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The aim of the research. To study the specifics in manifestations of the new coronavirus infection in newborns. Material and methods. A retrospective analysis of observations of 28 newborns diagnosed with the new coronavirus infection SARS-CoV-2 dated from June to December 2020 was performed. The infants were transferred from the perinatal centre for hospitalisation to the infectious department of a children's hospital. The patients were born to mothers with COVID-19 as well as mothers discharged from hospital and hospitalised later due to COVID-19 acquired through family contact. Clinical and laboratory data of 12 female and 16 male children aged 1 to 28 days were studied. Results. Clinical symptoms of the new coronavirus infection in newborns tend to be different: from asymptomatic course in 46.5 % of the patients to evident pneumonia in 50 % of the children. The newborns admitted with COVID-19 acquired through family contact had more severe disease manifestations. Conclusion. Amidst the pandemic rise of its incidence, the new coronavirus infection COVID-19 is not rare among newborns. COVID-19 newborns did not have a registered severe nosocomial infection, sepsis, multisystem inflammatory syndrome.Copyright © 2022, Krasnoyarsk State Medical University. All rights reserved.
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A clinical case of a severe course of coronavirus infection (COVID-19) in an adolescent is described. A 15-year-old patient was admitted to the surgical department with suspicion of acute appendicitis. According to the results of the ultrasound examination of the abdomen it was decided to perform diagnostic laparoscopy, which excluded the presence of acute surgical pathology. The increase of intoxication symptoms and the data of epidemiological anamnesis, concerning the contact with patients with the catarrhal symptoms 3-4 weeks before the disease onset, were the reason for the examination for SARS-CoV-2. On the basis of a positive polymerase chain reaction for SARS-CoV-2 and existing pneumonia according to X-ray examination of the chest, the patient was transferred to an infectious disease hospital. Further examination revealed polyserositis (ascites, pleurisy);acute kidney damage (high levels of urea, creatinine, oliguria);cytolytic syndrome (increased level of aspartate aminotransferase in 1,7 times);high level of C-reactive protein and increased level of procalcitonin, which corresponded to the local infection. After the administration of the first dose of intravenous immunoglobulin the patient's condition has improved significantly. The set of symptoms of multiple organ damage in this clinical case provides grounds for differential diagnosis between coronavirus disease and multisystem inflammatory syndrome in children on the background of the coronavirus infection COVID-19. Based on the diagnostic criteria for multisystem inflammatory syndrome in children presented by the World Health Organization, the Centers for Disease Control and Prevention, the British Medical Journal, the American Academy of Pediatrics, this clinical case can be considered as multisystem inflammatory syndrome.
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The experience of medical maintenance for assembly events annually held on the basis of the educational process of the Military Medical Academy named after S.M. Kirov. The main directions of the organization of sanitary and anti-epidemic (preventive) measures among the personnel at each stage of the camp gathering have been determined. It is shown that at the preparatory stage it is advisable to develop additional plans that concretize sanitary and anti-epidemic (preventive) measures for the stages of the camp gathering. At the stage of accepting participants, the main direction is the organization of events that prevent the introduction of infection with the arriving personnel. At the main stage of the camp training, the leading role belongs to disinfection measures. At the stage of departure of participants, the main efforts should be focused on minimizing the potential risk of infection along the route and the introduction of infection into their military units. The features of disinfection are described depending on the type of object being processed. The results of testing a designed device for fixing dispensers with a skin antiseptic on the basis of a unified military stand in a camp gathering are presented. The features of the organization of medical control over the material and household provision of the personnel of the training camp are stated. The basic principles of prophylaxis and anti-epidemic protection during assembly activities in the context of the spread of COVID-19 have been formulated. © 2019 Eco-Vector LLC. All rights reserved.
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COVID-hospital healthcare workers belong to a high-risk SARS-CoV-2 infection. The aminodihydrophthalazinedione sodium (Galavit) belongs to the group of immunomodulatory and anti-inflammatory drugs. It has been shown that aminodihydrophthalazinedione sodium is effective in the prevention of acute respiratory infections, respiratory tract diseases and ENT-organs of bacterial and viral etiology. The purpose of the study. To evaluate the effectiveness and safety of immunoprophylaxis of new coronavirus infection (COVID-19) with aminodihydrophthalazinedione sodium in healthcare workers providing medical care in the "red zone". Material and methods. A multicenter prospective-retrospective observational comparative non-randomized study in healthcare workers providing medical care in the "red zone" was conducted. 428 participants were included in the study: the observation group - healthcare workers who administered aminodihydrophthalazinedione sodium (Galavit) for prophylactic purposes (n=214), and control group (n=214). The observation period of the participants or the period of collecting retrospective data in the study was 30 days. The results of PCR tests and tests for antibodies to the SARS-CoV-2 were analyzed, clinical status (COVID-19 in any form) was assessed. Descriptive statistic methods and Pearson chi2 test were used. The risk ratios, odds ratios and 95% confidence intervals were calculated with them. The influence of potential confounding factors (age, gender, work place in clinical site, the presence or absence of concomitant disease) on the clinical status were analyzed using logistic regression. The analysis of propensity score matching was carried out. The Stata/IC 14.2 for Windows software used for statistical analysis. Results and discussion. Observational study results describe the risk ratios and odds ratios of infection with a new coronavirus (COVID-19) in healthcare workers providing medical care in the "red zone" considering prophylactic administration of aminodihydrophthalazinedione sodium (Galavit). 205 (95.8%) participants in the group of healthcare workers who took aminodihydrophthalazinedione sodium (Galavit) for prophylactic purposes and 194 (90.7%) participants in control group had a negative PCR test during the observation period, chi2=4.48, p=0.034. The risk of a positive status according to the PCR test for 30 days in the preventive group was 0,04, and in the control group 0.09. The risk difference was -0.05 [95% confidence interval (CI) -0.099;-0.004]. The adjusted odds ratio using multiple logistic regression was - 0.41 (95% CI 0.18-0.93). No adverse events were observed during the prophylactic administration of aminodihydrophthalazinedione sodium over 30 days. Conclusion. Galavit preventive administration in a tablet form at a dose of 50-100 mg per day by employees of medical institutions providing medical care to patients with CIVID-19 significantly reduces the risk of SARS-CoV-2 infection and more than 2 times increases the chances not ill of new coronavirus infection. Galavit administration up to 30 days at a dose of 50-100 mg was well tolerated, no adverse events were registered.Copyright © 2022 by the authors.
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Aims. The aim is to study the features of life and the incidence rate of anxiety and depressive disorders among medical faculty students studying remotely during the epidemic of a new coronavirus infection (Covid 19) at the Kabardino-Balkarian State University named after H.M. Berbekov. Materials and methods. We examined 335 students (34% males, 66% females) at the Faculty of Medicine in November- December 2020. The average age of the students examined was 20.3+/-2.3 years. The study included an anonymous mail survey to examine educational conditions, lifestyle, levels of anxiety and depression. Results. 43.8% of the students had insufficient sleep duration, 58.5% had low physical activity, in 24.8% of them we recorded high levels of situational anxiety and in 82.1% of them personal anxiety, in 7.1% of the students we recorded clinically expressed anxiety and 1.8% had clinically expressed depression. During the transition to remote learning, students increased the time use to prepare for classes (51.2%) and the duration of sleep (61.5%), while their physical activity decreased (76.5%). Statistically significant linear correlations were identified between the level of anxiety and depression and the duration of sleep, low physical activity, preparation time for classes, academic performance, and academic debt. Conclusions. The results obtained by us can be used to optimize the educational process, as well as to preserve the mental health of students during the transition to distance learning.Copyright © 2020 Novyi Russkii Universitet. All rights reserved.
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The aim of the work is to form the principles of a personalized approach to the management of patients with COVID-19 with a complicated comorbid background. Material and methods. The article describes a clinical case of successful recovery of an 87-year-old patient from a new coronavirus infection COVID-19, complicated by pneumonia involving 36% of the lung parenchyma area. Along with age, the situation was aggravated by the comorbid status of the patient: the presence of chronic lymphocytic leukemia, hypertension, mechanical prostheses of the mitral and aortic valves, postinfarction cardiosclerosis, paroxysmal atrial fibrillation, type 2 diabetes mellitus, stage 4 CKD, anemic syndrome, and subclinical hypothyroidism. Results. The C-reactive protein level at admission was 114.46 mg/L. The patient refused hospitalization. Baricitinib 4 mg, favipiravir according to the scheme, vitamin D 2000 units were prescribed for the previously taken therapy. Already after 3 days, C-reactive protein decreased by 4.6 times, and by the 8th day by 15.5 times and amounted to 7.38 mg/ml. The temperature returned to normal on day 2 from the start of baricitinib. In dynamics, a decrease in creatinine level to 177.0 mumol/l was noted, the glomerular filtration rate increased to 30 ml/min/1.73 m2, which corresponded to stage 3b of CKD (a pronounced decrease in glomerular filtration rate). Conclusion. Despite the age of the patient, many comorbidities, each of which could be fatal, the timely use of baricitinib on an outpatient basis made it possible to stop the progressive course of the disease.Copyright © Eco-Vector, 2023. All rights reserved.
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Objective. To assess the factors influencing mean length of hospitalisation (LOH) and treatment outcomes in patients with coro-navirus disease 2019 (COVID-19) between January 31, 2020 and June 10, 2021. Material and methods. We analyzed the results of specialized medical care in patients with COVID-19. Medical, gender and anam-nestic factors influencing treatment outcomes were chosen for analysis. The follow-up unit was a record with data about a patient with COVID-19. We harvested data from the Federal Register of Persons with COVID-19 developed in accordance with the De-cree of the Government of the Russian Federation dated March 31, 2020 No. 373 "On Approval of Interim Rules for Recording Information in order to Prevent the Spread of a New Coronavirus Infection (COVID-19)>>. Results. A retrospective cohort study of data from the Federal Register of patients with COVID-19 involving more than 3 million patients (40.7% men and 59.3% women) revealed the highest incidence of disease in men aged 60-64, 55-59 and 35-39 years, as well as in women aged 60-64, 55-59 and 50-54 years. There was no significant correlation between age and LOH (linear correlation coefficient (r-Pearson) for men 0.021 (p<0.05), for women 0.0124 (p<0.05)). Weighted mean LOH in all age groups was 14.7 days for men (standard deviation (SD) 5.6 days) and 15.7 days for women (SD 5.2 days). Thirty-seven comorbidities/ complications of the underlying disease worsened prognosis regarding LOH in patients with severe and extremely severe COV-ID-19 compared to course of disease without comorbidities or complications. Analysis of impact of COVID-19 severity on mortality revealed strong direct relationship between these signs (r-Pearson for men 0.830 (p<0.0001), for women 0.799 (p<0.0001). Patients with moderate COVID-19 died 89.4 times more often compared to those with mild infection. Severe patients died 20.5 times more often compared to patients with moderate severity of disease. Risk of mortality from COVID-19 is 11.3% higher in patients with extremely severe infection than in patients with severe disease. Conclusion. Our data on mean LOH differentiated by sex and age, as well as comparison of this indicator with comorbidities and severity of COVID-19, can be used for modeling of hospital workload for a stochastic flow of patients whose parameters are com-parable with data of patients analyzed in this study.Copyright © 2022, Media Sphera Publishing Group. All rights reserved.
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The aim of the work is to form the principles of a personalized approach to the management of patients with COVID-19 with a complicated comorbid background. Material and methods. The article describes a clinical case of successful recovery of an 87-year-old patient from a new coronavirus infection COVID-19, complicated by pneumonia involving 36% of the lung parenchyma area. Along with age, the situation was aggravated by the comorbid status of the patient: the presence of chronic lymphocytic leukemia, hypertension, mechanical prostheses of the mitral and aortic valves, postinfarction cardiosclerosis, paroxysmal atrial fibrillation, type 2 diabetes mellitus, stage 4 CKD, anemic syndrome, and subclinical hypothyroidism. Results. The C-reactive protein level at admission was 114.46 mg/L. The patient refused hospitalization. Baricitinib 4 mg, favipiravir according to the scheme, vitamin D 2000 units were prescribed for the previously taken therapy. Already after 3 days, C-reactive protein decreased by 4.6 times, and by the 8th day by 15.5 times and amounted to 7.38 mg/ml. The temperature returned to normal on day 2 from the start of baricitinib. In dynamics, a decrease in creatinine level to 177.0 mumol/l was noted, the glomerular filtration rate increased to 30 ml/min/1.73 m2, which corresponded to stage 3b of CKD (a pronounced decrease in glomerular filtration rate). Conclusion. Despite the age of the patient, many comorbidities, each of which could be fatal, the timely use of baricitinib on an outpatient basis made it possible to stop the progressive course of the disease.Copyright © Eco-Vector, 2023. All rights reserved.
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The global outbreak of the new coronavirus infection COVID-19 is still ongoing, leading to coinfections such as malaria and COVID-19 and others. As evidenced, by the increase in various reports of coinfections. In recent years, Uzbekistan has achieved epidemiological stability for malaria and in 2018 received, an official World Health Organization certificate confirming the country's "malaria-free" status. At the present stage during the COVID-19 pandemic, imported, malaria from abroad, is relevant for our republic and, therefore, there is a constant danger of renewed, transmission, from imported cases. In this article presented the clinical case of coinfection, of COVID-19 and. malaria in a patient. From, the epidemiological data, the patient was a citizen of Cameroon. During treatment of coronavirus infection, the patient noted intermittent chills all over the body and sweating, clinical symptoms of tropical malaria began to appear. Microscopy of a thick drop and. a thin blood, smear confirmed, the presence of Pl. falciparum.. The patient was prescribed, antimalarial therapy with mefloquine, resulting in clinical recovery.Copyright © 2022 Authors. All rights reserved.
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Introduction. In the context of a pandemic of a new coronavirus infection (COVID-19), research on the peculiarities of the formation of an immune response to SARS-CoV-2 in patients who have been ill and vaccinated is of particular relevance. However, most studies are currently devoted to evaluating only the humoral link of immunity, and its cellular component remains insufficiently studied. The aim of the study was to evaluate the features of the formation and changes of the T-cell link of immunity in patients with a new coronavirus infection and vaccinated against this disease. Materials and methods. The study was performed on the basis of the clinical and diagnostic laboratory of the European Medical Center "UMMC-Health "LLC. Specific T-cell immunity was evaluated using ELISPOT technology. In the course of the study, 72 blood samples of employees of medical organizations were analyzed, including 26 from those who had a new coronavirus infection, 23 from persons who were intact according to COVID-19 before vaccination and 23 from the same employees after vaccination (<<Gam-Covid-Vac>>). In addition, each of the study participants was examined to determine specific class G antibodies (IgG) by solid-phase enzyme immunoassay using SARS-CoV-2-IgG-ELISA-BEST test systems (manufactured by VECTOR-BEST JSC). Results and discussion. In the group of patients (26 people), T-lymphocytes capable of specifically reacting to SARSCoV-2 antigens were detected in 100% of cases, even in individuals with IgG elimination. It should be noted that the response was more pronounced when meeting with M-and N-pepdids, compared with S-protein. 22 out of 23 COVID-19 intact individuals had no T-cell immunity to coronavirus infection before vaccination, but one employee had a response to 3 proteins-M, N, S, which indicates that he had previously encountered the SARS-CoV-2 virus. After vaccination with the drug "Gam-Covid-Vac", 22 (95.6%) employees revealed a T-cell response, while 21-only to S-protein, and an employee with a previously detected immune response-after vaccination, the response to M -, N-proteins remained almost at the same level, and the cellular response to S-peptide doubled. Conclusion. Thus, based on the results of the study, important materials were obtained on the peculiarities of the formation of a specific T-cell immune response to a new coronavirus infection. The obtained data provide a broader understanding of the immune response in new coronavirus infection in patients who have been ill and vaccinated and can be used in the future when planning preventive and anti-epidemic measures.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
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Introduction. In the context of a pandemic of a new coronavirus infection (COVID-19), research on the peculiarities of the formation of an immune response to SARS-CoV-2 in patients who have been ill and vaccinated is of particular relevance. However, most studies are currently devoted to evaluating only the humoral link of immunity, and its cellular component remains insufficiently studied. The aim of the study was to evaluate the features of the formation and changes of the T-cell link of immunity in patients with a new coronavirus infection and vaccinated against this disease. Materials and methods. The study was performed on the basis of the clinical and diagnostic laboratory of the European Medical Center "UMMC-Health "LLC. Specific T-cell immunity was evaluated using ELISPOT technology. In the course of the study, 72 blood samples of employees of medical organizations were analyzed, including 26 from those who had a new coronavirus infection, 23 from persons who were intact according to COVID-19 before vaccination and 23 from the same employees after vaccination (<<Gam-Covid-Vac>>). In addition, each of the study participants was examined to determine specific class G antibodies (IgG) by solid-phase enzyme immunoassay using SARS-CoV-2-IgG-ELISA-BEST test systems (manufactured by VECTOR-BEST JSC). Results and discussion. In the group of patients (26 people), T-lymphocytes capable of specifically reacting to SARSCoV-2 antigens were detected in 100% of cases, even in individuals with IgG elimination. It should be noted that the response was more pronounced when meeting with M-and N-pepdids, compared with S-protein. 22 out of 23 COVID-19 intact individuals had no T-cell immunity to coronavirus infection before vaccination, but one employee had a response to 3 proteins-M, N, S, which indicates that he had previously encountered the SARS-CoV-2 virus. After vaccination with the drug "Gam-Covid-Vac", 22 (95.6%) employees revealed a T-cell response, while 21-only to S-protein, and an employee with a previously detected immune response-after vaccination, the response to M -, N-proteins remained almost at the same level, and the cellular response to S-peptide doubled. Conclusion. Thus, based on the results of the study, important materials were obtained on the peculiarities of the formation of a specific T-cell immune response to a new coronavirus infection. The obtained data provide a broader understanding of the immune response in new coronavirus infection in patients who have been ill and vaccinated and can be used in the future when planning preventive and anti-epidemic measures.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.
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Background: UMHATEM N.I. Pirogov" Sofia, is one of the largest and busiest hospitals for emergency medical care in Bulgaria. It is the legal successor of the former Institute of Emergency Medicine N.I. Pirogov", and it can be said that at the moment it is the only diagnostic-therapeutic, prophylactic and scientific-educational structure of this type within the Bulgarian healthcare system. The concept of adequate functioning and development of this type of hospital does not consider structuring an Infectious Diseases diagnostic-treatment unit. This reality makes necessary the formation of a radically different organization for the admission and treatment of patients in the hospital, both for those with symptoms of Covid 19 and for all other emergency patients. The organization created in this way must absolutely guarantee safety for both streams of patients. In the conditions of a pandemic, in case of a real threat to public health, the main task of triage in the Emergency Department is to establish indications for urgent hospitalization, or to refuse it in the absence of indications. The characteristic course of the disease, the prolonged treatment, the manifestations within the so-called post-Covid syndrome", require serious planning not only of the diagnostic-treatment and rehabilitation period, but also adequate monitoring in the first months after the patient's discharge. Within the national reorganization measures, during the determined periods, the main changes concerning the MED (Multi-profile emergency department) of Pirogov are implemented, with an emphasis on the formation of a specialized triage for the diagnosis and clinical evaluation of patients with a coronavirus infection. The main goal is the adequate diagnosis, treatment and follow-up of patients with coronavirus infection who have passed through the organized Covid-triage in a period of extreme pressure on the emergency structures and on the hospital system in the country as a whole. Objective(s): For a MED, which at the time of declaring an epidemic situation does not have a concept for the diagnosis and treatment of infectious diseases, to systematize the main urgently implemented organizational and structural changes, which turned out to be absolutely necessary to meet a newly emerging epidemiologically significant infectious disease. Aim(s): To systematize the organizational changes imposed by the situation and urgently implemented in the MED (multi-profile emergency department). To systematize the structural changes imposed by the situation and urgently implemented in the work of the MED. To analyze the organizational and structural changes carried out in this way and to differentiate the main difficulties caused by the regulations existing at the time of the announcement of the epidemic situationCopyright © Pantileeva D et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
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The relevance of research on a novel coronavirus infection is associated with an increase in the incidence among children since 2021, which may be due to the accumulation of mutations in the virus genome and its evolution towards increased contagiousness, replicative ability, and evasion of immune protection. While there are many studies in adults, data analyzing the clinical course of the disease in pediatric patients infected with SARS-CoV-2 are limited, particularly regarding adolescents. Objective. To study the clinical and laboratory features of the course of a novel coronavirus infection in hospitalized adolescents in Novosibirsk during the first, second and third waves of the pandemic. Materials and methods. A retrospective analysis of case histories of 125 children treated at Novosibirsk Children's Clinical Hospital No 6 with a confirmed diagnosis of coronavirus infection during three pandemic waves was carried out (June- August 2020, October-December 2020, June-August 2021). Based on these time intervals, three groups of adolescents admitted to the hospital during the first, second, and third waves of coronavirus infection were formed. SARS-CoV-2 RNA in nasopharyngeal and oropharyngeal scrapings was determined using the PCR-RT method. Biochemical and general clinical studies were performed in accordance with the guidelines of the Ministry of Health of the Russian Federation. Statistical processing was carried out using the Satistika 7.0 software package (StatSoft, USA). Differences between the groups were assessed using the Z-test and the Mann-Whitney U test. Differences between the compared series were considered statistically significant with a probability level of 95%. Results. It was shown that during three pandemic waves (June 2020 - August 2021), more than half of the hospitalized children were adolescents. At the same time, regardless of the pandemic wave, intoxication, catarrhal and intestinal syndromes predominated in hospitalized adolescents. CNS injury symptoms were significantly less frequent in the first wave, as were skin rashes. Cough in the third wave was observed in 100% of hospitalized adolescents. The average values of the parameters of complete blood count, as well as CRP, D-dimer and ferritin had no statistically significant differences in different pandemic waves, but there was a significant variation in individual values within the groups in each wave.Copyright © 2022, Dynasty Publishing House. All rights reserved.
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The relevance of research on a novel coronavirus infection is associated with an increase in the incidence among children since 2021, which may be due to the accumulation of mutations in the virus genome and its evolution towards increased contagiousness, replicative ability, and evasion of immune protection. While there are many studies in adults, data analyzing the clinical course of the disease in pediatric patients infected with SARS-CoV-2 are limited, particularly regarding adolescents. Objective. To study the clinical and laboratory features of the course of a novel coronavirus infection in hospitalized adolescents in Novosibirsk during the first, second and third waves of the pandemic. Materials and methods. A retrospective analysis of case histories of 125 children treated at Novosibirsk Children's Clinical Hospital No 6 with a confirmed diagnosis of coronavirus infection during three pandemic waves was carried out (June- August 2020, October-December 2020, June-August 2021). Based on these time intervals, three groups of adolescents admitted to the hospital during the first, second, and third waves of coronavirus infection were formed. SARS-CoV-2 RNA in nasopharyngeal and oropharyngeal scrapings was determined using the PCR-RT method. Biochemical and general clinical studies were performed in accordance with the guidelines of the Ministry of Health of the Russian Federation. Statistical processing was carried out using the Satistika 7.0 software package (StatSoft, USA). Differences between the groups were assessed using the Z-test and the Mann-Whitney U test. Differences between the compared series were considered statistically significant with a probability level of 95%. Results. It was shown that during three pandemic waves (June 2020 - August 2021), more than half of the hospitalized children were adolescents. At the same time, regardless of the pandemic wave, intoxication, catarrhal and intestinal syndromes predominated in hospitalized adolescents. CNS injury symptoms were significantly less frequent in the first wave, as were skin rashes. Cough in the third wave was observed in 100% of hospitalized adolescents. The average values of the parameters of complete blood count, as well as CRP, D-dimer and ferritin had no statistically significant differences in different pandemic waves, but there was a significant variation in individual values within the groups in each wave.Copyright © 2022, Dynasty Publishing House. All rights reserved.
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Introduction. Using of immunoglobulins containing SARS-CoV-2 neutralizing antibodies may be an effective and safe tool for COVID-19 treatment. An intravenous immunoglobulin COVID-globulin from donor blood plasma containing SARS-CoV-2 neutralizing antibodies was developed at Joint-Stock Company Nacimbio. Aim. A pilot study of the safety of the "COVID-globulin". Materials and methods. When studying the safety of the preparation in animals the following parameters were evaluated: general toxicity, thrombogenic potential, influence on hematological and biochemical parameters, blood clotting and hemolytic activity, determination of local irritant action, pyrogenic properties, bacterial endotoxins, allergic effect of the drug preparation and its physicochemical characteristics. Results and discussion. Safety studies of "COVID-globulin" in animals showed no signs of intoxication, local irritant action and thrombogenic properties. Macroscopic and histological examination of the organs of rats treated with COVID-globulin showed no signs of necrosis, inflammation, atypia, or any significant pathological changes. Hematological and biochemical parameters of the blood of laboratory animals after the administration of "COVID-globulin" corresponded to the reference values. Administration of COVID-globulin to rabbits did not activate blood clot formation. The IgG subclasses distribution in the preparation corresponded to that in human plasma. The activity of the Fc-function of the immunoglobulin molecule was more than 130 % compared to the reference standard preparation, the concentration of the prekallikrein activator in the COVID-globulin ranged from 4.2 to 4.8 IU/ml, anticomplementary activity was less than 1 unit complement per 1 mg of protein. Conclusion. The results of all studies have demonstrated a high level of safety of the developed COVID-globulin preparation, which meets the safety requirements for human immunoglobulins for intravenous administration by national regulatory documents and the European Pharmacopoeia. © Nikolaeva A. M., Ivanov A. V., Smolyanova T. I., Razumikhin M. V., Belyakova O. V., Shilova E. G., Selezneva N. R., Vyaznikova T. V., Semicheva A. I., Sakanyan E. I., 2023.
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New coronavirus infection (COVID-19) is a modern global problem that requires the rapid development of diagnostic and treatment methods, as well as the study of pathological effects on body tissues. Due to severe damage to the respiratory organs, special attention is paid to the study of pneumothorax as a manifestation of gas syndrome, one of the complications of COVID-19. The purpose of the study was to assess the incidence of pneumothorax as a complication of COVID-19, the features of the development of the pathological process, and to determine the criteria for treatment tactics. Materials and methods. In total, for the period from April 2020 to May 2022 at the Clinical Infectious Diseases Hospital named after. S.P. Botkin treated 31532 patients with a confirmed diagnosis of COVID-19. As part of this study, the case histories of 316 patients with clinical manifestations of gas syndrome were retrospectively analyzed. All patients were diagnosed with COVID-19, the diagnostic criterion of which was a positive result of the PCR test - the detection of RNA in a swab taken from the nasopharynx and oropharynx. Results. Analysis of case histories showed that severe COVID-19 occurs in all age groups. Collapse of half of the lung was observed in most cases (59 patients). The main treatment method for pneumothorax was Bulau drainage. At the same time, in 47 patients (32%) this method required active aspiration. In 37 patients (26%), drainage was corrected and the pleural cavity was re-drained. In 37 patients, the result of hospitalization was a fatal outcome, the main causes of which were severe pneumonia and/or severe immunodeficiency, 75 patients (52%) were discharged from the hospital in a stable condition. Conclusions. The occurrence of pneumothorax in patients with COVID-19 is characterized by late onset, protracted course, the formation of purulent complications and a high incidence of fatal outcomes, which do not always correlate with the severity of pneumonia.Copyright © 2022 Authors. All rights reserved.
ABSTRACT
New coronavirus infection (COVID-19) is a modern global problem that requires the rapid development of diagnostic and treatment methods, as well as the study of pathological effects on body tissues. Due to severe damage to the respiratory organs, special attention is paid to the study of pneumothorax as a manifestation of gas syndrome, one of the complications of COVID-19. The purpose of the study was to assess the incidence of pneumothorax as a complication of COVID-19, the features of the development of the pathological process, and to determine the criteria for treatment tactics. Materials and methods. In total, for the period from April 2020 to May 2022 at the Clinical Infectious Diseases Hospital named after. S.P. Botkin treated 31532 patients with a confirmed diagnosis of COVID-19. As part of this study, the case histories of 316 patients with clinical manifestations of gas syndrome were retrospectively analyzed. All patients were diagnosed with COVID-19, the diagnostic criterion of which was a positive result of the PCR test – the detection of RNA in a swab taken from the nasopharynx and oropharynx. Results. Analysis of case histories showed that severe COVID-19 occurs in all age groups. Collapse of half of the lung was observed in most cases (59 patients). The main treatment method for pneumothorax was Bulau drainage. At the same time, in 47 patients (32%) this method required active aspiration. In 37 patients (26%), drainage was corrected and the pleural cavity was re-drained. In 37 patients, the result of hospitalization was a fatal outcome, the main causes of which were severe pneumonia and/or severe immunodeficiency, 75 patients (52%) were discharged from the hospital in a stable condition. Conclusions. The occurrence of pneumothorax in patients with COVID-19 is characterized by late onset, protracted course, the formation of purulent complications and a high incidence of fatal outcomes, which do not always correlate with the severity of pneumonia. © 2022 Authors. All rights reserved.
ABSTRACT
New coronavirus infection (COVID-19) is a modern global problem that requires the rapid development of diagnostic and treatment methods, as well as the study of pathological effects on body tissues. Due to severe damage to the respiratory organs, special attention is paid to the study of pneumothorax as a manifestation of gas syndrome, one of the complications of COVID-19. The purpose of the study was to assess the incidence of pneumothorax as a complication of COVID-19, the features of the development of the pathological process, and to determine the criteria for treatment tactics. Materials and methods. In total, for the period from April 2020 to May 2022 at the Clinical Infectious Diseases Hospital named after. S.P. Botkin treated 31532 patients with a confirmed diagnosis of COVID-19. As part of this study, the case histories of 316 patients with clinical manifestations of gas syndrome were retrospectively analyzed. All patients were diagnosed with COVID-19, the diagnostic criterion of which was a positive result of the PCR test - the detection of RNA in a swab taken from the nasopharynx and oropharynx. Results. Analysis of case histories showed that severe COVID-19 occurs in all age groups. Collapse of half of the lung was observed in most cases (59 patients). The main treatment method for pneumothorax was Bulau drainage. At the same time, in 47 patients (32%) this method required active aspiration. In 37 patients (26%), drainage was corrected and the pleural cavity was re-drained. In 37 patients, the result of hospitalization was a fatal outcome, the main causes of which were severe pneumonia and/or severe immunodeficiency, 75 patients (52%) were discharged from the hospital in a stable condition. Conclusions. The occurrence of pneumothorax in patients with COVID-19 is characterized by late onset, protracted course, the formation of purulent complications and a high incidence of fatal outcomes, which do not always correlate with the severity of pneumonia.Copyright © 2022 Authors. All rights reserved.
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The objective is to present first-hand experience of microsurgical operations in patients with neuro-oncological diseases, vascular pathology and COVID-19 in the absence of unified standards of work during the pandemic, as well as summarize literature data on this problem. Clinical cases. Five cases of surgical interventions in patients with moderate COVID-19 pneumonia are presented: 1) microsurgical clipping of a saccular aneurysm of the posterior communicating artery which caused massive basal subarachnoid hemorrhage with bleeding into the IV ventricle;2) microsurgical resection of glioblastoma of the right temporal lobe;3) resection of an intracerebral hematoma in the right temporal, occipital and parietal lobes with total volume of 100 cm3 which caused transverse brain dislocation up to 10 mm to the left;4) microcoil embolization of a ruptured aneurysm of the posterior communicating artery;5) microcoil embolization of a ruptured aneurysm of the right middle cerebral artery. All surgeries were performed in personal protective gear and FFP3 masks. In 3 patients, positive pneumonia dynamics were observed;in 2 patients (with glioblastoma and subarachnoid hemorrhage from an aneurysm of the right middle cerebral artery), dynamics were negative. Among 5 patients, 4 were discharged in stable condition, 1 case ended in death (despite the absence of coagulopathy, massive brain ischemia with hemorrhagic transformation developed, probably due to endothelial cell dysfunction, high vascular permeability of cerebral arteries in conjunction with coronavirus effect on angiotensin transforming enzyme receptors). Literature analysis. Summarizing experiences of other researchers, the following changes in organization of neurosurgical practice during the pandemic can be recommended: 1) all patients should be considered potentially infected;2) emergency surgeries should be performed under local anesthesia and/or in separate operating rooms;3) in emergency cases of vascular pathology of the brain, endovascular interventions are the preferred approach;4) surgeries should be performed in FFP2/FFP3 masks, protective goggles, two pairs of gloves, protective suits and shoe covers;5) the number of personnel in the operating room should be minimized;6) manipulations that can potentially lead to increased formation of aerosol (craniotomies, coagulations) should be performed with special care, craniotome rotation speed should be decreased to minimize formation of bone particles, opening of paranasal sinuses and mastoid cells should be avoided if possible;7) negative pressure (–5 Pa) should be maintained in the operative room, frequency of interruption of the artificial lung ventilation machine circuit should be minimized, patients' nose and mouth should be covered with wet wipes;8) the personnel should be divided into several teams working in turns;9) personnel older than 65 years should be isolated;10) planned surgeries should be postponed indefinitely and patients should be consulted by phone, hospitalized only if their condition worsens;11) during admission, patients should be placed in observation rooms, where thermometry, computed tomography of the lungs and pharyngeal swab for SARS-CoV-2 should be performed;12) regardless of the SARS-CoV-2 analysis result, patients after surgery should be quarantined for 14 days. Conclusion. Our experience shows that patients with concomitant COVID-19 infection can receive neurosurgical help. Compliance with the guidelines leads to low risk of infection for the personnel and sufficient quality of medical care. © 2020 Authors. All rights reserved.
ABSTRACT
Background. The pandemic of novel coronavirus infection (NCI) COVID-19 is accompanied by a high risk of thrombosis and bleeding. The debate regarding the choice of dose of anticoagulant therapy in severe patients with NCI is ongoing at present. Objective: to assess coagulation parameters and identify risk factors in patients with severe COVID-19. Patients/Methods. Out of 370 patients with NCI COVID-19 treated in Ryazan covid hospitals in 2021, 173 (46.8%) patients with severe coronavirus infection were included in the retrospective study. Risk factors, the frequency of thrombotic complications and bleeding, laboratory parameters of hemostasis and inflammation (general blood analysis, blood biochemistry, coagulogram), dose variants of anticoagulant therapy (preventive, intermediate and therapeutic doses) were accessed. Results. Among 173 patients with severe COVID-19, 98 (56.7%) persons recovered, and 75 (43.3%) patients died. In non-survivors vs. survivors, hypertension was more often observed — in 64 (85.3%) cases (p = 0.043), as well as obesity — in 8 (50.7%) cases (p = 0.024) and type 2 diabetes mellitus — in 34 (45.3%) cases (p = 0.022), therapeutic dosage of anticoagulants was used more often (58.6% of cases). C-reactive protein (CRP) level on admission was significantly higher in non-survivors vs. survivors — 117.3 (185–356) mg/L vs. 90.4 (1.2–301.0) mg/L (p = 0.033) as well as fibrinogen content — 6.3 (1.3–10.0) g/L vs. 3.6 (1.1–12.0) g/L (p = 0.004). In patients with lethal outcome, pulmonary embolism (PE) without a source in the lower extremities was determined more often than in patients with favorable outcome — 10 (13.3%) vs. 0 (0%) cases (p = 0.002). Isolated deep vein thrombosis (DVT) occurred only in patients with favorable outcome. The analysis of hemorrhagic complications revealed that the frequency of major bleeding was higher among non-survivors vs. survivors — 7 (9.3%) vs. 2 (2.04%) cases (p = 0.032). Conclusions. The use of therapeutic doses of anticoagulants did not reduce the mortality rate in severe patients with NCI and was accompanied by PE development with and without a source in the lower extremities in 15 (20%) cases. High levels of CRP, fibrinogen, D-dimer, and low platelet count are predictive laboratory markers of unfavorable outcome in patients with severe NCI. © Kalinin R.E., Suchkov I.A., Agapov A.B., Mzhavanadze N.D., Maksaev D.A., Chobanyan A.A., 2022 © Gemostaz i Reologia LLC, 2022.