RESUMEN
Introduction: As the major mechanism for coronavirus disease 2019, cytokine storm-mediated organ harm continues to dominate current understanding. Despite the first hyper-inflammatory phase, emerging data show that virus-induced poor host immunity may be the true cause of mortality in many individuals. Interleukin 7 (IL-7) is an interleukin that participates in the COVID-19 cytokine storm and regulates the immune system. Its role in COVID-19 cytokine storms is thought to be related to its ability to stimulate the formation and activation of immune cells such as T cells and B cells. This meta-analysis aims to determine the relationship, if any, between interleukin-7 and COVID-19 severity. Methods: This study was planned as a systematic review and meta-analysis and followed the PRISMA guidelines. Four main electronic databases (Web of Science, PubMed, Scopus, and the Cochrane Central Register of Controlled Trials) were searched from January 1st, 2020 to September 2nd, 2022, to find papers investigating the prognostic significance of interleukin-7 in COVID-19-hospitalized adults. Google Scholar was used in addition to the online database search. A random effects model was used to calculate mean differences and 95% confidence interval (CIs) as well as the I2 statistics for heterogeneity analysis. Results: Seven papers were chosen for meta-analysis findings synthesis. All six trials reported interleukin-7 levels among severe and non-severe COVID-19 patients. Pooled analysis showed that IL-7 levels in the severe group were 62.79±81.03 pg/mL, compared to 33.39±56.54 pg/mL for the non-severe group (SMD =-0.17;95%CI:-0.93 to 0.60;p=0.67). Discussion: Available evidence suggests that elevated levels of IL-7 were not associated with the disease severity of COVID-19. While IL-7 levels alone may not have a substantial impact on COVID-19 severity, the interaction between IL-7 and other cytokines, immune cells, and variables such as viral load and genetics should be investigated further. Take-home message: This meta-analysis found that there was no strong link between levels of interleukin-7 and the severity of COVID-19. However, further research is needed to explore the interaction between IL-7 and other factors such as cytokines, immune cells, viral load, and genetics in order to better understand the role of IL-7 in COVID-19 pathogenesis. © 2023 by the authors.
RESUMEN
Objective of the research - to specify respiratory tract bacterial microflora in patients suffering from community-acquired pneumonia (CAP) during initial and repeat examination. To determine local factors affecting microflora in the cohort examined. Materials and methods. Surveillance subject - 241 patients with CAP differed by their status and age who stayed in two healthcare facilities of the Khabarovsk city. Examination of respiratory smears was performed. Results. Indices of Gram-negative enterobacteria (30.8% [22.6-39.7%]) and Gram-negative nonfermentable bacteria (14.5% [8.6-21.7%]), isolated from patients hospitalized in healthcare institution No. 1 and mostly comprised of the elderly (aged over 61 years - 82.0%;74.3-88.6%) with more severe disease state including patients at the ICU, were higher compared to data obtained from healthcare institution No. 2 (19.8% (13.4-27.0);6.1% (2.7-10.8) respectively). Prevalent pathogen was Klebsiella pneumoniae - 13.6% (7.8-20.6) and 10.7% (6.0-16.5). Identification of Acinetobacter baumannii complex 6.4% (2.6-11.7) and 3.1% (0.8-6.7) - should be also noted. A high percentage of drug-resistant bacterial variants was observed and for Klebsiella pneumoniae totaled 66.7% (41.8-87.4) and 57.1% (32.2-80.2) at the healthcare institutions No. 1 and No. 2, respectively. A. baumannii complex drug resistant variants were found in 85.7% (52.7-99.97) at healthcare institution No. 1. All isolates of A. baumannii complex at the healthcare institution No. 2 were drug resistant. High prevalence of Candida spp. was revealed in both healthcare institutions reaching 54.5% (45.2-63.7) and 58.0% (49.5-66.3), respectively, with minimal detection rate of classic pathogens such as S. pneumoniae - 5.4% (2.0-10.4) and 5.3% (2.1-9.8) and H. influenzae - 3.6% (0.9-7.9) and 3.8% (1.2-7.7), respectively. Repeat examination of 122 patients conducted 7-10 days later showed diverse changes in microflora spectrum regardless of the healthcare institution that was manifested as loss or emergence of drug-resistant variants as well as simultaneous presence of different variants of the same pathogen. Conclusion. The results obtained evidence about complexity and variety of mechanisms underlying microorganism community formation during the course of infectious process in patients. Local factors influencing microflora characteristics of patients at the two healthcare institutions were revealed.
RESUMEN
Microbiological monitoring after infectious diseases in the system of epidemiological surveillance implies simultaneous pathogen identification both among patients and in hospital environment. Our aim is to assess potential hospital environmental hazard for the two in-patient infectious disease hospitals of the Khabarovsk city by using bacteriological and epidemiological analysis during new coronavirus disease pandemic. Materials and methods. Bacteriological assessment of nasopharyngeal microflora in 241 patients suffering from community-acquired pneumonia that were hospitalized in the two prevention and treatment facilities of the Khabarovsk city was performed. Sanitary-bacteriological control of hospital environment (428 hospital environment samples and 91 air samples) was carried out in parallel. Bacteriological assessment was performed with classical methods. Identification of isolated bacteriological pathogens and evaluation of drug-resistant strains were carried out by utilizing bacteriological analyzer Vitek 2 Compact. Results. Nine different pathogens (Pseudomonas aeruginosa, Pseudomonas stutzeri, Acinetobacter baumannii, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, Pantoea, Enterococcus faecium, Staphylococcus haemolyticus) were isolated in 20 out of 428 samples - 4.7% [2.7-6.7]. Half of isolated agents - 2.3% [0.9-3.8] - were represented by drug-resistant isolates (10 out of 20 isolates) including 5 carbapenem-resistant isolates (Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae) and 5 isolates with multiple drug resistance (Enterobacter cloacae, Pantoea, Enterococcus faecium, Staphylococcus haemolyticus). Air samples contained pathogenic biological agents found in 6 out of 91 samples - 6.6% [1.5-11.7], and half of them - 3.3% [0.6-7.9] - were identified as drug-resistant variants, including S. aureus. S. haemolyticus. One of the surveyed hospitals was recognized as more hazardous due to microflora isolated from intensive care unit (A. baumannii and P. aeruginosa were resistant to 3rd- 4th generation cephalosporins and carbapenems). Conclusion. Revealed circulation of wide range of microorganisms isolated from environment of two in-patient hospitals indicates high risk of healthcare-associated infections formation. Intensive care units can serve as a reservoir of healthcare-associated infections due to high percentage of patients with severe disease cases ("main reservoir" of drug-resistant strains).
RESUMEN
Objective: to study the clinical and epidemiological features of the course of a new coronavirus infection in children of different ages undergoing outpatient treatment. The study participants were 812 children with COVID-19 aged from 1 month to 17 years, who were on outpatient treatment in the children's polyclinic of the city of Kirov from July to December 2021. The average age of patients with COVID-19 was 5.9 +/- 1.1 years. Among the sick young children there were 28%, adolescents - 16%. In 76% of cases, contact with patients with a new coronavirus infection was detected, mainly in the family, as well as in educational institutions. In 70% of cases, an early request for medical help was registered - in the first three days of illness. In most cases (89%), a mild severity of the disease was established with the development of subfebrile fever and pharyngitis. Rhinitis phenomena were recorded in 20% of cases. 7% of children complained of a dry cough. Lung tissue lesion (RG1) was detected in 5% of patients, gastrointestinal tract - 5%. In adolescents, the phenomena of rhinitis, pharyngitis, dry cough were less common than in other age groups. Recombinant interferon alpha-2b and umifenovir were used for etiotropic therapy. All children recovered within 7-10 days from the onset of the disease. Copyright © 2022 GEOTAR Media. All rights reserved.
RESUMEN
Purpose - to study the features of COVID-19 in hospitalized children. Materials and methods. Retrospective multicenter clinical and epidemiological study which includes 328 hospitalized children with laboratory-confirmed COVID-19 for the period from January to August 2021. Results, the highest specific weight among all hospitalized children falls on children of the first year (75/328;22.8%), in general, early childhood (up to 3 years) accounted for 43%(141/328) of all hospitalizations of children with COVID-19. Common symptoms of the disease included fever, upper respiratory symptoms, intoxication, diarrhea. In 99/328 (30.1%) hospitalized children pneumonia has developed, 50/99 (50.5%) of which needed oxygen support, 10/99 (10.1%) - mechanical ventilation. Pneumonia was most common in children under 1 year, children of the first 5 years of life accounted for more than a half of all pneumonia cases (53/99;53,5%). 13/328 (3.9%) children were hospitalized to the intensive care unit. Comorbidities including endocrine, oncological, neurological diseases, congenital malformations and others, were noted n 24.6% of hospitalized children. In children with comorbid conditions, pneumonia occurred 2 times more often (relative risk factor RR=1.98, CI 95%), the relative risk of getting into resuscitation RR in the presence of comorbidity is 10.86 (CI 95%). In addition to children with pneumonia, oxygen support or mechanical ventilation required children with obstructive syndrome, pancytopenia, convulsions. The largest proportion of comorbidities in patients hospitalized to the intensive care unit were diseases of the nervous system (congenital malformations of the CNS, cerebral palsy, epilepsy, astrocytoma). Lymphopenia and thrombocytopenia were most commonly associated with severe COVID-19. Conclusions. Children of all ages are susceptible to COVID-19. The main risk factors for severe disease are early age and the presence of comorbid conditions, among which the most relevant are diabetes, obesity, neurological diseases and cancer. The presence of comorbidities in children determines the priority groups for the prevention of coronavirus infection through vaccination. © 2022 by the Author(s).
RESUMEN
Microbiological monitoring after infectious diseases in the system of epidemiological surveillance implies simultaneous pathogen identification both among patients and in hospital environment. Our aim is to assess potential hospital environmental hazard for the two in-patient infectious disease hospitals of the Khabarovsk city by using bacteriological and epidemiological analysis during new coronavirus disease pandemic. Materials and methods. Bacteriological assessment of nasopharyngeal microflora in 241 patients suffering from community-acquired pneumonia that were hospitalized in the two prevention and treatment facilities of the Khabarovsk city was performed. Sanitary-bacteriological control of hospital environment (428 hospital environment samples and 91 air samples) was carried out in parallel. Bacteriological assessment was performed with classical methods. Identification of isolated bacteriological pathogens and evaluation of drug-resistant strains were carried out by utilizing bacteriological analyzer Vitek 2 Compact. Results. Nine different pathogens (Pseudomonas aeruginosa, Pseudomonas stutzeri, Acinetobacter baumannii, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, Pantoea, Enterococcus faecium, Staphylococcus haemolyticus) were isolated in 20 out of 428 samples — 4.7% [2.7–6.7]. Half of isolated agents — 2.3% [0.9–3.8] — were represented by drug-resistant isolates (10 out of 20 isolates) including 5 carbapenem-resistant isolates (Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae) and 5 isolates with multiple drug resistance (Enterobacter cloacae, Pantoea, Enterococcus faecium, Staphylococcus haemolyticus). Air samples contained pathogenic biological agents found in 6 out of 91 samples — 6.6% [1.5–11.7], and half of them — 3.3% [0.6–7.9] — were identified as drug-resistant variants, including S. aureus и S. haemolyticus. One of the surveyed hospitals was recognized as more hazardous due to microflora isolated from intensive care unit (A. baumannii and P. aeruginosa were resistant to 3rd–4th generation cephalosporins and carbapenems). Conclusion. Revealed circulation of wide range of microorganisms isolated from environment of two in-patient hospitals indicates high risk of healthcare-associated infections formation. Intensive care units can serve as a reservoir of healthcare-associated infections due to high percentage of patients with severe disease cases (“main reservoir” of drug-resistant strains).
RESUMEN
Objective. Detection of additional factors favoring progression of COVID-19 and developing lethal outcomes in hospitalized patients. Materials and methods. Analysis of 98 medical records of lethal cases of patients that underwent hospitalization with diagnosis of COVID-19 associated pneumonia of two in-patient facilities of the Amur oblast and Khabarovsk krai was performed. Two groups were formed: first included medical records of patients hospitalized in severe condition (n = 52) and second group included patients with state of moderate severity (n = 46). Length of hospitalization stay, time from admission to the medical facility to progression of the disease, time from hospitalization to death and bacterial pathogens species composition isolated from lungs tissue autopsy material were analyzed. Statistical assessment of obtained data was performed with StatSoft Statistica 12.0. Results. Majority of patients of 1st and 2nd groups (66.7 ± 6.80% and 69.6 ± 6.78%) were hospitalized on fourth day of the COVID-19 clinical manifestations onset or later. Two thirds of patients hospitalized in severe condition progressed to critical health status on 1st–3rd day of hospitalization. Majority of second group patients (65.2 ± 7.02%) deteriorated from moderate severity to severe health condition on 4th–14th day of hospital stay. Bacteriological assessment analysis of autopsy material revealed that material obtained from first group showed more frequent absence of bacterial flora growth compared with second group both in the Amur oblast (44.4 ± 9.74% и 29.4 ± 11.39%) and in the Khabarovsk krai (в 40.0 ± 10.0% and 27.6 ± 8.45% of cases). Klebsiella pneumoniae (57.7 ± 5.86%) and Candida spp. (18.3 ± 4.59%) were revealed more frequently in the structure of diagnosed pathogens. Substantial proportion of pathogens (81.7 ± 4.59%) were isolated in autopsy material of patients which hospital stay was 4 days and longer. Prolonged hospital stay was associated with more frequent detection of K. pneumoniae and Candida spp. in patients that suffered from COVID-19 pneumonia and eventually died from the disease. With duration of hospitalization of 4 days and longer Acinetobacter baumannii – an extremely virulent pathogen with natural drug resistance was isolated from autopsy material. Conclusion. Factors influencing unfavorable outcomes of COVID-19 include signs of secondary bacterial infection as well as detection of aggressive drug-resistant bacterial microflora that most likely had nosocomial origin due to prolonged hospitalization. © 2021, Dynasty Publishing House. All rights reserved.
RESUMEN
The aim of the study - systematization and analysis of information on the prevalence of SARS-CoV-2 virus variants according to information databases and own cross-sectional studies. Materials and methods. The analysis was conducted in the period 2020-2021 using information databases and research re-sources: Google Scholar, Cochrane Library, Scirus, Springer, Medline, Embase, PubMed, Web of Science. Our own examination included a total of 80 nasopharyngeal swabs (at least two specimens in each case) collected from ARVI symptomatic or suspected COVID-19 patients, who were treated at the MNE KRC "Regional Clinical Infectious Diseases Hospital" from June to October 2021 and tested positive on SARS-CoV-2. The first study was performed in the inter-peak period, and the second one - on the rise of the disease. A real-time polymerase chain reaction (PCR) method was used for primary identification with the diagnostic kit "Bio-core (R) SARS-CoV-2" (LLC "Biocor Technology Ltd.", Ukraine) in accordance with the manufacturer's instructions. Multiplex analysis SNPsig (R) VariPLEXTM Covid-19 (PrimerdesignTM Ltd., UK) was used in the first cross-sectional study for secondary identification. Results. Systematization and analysis of the prevalence of SARS-CoV-2 variants according to information databases were per-formed. According to the results of our cross-sectional studies on SARS-CoV2 variants circulating in the Kharkiv region in June - October 2021, the complete replacement of the alpha variant, which was dominant in June - 87.5 %, with the delta variant - 95.0 %. All patients had signs of respiratory failure, community-acquired pneumonia was visualized instrumentally (computed tomography, radiography, ultrasound) at the first study in 90 % of cases, and at the second - in 100 %. The median age of patients was 60.4 years (minimum - 25 years, maximum - 91 years) during the first study, but during the second - 52.6 years (minimum - 18 years, maximum - 84 years). Thus, the more aggressive and contagious delta variant has become dominant requiring thorough public health anti-epidemic measures. Conclusions. Monitoring and control of the virus evolution using epidemiological studies, viral genetic sequence, as well as la- boratory PCR are necessary to prevent the spread of COVID-19, to study the effectiveness of test systems and optimize diagnosis and etiotropic therapy as well as vaccine modifications.
RESUMEN
OBJECTIVE: The aim: The paper aims at reviewing the recent studies on the impact of the Eastern mind-body practices on mental health during the COVID-19 pandemic. PATIENTS AND METHODS: Materials and methods: The recent studies (2020 - 2021) on the Eastern mind-body practices in combating the psychological impacts of the COVID-19 pandemic were identified in PubMed, Scopus, Google Scholar. Research papers were found by using the keywords "mental health", "psychological impacts of the COVID-19 pandemic", "Eastern mind-body practices", "meditation", "mindfulness", "yoga", "tai chi", "qigong". A total of 27 selected publications were analyzed based on our criteria. Given the relatively small number of relevant articles in recent years, we also examined papers published before 2020. Along with the aforementioned, the authors used integrative anthropological approach and interpretive research paradigm. CONCLUSION: Conclusions: The Eastern mind-body practices are becoming increasingly popular, especially now when the outbreak of COVID-19 has created mental health concerns among the general population worldwide. They may prove an effective preventive or therapeutical intervention for mental health issues during and after the pandemic. However, the underlying mechanisms of these techniques are still insufficiently studied. Therefore, it is necessary to conduct a well-planned study and interpret it from multiply perspectives involving an interdisciplinary team of specialists.
RESUMEN
Objective: to study the bacterial microflora in the sputum of patients with pneumonia caused by SARSCoV-2 or other pathogens. Materials and methods. The bacterial microflora of sputum of 173 patients with pneumonia admitted to hospitals in Khabarovsk and the Khabarovsk Territory in May – June 2020 was examined. Detection of RNA of the SARS-CoV-2 virus was carried out by PCR with the Vector-PCRRV-2019-nCoV-RG test system (manufactured by the State Scientific Center of VB “Vector”, Koltsovo). Determination of the DNA of mycoplasmosis agents and chlamydia was carried out with the test system “AmpliSens® Mycoplasma pneumoniae/Chlamydophila pneumonia” (manufactured by CRIE). Statistical data processing was performed using the Excel program. Results and discussion. Both groups of patients (Covid-19+ and Covid-19–) had high levels of bacterial flora isolation (81.4 and 74.7 %) including common pathogens for community-acquired pneumonia as well as notable detection frequency of Candida spp. and microbial associations. The group of Covid-19+ patients demonstrated a wider range of detected pathogens, was positive for poly-resistant gram-negative Enterobacteriaceae, non-fermenting gram-negative poly-resistant bacteria, with more expressed manifestation of microbial associations. In the group of Covid-19– participants drug-resistant microflora was presented only by MRSA and MRSE staphylococci. © 2020 Russian Research Anti-Plague Institute. All rights reserved.