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Listeriosis and the COVID-19 pandemic 李斯特菌病与COVID-19大流行
Q4 Social Sciences Pub Date : 2022-01-01 DOI: 10.33029/2305-3496-2022-11-1-102-112
E. Klimova, O. Voronina, G. Karetkina, E.A. Posukhovsky, N. Ryzhova, M. Kunda, E. Aksenova, A. Kutuzova, T. Karpova, I. Tartakovskiy, A.Yu. Pokidysheva, T. Pronina, A. Melkumyan, O. E. Orlova, E. Burmistrova, A.A. Syrochev, S. Smetanina, N. D. Yushchuk
Listeriosis is a saprozoonotic infection that occurs when eating foods contaminated with Listeria. Invasive forms of listeriosis can have extremely severe consequences. Respiratory viral diseases predispose to the occurrence of combined viral-bacterial infections. With a mixed infection of listeriosis and COVID-19, a severe course of the disease is observed, which has a serious prognosis. The aim of the study was to analyze the frequency of various variants of invasive listeriosis and their outcomes in the period before the COVID-19 pandemic and against the background of its development, as well as to determine the genetic diversity of L. monocytogenes isolates. Material and methods. We analyzed 55 cases of invasive listeriosis in patients observed in 2018-2021 in various medical organizations in Moscow. The diagnosis was established on the basis of epidemiological, clinical and laboratory data, listeriosis was confirmed by bacteriological and molecular genetic methods, COVID-19 was confirmed by the detection of SARS-CoV-2 RNA in an oropharyngeal swab using real-time RT-PCR, as well as computed tomography of the lungs. Results. During the current COVID-19 pandemic (2020-2021), the incidence of listeriosis in pregnant women and invasive listeriosis occurring in the form of sepsis and/or lesions of the central nervous system did not differ significantly from similar indicators registered in 2018-2019. Listeria sepsis and/or meningitis/meningoencephalitis in association with severe SARS-CoV-2 novel coronavirus infection are at high risk of death. During the years of the COVID-19 pandemic, the diversity and range of L. monocytogenes genotypes in invasive listeriosis changed, new genotypes appeared that were not previously characteristic of the Russian Federation. Conclusion. The likelihood of developing listeriosis sepsis and/or meningitis/meningoencephalitis against the background of a severe course of COVID-19, and a high risk of an adverse outcome, require increased awareness of medical workers in the field of diagnosis and treatment of invasive listeriosis in order to conduct the earliest and most adequate antibiotic therapy. © 2022 Geotar Media Publishing Group. All Rights Reserved.
李斯特菌病是一种腐生人畜共患感染,当食用被李斯特菌污染的食物时发生。侵袭性李斯特菌病可造成极其严重的后果。呼吸道病毒性疾病易发生病毒-细菌联合感染。李斯特菌病与COVID-19混合感染,病程严重,预后严重。本研究旨在分析2019冠状病毒病大流行前及其发展背景下侵袭性李斯特菌病各种变异的发生频率及其结局,并确定单增李斯特菌分离株的遗传多样性。材料和方法。我们分析了莫斯科各医疗机构2018-2021年观察到的55例侵袭性李斯特菌病患者。根据流行病学、临床和实验室资料确定诊断,采用细菌学和分子遗传学方法确诊李斯特菌病,采用实时RT-PCR检测口咽拭子中SARS-CoV-2 RNA以及肺部计算机断层扫描确诊COVID-19。结果。在当前的COVID-19大流行(2020-2021年)期间,孕妇李斯特菌病和以败血症和/或中枢神经系统病变形式发生的侵袭性李斯特菌病的发病率与2018-2019年登记的类似指标没有显著差异。与严重SARS-CoV-2新型冠状病毒感染相关的李斯特菌败血症和/或脑膜炎/脑膜脑炎具有很高的死亡风险。在2019冠状病毒病大流行期间,侵袭性李斯特菌中单核细胞增生李斯特菌基因型的多样性和范围发生了变化,出现了以前俄罗斯联邦没有的新基因型。结论。在COVID-19严重病程的背景下,发生李斯特菌病、败血症和/或脑膜炎/脑膜脑炎的可能性以及不良后果的高风险,要求医务工作者提高对侵袭性李斯特菌病诊断和治疗领域的认识,以便尽早进行最充分的抗生素治疗。©2022 Geotar Media Publishing Group。版权所有。
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引用次数: 2
Trace elements: role in the development of severe forms of COVID-19 and the possibility of correction 微量元素:在COVID-19严重形式发展中的作用和纠正的可能性
Q4 Social Sciences Pub Date : 2022-01-01 DOI: 10.33029/2305-3496-2022-11-4-91-98
A. O. Romanov, M. M. Sharipova, I. A. Popova, A. Arkhangelskaia, K. Gurevich, N. Shimanovskiy
The COVID-19 pandemic has set tasks for health professionals, in particular, related to the rapid diagnosis of the disease and the provision of medical care to patients with a new coronavirus infection. All over the world, scientific work is being carried out on the study of the clinical and epidemiological characteristics of the dis-ease, the development of new means of its prevention and treatment. Epidemiological studies have identified a number of physiological and other factors that increase the risk of developing severe forms of the disease. Among them: old age, as well as concomitant diseases, including diabetes mellitus, cardiovascular diseases, chronic kidney disease and others. Changes in the balance of trace elements (ME) are considered as a risk factor for the development of severe forms of COVID-19. It is especially important that this factor can potentially be influenced, especially given the potential for replenishing the ME deficit in patients with COVID-19 for the purpose of early recovery and faster rehabilitation. © 2022 Tomsk Polytechnic University, Publishing House. All rights reserved.
COVID-19大流行为卫生专业人员提出了任务,特别是与疾病的快速诊断和向新型冠状病毒感染患者提供医疗服务有关的任务。全世界正在开展科学工作,研究该疾病的临床和流行病学特征,开发新的预防和治疗手段。流行病学研究已经确定了一些生理因素和其他因素,这些因素会增加患严重形式疾病的风险。其中:老年,以及伴随疾病,包括糖尿病、心血管疾病、慢性肾病等。微量元素(ME)平衡的变化被认为是发展为严重形式的COVID-19的危险因素。尤其重要的是,这一因素可能会受到影响,特别是考虑到COVID-19患者有可能补充ME缺陷,以实现早期恢复和更快康复。©2022托木斯克理工大学出版社。版权所有。
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引用次数: 0
Effectiveness of regional varicella vaccination programmes 区域水痘疫苗接种规划的有效性
Q4 Social Sciences Pub Date : 2022-01-01 DOI: 10.33029/2305-3496-2022-11-3-95-103
N. M. Afonina, I. Mikheeva
The article presents data on the epidemic process of varicella (chickenpox) in Moscow and the Sverdlovsk region against the background of many years of use of varicella vaccines in the implementation of regional programs for children's immunization against varicella. An estimate of the volume of varicella vaccination in these regions is given. Aim. Evaluation of the effectiveness of varicella vaccination within the framework of regional vaccination schedules in Moscow and the Sverdlovsk region for the scientific substantiation of recommendations for expanding the National Immunization Schedule of the Russian Federation. Material and methods. To assess the epidemic situation in terms of the incidence of varicella in 2006–2021, data from forms No. 2 of the Federal State Statistical Observation "Information on infectious and parasitic diseases” and forms No. 23-17 "Information on outbreaks of infectious diseases” in Moscow in 2017–2021 were used. To assess the volume of vaccination against chickenpox, we took into account the data of form No. 5 of the Federal State Statistical Observation "Information on preventive vaccinations” in the Russian Federation and certain territories in 2013–2021. We have carried out a retrospective epidemiological analysis of the distribution of the incidence of chickenpox in general on the territory of the Russian Federation, Moscow and the Sverdlovsk region. Results and discussion. In the regions of the Russia where the planned varicella vaccination of children is carried out with low coverage and the use of a single-dose immunization scheme, after the success of regional programs in the first years of their implementation, the "growing up” of infection, an increase in the incidence of varicella of children of the first year of life, and an increase in the probability of congenital forms were revealed. Against the background of a decrease in the incidence of varicella in 2020–2021, as a result of restrictive measures in organized groups, as part of the response to the COVID-19 epidemic, susceptible individuals accumulate, which allows predicting another epidemic increase in incidence. Conclusion. Based on regional experience, it is recommended to introduce 2 doses of varicella vaccination into the National Vaccination Schedule with at least 90% coverage. © Eco-Vector, 2022.
本文介绍了莫斯科和斯维尔德洛夫斯克地区水痘(水痘)流行过程的数据,背景是多年来在实施儿童水痘免疫接种区域方案中使用水痘疫苗。对这些地区的水痘疫苗接种量进行了估计。的目标。在莫斯科和斯维尔德洛夫斯克地区区域疫苗接种计划框架内评估水痘疫苗接种的有效性,以科学地证实扩大俄罗斯联邦国家免疫计划的建议。材料和方法。为了评估2006-2021年水痘发病率的流行情况,使用了2017-2021年莫斯科联邦国家统计观察表“传染病和寄生虫病信息”第2表和表23-17“传染病暴发信息”的数据。为了评估水痘疫苗接种量,我们参考了俄罗斯联邦和某些地区2013-2021年联邦国家统计观察表“预防性疫苗接种信息”第5表的数据。我们对俄罗斯联邦、莫斯科和斯维尔德洛夫斯克地区水痘发病率的总体分布情况进行了回顾性流行病学分析。结果和讨论。在俄罗斯的一些地区,计划中的儿童水痘疫苗接种覆盖率低,使用单剂免疫方案,在实施的头几年区域方案取得成功后,感染的“增长”、一岁儿童水痘发病率的增加以及先天性形式的可能性的增加都显示出来。在2020-2021年水痘发病率下降的背景下,作为应对COVID-19流行病的一部分,在有组织的群体中采取了限制性措施,易感个体不断积累,从而可以预测发病率将再次增加。结论。根据区域经验,建议在国家疫苗接种计划中引入2剂水痘疫苗接种,覆盖率至少为90%。©Eco-Vector, 2022。
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引用次数: 1
Clinical and laboratory manifestations and pathological anatomical picture of a severe course of a new coronavirus infection COVID-19 with a fatal outcome 新型冠状病毒感染COVID-19致死性重症病程的临床、实验室表现及病理解剖图
Q4 Social Sciences Pub Date : 2022-01-01 DOI: 10.33029/2305-3496-2022-11-4-30-37
R. Abdullaev, O. Komissarova, M. Rybka, E.M. Greсov, L. A. Semenova, Y. Berezovsky
Aim - to study the clinical and laboratory manifestations of a severe course of COVID-19 in a lethal outcome with an assessment of the pathomorphological picture based on autopsy material. Material and methods. A retrospective analysis of demographic, clinical and laboratory parameters, as well as the results of a pathoanatomical study of 54 patients with severe COVID-19 who died in the intensive care unit, was carried out. Results. Among the patients included in the study, women and men were equally divided. The mean age was 73.1+/-1.86 years (median 73 years). An increase in body temperature above 38 degreeS was observed in 81.5% of cases, weakness - in 70.4%, dry cough - in 46.3%, a feeling of lack of air - in 46.3%, muscle pain - in 40.7%. The volume of lung damage by the type of bilateral polysegmental pneumonia with areas of compaction of the type of "frosted glasses" and consolidation was more than 75.0% and was determined in 68.5% of patients. Concomitant diseases were detected in 94.4% of patients. It was found that all patients had a pronounced systemic inflammatory response, as evidenced by an increase in the level of C-reactive protein and procalcitonin in all patients. A decrease in albumin levels was observed in 88.9% of cases. A hypercoagulable shift with intravascular coagulation was noted. Morphological studies revealed damage to the lungs, liver, kidneys and pancreas with the development of thrombovascular changes. Conclusion. A severe course of COVID-19 with a fatal outcome was observed in older patients with clinical, radiological and laboratory manifestations of a systemic inflammatory response, which was accompanied by damage to various organs and systems.Copyright © Authors, 2022.
目的:通过基于尸检材料的病理形态学图像评估,研究COVID-19严重病程致死性结局的临床和实验室表现。材料和方法。回顾性分析了54例在重症监护病房死亡的重症COVID-19患者的人口学、临床和实验室参数以及病理解剖研究结果。结果。在参与研究的患者中,男女比例相等。平均年龄73.1±1.86岁(中位73岁)。81.5%的患者体温高于38度,70.4%的患者身体虚弱,46.3%的患者干咳,46.3%的患者感到缺乏空气,40.7%的患者感到肌肉疼痛。双侧多节段性肺炎伴“磨砂玻璃”型压实区和实变区肺损伤体积大于75.0%,68.5%的患者确定肺损伤体积。94.4%的患者并发疾病。结果发现,所有患者都有明显的全身炎症反应,所有患者的c反应蛋白和降钙素原水平均有所升高。88.9%的病例出现白蛋白水平下降。高凝转移伴血管内凝血。形态学研究显示肺、肝、肾和胰腺损伤伴血栓血管改变。结论。老年患者出现系统性炎症反应的临床、放射学和实验室表现,并伴有各器官和系统的损伤。版权所有©作者,2022。
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引用次数: 0
The use of neutralizing monoclonal antibodies against SARS-CoV-2 in hemodialysis patients 抗SARS-CoV-2中和性单克隆抗体在血液透析患者中的应用
Q4 Social Sciences Pub Date : 2022-01-01 DOI: 10.33029/2305-3496-2022-11-4-38-46
E. Volodina, N. Frolova, M. Lysenko, I.G. Kim, A. Ushakova, V. Vinogradov, S. S. Usatiuk, A. Nikitina, U. Markina, V. I. Chervinko, E. Kryukov, M. Zubkin
Patients with end-stage kidney disease undergoing hemodialysis have one of the highest COVID-19 mortality rates. The use of innovative methods capable of optimizing their treatment outcomes is important for clinical practice. Aims – to investigate the efficacy and safety of neutralizing monoclonal antibodies in COVID-19 patients treated with hemodialysis. Material and methods. We conducted a retrospective controlled single-center study with 102 COVID-19 patients on maintenance hemodialysis involved (M: 67;65.7%;W: 35;34.3%), aged 57.2±15.3 years. PCR-detected SARS-CoV-2 infection was diagnosed in all patients. Neutralizing monoclonal antibodies were administered to 69 patients, who formed the study group (group 1). The control group included 33 patients (group 2). The combination of bamlanevimab and etesevimab was the most frequent therapy used (in 59 patients). Results. In the course of the disease, group 1 patients, compared to those of group 2, had statistically significantly higher blood oxygen saturation values (94.2±5.7 vs 89.8±10.7);they required less frequent oxygen support (29.0 vs 54.5%) and ICU treatment (18.8 vs 48.5%), respectively. Fatal outcomes occurred in 4 (5.8%) of 69 patients who received neutralizing antibodies and in 6 (18.2%) of 33 patients who did not receive the therapy, p<0.05. Except for one patient, all other patients in both groups developed an unfavorable outcome due to progressive lung damage. However, only 4 of 6 (2/3) patients with progressive lung damage died in group 1, whereas the similar course of the disease proved fatal in all cases in group 2. Conclusion. The use of neutralizing monoclonal antibodies in hemodialysis patients is safe and effective when the drugs are administered early, the pulmonary process progression is insignificant and dominant SARSCoV-2 variants are sensitive to them. © 2022 Tomsk Polytechnic University, Publishing House. All rights reserved.
接受血液透析的终末期肾病患者是COVID-19死亡率最高的患者之一。使用能够优化其治疗结果的创新方法对临床实践很重要。目的:探讨中和性单克隆抗体在血液透析治疗的COVID-19患者中的疗效和安全性。材料和方法。我们对102例参与维持性血液透析的COVID-19患者进行了回顾性对照单中心研究(男:67例;65.7%;女:35例;34.3%),年龄57.2±15.3岁。所有患者均经pcr检测为SARS-CoV-2感染。给予69例患者中和性单克隆抗体,组成研究组(1组)。对照组包括33例患者(2组)。bamlanevimab和etesevimab联合使用是最常用的治疗方法(59例)。结果。在病程中,1组患者的血氧饱和度(94.2±5.7 vs 89.8±10.7)高于2组患者,需要更少的氧支持(29.0 vs 54.5%)和ICU治疗(18.8 vs 48.5%)。69例接受中和抗体治疗的患者中有4例(5.8%)死亡,33例未接受中和抗体治疗的患者中有6例(18.2%)死亡,p<0.05。除1例患者外,两组中所有其他患者均因进行性肺损伤而出现不良结果。然而,在第1组中,6例进行性肺损伤患者中只有4例(2/3)死亡,而在第2组中,病程相似的所有病例均死亡。结论。在血液透析患者中使用中和性单克隆抗体是安全有效的,前提是早期给药,肺过程进展不显著,显性SARSCoV-2变异对它们敏感。©2022托木斯克理工大学出版社。版权所有。
{"title":"The use of neutralizing monoclonal antibodies against SARS-CoV-2 in hemodialysis patients","authors":"E. Volodina, N. Frolova, M. Lysenko, I.G. Kim, A. Ushakova, V. Vinogradov, S. S. Usatiuk, A. Nikitina, U. Markina, V. I. Chervinko, E. Kryukov, M. Zubkin","doi":"10.33029/2305-3496-2022-11-4-38-46","DOIUrl":"https://doi.org/10.33029/2305-3496-2022-11-4-38-46","url":null,"abstract":"Patients with end-stage kidney disease undergoing hemodialysis have one of the highest COVID-19 mortality rates. The use of innovative methods capable of optimizing their treatment outcomes is important for clinical practice. Aims – to investigate the efficacy and safety of neutralizing monoclonal antibodies in COVID-19 patients treated with hemodialysis. Material and methods. We conducted a retrospective controlled single-center study with 102 COVID-19 patients on maintenance hemodialysis involved (M: 67;65.7%;W: 35;34.3%), aged 57.2±15.3 years. PCR-detected SARS-CoV-2 infection was diagnosed in all patients. Neutralizing monoclonal antibodies were administered to 69 patients, who formed the study group (group 1). The control group included 33 patients (group 2). The combination of bamlanevimab and etesevimab was the most frequent therapy used (in 59 patients). Results. In the course of the disease, group 1 patients, compared to those of group 2, had statistically significantly higher blood oxygen saturation values (94.2±5.7 vs 89.8±10.7);they required less frequent oxygen support (29.0 vs 54.5%) and ICU treatment (18.8 vs 48.5%), respectively. Fatal outcomes occurred in 4 (5.8%) of 69 patients who received neutralizing antibodies and in 6 (18.2%) of 33 patients who did not receive the therapy, p<0.05. Except for one patient, all other patients in both groups developed an unfavorable outcome due to progressive lung damage. However, only 4 of 6 (2/3) patients with progressive lung damage died in group 1, whereas the similar course of the disease proved fatal in all cases in group 2. Conclusion. The use of neutralizing monoclonal antibodies in hemodialysis patients is safe and effective when the drugs are administered early, the pulmonary process progression is insignificant and dominant SARSCoV-2 variants are sensitive to them. © 2022 Tomsk Polytechnic University, Publishing House. All rights reserved.","PeriodicalId":36113,"journal":{"name":"Infectious Diseases: News, Opinions, Training","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69484827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical case of co-infection: COVID19 and invasive meningococcal infection 新冠肺炎合并侵袭性脑膜炎球菌感染临床1例
Q4 Social Sciences Pub Date : 2022-01-01 DOI: 10.33029/2305-3496-2022-11-3-151-155
O. Samodova, E. Krieger, N. Rogushina
In light of the current pandemic, doctors need to raise the suspicion of concurrent SARS-CoV-2 infection with Neisseria meningitides infection. In this article we reported a case of invasive meningococcal infection in an adolescent with COVID-19. Severity of the disease depended on septic shock due to invasive meningococcal infection associated with sepsis and meningitis. The differential diagnosis with a multisystem inflammatory syndrome was tricky considering the fever, shock, meningeal symptoms, elevated levels of C-reactive protein and D-dimer, patient age, and a positive test for SARS-CoV-2. The disease outcome was good. Given the risk of invasive forms of meningococcal infection, the possible synergy of SARS-CoV-2 and Neisseria meningitidis, the complexity of differential diagnosis in patients in critical condition, immunization against meningococcal infection should be carried out according to epidemic indications, despite the COVID-19 pandemic. © 2022 Sorbtsionnye i Khromatograficheskie Protsessy. All rights reserved.
鉴于目前的大流行,医生需要提出SARS-CoV-2感染与脑膜炎奈瑟菌感染同时发生的怀疑。在本文中,我们报告了一例患有COVID-19的青少年侵袭性脑膜炎球菌感染。疾病的严重程度取决于脓毒症和脑膜炎相关的侵袭性脑膜炎球菌感染引起的脓毒性休克。考虑到发烧、休克、脑膜症状、c反应蛋白和d -二聚体水平升高、患者年龄以及SARS-CoV-2检测呈阳性,多系统炎症综合征的鉴别诊断非常棘手。治疗结果良好。考虑到侵袭性脑膜炎球菌感染的风险、SARS-CoV-2和脑膜炎奈瑟菌可能的协同作用以及危重患者鉴别诊断的复杂性,尽管2019冠状病毒病大流行,仍应根据流行指征开展脑膜炎球菌感染免疫接种。©2022 Sorbtsionnye i Khromatograficheskie protesessy。版权所有。
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引用次数: 0
Features of the diagnosis and course of COVID-19 in HIV-infected patients hospitalized in a hospital 某医院hiv感染者COVID-19诊断及病程特点
Q4 Social Sciences Pub Date : 2022-01-01 DOI: 10.33029/2305-3496-2022-11-3-44-51
A. S. Sycheva, M. Nagibina, K.A. Uryanskaya, A. Solodov, A. L. Kebinа, I. Semeniakin, O. Levchenko, O. Yanushevich
The global pandemic of coronavirus infection (COVID-19) has set complex diagnostic tasks for doctors of polyclinics and hospitals. Considering the simultaneous pandemic spread of two infectious diseases – COVID-19 and HIV infection, the problem of studying the clinical features of combined COVID-19/HIV infection becomes urgent. The aim of the study was to determine the features of the diagnosis and course of COVID-19 against the background of HIV infection in patients undergoing inpatient treatment. Material and methods. The study was conducted on the basis of the temporary Clinical Medical Center COVID-19 of the A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation in Moscow from October 2020 to January 2022. The study included 31 233 patients with COVID-19 complicated by pneumonia. To analyze the features of the course of combined COVID-19/HIV infection, a group of 51 HIV-infected patients was identified. The diagnosis of COVID-19 was determined based on the detection of SARS-CoV-2 RNA by PCR in nasal/oropharyngeal smears and/or according to computed tomography of the lungs (CT). During the study, age, gender, anamnesis, objective examination data were analyzed, taking into account the results of CT scans of the chest organs, data from routine laboratory blood tests, oxygen support regimens, treatment outcomes and duration of detection of SARS-CoV-2 RNA. All patients were treated according to the Temporary Clinical Guidelines for the Diagnosis and Treatment of COVID-19, 14 version dated 12/27/2021. Results. The number of patients with combined HIV infection and SARS-CoV-2 out of the total number of hospitalized COVID-19 patients (n=31 233) was 0.16%. Upon admission, 30 (59%) patients reported having HIV infection and receiving antiretroviral therapy (ART). HIV infection was first diagnosed in 21 patients at 2–3 weeks of inpatient treatment. The average age of patients with SARS-Cov-2/HIV co-infection was 1.5 times less than in patients without HIV (41.1±5.3 and 64.4±10.1, respectively) (p≤0.05). Concomitant pathology (hypertension, type 2 diabetes mellitus, chronic kidney disease and chronic lung diseases) was less common (51%) in the group of combined infection than in the group without HIV (83%). However, in 41% of patients with coinfection, chronic viral hepatitis B, C was detected, in contrast to 0.3% of cases of COVID-19 patients without HIV. 26 (51%) patients were discharged with improvement, while the average bed-day did not differ from patients without HIV infection (13.4±4.5 days and 11.7±5.2, respectively) (p≥0.05). 7 (24%) patients at the time of discharge (16.8±4.2 days) with clinical and laboratory improvement maintained a positive result of PCR RNA on SARS-Cov-2. In 22 (43%) patients with coinfection, hospitalization was fatal for 3 to 21 days of treatment, with ARDS with respiratory and multiple organ failure, which is 3.6 times higher than in patients without HI
冠状病毒感染(COVID-19)全球大流行给综合诊所和医院的医生带来了复杂的诊断任务。考虑到COVID-19和HIV感染两种传染病同时大流行的情况,研究COVID-19/HIV合并感染的临床特征成为当务之急。本研究的目的是在住院患者感染艾滋病毒的背景下确定COVID-19的诊断和病程特征。材料和方法。该研究是在2020年10月至2022年1月期间在俄罗斯联邦卫生部莫斯科国立医学和牙科大学人工智能叶夫多基莫夫COVID-19临时临床医学中心的基础上进行的。该研究纳入了31 233例新冠肺炎合并肺炎患者。为分析COVID-19/HIV合并感染的病程特点,对51例HIV感染患者进行鉴定。根据鼻/口咽涂片PCR检测SARS-CoV-2 RNA和/或肺部计算机断层扫描(CT)确定COVID-19的诊断。在研究期间,考虑到胸部器官的CT扫描结果、常规实验室血液检查数据、氧支持方案、治疗结果和检测SARS-CoV-2 RNA的持续时间,分析了年龄、性别、记忆、客观检查数据。所有患者均按照2021年12月27日《新冠肺炎临时临床诊疗指南第14版》进行治疗。结果。合并HIV感染和SARS-CoV-2患者占COVID-19住院总人数(n=31 233人)的0.16%。入院时,30名(59%)患者报告感染了艾滋病毒并接受了抗逆转录病毒治疗(ART)。21名患者在住院治疗2-3周后首次被诊断出感染艾滋病毒。SARS-Cov-2/HIV合并感染患者的平均年龄是未感染患者的1.5倍(分别为41.1±5.3和64.4±10.1),差异有统计学意义(p≤0.05)。合并感染组的合并病理(高血压、2型糖尿病、慢性肾脏疾病和慢性肺部疾病)(51%)低于未感染HIV组(83%)。然而,在41%的合并感染患者中检测到慢性病毒性乙型和丙型肝炎,而在未感染艾滋病毒的COVID-19患者中,这一比例为0.3%。26例(51%)患者出院后病情好转,平均住床天数与未感染HIV的患者无显著差异(分别为13.4±4.5天和11.7±5.2天)(p≥0.05)。7例(24%)临床和实验室改善的患者出院时(16.8±4.2 d) PCR - RNA检测结果均为阳性。在22例(43%)合并感染的患者中,住院治疗3至21天是致命的,ARDS合并呼吸和多器官衰竭,比未感染HIV的患者高3.6倍。分析显示,无论SARS-CoV-2 RNA PCR结果如何,在非专科医院,发热超过14天、CT显示双侧间质改变形式肺损伤、有慢性丙型肝炎、乙型肝炎病史、在COVID-19治疗背景下病情逐渐严重的年轻患者都需要进行HIV检测。早期咨询传染病专家,通过PCR检查痰/灌洗液检查机会性感染病原体,预约ART和药物治疗机会性疾病,将提高非核心HIV医院患者的医疗质量,改善COVID-19的预后。©Eco-Vector, 2022。
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引用次数: 0
Mechanisms of olfactory impairment in COVID-19: a systematic review COVID-19嗅觉损伤机制的系统综述
Q4 Social Sciences Pub Date : 2022-01-01 DOI: 10.33029/2305-3496-2022-11-2-8-13
A. Medeulova, K. Zhapar, D. Kussainova
One of the symptoms of a new coronavirus infection (COVID-19) is a complete or partial violation of the sense of smell. The aim of the work is to analyze the published results of scientific research on the mechanisms of olfactory impairment in COVID-19. Material and methods. Research was conducted for publications in Pubmed on the problem of olfactory impairment in COVID-19 using terms indexed by MeSH. The systematic review was compiled in accordance with the checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). Results. Publication’s analysis has shown that the existing ideas about conductive anosmia are insufficient to explain the causes of olfactory impairment caused by SARS-CoV-2. It has been established that ACE2 and TMPRSS2 receptors located on the surface of target cells are necessary for the penetration of a new coronavirus. It is known that these receptors are mainly located on the cells of the olfactory epithelium. The main hypothesis of olfactory impairment in COVID-19 is that anosmia/hyposmia is caused by damage not to neuronal cells (as previously assumed), but to the olfactory epithelium. There is no confirmation of the point of view about the damage of SARS-CoV-2 olfactory bulbs and olfactory neurons, since they do not express receptor proteins for the virus on their surface. © 2022 by the authors.
新型冠状病毒感染(COVID-19)的症状之一是完全或部分丧失嗅觉。本研究的目的是对已发表的关于新冠肺炎嗅觉损伤机制的科学研究结果进行分析。材料和方法。使用MeSH索引的术语对Pubmed上发表的关于COVID-19嗅觉损伤问题的出版物进行了研究。根据系统评价和荟萃分析声明首选报告项目清单(PRISMA)编制系统评价。结果。《出版物》的分析表明,现有的传导性嗅觉缺失理论不足以解释新冠病毒导致嗅觉损伤的原因。已经确定,位于靶细胞表面的ACE2和TMPRSS2受体是新型冠状病毒渗透所必需的。已知这些受体主要位于嗅上皮细胞上。关于COVID-19嗅觉障碍的主要假设是嗅觉缺失/嗅觉减退不是由神经元细胞损伤引起的(如先前假设的那样),而是由嗅觉上皮损伤引起的。关于SARS-CoV-2嗅球和嗅觉神经元受损的观点还没有得到证实,因为它们的表面不表达病毒的受体蛋白。©2022作者所有。
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引用次数: 0
Results of screening examination of employees of a medical hospital for antibodies to SARS-CoV-2 某医院职工SARS-CoV-2抗体筛查检查结果
Q4 Social Sciences Pub Date : 2022-01-01 DOI: 10.33029/2305-3496-2022-11-1-28-33
R. F. Sayfullin, S. K. Pylaeva, D. O. Sinyavkin
While providing medical care to patients with a new coronavirus infection, medical workers are at risk of developing COVID-19 significantly more often than the general population. In addition to morbidity risks, an important question is the duration of the immune response to COVID-19. The aim of our study is to assess the incidence of COVID-19 and the duration of the persistence of anti-SARS-CoV-2 antibodies among hospital medical staff. Material and methods. We conducted a retrospective non-randomized single-center study, based on the analysis of the laboratory database of the Municipal Clinical Hospital No. 52 (Moscow). The results of the 2160 employees were included into analysis. The inclusion criteria were as follows: at least one result of antibody determination to SARS-CoV-2 in period from June 2020 to January 2021;the date of the last antibody determination to SARS-CoV-2 no earlier than November 1, 2020. Additionally, a group of 100 employees were selected for further investigation of the persistence of immunoglobulin G (IgG) antibodies to SARS-CoV-2. Additionally, a group of 100 employees was selected, who had a confirmed fact of seroconversion for IgG and the presence of at least three results of IgG to SARS-CoV-2 determination with an interval of at least 4 weeks. Results. According to IgG determination results, by January 2021, 66.6% of all hospital employees have already been ill with COVID-19. The medical staff who worked with patients with COVID-19 been ill with COVID-19 in 78.2% of cases. The share of sick medical personnel who did not work with this group of patients was 55.3%. The first termination of antibodies persistence to SARS-CoV-2 from employees was marked from 3-4 months of observation. After 7-9 months, 23% of the observed group became seronegative. Odds ratio for the risk of COVID-19 for medical staff, who worked with COVID-19 patients was 2.89 (95% CI 2.34-3.56) to other medical staff and 3.6 (95% CI 2.82-4.59) to non-medical staff. Conclusion. The incidence of COVID-19 and the risk of infection among medical workers is significantly higher than among the general population, which dictates the need of further improvement of COVID-19 prevention measures among medical workers. © 2022 by the authors.
医务工作者在为新型冠状病毒感染患者提供医疗服务的同时,患COVID-19的风险要比普通人群高得多。除了发病风险外,一个重要的问题是对COVID-19的免疫反应的持续时间。本研究的目的是评估医院医务人员中COVID-19的发病率和抗sars - cov -2抗体的持续时间。材料和方法。我们基于对莫斯科第52市临床医院实验室数据库的分析,进行了一项回顾性非随机单中心研究。2160名员工的结果被纳入分析。纳入标准为:在2020年6月至2021年1月期间至少有一次SARS-CoV-2抗体检测结果,最后一次SARS-CoV-2抗体检测日期不早于2020年11月1日。此外,还选择了100名员工,进一步调查SARS-CoV-2免疫球蛋白G (IgG)抗体的持久性。此外,还选择了一组100名员工,他们已确认IgG血清转化事实,并且至少有三次IgG对SARS-CoV-2的检测结果,间隔至少为4周。结果。根据IgG检测结果,截至2021年1月,66.6%的医院员工已感染COVID-19。与新冠肺炎患者一起工作的医务人员感染新冠肺炎的比例为78.2%。不与这组患者一起工作的患病医务人员的比例为55.3%。在3-4个月的观察中,员工对SARS-CoV-2的抗体持久性首次终止。7-9个月后,23%的观察组血清呈阴性。与COVID-19患者一起工作的医务人员与其他医务人员的COVID-19风险比值比为2.89 (95% CI 2.34-3.56),与非医务人员的比值比为3.6 (95% CI 2.82-4.59)。结论。医务人员的新冠肺炎发病率和感染风险明显高于普通人群,医务人员的新冠肺炎预防措施需要进一步完善。©2022作者所有。
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引用次数: 1
Diversity of circulating rotavirus strains before and after the introduction of rotavirus vaccine 引入轮状病毒疫苗前后循环轮状病毒株的多样性
Q4 Social Sciences Pub Date : 2022-01-01 DOI: 10.33029/2305-3496-2022-11-4-77-81
A. Nazurdinov, F. Tishkova, R. Tursunov
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引用次数: 0
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Infectious Diseases: News, Opinions, Training
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