–2020. Rospotrebnadzor Administration for the Rostov Region, Center for Hygiene and Epidemiology in the Rostov Region. Statistical data processing was carried out by a generally accepted method. Results. The analysis showed that the periods 2009–2010, 2015–2016, 2020–2021 had significant changes in the epidemic process in relation to its typical long-term course with a predominance in the structure of the incidence of ARVI, including influenza and new coronavirus infection, of various age groups for each period, an atypically severe infectious process and an increase in the number of community-acquired pneumonia. Moreover, in the periods 2009–2010, 2015–2016. Influenza A (H1N1) pdm09 virus was dominant in the etiological structure, in 2020–2021 – the causative agent of the new coronavirus infection SARS-CoV-2. Thus, the features of the epidemic (against the backdrop of a pandemic) spread of ARVI in Rostov-on-Don, established as a result of a retrospective analysis, made it possible to differentiate the main-external and internal-risks of the formation of emergencies of an еpidemic nature associated with new respiratory viruses in a city with a population of more than one million people. © Slis’ SS, et al.

Epidemiological peculiarities and analysis of the incidence time series of viral airborne infections in Ukraine in 2010-2020

Illnesses with aerosol mode of transmission dominate in the structure of infectious diseases. Influenced by natural, social and biological factors, epidemiological characteristics of the infectious diseases change, that's why the objective of this research was to determine modern peculiar features of the epidemiological situation regarding viral infections with aerosol transmission in Ukraine. Influenza incidence ranged from 31.14‒184.45 per 100 thousand people, other acute respiratory viral infections from 13685.24‒ 18382.5. Epidemic process of measles was characterized by increasing incidence in 2018 and 2019. In Ukraine, there is a tendency to reduce the incidence of rubella and mumps (р <0.05). The positive effect of immunization on the incidence of mumps and rubella has been established. Vaccination against measles cannot be considered as evidence of immunity against measles. The demographic situation in Ukraine may indirectly influence the intensity of the epidemic situation of viral infections with aerosol transmission.

Respiratory viral infections in the lower respiratory tract failure (Literature review)

The sharp increase in viral pneumonia against the background of the pandemic of the new coronavirus infection SARS-CoV-2 requires more attention to the study of the role of viruses in damage to the lower respiratory tract, including their etiological significance in the development of community-acquired pneumonia. Modern possibilities of laboratory diagnostics make it possible not only to identify and study respiratory viruses, but also to help differentiate active viral infections as a cause of lower respiratory tract disease from virus carriers. The review describes the epidemiological and clinical features of the most relevant or less studied pneumotropic viral infections in children (respiratory syncytial, adenovirus, bocavirus, metapneumovirus), including their role in the etiology of pneumonia in children. Understanding the viral etiology of pneumonia in children will reduce the antibacterial load, which will help to reduce the side effects of chemotherapy and slow the emergence of antimicrobial-resistant bacterial strains. © 2021 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

SALIENT FEATURES OF CIRCULATING RESPIRATORY VIRUSES IN THE PRE- AND PANDEMIC INFLUENZA AND COVID-19 SEASONS

A wide variety of zoonotic viruses that can cross the interspecies barrier promote the emergence of new, potentially pandemic viruses in the human population that is often accompanied by the disappearance of existing circulating strains. Among the various reasons underlying this phenomenon is the strengthening of herd immunity by expanding the immune layer of population and improving means and methods of medical care. However, natura abhorret vacuum, and new pathogens come to replace disappearing ones. Over the past ten years, humanity has faced two pandemics: swine flu A(H1N1)pdm09 in 2009 and COVID-19 in 2019, providing scientists with a unique opportunity to learn more about a relationship between respiratory viruses and their pathogenesis. Together with viruses of pandemic significance, a large number of seasonal respiratory viruses circulate, which contribute to the structure of human morbidity, and coinfections aggravate the condition of the illness. In the conditions of the spread of new viruses with unexplored characteristics, in the absence of means of prevention and therapy, it is especially important to prevent the aggravation of morbidity due to mixed infections. Here we review the mutual involvement of pandemic influenza A(H1N1)pdm09 and SARS-CoV-2 coronavirus and seasonal respiratory viruses in the epidemic process, discuss some issues related to their spread, potential causes affecting the spread and severity of the morbidity. The given facts testify to the existence of seasonality and temporal patterns of the beginning and end of respiratory viruses circulation. Interestingly, the beginning of circulation of the pandemic influenza A(H1N1)pdm09 virus led to a shift in the timing and intensity of circulation of some respiratory viruses, which is probably caused by existence of “replication conflicts” between them, and did not affect others. Coinfection with SARS-CoV-2-19 and other respiratory viruses, especially respiratory syncytial virus and rhinoviruses, was quite often observed. At the current stage, no aggravating effect of influenza on the course of COVID-19 in mixed infection has been established. Whether this is due to the mild course of influenza infection in the 2020 epidemic season, or the competitive impact of SARS-CoV-2 on influenza viruses is not yet clear. Experts are still at the stage of accumulating facts and working on creating means of effective prevention and treatment of the new coronavirus infection. © 2021 Saint Petersburg Pasteur Institute. All rights reserved.

[Evaluation of the effectiveness of ARVI treatment regimen including etiotropic (enisamium iodide) and symptomatic treatment].

AIM: To assess the effectiveness of the use of the antiviral drug enisamium iodide in the complex treatment of acute respiratory viral infections (ARVI) caused by various pathogens in routine clinical practice. MATERIALS AND METHODS: А prospective randomized study included 134 patients who were treated in the epidemic season of influenza and ARVI in 20182019. All patients were examined for the presence of influenza A and B viruses, respiratory syncytial virus, human metapneumovirus, parainfluenza virus, coronaviruses, rhinoviruses, adenoviruses in nasopharyngeal swabs by PCR. Patients of the main group received enisamium iodide along with symptomatic therapy, the control group received only symptomatic therapy. The primary parameter of the effectiveness of therapy was evaluated on the scale of the general severity of the manifestations of ARVI (Total Symptom Score TSS) from the 2nd to the 4th day and by the secondary criteria of effectiveness: assessment of the duration of ARVI, the severity of fever, the proportion of patients with normal body temperature, the duration of the main clinical symptoms of acute respiratory viral infections, the proportion of patients in whom complications requiring antibiotics were noted, the dynamics of interferon status on the 6th day. To conduct a statistical analysis, depending on the efficiency parameter, the ANCOVA method with a fixed group factor and an initial score on the TSS severity scale was used as covariates, a criterion for comparing quantitative indicators in two independent groups. RESULTS: According to the results of the analysis of the primary efficacy parameter, the median (interquartile range) of the average score on the scale of the general severity of ARVI manifestations in the main group was 4.33 (3.675.83), in the comparison group 6.00 (4.677.25; p0.001). The duration of systemic and local manifestations of acute respiratory viral infections was statistically significantly less in the main group (p=0.002 and p=0.019, respectively). Prescription of additional therapy was required in 2 (2.9%) patients of the main group (patients taking enisamium iodide), compared with 8 (11.9%) patients in the control group. Serum levels of interferon  and interferon  on the last day of treatment were statistically significantly higher in patients of the main group compared with the control group (p0.001). Treatment (excellent) was evaluated by 42 (62.7%) patients, while in the control group only 17 (25.8%) patients gave similar ratings. Both patients (p0.001) and doctors (p0.002) rated therapy tolerance better in the study group. CONCLUSION: The results confirmed the safety and effectiveness of enisamium iodide as a treatment for ARVI and influenza. The antiviral, interferonogenic and anti-inflammatory properties of the drug are involved in the formation of an antiviral response and reduce the risk of complications, which makes it possible to reduce the number of symptomatic agents used.