[Molecular epidemiological analysis of SARS-CoV-2 genovariants in Moscow and Moscow region].

INTRODUCTION: SARS-CoV-2, a severe acute respiratory illness virus that emerged in China in late 2019, continues to spread rapidly around the world, accumulating mutations and thus causing serious concern. Five virus variants of concern are currently known: Alpha (lineage B.1.1.7), Beta (lineage B.1.351), Gamma (lineage P.1), Delta (lineage B.1.617.2), and Omicron (lineage B.1.1.529). In this study, we conducted a molecular epidemiological analysis of the most prevalent genovariants in Moscow and the region. The aim of the study is to estimate the distribution of various variants of SARS-CoV-2 in Moscow city and the Moscow Region. MATERIALS AND METHODS: 227 SARS-CoV-2 sequences were used for analysis. Isolation of the SARS-CoV-2 virus was performed on Vero E6 cell culture. Sequencing was performed by the Sanger method. Bioinformatic analysis was carried out using software packages: MAFFT, IQ-TREE v1.6.12, jModelTest 2.1.7, Nextstrain, Auspice v2.34. RESULTS: As a result of phylogenetic analysis, we have identified the main variants of the virus circulating in Russia that have been of concern throughout the existence of the pandemic, namely: variant B.1.1.7, which accounted for 30% (9/30), AY.122, which accounted for 16.7% (5/30), BA.1.1 with 20% (6/30) and B.1.1 with 33.3% (10/30). When examining Moscow samples for the presence of mutations in SARS-CoV-2 structural proteins of different genovariants, a significant percentage of the most common substitutions was recorded: S protein D614G (86.7%), P681H/R (63.3%), E protein T9I (20.0%); M protein I82T (30.0%), D3G (20.0%), Q19E (20.0%) and finally N protein R203K/M (90.0%), G204R/P (73.3 %). CONCLUSION: The study of the frequency and impact of mutations, as well as the analysis of the predominant variants of the virus are important for the development and improvement of vaccines for the prevention of COVID-19. Therefore, ongoing molecular epidemiological studies are needed, as these data provide important information about changes in the genome of circulating SARS-CoV-2 variants.

Multisystem inflammatory syndrome associated with COVID-19 in adult: the case report

The multisystem inflammatory syndrome associated with COVID-19 coronavirus infection was first described in April-May 2020, mainly among children who had an acute infectious disease. Soon there were reports of the development of MIS in adults (MIS-A). More than 200 cases of MVS in adults have been described and systematized in the world, while in Russia there is no separate registration of MVS, a single description of MVS is given in the literature. Material and methods. We presented Case report of MIS-A in a 21-year-old woman, accompanied by persistent fever, multiple organ failure syndrome, is presented. The stages of diagnosis and treatment of MIS-A. Result and discussion. A positive effect was achieved during therapy with corticosteroids and intravenous immunoglobulin. MIS-A is a rare life-threatening complication of a COVID-19 that requires emergency therapy with the inclusion of corticosteroids and intravenous immunoglobulin in an adequate dose. The given example will be interesting for general practitioners, infectious disease specialists and therapists.Copyright © 2023 The authors.

Multisystem inflammatory syndrome associated with COVID-19 in adult: the case report.

The multisystem inflammatory syndrome associated with COVID-19 coronavirus infection was first described in April-May 2020, mainly among children who had an acute infectious disease. Soon there were reports of the development of MIS in adults (MIS-A). More than 200 cases of MVS in adults have been described and systematized in the world, while in Russia there is no separate registration of MVS, a single description of MVS is given in the literature. Material and methods. We presented Case report of MIS-A in a 21-year-old woman, accompanied by persistent fever, multiple organ failure syndrome, is presented. The stages of diagnosis and treatment of MIS-A. Result and discussion. A positive effect was achieved during therapy with corticosteroids and intravenous immunoglobulin. MIS-A is a rare life-threatening complication of a COVID-19 that requires emergency therapy with the inclusion of corticosteroids and intravenous immunoglobulin in an adequate dose. The given example will be interesting for general practitioners, infectious disease specialists and therapists.Copyright © 2023 The authors.

The Cases of COVID-19 and Measles Co-Infection in Children

Relevance. The rapid spread of new pathogens inevitably leads to the occurrence of joint circulation with already known infectious agents, leading to the development of mixed infections. The simultaneous circulation of the pandemic coronavirus SARS-CoV-2 with a highly contagious measles virus leads to the development of mixed infections in people who have not been sick or vaccinated against measles. Aims. Review cases of co-infection with measles and COVID-19 in Moscow. Material and methods. A retrospective study of cases of measles and COVID-19 co-infection in three children with a description of the epidemiological and clinical picture of the disease. Results. In all observed children, the manifestation of the disease was typical for measles, the diagnosis of COVID-19 was established based on a laboratory study carried out in a hospital, which gave reason to count. That the infection with SARS-CoV-2 occurred after the infection of children with measles. Conclusions. Different incubation periods can lead to several options for the development of co-infection. The similarity of clinical symptoms at the onset of the disease does not allow excluding a certain infection clinically, without laboratory verification. © Zvereva NN et al.

Association of Computer Tomography Features of COVID-19 with Outcomes, Clinical and Laboratory Parameters

Aim: to assess the results of chest computer tomography (CT) of patients with novel coronavirus infection in correspondence with their outcomes, clinical and laboratory data. Methods: retrospective analysis of 962 chest CT scans, outcomes, clinical and laboratory data of all 354 COVID-19 patients hospitalized from April to June 2020. Results: Sensitivity and specificity of CT with polimerase chain reaction (PCR) as a reference were: 98.0 % and 5.7 % respectively;for PCR with CT as a reference: 54.6 % and 70.7 % respectively. Patients with positive and negative PCR tests had no significant differences in mean CT score and CO-RADS score. Cumulative survival was better in patients with lower CT score (significant only for maximal, not baseline scores). CT score changed during hospitalization in survived patients clinically insignificant (from 2 (1-2) to 2 (1-2), p=0.001), and increased in dead (from 2 (1,5-3) to 4 (4-4), p <0.001). Lower CT score and better survival was in females, patient younger than 59 years, with NEWS score <3, without atrial fibrillation. Diabetes mellitus and obesity was associated with higher CT score, but not with survival. Chronic obstructive pulmonary disease, coronary heart disease and chronic heart failure was associated with lower survival, but not CT score. Conclusion: chest CT significantly increases diagnostic accuracy and assessment of the prognosis in COVID-19 patients.

[Organizing the medical care for the COVID-19 patients in non-infectious Moscow hospital: reassignment experience].

AIM: To present the results of work of National Medical Research Center of Treatment and Rehabilitation, reassigned for COVID-19 patients treatment during pandemic. Run-up methodology, procedures and working process organization are detailed. MATERIALS AND METHODS: 354 COVID-19 patients were treated from 13.04.2020 to 10.06.2020 [age 59 (470) years, 56% women, body mass index 28.5 (24.932.2) kg/m2]. Patients were admitted at 8 (611) day of sickness. In-hospital stay was 16 (1420) days. RESULTS: NEWS scale at the day of admittance was 2 (14); 2 (13) in patients discharged alive and 6 (47) in died patients, p=0.0001. So prognostic accuracy of NEWS scale was confirmed as very well (area under ROC-curve = 0.819). 69 patients (19.5%) were treated at intensive care department for 7 (413) days. 13 patients died, 11 of them had COVID-19 as direct or indirect cause of death. Total in-hospital mortality was 3.67%, in-hospital mortality of COVID-19 patients 3.1%. 17 healthcare workers (HCW), contacted with COVID-19 patients were infected (2.67%). 4 HCW, who had no direct contact with patients were also infected and 7 HCW were infected before the first patient was admitted. No one of them died. CONCLUSION: Complex tasks of healthcare organization during COVID-19 pandemic can be solved quickly with acceptable quality, characterized by low levels of patients; mortality and HCW infection.

The role of computed tomography in differentiation of coronavirus pneumonia, its complications and comorbidities. Case reports

Background: computer tomography (CT) features of COVID-19, their temporal changes and differences from other pulmonary (viral and bacterial pneumonia) and non-pulmonary diseases are well described in recent publications. The prevalence and characteristics of signs of concomitant problems that could be identified at chest CT are less studied. Aim: to analyze the prevalence and characteristics of chest CT features of COVID-19, its complications and comorbidities. Methods: retrospective analysis of CT and clinical data of 354 patients hospitalized with suspected COVID at April and May of 2020. Results: 962 CT scans were analyzed (3 (2-3) scans per patient). First CT was performed at 8 (5-11) day of sickness. Several roentgenological scenarios could be highlighted: patients with coronavirus pneumonia (n=295;83%);with combination of COVID-19 and another pathology (n=36;10%);with complications of COVID-19 (n=12;3%);with alternative pathology (n=2;1%);without any pathological signs (n=9;3%). Several cases, illustrating CT signs of coronavirus pneumonia, its complications and comorbidities are reported. Conclusion: CT possibilities are not limited to detect typical COVID-19 signs, it also helps to differentiate pulmonary and other thoracis pathology.