EFFECT OF THE COVID-19 ON THE REPRODUCTIVE HEALTH INDICATORS OF CADETS

The study investigated the influence of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 on the reproductive health indicators of cadets of military educational organizations. In the Department of Assisted Reproductive Technologies at the Clinic of Obstetrics and Gynecology of the Kirov Military Medical Academy, 183 male cadets aged 21–27 years were divided into two groups and examined. The first group consisted of 132 cadets who had mild and moderate COVID-19, and the second group included 51 cadets without COVID-19 in the anamnesis. COVID-19 was found negatively affect the reproductive health of cadets. Individuals who previously had COVID-19 were found to have a significant decrease in the level of total testosterone and decreased concentration and mobility of sperm in the ejaculate. Moreover, in cadets without COVID-19 who were vaccinated with the combined vector vaccine "Gam-COVID-Vac,” the indicators of the hormonal profile and spermograms were within the reference values. The results indicate the need for further investigation of the effect of various negative factors, including severe acute respiratory syndrome coronavirus 2, on the reproductive health of cadets of military educational organizations. Moreover, the development of preventive, therapeutic, and rehabilitation measures will reduce the risk of infertility and reproductive losses, which is consistent with the interests of national projects on healthcare and demography. The article can be used under the CC BY-NC-ND 4.0 license © Authors, 2022.

ASSESSMENT OF POST-VACCINATION COLLECTIVE IMMUNITY AGAINST NEW CORONAVIRUS INFECTION (COVID-19) AMONG SERVICEMEN OF THE ARMED FORCES OF THE RUSSIAN FEDERATION

The recent vaccination campaign targeting the new coronavirus infection (COVID-19) carried out in the Armed Forces of the Russian Federation, on the background of the current unstable global pandemic situation, makes it necessary to study post-vaccination population immunity to the SARS-CoV-2 virus and thus identify key features of immunity in organized military collectives. In the future, this will make it possible to objectively assess the risks of a worsening pandemic situation, effectively adjust the ongoing sanitary and anti-epidemic measures aimed at preserving and strengthening the health of military personnel, as one of the main conditions for maintaining the combat readiness of the Armed Forces of the Russian Federation. During a study conducted on epidemic indications, it was found that vaccination with Gam-Covid-Vac contributes to the formation of collective immunity with 95% effectiveness. A gender-based analysis of the immune response showed that the proportion of persons who lack class G immunoglobulins to SARS-CoV-2 among females is twice than that among men (9.3% and 4.7%, respectively). Seroprevalence indicators, classified by blood group, range from 94.4% (AB (IV) Rh–) to 97.4% (A (II) Rh–). There were no significant differences in seroprevalence between groups of people with different blood groups;however, the highest value of seroprevalence was seen among military personnel with blood group A (II) Rh–. In this context, it is advisable to continue monitoring the formation of immunity in individuals with various blood groups. The results obtained made it possible to form a primary medical and social "portrait” of a serviceman with the most adequate immune response to the introduction of the Gam-Covid-Vac vaccine (a man under the age of 20 with blood type A (II) Rh–) and to draw a conclusion about the high effectiveness of vaccination in military units (formations) staffed by conscripts and military educational organizations. The article can be used under the CC BY-NC-ND 4.0 license © Authors, 2022.

Ssessment of post-vaccination collective immunity against new coronavirus infection (COVID-19) among servicemen of the armed forces of the Russian Federation

The recent vaccination campaign targeting the new coronavirus infection (COVID-19) carried out in the Armed Forces of the Russian Federation, on the background of the current unstable global pandemic situation, makes it necessary to study post-vaccination population immunity to the SARS-CoV-2 virus and thus identify key features of immunity in organized military collectives. In the future, this will make it possible to objectively assess the risks of a worsening pandemic situation, effectively adjust the ongoing sanitary and anti-epidemic measures aimed at preserving and strengthening the health of military personnel, as one of the main conditions for maintaining the combat readiness of the Armed Forces of the Russian Federation. During a study conducted on epidemic indications, it was found that vaccination with Gam-Covid-Vac contributes to the formation of collective immunity with 95% effectiveness. A gender-based analysis of the immune response showed that the proportion of persons who lack class G immunoglobulins to SARS-CoV-2 among females is twice than that among men (9.3% and 4.7%, respectively). Seroprevalence indicators, classified by blood group, range from 94.4% (AB (IV) Rh-) to 97.4% (A (II) Rh-). There were no significant differences in seroprevalence between groups of people with different blood groups;however, the highest value of seroprevalence was seen among military personnel with blood group A (II) Rh-. In this context, it is advisable to continue monitoring the formation of immunity in individuals with various blood groups. The results obtained made it possible to form a primary medical and social "portrait" of a serviceman with the most adequate immune response to the introduction of the Gam-Covid-Vac vaccine (a man under the age of 20 with blood type A (II) Rh-) and to draw a conclusion about the high effectiveness of vaccination in military units (formations) staffed by conscripts and military educational organizations.

HERD IMMUNITY TO SARS-CoV-2 AMONG ADOLESCENT STUDENTS OF THE RUSSIAN DEFENSE MINISTRY COLLEGES OF THE CITY OF SAINT PETERSBURG

The morbidity of the new coronavirus infection (COVID-19) in the Russian Armed Forces is decreasing thanks to the sanitary and preventive anti-epidemic measures, the most effective of which is mass vaccination. The purpose of this research was to study the peculiarities of the formation of herd immunity among adolescent students of the Russian Ministry of Defense (MoD) colleges against the background of the COVID-19 epidemic. Materials and methods of the research: according to the epidemic indications, a two-stage seroepidemiological multicenter prospective study of herd immunity to SARS-CoV-2 was carried out in Dec. 2021 - May 2022, against the background of vaccination, among adolescent students of the Russian Defense Ministry colleges. 515 adolescents aged 11 to 17 years old (median age 13 [12;15] years old) from the two Russian MoD schools located in the city of Saint Petersburg, of which 292 (57%) girls and 223 (43%) boys, were involved in the study. The adolescents were divided into groups based on gender and previous COVID-19 illness e.g., those who already had COVID-19 and those who had not prior to the study. In the second stage of the study the number of samples from boys and girls decreased by 74.3% and 34.4%, respectively, due to the lack of parents' consent to the vaccination. The assessment of the immunity intensity was carried out using the Anti-SARS-CoV-2 IgG levels in blood serum by enzyme-linked immunosorbent assay (ELISA). Result(s): the initially high levels of seroprevalence to SARS-CoV-2 were established among both girls and boys (90.4% and 91.5%, respectively, p=0.09) that indicated a latent course of the epidemic process in the studied groups of teenagers. In adolescent girls and boys vaccinated against the background of a previous COVID-19 illness, the combined immunity is formed in 62.3% and 68.1%, respectively (p=0.11). Conclusion(s): the epidemic process of COVID-19 tends to be latent in organized adolescent groups, being realized in inapparent forms of the infection. Those adolescents who've been vaccinated after COVID-19 illness develop the immunity with positive seroconversion dynamics. Copyright © 2022, Pediatria Ltd. All rights reserved.

Results of the work of the military medical academy research institute of novel coronavirus infection problems through 2020-2021

Novel coronavirus infection COVID-19 pandemic has become a serious test for the world's population across the board - from individual to population. Introduced restrictive measures of self-isolation, observation, and quarantine, mostly known before the pandemic only to medical specialists, have become a forced "lifestyle" for most of the people across the globe, their specific adaptation to the new, unusual conditions of the existence and communication. Healthcare has faced off with an unknown infection, while traditional methods of the treatment showed their ineffectiveness at the initial stage. The results of the Research Institute of Problems of New Coronavirus Infection of the Military Medical Academy named after S.M. Kirov from April 2020 to present are listed. Work basis is formed by the scientific and clinical results of the Academy's work during the COVID-19 pandemic. The experience of organizing sanitary, antiepidemic and preventive measures at the permanent disposition and in the field in the regions of Russia and abroad is presented. Developed, improved, and put into the practice methods of diagnosis and treatment of the patients, including the electron microscopic diagnostics of long-term carrier, ultrasound examination of the lungs, glucocorticosteroid therapy, helium-oxygen therapy, risk prediction algorithms and computer-aided evaluation of the degree of lung tissue damage, evaluation of the drug effectiveness are listed. In a separate section study related to the Russian vaccine "Gam-COVID-Vac", the assessment of immunity after the disease, complex disorders, and in postvaccination cases, the use of the immune pathogen-reduced plasma, the mutual influence of various vaccines are presented. Methods of rehabilitation of convalescents, dispensary-dynamic observation, and military medical examination are studied and developed.

Factors affecting the content of IgG-antibodies to S-protein SARS-CoV-2 in the blood of reconvalescents after new coronaviral infection (COVID-19)

Introduction. Morbidity and mortality of COVID-19 actualizes the identification of groups with the greatest risk of primary and re-infection, persons in need of priority vaccination or revaccination. Objective. To study the factors affecting the content of IgG antibodies to the S-protein SARS-CoV-2 in convalescents after suffering COVID-19 for 6 months Materials and methods. The study of the Military Medical Academy and the Helix Laboratory Service was carried out from 06/01/2020 to 08/01/2021 on the basis of the Military Medical Academy and the Helix centers. The study included 1421 people – both sexes from 18 to 70 years old. 1205 with asymptomatic and mild disease (outpatient group). 216 with moderate or severe form (inpatient group). The outpatient group underwent a quantitative determination of IgG to the spike (S) protein SARS-CoV-2 by immunochemiluminescence analysis at 30, 45, 60, 90, 180 days from diagnosis. The diagnosis was verified by a positive RT-PCR result. The inpatient group underwent an identical study on the 1st, 14th, 45th, 60th, 90th and 180th days from the moment of admission to the hospital. The diagnosis was verified in the same way. Results. In convalescents, post-infectious immunity is formed from 30 days. Older age was associated with a more pronounced production of IgG to the S-protein SARS-CoV-2, mainly in older women. Moderate and severe course is characterized by higher concentrations of IgG to the SARS-CoV-2 S protein. a high level of IgG to the S-protein SARS-CoV-2 persists for up to 90 days, with a subsequent decrease by 180 days. Body weight, days of oxygen therapy, hyperthermia, the volume of lung tissue lesions and the level of C-reactive protein correlate with the concentration of IgG to the S-protein SARS-CoV-2. The use of glucocorticoids (GCS) is characterized by the presence of a higher concentration of IgG to the S-protein SARS-CoV-2 up to 6 months. There is a dose-dependent effect of using GCS. Conclusion. The formation and maintenance of the level of neutralizing antibodies for 6 months depends on the severity of the disease, the gender and age of the patients, and the fact of using GCS. This must be taken into account when carrying out therapeutic and preventive measures, planning vaccination. © 2022, Remedium Group Ltd. All rights reserved.

Comparative Cohort Epidemiological Study of Collective Immunity against New Coronavirus Infection among Different Groups of Military Personnel

Background. The need to study the population immunity to the SARS-CoV-2 virus is due to the intensive spread of COVID-19 and the implementation of immunoprophylaxis of this infection. The identification of the features of the formation of immunoresistance in organized military collectives will allow us to predict the development of the epidemic situation, including among comparable population groups. Aims ' the study of population immunity to the SARS-CoV-2 virus in the context of the COVID-19 pandemic against the background of specific immunoprophylaxis in organized military collectives. Methods. According to epidemiological indications, an epidemiological study of collective immunity to the SARS-CoV-2 virus was conducted against the background of vaccination among cadets of military educational organizations. The study involved 497 people, divided into groups by epidemiological and vaccination history for COVID-19, blood groups and Rh factor. The assessment of the immunity intensity was carried out by the levels of class G immunoglobulins (IgG) to SARS-CoV-2 in the blood serum by the method of solid-phase enzyme immunoassay. Results. Seroprevalence in the total sample was 92.6%. The highest rates were observed among vaccinated patients: those who were not ill and vaccinated ' 99.0 ± 0.7%, those who were ill and vaccinated-100% (mean geometric antibody titers ' 1:2234 and 1:4399). Among the ill, unvaccinated individuals, the seroprevalence index was 84.5 ± 3.2% (1:220). Among those who were not ill, not vaccinated ' 8.2 ± 3.1% (1:113), which may indicate a hidden course of the epidemic process in the team. A negative immune response was more common (tSt = 2.01;p < 0.05) in individuals A(II)Rh+ blood group. The highest proportion of maximum antibody titers (1:3200-1:6400) was determined in AB(IV) individuals. Rh-blood groups (tSt=2.21;p < 0.05). Conclusions. For the first time, the formation of combined immunity with the highest concentrations of specific antibodies was revealed in patients who have been ill and vaccinated has been revealed, which allows us to recommend vaccination to those who have suffered from COVID-19. The emergence of post-infectious immunity in organized groups with a latent epidemic process has been established. The relationship between the intensity of immunity with blood groups and the Rh factor was found. © 2021 Izdatel'stvo Meditsina. All rights reserved.

Justification of the tasks of the register of military personnel, affected by SARS-CoV-2

The current regulatory framework of the Ministry of Health and the Ministry of Defense of the Russian Federation on the regulation of the provision of medical assistance to military personnel affected by the infection caused by the SARS-CoV-2 coronavirus is considered. The state of the problem of information support for the provision of medical care to military personnel of this category is assessed. The developed methodology and the draft regulatory document for organizing the collection of medical information in the register of military personnel affected by the infection caused by the SARS-CoV-2 coronavirus are presented, and a regulation on this register is developed. The content, scope and algorithm of creating an information-analytical system for registering this pathology among military personnel, as well as the need to introduce new medical document management technologies into the medical service of the Armed Forces of Russia based on personified records of military personnel and the medical and psychological assistance provided to them, are substantiated. It is shown that for the smooth functioning of the register within the framework of a justified list of tasks, the presence of high-speed secure communication channels between the participating military units, institutions and medical service management bodies will be required. Consequently, the improvement of the information support system for managing the medical support of troops in peacetime and wartime is an important component of increasing the effectiveness of managing medical support for military.