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The objective of our study was to compare complications of endovascular thrombectomy (EVT), in ischemic stroke (IS) patients admitted with or without COVID-19 to hospitals converted to deliver COVID-19-specific care. Materials and methods. A retrospective analysis of 817 clinical cases of IS patients aged 25–99 years treated in regional vascular centers of Saint Petersburg from 1 January to 31 December 2021, with confirmed thrombotic occlusion of cerebral vessels and subsequent EVT intervention. Results. The EVT number per bed was significantly higher (1.6) in the non-converted hospitals compared to the COVID-19-converted hospitals (0.49; p 0.001). At the same time, more intraoperative complications (12% vs. 7.1%; p = 0.03) were reported in non-converted hospitals compared to COVID-19 converted hospitals. The likelihood of a favorable functional outcome was higher in younger patients with less severe neurological deficits on admission and without concomitant COVID-19 or post-operative complications. Conclusion. COVID-19 is a limiting factor for the effectiveness of an IS treatment in patients who underwent EVT, affecting thereby functional outcomes in this cohort of patients. The impact of the COVID-19 pandemic on intra-operative EVT complication rate was associated with disrupted triage of IS patients and an uneven distribution of the workload among surgical teams in the city hospitals.

Goal: Analysis of the results of thrombectomy from the arteries of the lower extremities in patients with COVID-19 against the background of different severity of respiratory failure. Materials and Methods: This retrospective, cohort, comparative study for the period from 05/01/2022 to 20/07/2022 included 305 patients with acute thrombosis of the arteries of the lower extremities against the background of the course of COVID-19 (SARS-CoV-2 Omicron variant). Depending on the type of oxygen support, 3 groups of patients were formed: group 1 (n = 168) – oxygen insufflation through nasal cannulas; group 2 (n = 92) – non-invasive lung ventilation; and group 3 (n = 45) – artificial lung ventilation. Results: Myocardial infarction and ischemic stroke were not detected in the total sample. The highest number of deaths (group 1: 5.3%, n = 9; group 2: 72.8%, n = 67; group 3: 100%, n = 45; p < 0.0001), rethrombosis (group 1 : 18.4%, n = 31; group 2: 69.5%, n = 64; group 3: 91.1%, n = 41; p < 0.0001), and limb amputations (group 1: 9.5%, n = 16; group 2: 56.5%, n = 52; group 3: 91.1%, n = 41; p < 0.0001) was recorded in group 3 (ventilated) patients. Conclusion: In patients infected with COVID-19 and on artificial lung ventilation, a more aggressive course of the disease is noted, expressed in an increase in laboratory parameters (C-reactive protein, ferritin, interleukin-6, and D-dimer) of the degree of pneumonia (CT-4 in overwhelming number) and localization of thrombosis of the arteries of the lower extremities, mainly in the tibial arteries. [ABSTRACT FROM AUTHOR]

Objective To investigate whether the amino acid variation in the nonstructural protein of Severe Acute Respiratory Syndrome Coronavirus2 (SARS-CoV-2) is related to the severity of Corona Virus Disease 2019 (COVID-19). Methods The data obtained from the Global Shared Influenza Data Initiative (GISAID) database were analyzed, and the nonstructural protein amino acid mutations with high mutation rate in SARS-CoV-2 sequences were screened. The outcomes were divided into mild and severe diseases, and the chi-square test was used to compare the basic characteristics between the groups. The relationship between the mutations selected and the prognosis of the patients was analyzed. Results A total of 23 498 cases were included, including 11 444 males (48,70%) and 12 054 females (51.30%). The median age\M] was 38 (26-53) years old. The severe infection rate of novel coronavirus in male was higher than that in female (於=226.564, P < 0.001). The severe infection rate of novel coronavirus increased with the increase of age (=6 088.032, P < 0.001). The year of onset (於=1 604.070, P < 0,001) and continent (於=4 520.240, P < 0,001) were significantly correlated with the severity of novel corona virus infection. Several amino acid variations in the SARS-CoV-2 gene group associated with the severity of novel corona virusJ s sensitive dyeing were determined. NSP4_T492I (aOi二0.574, 95%CI: 0.487-0.676)： NSP12_G671S (aOR-0.657： 95%CZ： 0.458 -0.941), NSP6_T77A (aOR 二0.422, 95%CZ： 0.235-0.759), and NSP3_P1228L ©OR 二0.124, 95%CI： 0.080-0.190) were negatively correlated with novel coronavirusJ s severe infection. NSP12_P323L (aOR =2.126, 95% CI: 1.531-2.953), NSP13_P77L (aORl.923, 95%CI： 1.115-2.369), and NSP14.A394V (°QR=20.486： 95%CI： 9.649-43.495) were positively correlated with novel coronavirusJ s severe infection. Conclusion The amino acid variation of SARS-CoV-2 nonstructural protein may be related to the severity of COVID -19 virus infection, and it is necessary to screen several nonstructural protein amino acid variants which can be related to the severity of novel coronavirus infection. [ABSTRACT FROM AUTHOR]

COVID-19 sequelae are long-term symptoms of COVID-19. Cardiovascular disease is not only a risk factor for the occurrence of COVID-19 sequelae but also a potential result directly or indirectly caused by COVID-19 infection.

This article presents a case study of a patient who had Cronkhite-Canada syndrome in combination with an asymptomatic novel coronavirus infection. The patient exhibited clinical symptoms of loss of appetite, hair and nail loss, and skin pigmentation. Digestive endoscopy revealed widespread and varying-sized polypoid changes in the mucosa of the stomach, duodenum, and colon. During the course of the illness, the patient tested positive for novel coronavirus nucleic acid. Treatment with moderate doses of prednisone resulted in the patient's hair regrowth and decreased skin hypopigmentation. The article provides a summary of the patient's diagnosis and treatment and a review of relevant literature, with the aim of enhancing clinicians' understanding of the disease.

Objective: To investigate symptoms of anxiety and depression among primary and middle school students quarantined in hotels during the COVID-19 epidemic. Methods: Anxiety and depression symptoms among 726 primary and middle school students quarantined in hotels were investigated with The Screen for Child Anxiety Related Emotional Disorders (SCARED) and Depression Self-rating Scale for Children (DSRSC) from September to October 2022 in Chifeng City, Inner Mongolia Autonomous Region. There were 624 students completed investigation with response rate of 86%. The positive score of SCARED was 23 and DSRSC was 15. Results: The detection rates of anxiety and depression were 17.9% and 15.4% respectively. The detection rates of anxiety and depression were higher in middle school students than in primary school students (Ps <0.05). The scores of generalized anxiety and social phobia factors were higher in female students than in male students (Ps <0.05). The scores of dissociative anxiety factor and depression were higher in middle school students than in primary school students (Ps <0.05). Conclusion: During the COVID-19 epidemic, middle school students quarantined in hotels are more likely to have anxiety and depression symptoms than primary school students, and female students are more likely to have anxiety symptoms than male students. [ABSTRACT FROM AUTHOR]

Jing Zhao,1 Yan Li,1 Miao Guo,1 Guijuan Zhang,2 Ping Chen1 1Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China; 2Department of Gynaecology and Obstetrics, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of ChinaCorrespondence: Ping Chen, Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China, Tel +8613783589566, Fax +86037166262974, Email pingping6768@126.comBackground: COVID-19 is a highly contagious respiratory infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which became a global public health crisis. In the past 3 years, the COVID-19 pandemic has resulted in a dramatic increase in the occurrence of psychological symptoms such as depression, anxiety, and stress in global populations. Therefore, it is important to help pregnant women cope with major public emergencies and improve their physical and mental health.Objective: To investigate the status and influencing factors of anxiety, insomnia, and psychological stress disorder in pregnant women with COVID-19 to provide a theoretical basis for psychological intervention in pregnant women in the case of public health emergency events.Patients and methods: A cross-sectional survey was conducted with 435 pregnant women from multiple tertiary hospitals in Zhengzhou from November 6 to December 6, 2022. The questionnaire contents included the general information of pregnant women, insomnia scale, generalized anxiety scale, and the revised version of the Accident Impact Scale.Results: There are 251 pregnant women with anxiety (57.7%, 95% CI: (53.0%-62.4%).There are 166 pregnant women with insomnia.(38.2%, 95% CI: 33.6%-42.7%), There are 314 pregnant women with stress disorder.(72.2%, 95% CI: 68.0%– 76.4%). During the epidemic prevention and control period, whether pregnant women had a history of adverse pregnancy had a statistically significant difference in anxiety, insomnia and stress disorders.Conclusion and Recommendation: During the COVID-19 pandemic, pregnant women appeared to generally have anxiety, insomnia, and stress disorders. Poor pregnancy history is a protective factor for pregnant women with anxiety, insomnia, and post-traumatic stress disorder. In the case of similar public health emergencies, attention bias modification (ABM) may be a potential intervention measure to provide potentially new ideas for alleviating the psychological disorders of pregnant women during this special period.Keywords: novel coronavirus infection, pregnancy, anxiety, insomnia, psychological stress disorder

Aim: The current study aimed to describe various types of myelitis associated with a novel coronavirus infection [coronavirus disease 2019 (COVID-19)] as well as to analyze cytokine profiles and cerebrospinal fluid (CSF) parameters in affected patients and to compare them to patients with other immune-mediated disorders—multiple sclerosis (MS), in order to identify possible common pathogenetic pathways and consequently treatment targets. Methods: Clinical, radiological, and laboratory characteristics were studied based on patients’ history. CSF from patients with myelitis associated with COVID-19 (11 patients) was compared with CSF of healthy controls (HC) (7 patients) and patients with MS (37 patients) from the non-COVID era. CSF cytological examination, protein levels and oligoclonal bands (OCBs) evaluation, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus detection and cytokine profiling using Bio-Plex Pro Human Inflammation Panel 1, 37-Plex were performed. Results: In total 11 patients with different types of myelitis developed up to 3 months after COVID-19 were enrolled in the study. Radiological findings were diverse: short transverse myelitis (lesion of fewer than 3 segments) (n = 6), longitudinal extensive transverse myelitis (LETM) (n = 2), multifocal spinal cord lesions (n = 1), and myelitis involving dorsal and lateral columns (n = 2). The most pronounced response to treatment was observed in patients with partial transverse myelitis and patients with anti-myelin oligodendrocyte glycoprotein (MOG) antibodies (MOG Abs). Multiple comparisons have demonstrated decreased levels of interleukin-10 (IL-10), interferon-α2 (IFN-α2), IFN-β, and thymic stromal lymphopoietin (TSLP), and increased IL-19 and B cell activating factor (BAFF) in patients with COVID-19 myelitis (CM) compared to the MS group. The highest BAFF and a proliferation-inducing ligand (APRIL) concentrations were found in patients with the most profound neurological disability. Conclusions: Myelitis associated with COVID-19 is clinically and radiologically heterogeneous. Evaluation of cytokine profiles in patients with myelitis associated with COVID-19 revealed their relative similarity with ones of MS patients, except for a few cytokines. BAFF/APRIL system as well as IL-10 is well-known for the role in the development and progression of autoimmune diseases, however, their links with COVID-19 and effects on the development of immune-mediated central nervous system (CNS) disorders after SARS-CoV-2 remain to be further studied.

RELEVANCE. It is known that patients with severe cases of the novel coronavirus infection (COVID-19) are characterized by the development of COVID-19-associated dysautonomia (COVID-19-DA). At the moment, there are no studies examining the impact of this phenomenon on the course and outcomes of the disease in the most severe cohort of patients with COVID-19, namely those requiring venovenous extracorporeal membrane oxygenation (VV ECMO). AIM OF STUDY. The purpose of the presented work is to study the effect of different COVID-19-DA phenotypes on the performance parameters and effectiveness of VV ECMO, gas exchange and hemodynamics in patients with COVID-19. MATERIAL AND METHODS. The study included 20 patients, 12 (60%) women, 8 (40%) men, with COVID-19 who underwent VV ECMO. Patients underwent 24-hour Holter monitoring with assessment of the spectral parameters of heart rate variability (HRV): the low-frequency component (LF), the high-frequency component (HF), the ratio of the low-frequency component to the high frequency component (LF / HF) on days 1, 3, 5 of the VV ECMO. Patients were divided into three groups based on the identified COVID-19-DA phenotypes. The groups were compared in terms of gas exchange, hemodynamics, and VV ECMO performance parameters. RESULTS. The level of partial pressure of carbon dioxide in arterial blood (paCO2) in the phenotype with low sympathetic tone and high tone of the parasympathetic division of the autonomic nervous system (ANS) (lShP) was significantly higher than in the phenotype with normal sympathetic tone and high tone of the parasympathetic division of the ANS (nShP) with equal VV ECMO performance parameters. The heart rate (HR) in the nShP phenotype was significantly lower than in the lShP phenotype. A significant increase in respiratory dysfunction was revealed over time in the lShP phenotype. Weaning from VV ECMO in the nShP phenotype was successful in 50 %, whereas in the lShP phenotype, weaning from VV ECMO was observed in 7,2 % of patients. No significant differences in the mortality rate were obtained. The most common cause of death in both groups was septic shock. CONCLUSIONS. The COVID-19-DA phenotype, manifested by decreased tone of the sympathetic division and increased tone of the parasympathetic division of the ANS, leads to low efficiency of VV ECMO, resulting in a statistically significantly less frequent ECMO discontinuation in those patients.

The purpose of this review is to describe the available scientific data on the post-COVID-19 syndrome, formulate the main approaches to classification, determine the potential mechanisms of its pathogenesis, as well as determine the mechanisms of the occurrence of bronchopulmonary system pathology within the framework of the post-COVID-19 syndrome. It is known that long-term persistence of COVID-19 symptoms significantly reduces the quality of life of patients through the direct or indirect effect of the SARS-CoV-2 virus on a number of organs and systems. The review examines in detail the possible pathogenetic mechanisms of the post-COVID-19 syndrome, describes and studies the most common consequences of acute COVID-19, taking into account the severity of the disease, including diseases of the respiratory system, in particular interstitial and broncho-obstructive diseases. Particular attention is paid to the above problems in order to describe and structure the available scientific data on lung diseases within the framework of the post-COVID-19 syndrome. It should be noted, however, that there are very few studies on pathogenesis of changes in the bronchopulmonary system in the post-COVID-19 period. The bulk of them affect only individual manifestations of diseases of the respiratory system, in particular cough and shortness of breath, and are not aimed at determining causeand-effect relationships and the relationship of these symptoms to a specific nosology. Taking into consideration the continued high incidence of COVID-19, there is no doubt that additional studies of bronchopulmonary manifestations of post-COVID-19 syndrome should be conducted. Information from the databases PubMed, eLibrary, Scopus, Jstor was used as literary sources.

Ye Wang,1,&ast; Fenxiang Li,1,&ast; Jian Liu,2 Jing Liu,3 Pei Qin,4 Jiayi Zhang,5 Yingtao Zhang,5 Shuning Wu6 1Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, People’s Republic of China; 2Department of General Surgery, Maternal and Child Health Hospital, Qingyuan, Guangdong, People’s Republic of China; 3Intensive Care Unit 1, The First Affiliated Hospital, Jinan University, Guangdong, Guangzhou, People’s Republic of China; 4Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, People’s Republic of China; 5Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People’s Republic of China; 6Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yingtao Zhang, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 510000, People’s Republic of China, Tel +86 15918805867, Email zhangyt9@mail2.sysu.edu.cn Shuning Wu, Thyroid and Breast Surgical Department, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, 518067, People’s Republic of China, Tel +86 13480209989, Email jessica540wu@outlook.comPurpose: This study aims to identify common COVID-19 symptoms and asymptomatic infection rates during the epidemic in China. We also introduce the concepts of “Time-point asymptomatic rate” and “Period asymptomatic rate”.Object and Methods: A questionnaire survey was conducted online from December 2022 to January 5, 2023, collecting demographic characteristics, laboratory results, clinical symptoms, lifestyle and vaccination history. Statistical methods were used to analyze symptom characteristics, associated factors, and patterns during an 8-day observation period. Numerical variables were described by median M (Q1-Q3) or mean and standard deviation (). Categorical variables are described by frequency (N), ratio (%) or rate (%). The influencing factors were studied by Wilcoxon or Kruskal-Willis H rank sum test or logistic regression analysis, and the trend of symptom incidence by Spearman rank correlation. P value being ≤ 0.05 was statistically significant.Results: Out of 536 participants, 493 (91.98%) were infected, with 3 asymptomatic cases and 490 symptomatic cases within 8 days. The time-point asymptomatic rate increased from 0.61% on day 1 to 15.42% on day 8. Fever, cough, and fatigue were the main symptoms, with additional symptoms such as vomiting, diarrhea, and hyposmia reported. Symptom durations varied, with cough and expectoration lasting longer and vomiting and diarrhea lasting shorter. Several symptoms showed a downward trend over time.Conclusion: Our online survey highlighted that most COVID-19 patients experienced symptoms, and the time-point asymptomatic rate showed a dynamic change among the infected population. Onset patterns and demographic factors influence symptom occurrence and duration. These findings have implications for clinical practitioners and decision-makers in public health measures and strategies.Keywords: Novel coronavirus infection, onset patterns, clinical features, associated factors, time-point asymptomatic, period asymptomatic rate

lymphangitic carcinomatosis is characterized by the spread of cancer cells through pulmonary lymphatic vessels, which results in secondary interstitial inflammation. The diagnosis of lymphangitic carcinomatosis is challenging due to nonspecific clinical symptoms and radiological findings that similar to those of interstitial lung disease.The purpose of the study was to demonstrate difficulties in the diagnosis of lymphangitic carcinomatosis with a systemic dissemination from unknown primary site. Case presentation. We report on a case of lymphangitic carcinomatosis from cancer of unknown primary origin with systemic involvement of internal organs imitating pulmonary disease caused by coVid-19. patient K., 58 years old, was treated for 12 bed-days in therapy departments with the diagnosis of bilateral viral coVid-19 pneumonia. clinical, laboratory and instrumental data were nonspecific. despite treatment, heart failure and kidney disease progressed to terminal stages, leading to the death of the patient. Autopsy revealed systemic lymphangitic carcinomatosis from cancer of unknown primary origin with involvement of the lungs, heart, liver, pancreas, spleen, kidneys and adrenal glands. lymphangitic carcinomatosis mimicked interstitial lung disease in a novel coronavirus infection coVid-19. metastasis to the heart mimicked coronary disease, and metastases to the kidneys led to acute kidney failure, which along with acute respiratory and heart failure caused the death of the patient.Conclusion. lymphangitic carcinomatosis, which does not have specific clinical manifestations, is able to mimic interstitial lung diseases, including a new coronavirus infection. cancer of unknown primary and multiple visceral metastases in this case confirm the concept of the independence of different types of tumor progression.

The course of the pandemic revealed that despite the general populational risks for developing novel coronavirus infection (NCI) COVID-19, pregnant women are more susceptible to its severe course and unfavorable perinatal outcomes. Currently, NCI is associated with a high risk of spontaneous miscarriages, premature rupture of fetal membranes, preterm delivery, development of fetoplacental insufficiency, fetal growth retardation, fetal distress, exacerbation of chronic somatic pathology, and postpartum bleeding. A brief literature review and the described clinical case demonstrate a need to thoroughly examine puerperal women with preterm delivery.

Objective To investigate the incidence of COVID-19 infection in maintenance hemodialysis（MHD） patients and analyze factors influencing prognosis, providing insights for improved management of MHD patients. Methods A total of 280 MHD patients were systematically sampled for the investigation of COVID-19 infection incidence. Those infected were categorized into recovery and death groups based on prognosis, with relevant factors investigated. Results Among 265 MHD patients with COVID-19 infection（94.64% incidence）, 15 deaths occurred, yielding a mortality rate of 5.66%. Asymptomatic infections were observed in 30 patients（11.32%）. The death group（n=15） exhibited higher proportions of fatigue, poor appetite, cough, sore throat, and difficulty breathing compared to the recovery group（n=250）（P＜0.05）. The recovery group showed a higher proportion of muscle soreness compared to the death group（P＜0.05）. No significant differences were noted in fever, anosmia, ageusia, dizziness, headache, and diarrhea percentages（P＞0.05）. Additionally, no marked distinctions were found in primary diseases, COVID-19 vaccination doses, dialysis vintage, blood phosphate, parathyroid hormone, interdialytic weight gain, hemoglobin, fasting blood glucose, and blood pressure between the groups（P＞0.05）. The death group, however, had higher proportions of diabetes, post-COVID-19 viral pneumonia, less exercise during dialysis intervals, older age, lower blood calcium, elevated inflammatory indicators（white blood cell count, C-reactive protein, parathyroid hormone, interleukin-6）, and more instances of substandard single-pool urea clearance index（spKt/V）（P＜0.05）. Conclusion Major factors influencing death in MHD patients with COVID-19 infection include diabetes, post-COVID-19 viral pneumonia, lack of exercise during dialysis intervals, advanced age, low blood calcium, elevated inflammatory indicators, and substandard spKt/V. Encouraging exercise during dialysis intervals and improving dialysis adequacy can enhance the prognosis of MHD patients with COVID-19 infection. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the application value of early subclinical myocardial damage in patients with long COVID using two ⁃ dimensional speckle tracking imaging (2D ⁃ STI) technology. Methods: Fifty ⁃ nine patients with post ⁃ COVID infection after the unsealing of the COVID epidemic in China on December 7, 2022 were enrolled as the observation group, and 60 pre⁃epidemic healthy people who were screened in the out patient department were selected as the healthy control group. Basic clinical data, markers of myocardial injury and other laboratory indicators of patients were collected. Two⁃dimensional echocardiography and 2D⁃STI were used to evaluate left ventricular ejection fraction (LVEF), left ventricular diastolic function (E/A, E/e’), global longitudinal strain (GLS), and segmental strain values, and the heart rate, LVEF, E/A, E/e’, GLS, and segmental strain values were calculated and compared between the groups. Results: The study found that the left ventricular diastolic function E/A (1.14±0.34 vs. 1.46±0.44, P<0.001), E/e’ (8.01±2.08 vs. 7.21±1.53, P<0.05), and GLS［ (-20.57±2.15) % vs. (-21.90±1.73) %, P<0.001］of patients with long COVID syndrome were significantly decreased compared to healthy control individuals. Further segmental strain analysis revealed significant decreases in ten segments, including basal anteroseptal, mid anterior, mid anteroseptal, mid inferolateral, mid anterolateral, apical anterior, apical anteroseptal, apical inferior, apical inferolateral and apical anterolateral in the COVID group (P<0.05) . Subgroup analysis based on post ⁃ infection time found that as the recovery time from COVID prolonged, the GLS of patients showed a gradual improvement trend. Conclusion: Patients after COVID infection often experience a decrease in left ventricular diastolic function and GLS. With the prolongation of COVID recovery time, the above indicators show a gradual improvement trend. The application of 2D⁃STI technique can quantitatively evaluate early subclinical myocardial injury in patients with long novel coronavirus syndrome, which may provide evidence for clinical diagnosis and treatment of COVID patients. [ABSTRACT FROM AUTHOR]

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Objective To investigate the clinical features of novel coronavirus infection complicated with renal injury in children.Methods The clinical data of children diagnosed with novel coronavirus infection in the Pediatric Intensive Care Unit (PICU),General Hospital of Ningxia Medical University from December 2022 to January 2023 were retrospectively studied.Results Among the 41 children with confirmed novel coronavirus infection, 5 cases (12.2%) had renal injury and 10 cases (24.4%) had abnormal urinalysis (microscopic hematuria and/or proteinuria) .Children with elevated serum urea and creatinine, decreased sodium, potassium and abnormal urine analysis on admission returned to normal at discharge.Among the 5 children with renal injury, 4 cases died in critical condition, and one recovered completely and was discharged.Multifactor logistic regression analysis suggested that female and fever were risk factors for renal injury [odds ratio (OR) =1.87,95% confidence interval (95%CI) 1.02-3.50,P=0.035;OR=2.21,95%CI 1.18-4.30,P=0.012].Conclusion Children with novel coronavirus infection have a high risk of renal injury, and effective measures should be taken to prevent it, so as to reduce the mortality of such children. [ABSTRACT FROM AUTHOR]

Objective: to evaluate the pharmacoeconomic feasibility of using monoclonal antibodies or their combinations vs standard therapy in patients with mild and moderate-severe COVID-19 in order to prevent the severe course of the disease.Material and methods. The decision tree and Markov models for calculation of costs and outcomes were used for patients with COVID-19 and post-COVID-19 syndrome, respectively. The cost-effectiveness of tixagevimab and cilgavimab was evaluated in persons ≥18 years old not vaccinated against COVID-19 with a high risk of progression to severe COVID-19. Effectiveness and safety of tixagevimab and cilgavimab combination was assessed based on TACKLE phase III study results. The quantities of life years gained (LYG) and quality-adjusted life years (QALY) were calculated. Results were compared with the wiliness-to-pay threshold measured as tripled gross domestic product per capita according the World Health Organization recommendations.Results. Treatment of COVID-19 with tixagevimab and cilgavimab results in additional 0.2657 LIGs or 0.2255 QALYs. The cost of 1 LIG was 213,4 thousand rubles, the cost of 1 QALY was 251,5 thousand rubles. Both costs of LIG and QALY appeared to be significantly less compared to the wiliness-to-pay threshold equal to 3.09 million rubles in 2022.Conclusion. Treatment of mild and moderate-severe COVID-19 is economically feasible and may be recommended for wide use in the Russian healthcare system.

Bei Tian,1 Zhongping Ning,2 Pingan Tu3 1Department of Nursing, Shanghai Pudong New Area Zhoupu Hospital (Zhoupu Hospital Affiliated with Shanghai Medical College of Health), Shanghai, 201318, People’s Republic of China; 2Department of Cardiology, Shanghai Pudong New Area Zhoupu Hospital (Zhoupu Hospital Affiliated with Shanghai Medical College of Health), Shanghai, 201318, People’s Republic of China; 3Vice President Office, Shanghai Pudong New Area Zhoupu Hospital (Zhoupu Hospital Affiliated with Shanghai Medical College of Health), Shanghai, 201318, People’s Republic of ChinaCorrespondence: Pingan Tu, Vice President Office, Shanghai Pudong New Area Zhoupu Hospital (Zhoupu Hospital Affiliated with Shanghai Medical College of Health), No. 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, People’s Republic of China, Tel +86-18121216136, Email shanghai5288@hotmail.com Zhongping Ning, Department of Cardiology, Shanghai Pudong New Area Zhoupu Hospital (Zhoupu Hospital Affiliated with Shanghai Medical College of Health), No. 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, People’s Republic of China, Tel +86-021-68135590, Email ningzpsh@163.comAbstract: During the coronavirus disease 2019 (COVID-19) outbreak in Shanghai with the Omicron variant in March 2022, locally accessible hospitals and healthcare centres encountered difficulties quickly responding to a demand for hospitals that were rapidly increasing, optimizing clinical results and controlling the infection. In this commentary, we summarize the management strategies of patients in a temporary COVID-19 specialized hospital during the outbreak in Shanghai, China. The present commentary was considered eight characteristics of management system, including general idea, infection prevention team, and efficient time management, and preventive and protective measures management, strategies for the management of infected patients, disinfection management, drug supply management strategies, and medical waste management. Following eight characteristics, the temporary COVID-19 specialized hospital operated effectively for 21 days. A total of 9674 patients were admitted, 7127 cases (73.67%) were cured and discharged, and 36 were transferred to designate hospitals for better treatment. Twenty-five management staff, 1130 medical, nursing staff, 565 logistics staff, and 15 volunteers participated in the temporary COVID-19 specialized hospital, and no infection prevention team member was infected. We speculated that these management strategies could be potential references for public health emergencies.Keywords: novel coronavirus infection, specialized hospital, management strategies, Omicron variant, outbreak

BackgroundChina managed coronavirus disease 2019 (COVID-19) with measures against Class B infectious diseases, instead of Class A infectious diseases, in a major shift of its epidemic response policies. We aimed to generate robust information on the transmission dynamics of novel coronavirus infection in Shanxi, a province located in northern China, after the implementation of the “Class B infectious disease Class B management” policy.MethodsWe consolidated infection data in Shanxi province from December 6, 2022 to January 14, 2023 through a network questionnaire survey and sentinel surveillance. A dynamics model of the SEIQHCVR was developed to track the infection curves and effective reproduction number (Rt).ResultsOur model was effective in estimating the trends of novel coronavirus infection, with the coefficient of determination (R2) above 90% in infections, inpatients, and critically ill patients. The number of infections in Shanxi province as well as in urban and rural areas peaked on December 20, 2022, with the peak of inpatients and critically ill patients occurring 2 to 3 weeks after the peak of infections. By the end of January 2023, 87.72% of the Shanxi residents were predicted to be infected, and the outbreak subsequently subsided. A small wave of COVID-19 infections may re-emerge at the end of April. In less than a month, the Rt values of positive infections, inpatients and critically ill patients were all below 1.0.ConclusionThe outbreak in Shanxi province is currently at a low prevalence level. In the face of possible future waves of infection, there is a strong need to strengthen surveillance and early warning.

To investigate the value of the peripheral blood lymphocyte count (LYM) combined with interleukin-6 (IL-6) in predicting disease severity and prognosis in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. This was a prospective observational cohort study. A total of 109 patients with SARS-CoV-2 pneumonia who were admitted to Nanjing First Hospital from December 2022 to January 2023 were enrolled. The patients were divided into two groups based on disease severity: severe (46 patients) and critically ill (63 patients). The clinical data of all patients were collected. The clinical characteristics, sequential organ failure assessment (SOFA) score, peripheral blood lymphocyte count, IL-6 level and other laboratory test results were compared between the two groups. A receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of each index for SARS-CoV-2 pneumonia severity; patients were regrouped using the optimal cut-off value of the ROC curve, and the relationship between different LYM and IL-6 levels and the prognosis of patients was analysed. Kaplan‒Meier survival curve analysis was performed; in the different LYM and IL-6 groups, the patients were regrouped based on whether thymosin was used, and the effect of thymosin on patient prognosis was compared between the groups. Patients in the critically ill group were significantly older than patients in the severe group (age: 78 ± 8 vs. 71 ± 17, t = 2.982, P < 0.05), and the proportion of patients with hypertension, diabetes and cerebrovascular disease was significantly higher in the critically ill group than in the severe group (69.8% vs. 45.7%, 38.1% vs. 17.4%, 36.5% vs. 13.0%; χ2 values, 6.462, 5.495, 7.496, respectively, all P < 0.05). Compared with the severe group, the critically ill group had a higher SOFA score on admission (score: 5.4 ± 3.0 vs. 1.9 ± 1.5, t = 24.269, P < 0.05); IL-6 and procalcitonin (PCT) in the critically ill group were significantly higher than those in the severe group on the first day of admission [288.4 (191.4, 412.9) vs. 513.0 (288.2, 857.4), 0.4 (0.1, 3.2) vs. 0.1 (0.05, 0.2); Z values, 4.000, 4.456, both P < 0.05]. The lymphocyte count continued to decline, and the lymphocyte count on the 5th day (LYM-5d) was still low (0.6 ± 0.4 vs. 1.0 ± 0.4, t = 4.515, both P < 0.05), with statistically significant differences between the two groups. ROC curve analysis indicated that LYM-5d, IL-6 and LYM-5d + IL-6 all had value for predicting SARS-CoV-2 pneumonia severity; the areas under the curve (AUCs) were 0.766, 0.725, and 0.817, respectively, and the 95% confidence intervals (95% CI) were 0.676–0.856, 0.631–0.819, and 0.737–0.897, respectively. The optimal cut-off values for LYM-5d and IL-6 were 0.7 × 109/L and 416.4 pg/ml, respectively. LYM-5d + IL-6 had the greatest value in predicting disease severity, and LYM-5d had higher sensitivity and specificity in predicting SARS-CoV-2 pneumonia severity. Regrouping was performed based on the optimal cut-off values for LYM-5d and IL-6. Comparing the IL-6 ≥ 416.4 pg/ml and LYM-5d < 0.7 × 109/L group with the other group, i.e., patients in the non–low-LYM-5d and high-IL-6 group, patients in the low-LYM-5d and high-IL-6 group had a higher 28-day mortality rate (71.9% vs. 29.9%, χ2 value 16.352, P < 0.05) and a longer hospital stay, intensive care unit (ICU) stay and mechanical ventilation time (days: 13.7 ± 6.3 vs. 8.4 ± 4.3, 9.0 (7.0, 11.5) vs. 7.5 (4.0, 9.5), 8.0 (6.0, 10.0) vs. 6.0 (3.3, 8.5); t/Z values, 11.657, 2.113, 2.553, respectively, all P < 0.05), as well as a higher incidence of secondary bacterial infection during the disease course (75.0% vs. 41.6%, χ2 value 10.120, P < 0.05). Kaplan‒Meier survival analysis indicated that the median survival time of patients in the low LYM-5d and high-IL-6 group was significantly shorter than that of patients in the non-low LYM-5d and high-IL-6 group (14.5 ± 1.8 d vs. 22.2 ± 1.1 d, Z value 18.086, P < 0.05). There was no significant difference in the curative effect between the thymosin group and the nonthymosin group. LYM and IL-6 levels are closely related to SARS-CoV-2 pneumonia severity. The prognosis for patients with IL-6 ≥ 416.4 pg/ml at admission and a lymphocyte count < 0.7 × 10 9/L on the 5th day is poor. [ABSTRACT FROM AUTHOR]

Aim: Comparative analysis of the results of open thrombectomy and conservative therapy in patients with acute thrombosis of the lower limb arteries against the background of the XBB.1.5 ("Kraken") subvariant of Omicron Severe acute respiratory syndrome-related coronavirus-2 (Sars-cov-2). Material and methods: The present prospective, open, multicenter comparative study for the period 04/01/2022 to 12/01/2023 included 167 patients with acute thrombosis of the lower limb arteries against the background of the XBB.1.5 ("Kraken") subvariant of the XBB.1.5 ("Kraken") subvariant of Omicron Sars-cov-2. Depending on the treatment strategy, two groups were formed: group 1 — open thrombectomy (n = 136) and drug treatment with an anticoagulant (unfractionated heparin in a therapeutic dosage) and an antiplatelet (acetylsalicylic acid 125 mg once a day); group 2 — only drug therapy (n = 31). This group consisted of patients who refused surgical revascularization and were on a prophylactic dose of unfractionated heparin (5000 U 3 times a day subcutaneously). On the development of acute arterial thrombosis, 80 U/kg (maximum 5000 U) of unfractionated heparin was injected intravenously in a bolus, followed by transfer to intravenous infusion using an infusion pump with an initial rate of 18 U/kg per hour under control of activated partial thromboplastin time. Analgesic and antiplatelet therapy was also prescribed (acetylsalicylic acid 125 mg once a day). Results: No significant intergroup differences either in mortality rates (group 1: n = 58, 38.2%; group 2: n = 7, 22.6%; p = 0.09) or limb amputation (group 1: n = 63, 46.3%; group 2: n = 9, 29.0%; p = 0.07) were found. However, there was a trend towards a decrease in the incidence of these events in the drug treatment group. After open thrombectomy, rethrombosis developed in 50.7% (n = 69) cases; and thrombosis after rethrombectomy followed by amputation in 46.3% (n = 63). There were no hemorrhagic complications in both groups. Myocardial infarction and ischemic strokes were not recorded. Conclusion: Anticoagulant therapy demonstrates several advantages over aggressive surgical management. However, probably due to the small size of the studied sample, significant differences were not obtained. Further study of this issue is required with the identification of the optimal reperfusion method in this complex cohort of patients. [ABSTRACT FROM AUTHOR]

Macrophage-derived chemokine (MDC/CCL22) is a chemokine of the C-C subfamily. It is involved in T-cellular maturation and migration. Our previous research shows that plasma CCL22/MDC tends to show a statistically significant depletion of concentrations in acute patients and convalescents when compared to healthy donors. In the current work, we investigate existing views on MDC/CCL22 dynamics in association with various pathologies, including respiratory diseases and, specifically, COVID-19. Additionally, we present our explanations for the observed decrease in MDC/CCL22 concentrations in COVID-19. The first hypothesis we provide implies that viral products bind to MDC/CCL22 and block its activity. Another explanation for this phenomenon is based on dendritic cells population and the inhibition of their function. [ABSTRACT FROM AUTHOR]

The novel coronavirus infection outbreak, which spread globally since the beginning of 2020, continues to significantly affect society up to the present time. We report the new coronavirus infection outbreak that occurred across the Tokyo islands and the measures adopted, such as vaccination, between April 2020 and March 2023. Local medical institutions and government agencies implemented various preventive measures even before the first year of the outbreak and its subsequent spread. Tokyo Metropolitan Hiroo Hospital, the main hospital on the island, initially accepted all infected patients including those with suspected infection, who were transferred via emergency air transport. Vaccines have been used in clinical practice since 2021, and inoculations have been performed after careful consideration of the location and characteristics of the islands, which has led to high vaccination rates. A remarkable upsurge in cases was observed in 2022; however, the situation did not worsen, and we were able to control the emergency situation. Tokyo Metropolitan Hiroo Hospital maintained a close collaboration system for each stage of the pandemic, from hospitalizing suspected/infected patients to providing home care. We actively accepted a total of 83 emergency referrals over 3 years, and all patients （excluding a few deaths） were discharged in a good condition. Infectious disease emergencies are one of the natural disasters and have historically most frequently required countermeasures in island medical care. We have continued to add disease-specific emergency measures to our existing medical system that is operational over the years to overcome any unprecedented emergency secondary to the pandemic. [ABSTRACT FROM AUTHOR]

Aim. To study the association of the level of endothelial dysfunction marker sVCAM-1 with the severe course of COVID-19.Material and methods. The study included 100 patients with COVID-19, who were divided into 3 groups depending on the degree of lung damage based on the results of computed tomography (CT): group CT 1 – 29 patients, group CT 2 – 61 patients and the group CT 3 – 10 patients. In addition to the standard examination performed for coronavirus infection, all patients underwent carotid Doppler ultrasound, analysis of arterial stiffness indices (CAVI, ABI) using the VaSera device, and evaluation of the plasma sVCAM-1 concentration by ELISA.Results. The plasma sVCAM-1 concentration was significantly higher in the groups of patients with moderately severe (CT 2) and severe (CT 3) lung lesions than in patients with mild lesions (CT 1). In the general group of patients significant correlations were found between the plasma sVCAM-1 concentration and the level of oxygen saturation (r=-0.39, p=0.032), hospital length of stay (r=0.24, p=0.026), values of C-reactive protein (r=0.25, p=0.042), ferritin (r=0.38, p=0.021), LDH (r=0.52, p=0.015) , as well as the percentage of pulmonary involvement according to CT data at admission (r=0.41, p=0.019) and on the day of discharge (r=0.35, p=0.022). According to multivariate regression analysis, sVCAM-1 does not depend upon gender, age, body mass index (BMI), the presence of type 2 diabetes mellitus (T2DM) and hypertension, and is a marker associated with cytokine storm progression, intermediate negative dynamics according to CT data, and need for respiratory support. The presence of type 2 diabetes, as well as elevated sVCAM-1 concentrations, is associated with an increased risk of high-dose glucocorticosteroid therapy. The threshold levels of this marker were calculated for each of the above events. We revealed a correlation between the sVCAM-1 concentration and the carotid intimal medial thickness in the general group of patients (r=0.25, p=0.036).Conclusion. An increase in the plasma sVCAM-1 concentration reflects the progression of endothelial dysfunction, one of the key factors in the pathogenesis of COVID-19. The latter necessitates the need for endothelium protective therapy for these patients. The evaluation of sVCAM-1 in blood plasma is a promising diagnostic technique aimed at predicting the risk of a severe course of COVID-19 and its long-term health hazards.

Background/purpose: Although many coronavirus disease 2019 (COVID-19) vaccine injections have been administered worldwide, the safety of this practice remains unclear. This study aimed to compare the rates of complications associated with COVID-19 vaccines administered by dentists with those of vaccines administered by nurses. This study aimed to evaluate the safety of a vaccination program delivered by dentists. Materials and methods: This observational cohort study included 537 recipients of the second dose of the Pfizer COVID-19 vaccine, delivered as an intramuscular injection to the upper arm deltoid muscle by dentists or nurses at the study site. Vaccine recipients were divided into two groups according to the vaccination administrator (dentist vs. nurse groups). The rates of complications associated with intramuscular injection technique (numbness in the hand or arm at the time of the injection, vasovagal reflex at the time of the injection, vaccine-related shoulder injury, and prolonged numbness) were examined. Results: A total of 125 vaccine recipients were included (nurse group, n = 84; dentist group, n = 41). The overall incidence rate of complications was lower in the dentist group (2.4%; 1/41) than in the nurse group (8.3%; 7/84). However, this difference was not statistically significant (P = 0.3). Conclusion: This study suggests that the safety of COVID-19 vaccine administration is comparable between dentists and nurses.

Objective To investigate the situation of whole blood collection in Tianjin after COVID-19 prevention and control measures were fully lifted. Methods The relevant data on whole blood collection of voluntary blood donors in Tianjin 15 days before Spring Festival (2023.01.07-2023.01.21, when China has managed COVID-19 with measures against Class B infectious disease instead of Class A infectious diseases) and 15 days before Spring Festival in 2018 (2018.02.01- 2018.02.15) and 2019 (2019.01.21-2019.02.04) before the breakout of COVID-19 were retrospectively collected and compared. Results The comparison between the above period in 2023, 2018 and 2019 was as follows: the number of blood donors was 6 124 vs 3 940 vs 4 069; blood collection volume (U) was 9 623 vs 7 378 vs 7 808; the proportion of first-time blood donors, local blood donors and group blood donors was 69.17% (4 236/6 124) vs 65.86% (2 595/3 940) vs 62.05% (2 525/4 069), 59.31% (3 632/6 124) vs 23.27% (9170) vs 18.19% (740/4 069) and 43.42% (2 659/6 124) vs 8.05% (317/2 595) vs 0.15% (6/4 069) (all P

Background. Currently, a great body of data regarding the link between epilepsy and novel coronavirus infection (NCI) has been accumulated. Numerous studies have paid a great attention to rise in frequency and severity of epileptic seizures as well as failure of remission in individuals suffering from epilepsy.Objective: to study clinical and mental changes during NCI in patients with epilepsy.Material and methods. Fifty patients with epilepsy were examined, who were divided into two groups depending on the NCI history: Group 1 (main) – 25 patients undergone COVID-19 in the period from 2020 to 2022; Group 2 (control) – 25 patients not undergone COVID-19 during the same period. Clinical-anamnestic and psychometric methods were used as well as the following scales and questionnaires: National Hospital Seizure Severity Scale (NHS-3), Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Medical Outcomes Study Sleep Scale (MOS-SS), Multidimensional Fatigue Inventory (MFI-20).Results. In patients with epilepsy who had undergone COVID-19, there was a tendency for more frequent epileptic seizures and increased severity of seizure course. Among such patients, mild depression and more severe asthenia, cognitive impairment, moderate sleep disturbances were more common than in the control group.Conclusion. The NCI pandemic has had a pronounced negative impact on the severity of epilepsy (the underlying disease).

Relevance. The incidence of the novel coronavirus infection is on the rise worldwide. To effectively combat COVID-19, both vaccination and control of the circulation of SARS-CoV-2 strains among the population and, especially, foreign citizens arriving in Russia from around the world are necessary. Aim. To determine the frequency of detection of SARS-CoV-2 RNA in foreign medical students vaccinated against COVID-19 with various vaccine preparations. Materials and methods. Foreign students (510 people) of a medical university aged 18-25 years, vaccinated against COVID-19, who arrived in Russia during June-August 2021, were examined. The determination of SARS-CoV-2 RNA was carried out weekly from December 2021 to January 2022 by taking smears from the oropharynx and examining them using a test-PCR systems manufactured by the Federal State Budgetary Institution of the Central Research Institute of Epidemiology of Rospotrebnadzor «AmplisensCov-Bat-FL» (registration certificate No. RZN 2014/1987 dated 07.04.2020). Results. SARS-CoV-2 RNA was detected in 41 (8.0% [95% CI 5.6÷10.4]) of 510 international students surveyed. Among those vaccinated with vector vaccines based on human adenovirus (Sputnik V, Sputnik Light, Ad26. COV2.S (Johnson&Johnson)) SARS-CoV-2 RNA was detected in 27 (7.6% [95% CI 4.8÷10.4]) a person, mainly after 4–6 months. after vaccination; vaccines based on modified mRNA (BNT162b2 (Pfizer/BioNTech), mRNA1273 (Moderna)) – 5.7% [95% CI 1.1÷10.3] people within six months after vaccination. The infectious process was asymptomatic in 39 people, in two (vaccinated with the BNT162b2 vaccine (Pfizer / BioNTech) and Sputnik Light) it had clinical manifestations of severe and moderate severity. Conclusion. Among foreign students vaccinated against COVID-19, in addition to two cases, asymptomatic carriers of SARS-CoV-2 have been identified, which may be a potential source of infection. This indicates the need for vaccination and timely revaccination of foreign and Russian students, as well as compliance with the anti-epidemic regime.

Aim: to study the course of COVID-19 in patients with inflammatory bowel diseases (IBD) using the example of the region of the Republic of Tatarstan.Material and methods. The study included 101 patients diagnosed with IBD and COVID-19, who were observed in two infectious diseases hospitals in Kazan (Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan and City Clinical Hospital No. 7) and on an outpatient basis from April 2020 to March 2022. All patients underwent physical examination, laboratory and instrumental diagnostic methods, including a PCR test for SARSCoV-2. Chest computed tomography was performed in patients with clinical signs of moderate to severe COVID-19.Results. Ulcerative colitis (UC) was diagnosed in 60 (59.4 %) patients, Crohn's disease (CD) — in 41 (40.6 %) patients. The mean age of the patients was 41.0 ± 14.7 years, of which 59 (58.4 %) were men and 42 (41.6 %) were women. A comparative analysis of patients with and without IBD and CT-verified lung disease was carried out. It was found that the development of viral pneumonia was influenced by age over 55 years (39.2 ± 9.7 vs. 46.3 ± 10.6, p < 0.05), increased Body Mass Index (BMI) (23.1 ± 5.35 vs. 30.25 ± 6.17, p < 0.05), hypertension (6 (8.3 %) vs. 8 (27.6 %), p < 0.05), diabetes mellitus (2 (2.7 %) vs. 5 (17.2 %), p < 0.05), the use of corticosteroids in the treatment of IBD (8 (11.1 %) vs. 10 (34.5 %), p < 0.05). In a comparative analysis of patients with IBD and COVID-19 from the SECURE-IBD database and own data, it was found that the average age of patients was comparable (42.7 vs 41.0). At the same time, in our group of male patients, there were slightly more people with DM, increased BMI, and an active course of IBD. The proportion of hospitalized patients was higher. In our cohort, there were fewer patients receiving biological therapy, but more patients on 5-aminosalicylic acid (5-ASA) and systemic corticosteroids. At the same time, lethal outcomes were comparable.Conclusion. In patients with IBD, the development of viral pneumonia was influenced by known risk factors for COVID-19: age over 55 years (p < 0.05, odds ratio (OR) 3.153), increased BMI (p < 0.05, OR 1.667), hypertension (p < 0.05, OR 2.724), diabetes (p < 0.05, OR 1.489), as well as the use of systemic corticosteroids (p < 0.05, OR 1.5).

Introduction: The pandemic caused by the novel coronavirus (COVID-19) has produced dramatic changes in the learning environment for clinical practice in medical education, and the impact on medical students has been significant. However, few program evaluation studies involving professional identity, now emphasised in medical education, have compared current with pre-COVID-19 programs. Here, we compared the professional identity recognised by medical students in the years before and during COVID-19. Methods: Medical students who participated in clinical practice were evaluated using the Japanese version of the Professional Self-Identity Questionnaire (PSIQ), a 9-item inventory rated using 7-point Likert scales. They answered on the first day of a 4-week clinical practice module within a community-based medical education (CBME) program and at graduation in 2018-2019 (pre-COVID-19 pandemic) and in 2019-2020 (during-COVID-19 pandemic). We compared the mean difference in total PSIQ score of the 2019-2020 students to those of the 2018-2019 students as a historical cohort using an unpaired t-test. Results: Participants were 104 medical students in the 2018-2019 academic year and 92 in the 2019-2020 academic year. PSIQ was increased at graduation. Mean difference in total PSIQ score was statistically higher for the 2019-2020 students (13.5 ± 9.4) than for the 2018-2019 students (10.3 ± 8.1) (t =2.6, df =195, p = 0.01). Conclusion: Although clinical practice was restricted by COVID-19, this had some positive impact on the strengthening of professional identity recognised by medical students. This finding may have been influenced by the imprinting of professional norms and changes in society.

Introduction/Objective. The study estimates the associations between the key pandemic indicators and the allocation of COVID-19-related bonus and welfare payments to Russian healthcare workers. Methods. The study uses regression analysis. Results. The study examines two consecutive types of COVID-19-related bonus payments: (1) incentive payments (in 2020) and (2) welfare payments (in 2020–2022). Concerning incentive payments (type 1), the study supports hypotheses regarding the association between the number of persons infected with COVID-19 in a relevant region and the actual/estimated amount of budget transfers to a relevant region for bonus payments to medical workers (a) for special working conditions and additional workload and (b) for performing particularly important work. As for welfare payments (type 2), the study supports hypotheses regarding the association between (1) COVID-19 cases, (2) COVID-19 recoveries, and (3) the fiscal year-end closeout and the amount of welfare payments. Conclusion. The main channel for financing payments to medical workers is a special welfare payment through the system of the Social Insurance Fund of the Russian Federation. This source exceeds the estimated total transfers and subsidies for similar purposes in 2020. The study tests hypotheses regarding the association between the key pandemic indicators and the size of various types of budget transfers for bonus and welfare payments to medical workers.

Nutritional support is one of the comprehensive treatments for the patients with novel coronavirus infection, especially for critically ill patients. Nutritional therapy needs to follow the standard process, which includes nutritional risk screening, assessment, intervention and monitoring. Nutrition intervention is recommended to follow the principle of "five-step" of nutritional therapy. Appropriated diet and evidence-based nutritional support should be given to improve the nutritional status and immunologic function of the patients, and to get best of overall clinical outcomes.

Timely, effective, and safe antiviral therapy in COVID-19 patients reduces complications, disability and mortality rates. The greatest concern with remdesivir is the risk of drug-induced liver injury, including in patients whose liver function is compromised by COVID-19.The aim of the study was to investigate the efficacy and safety of remdesivir in patients with confirmed SARS-CoV-2 infection who had been admitted to an infectious diseases hospital in the Volgograd region in March 2022. Materials and methods: the authors carried out an open, non-randomised, single-arm study using medical records of 234 patients who had been diagnosed with “U07.1 COVID-19, virus identified” and prescribed remdesivir upon admission. The effectiveness of therapy was evaluated using two criteria: the need for oxygen supplementation or ventilatory support, or mortality. The authors conducted the evaluation on days 7, 14, and 28 using the six-point ordinal severity scale by Y. Wang et al. The safety of therapy was assessed on the basis of complaints and changes in laboratory findings.Results: for the patients prescribed remdesivir at admission, the 7-day mortality rate was 3.0%, the 14-day mortality rate was 5.6%, and the 28-day mortality rate was 7.3%. With the exception of a patient with myocardial infarction, all the patients who had been hospitalised with mild COVID-19 and prescribed remdesivir did not require oxygen therapy and/or transfer to intensive care and were discharged following recovery. The patients with moderate to severe COVID-19 had the 14-day mortality rate of 6.4% and the 28-day mortality rate of 8.6%. 17 patients (7.2%) discontinued remdesivir prematurely for various reasons, including adverse drug reactions. Remdesivir therapy of 5-10 days was associated with an increase in ALT activity by 2.7 ± 0.8 times in 15.9% of patients with mild COVID-19, by 3.8 ± 1.8 times in 20.4% of patients with moderately severe COVID-19, and by 4.8 ± 2.7 times in 24% (12/50) of patients with severe COVID-19. In two patients (0.9%), the increase exceeded 10-fold the upper limit of normal.Conclusions: the obtained results support recommending remdesivir to patients with mild, moderate and severe COVID-19, including those with moderately elevated baseline activity of hepatic transaminases.

There is considerable interest worldwide in developing safe and effective vaccines against COVID-19. Pharma-covigilance of adverse events following immunisation (AEFIs) is a key to making informed decisions regarding the global COVID-19 vaccination campaign. In the Kyrgyz Republic, there have been developed a national immunisation information system (IIS) for automated recording of vaccines, vaccinated persons, and AEFIs and a mobile application for AEFI reporting, called Den Sooluk.The aim of the study was to analyse the pattern of AEFIs against COVID-19 in the Kyrgyz Republic.Materials and methods: the study analysed the spontaneous safety reports submitted to the national IIS database through the Den Sooluk mobile application from 29.03.2021 to 25.09.2022.Results: according to the data available by 25.09.2022, the total number of vaccinated people in the country amounted to 2,940,082. At the time, the IIS database included 2111 AEFIs: 1 fatal (and coincidental), 3 severe and 2108 minor ones. AEFIs were more frequent in the young and middle-aged population (81.5%), than in the elderly (18.5%). The following AEFIs were reported: injection site pain (21.25%), fatigue (20.7%), headache (19.8%), body temperature above 38 °C (10.10%), miscellaneous symptoms (5.12%), chills (4.41%), dizziness (4.32%), sore throat (3.36%), myalgia (2.9%), and nausea (2.2%).Conclusions: all COVID-19 vaccines used in the Kyrgyz Republic can be considered adequately safe. Pharmacovigilance of AEFIs is an integral part of the requirements to ensure the safe use of vaccines, and collecting of spontaneous reports on AEFIs supports adequate functioning of the post-marketing surveillance system. It is essential to provide access to electronic information platforms to health professionals and patients in order to ensure vaccination transparency and coordination and enable quick and safe reporting of AEFIs associated with the use of COVID-19 vaccines.

Novel coronavirus infection is a highly infectious respiratory disease, which mainly affects the lungs. The progression of this disease is probably related to the excessive release of inflammatory mediators (such as cytokines), which further causes lung deterioration resulting in acute respiratory distress syndrome and respiratory failure, seriously threatening patients' lives. Pulmonary fibrosis is a long-term pulmonary sequela faced by the survivors of critical illness from novel coronavirus infection. It is also one of important risk factors leading to the aggravation of corona virus disease 2019. This article summarizes the research advances in the pathogenesis and treatment of pulmonary fibrosis after novel coronavirus infection. [ABSTRACT FROM AUTHOR]

Since the outbreak of corona virus disease 2019, deep learning has been widely used in predicting epidemic trends, screening high-risk groups and making early diagnosis. Novel coronavirus infection mainly causes pulmonary diseases, and also affects cardiovascular system, resulting in electrocardiogram (ECG) abnormalities. ECG tracking image technology is a hot spot in the research of deep learning. Compared with traditional ECG judgment methods, its accuracy and sensitivity are both higher. It can be used in the effective diagnosis, clinical decision-making and prognosis evaluation of patients with novel coronavirus infection. This paper reviews on the ECG changes after novel coronavirus infection, and the advances of ECG tracking image technology applied in the auxiliary diagnosis of novel coronavirus infection, so as to provide references for clinical healthcare workers. [ABSTRACT FROM AUTHOR]

Objective To explore the relationship between the severity of novel coronavirus infection and arrhythmia or heart rate variability (HRV). Methods We selected 178 inpatients and 30 outpatients infected with novel coronavirus. According to the diagnosis results, the inpatients were divided into mild, medium, severe, and critical novel coronavirus infection groups. The baseline data, ECG, and outcomes of the four groups were compared; ordinal Logistic regression analysis was performed. HRV indexes were compared between these outpatients and inpatients. Results The incidences of first degree atrioventricular block (Ⅰ° AVB), abnormal Q-wave, and left ventricular high voltage (LVHV) in the critical novel coronavirus infection group are all higher than those in the other three groups while the incidences of Ⅰ° AVB and LVHV in the death group are both higher than those in the good outcome group (P < 0. 05). Univariate ordinal Logistic regression analysis shows that age, sex, LVHV and Ⅰ° AVB are related to the severity of novel coronavirus infection. Multivariate ordinal Logistic regression analysis reveals that age, prolonged QTc and Ⅰ° AVB are independent risk factors for the severity of novel coronavirus infection. The SDNN and trigonometric index of the outpatients are both higher than those of the inpatients ( P < 0. 05 ). Conclusion ECG changes and HRV indexes are related to the severity of novel coronavirus infection, hospitalization rate and clinical outcome. [ABSTRACT FROM AUTHOR]

A patient with SARS-CoV-2 infection was adimitted to Shanghai Shibei hospital of Jing'an District in early 2023. According to the patient's complaits， clinical manifestations， physical symptoms， laboratory examination， radiological image results， plus lumbar puncture， the patient was diagnosed with novel coronavirus encephalitis. The patient was discharged from the hospital after a combined treatment of Chinese and western medicine.

Aim. To evaluate clinical efficacy of nucleoside analogues in therapy of moderate COVID-19 in in-patients. Materials and methods. Retrospective processing of 108 completed clinical cases with moderate novel coronavirus disease was carried out for the period 20202021. The duration of the disease at the time of admission did not exceed three days. Experimental group consisted of 53 patients who, in addition to standard therapy, were prescribed off-label riamilovir at a daily dosage of 1250 mg for 5 days by the decision of the medical commission. Comparison group included 55 patients who received a combination of umifenovir and ribavirin as antiviral therapy for 5 days. The duration of the main clinical manifestations of the disease, the indicators of clinical and biochemical blood tests, results of the SARS-CoV-2 virus RNA study using the nucleic acid amplification method (NAAT diagnostics). Results. Significantly faster achievement of clinical improvement in the group of patients treated with riamilovir was shown, as well as faster sanitation from SARS-CoV-2 virus based on the results of etiological testing. Conclusion. The use of riamilovir for the treatment of patients with moderate novel coronavirus infection (COVID-19) resulted in a significant reduction of general infectious syndromes and respiratory symptoms. Patients from the experimental group significantly faster achieved clinical recovery and sanitation from the pathogen according to the results of NAAT diagnostics.

COVID‑19 continues demonstrating possible complications after recovery. One of these complications is avascular osteonecrosis, which can lead to bone destruction and patient disability. Cases of the development of osteonecrosis associated with coronavirus infection were widely reported during and after the SARS epidemic in 2003. They also appear to be common in COVID‑19 infection. All patients who have recovered from COVID‑19 infection, especially who received glucocorticoids, are threaten of osteonecrosis development.We describe a case of bone necrosis in a healthy young woman without additional risk factors with a mild course of COVID, who received a short course of glucocorticoids.This is the first described case of COVID‑induced osteonecrosis in our country, although due to the large‑scale use of glucocorticoids, there are probably more such cases. Early diagnosis is important to prevent disease progression. Therefore, clinical alertness is necessary in all patients with COVID‑19.

Computed tomography has become the main method of early diagnostics of COVID-19 during the pandemic of the novel coronavirus infection. Based on results of computed tomography of the chest it is possible to diagnose viral pneumonia associated with COVIS-19, to quickly assess the lung damage volume and severity of changes, to perform quick routing of patients and to start antiviral treatment. Hence, 2020 was associated with a rapid increase in the number of computed tomography examinations with corresponding changes in the structure of X-ray diagnostics. The aim of the current study was to evaluate the impact of the pandemic of the novel coronavirus infection on the structure of X-ray diagnostics and collective doses from medical exposure in the Russian Federation in 2019-2020. The study was based on the results of analysis of the federal state statistical surveillance forms №3-DOZ and №30 as well as on the data on Covid-19 morbidity in the regions of the Russian Federation. The results of the study indicate that there were no significant changes in the structure of X-ray diagnostics in 2020 compared to 2019 except for the increase in the number of computed tomography examinations. Their contribution to the total number of X-ray examinations has increased to 8,2% in 2020 compared to 4,6% in 2019. Contribution of other imaging modalities to the total number of X-ray examinations has not changed significantly. In 2020 the number of X-ray examinations decreased by 20% in average, varying from 6% for diagnostic nuclear medicine to 42% for interventional examinations. At the same time, the number of computed tomography examinations has rapidly increased by 60%. The structure of collective dose from medical exposure has significantly changed in 2020. Contribution of computed tomography to the collective dose in 2020 accounted for to 74% compared to 57% in 2019. Contribution of other imaging modalities has decreased by the factor of 1,5-2. Contribution of radiography examinations has decreased to 10,5% compared to 19% in 2019. Collective doses have correspondingly decreased by 20-30% for all imaging modalities except for computed tomography. Collective dose from computed tomography has increased by 71% compared to 2019. The number of all X-ray examinations in the Russian Federation has decreased by 12%: from 294 million in 2019 to 258 million in 2020. Collective dose from medical exposure has rapidly increased in 2020 by 30% to 115 thousand man. -Sv compared to 88 thousand man. -Sv in 2019. In average, in regions of the Russian Federation in 2020 each second computed tomography examination has been performed as a part of COVID-19 diagnostics with 2,3 computed tomography examinations per person infected with COVID.

Objective: to conduct an analysis of the channels, the volume of COVID payments to medical workers and assess the preliminary effectiveness of funding for coronavirus health worker payments.Material and methods. Statistical comparative analysis of data in the field of health care funding was carried out. The assessment of changes in the level of wages of medical workers was performed using the index method and the grouping method. Relative indicators of the structure were used to evaluate the distribution of transfers by region. The study was conducted on the basis of open Rosstat data on the salaries of medical workers.Results. The regional distribution of transfers was regulated in 2020 by the Federal Government. The main channel for financing COVID payments to medical workers was the allocation of transfers and subsidies. More than half of the funding was accounted for by transfers for incentive payments to health care workers for fulfilling particularly important works. The largest share of allocated transfers fell on the Moscow Region (5.6% of the total volume of transfers), Nizhny Novgorod Region (5.1%), and Saint Petersburg (5.0%), the lowest – on the Republic of Kalmykia, the Republic of Khakassia, the Amur Region (0.2% each), the Nenets Autonomous District (0.1%). Transfers for incentive payments for special working conditions and additional workload were paid in 2020 in a total of 670 thousand persons. Transfers for incentive payments for fulfilling particularly important works were paid in a total of 363 thousand medical workers and 53 thousand ambulance drivers. An assessment of the effectiveness of financing COVID payments in the form of transfers and subsidies showed that it was largely due to them that the medical workers’ mean salary increased.Conclusion. The distribution of aggregated amounts of transfers between the constituent entities of the Russian Federation was carried out until November 2020 on the basis of the number of persons insured under Compulsory Health Insurance program in a corresponding region. In the early months of fighting the pandemic, the use of this aggregate was appropriate.

Most of the medicines used to treat the novel coronavirus infection (COVID-19) are either approved under an accelerated procedure or not approved for the indication. Consequently, their safety requires special attention.The aim of the study was to review methodological approaches to collecting data on the safety of medicines, using COVID-19 treatment regimens involving azithromycin as a case study.Materials and methods: PubMed® (MEDLINE), Scopus, eLIBRARY, and Cyberleninka databases were searched for publications on azithromycin as part of combination therapy for COVID-19 in 2020–2021. Search queries included names of the medicinal product or its pharmacotherapeutic group and words describing adverse drug reactions (ADRs) during treatment.Results: the analysis included 7 publications presenting the results of studies covering the use of azithromycin as part of COVID-19 combination therapy in more than 4000 patients. Most commonly, the patients receiving COVID-19 therapy including azithromycin developed cardiovascular ADRs (up to 30% of azithromycin prescription cases). In 3 of the analysed publications, safety information was collected through spontaneous reporting and active identification based on the findings of laboratory and instrumental investigations performed during the clinical studies; in other 3, only spontaneous reports were used; and in the last one, ADR database information was studied.Conclusion: currently, information on ADRs associated with the use of medicines is mainly gathered via spontaneous reporting. Direct sourcing of information on personal experiences with a certain product from patients, among other means through social media analysis, opens a promising direction towards the improvement of existing approaches to collecting safety data.

At the beginning of 2020, a pandemic of a novel coronavirus infection was declared in the world. Since the beginning of the pandemic, the search for drugs for etiotropic therapy as the basis for the treatment of the infectious process has begun. The review provides data on the application points of antiviral activity of drugs, taking into account the life cycle of the etiological agent – the SARS-CoV-2 virus. The mechanisms of drug action on RNA-dependent RNA polymerase (molnupiravir, remdesivir, favipiravir) and protease (nirmatrelvir together with ritonavir) SARS-CoV-2 are described. Among of outpatient patients at risk, the use of molnupiravir up to 5 days from the onset of the disease provided a 30% reduction in the risk of hospitalization and an 89% reduction in the risk of death. The use of a 10-day course of remdesivir in inpatient patients led to a reduction in the duration of clinical manifestations by 5 days, and the use of the drug for 3 days on an outpatient basis had a beneficial effect on a group of high-risk patients in the form of a reduction in the risk of hospitalization and death by 87%. Among outpatient patients using favipiravir, the onset of clinical improvement was noted 4 days earlier compared to the control group. The administration of nirmatrelvir in combination with ritonavir on an outpatient basis led to an 89% reduction in the risk of hospitalization or death. The molecular basis and principles of the use of blocking monoclonal antibodies as a fundamentally new group of biological drugs for etiotropic therapy are discussed. Information is provided on the effects of drugs on alpha, beta, gamma, delta and omicron variants of the virus. The profile of drug-drug interaction of drugs and basic therapy is analyzed. Early initiation of etiotropic therapy on an outpatient regime provides a more favorable course of the disease, which is characterized by a shorter duration of clinical manifestations, a reduced risk of hospitalization and the onset of death.

This literature review focuses on the problem of peripheral arterial thrombosis in patients with COVID-19. Russian and international recommendations for the treatment of this cohort of patients were created in the period before the pandemic and do not take into account the new genesis of the development of the disease. In turn, this leads to the ineffectiveness of the existing methods of reperfusion, aimed primarily at removing the thrombus and administering anticoagulants/antiplatelet agents. The elimination of endotheliitis, as one of the key factors of arterial thrombosis, is not always possible, which is accompanied by the development of repeated thrombosis with further unfavorable events. The lack of prospective randomized trials, as well as information in the Interim Guidelines for the Prevention, Diagnosis and Treatment of New Coronavirus Infection (COVID-19) of the Ministry of Health of the Russian Federation, where infectious coronavirus hospitals operate, creates uncertainty in the choice of methods for treating arterial thrombosis when infected with SARS-CoV -2. This trend is associated with a high rate of amputations and deaths in patients with COVID-19. To date, there is no method of revascularization in the presence of arterial thrombosis that demonstrates optimal results for patients with new coronavirus infection.

Aim. To analyze the literature data on the peculiarities of vaccination of patients with chronic liver diseases (CLD) and inflammatory bowel diseases (IBD) against COVID-19 infection.Key findings. It has been shown that many patients with CLD (cirrhosis of the liver, non-alcoholic fatty liver disease) have a higher risk of severe course of a novel coronavirus infection, which necessitates their vaccination. IBD patients are also subject to vaccination, although the immunomodulatory drugs which they take may reduce its effectiveness. In addition, the correct timing of the vaccine administration is of great importance. Vaccination of patients with CLD and IBD is safe, and the frequency of side effects during its implementation does not differ from that in the general population.Conclusion. Analysis of literature data shows that patients with CLD and IBD are subject to vaccination against COVID-19 infection, which is effective and safe.

Aim. This study aims to assess the clinical specificity of course of hypertensive disease (HD) during the first 6 months after new coronavirus infection (COVID-19) and to investigate prognostic significance of laboratory and instrumental parameters for organ dysfunctions in acute period of COVID-19 in patients with HD.Material and methods. The study included 82 patients. The main group included 50 patients with HD duration of at least 3 years, who received antihypertensive therapy and had confirmed moderate COVID-19. The control group included 32 patients with HD and without COVID-19. The mean age was 63,6±7,9 years and 66,6±10,3 years, respectively. The standard parameters of carbohydrate and lipid metabolism, inflammatory markers, hematological indicators, glomerular filtration rate (GFR) were measured, and also arterial pressure, Ps, to C, SpO2, peak expiratory flow rate (PEFR) were recorded. In 6 months we contacted by phone to conduct a survey concerning the 6-month period after hospitalization or outpatient examination with filling the questionnaire form SF-36.Results. Before inclusion, 76,5% and 83,3% of the patients in the main and control groups, respectively, took 1 hypotensive drug; 17,7% and 16,6% — 2-3 drugs; 5,9% (p