Pub Date : 2022-01-01DOI: 10.20953/1729-9225-2022-1-32-41
L. Mazankova, I. Osmanov, E. Samitova, M. Antsupova, I. Afukov, A. Malakhov, N. V. Loban, N. Dracheva, A. A. Volter
Objective. To analyze the accumulated clinical experience in the management of patients with severe and extremely severe forms of COVID-19 coronavirus infection using biological therapy with an assessment of its efficacy and safety. Patients and methods. Forty-seven patients with severe and extremely severe COVID-19 infection were under observation, who were prescribed biological therapy with tocilizumab according to indications. All patients underwent a complete comprehensive clinical, laboratory and instrumental examination based on the current clinical protocol for the treatment of children with COVID-19 coronavirus infection. Results. Before and after biological therapy, no significant differences in the parameters of complete blood count and urinalysis were obtained. The study of biochemical blood parameters and coagulogram in dynamics showed a significant decrease in the levels of LDH and CPK, as well as inflammatory markers CRP and PCT, fibrinogen. Most patients had extremely high levels of proinflammatory cytokine IL-6 in the acute period of the disease, which decreased by 3.5 times after biological therapy, on average, 3–5 days after the start of treatment with tocilizumab, which coincided with a clinical improvement in the condition of patients. Prolonged SARS-CoV-2 isolation was noted according to nasopharyngeal smear PCR in 37 (88%) children up to 3–5 days after tocilizumab administration and in 10 (21%) patients over 10–14 days. On days 3–5 after the application of biological therapy, there was a decrease in the volume of lung damage to 50.7 ± 26.9% on average [0; 90], however, by 10–14 days, most patients still had signs of viral pneumonia up to 50.2 ± 27.2% of lung damage [0; 80] without clinical manifestations. Conclusion. After tocilizumab administration, most children with severe COVID-19 showed clinical and laboratory improvement in the form of normalized body temperature and reduced severity of intoxication syndrome, a 3.5-fold decrease in the level of IL-6, a decrease in the values of markers of systemic inflammation (CRP, PCT, fibrinogen) with a significant increase in antibody titer to SARS-CoV-2 IgM/IgG, in connection with which further observation was carried out by specialists at the outpatient stage. Key words: children, SARS-CoV-2, COVID-19, tocilizumab
{"title":"Experience in the use of biological therapy (tocilizumab) in children with severe forms of COVID-19","authors":"L. Mazankova, I. Osmanov, E. Samitova, M. Antsupova, I. Afukov, A. Malakhov, N. V. Loban, N. Dracheva, A. A. Volter","doi":"10.20953/1729-9225-2022-1-32-41","DOIUrl":"https://doi.org/10.20953/1729-9225-2022-1-32-41","url":null,"abstract":"Objective. To analyze the accumulated clinical experience in the management of patients with severe and extremely severe forms of COVID-19 coronavirus infection using biological therapy with an assessment of its efficacy and safety. Patients and methods. Forty-seven patients with severe and extremely severe COVID-19 infection were under observation, who were prescribed biological therapy with tocilizumab according to indications. All patients underwent a complete comprehensive clinical, laboratory and instrumental examination based on the current clinical protocol for the treatment of children with COVID-19 coronavirus infection. Results. Before and after biological therapy, no significant differences in the parameters of complete blood count and urinalysis were obtained. The study of biochemical blood parameters and coagulogram in dynamics showed a significant decrease in the levels of LDH and CPK, as well as inflammatory markers CRP and PCT, fibrinogen. Most patients had extremely high levels of proinflammatory cytokine IL-6 in the acute period of the disease, which decreased by 3.5 times after biological therapy, on average, 3–5 days after the start of treatment with tocilizumab, which coincided with a clinical improvement in the condition of patients. Prolonged SARS-CoV-2 isolation was noted according to nasopharyngeal smear PCR in 37 (88%) children up to 3–5 days after tocilizumab administration and in 10 (21%) patients over 10–14 days. On days 3–5 after the application of biological therapy, there was a decrease in the volume of lung damage to 50.7 ± 26.9% on average [0; 90], however, by 10–14 days, most patients still had signs of viral pneumonia up to 50.2 ± 27.2% of lung damage [0; 80] without clinical manifestations. Conclusion. After tocilizumab administration, most children with severe COVID-19 showed clinical and laboratory improvement in the form of normalized body temperature and reduced severity of intoxication syndrome, a 3.5-fold decrease in the level of IL-6, a decrease in the values of markers of systemic inflammation (CRP, PCT, fibrinogen) with a significant increase in antibody titer to SARS-CoV-2 IgM/IgG, in connection with which further observation was carried out by specialists at the outpatient stage. Key words: children, SARS-CoV-2, COVID-19, tocilizumab","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","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":"67727303","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}
Pub Date : 2022-01-01DOI: 10.20953/1729-9225-2022-1-5-15
S. Petrikov, M. Godkov, A. Kanibolotsky, N.S. Dyakun, A. Shabanov, V. Kulabukhov, A. Leinsoo, A. Bazhenov
The aim of this research work was to study the ability of SARS-CoV-2 to persist in multiple organs of people who have recovered from COVID-19. For this purpose, autopsy material was used from patients with a history of COVID-19 who died from causes unrelated to a new coronavirus infection. Autopsy material collected from 11 different organs was analyzed for the presence of SARS-CoV-2 RNA using real-time polymerase chain reaction (RT-PCR). Among the organs tested, SARS-CoV-2 RNA persisted longest in the bronchi and lungs. Thus, in both patients tested positive more than 100 days after recovery, SARS-CoV-2 RNA was detected only in the bronchi and lungs. On the contrary, the shorter the recovery time was, the more organs were found to have SARS-Cov-2 RNA. SARS-CoV-2 RNA was most frequently detected in biomaterials of deceased people over 80 years of age, which may indicate a longer period of virus elimination in the elderly. No correlation between the distribution of SARS-CoV-2 across organs and the age of patients could be detected, but it was shown that SARS-CoV-2 persisted in more organs in males after recovery. In females, SARS-CoV-2 RNA was found predominantly in the bronchi and lungs. Key words: SARS-CoV-2, autopsy material, real-time polymerase chain reaction
{"title":"Results of RT-PCR test for the presence of SARS-CoV-2 in multiple organs of post-COVID patients who died from causes other than COVID-19","authors":"S. Petrikov, M. Godkov, A. Kanibolotsky, N.S. Dyakun, A. Shabanov, V. Kulabukhov, A. Leinsoo, A. Bazhenov","doi":"10.20953/1729-9225-2022-1-5-15","DOIUrl":"https://doi.org/10.20953/1729-9225-2022-1-5-15","url":null,"abstract":"The aim of this research work was to study the ability of SARS-CoV-2 to persist in multiple organs of people who have recovered from COVID-19. For this purpose, autopsy material was used from patients with a history of COVID-19 who died from causes unrelated to a new coronavirus infection. Autopsy material collected from 11 different organs was analyzed for the presence of SARS-CoV-2 RNA using real-time polymerase chain reaction (RT-PCR). Among the organs tested, SARS-CoV-2 RNA persisted longest in the bronchi and lungs. Thus, in both patients tested positive more than 100 days after recovery, SARS-CoV-2 RNA was detected only in the bronchi and lungs. On the contrary, the shorter the recovery time was, the more organs were found to have SARS-Cov-2 RNA. SARS-CoV-2 RNA was most frequently detected in biomaterials of deceased people over 80 years of age, which may indicate a longer period of virus elimination in the elderly. No correlation between the distribution of SARS-CoV-2 across organs and the age of patients could be detected, but it was shown that SARS-CoV-2 persisted in more organs in males after recovery. In females, SARS-CoV-2 RNA was found predominantly in the bronchi and lungs. Key words: SARS-CoV-2, autopsy material, real-time polymerase chain reaction","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","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":"67727491","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}
Pub Date : 2022-01-01DOI: 10.20953/1729-9225-2022-2-16-22
V. Akimkin, O. Levin, A. Ploskireva, A. Gorelov, A. Komarova, A. Litvinenko, N. Krivosheeva, I. O. Tinkova
New coronavirus infection (COVID-19) is highly contagious viral disease caused by SARS-CoV-2 leading to the pandemic. The autopsy of COVID-19 patients often showed features of previous brain diseases including neurodegeneration, previous strokes, demyelinating diseases and atherosclerosis. Patients with acute cerebrovascular accidents and severe COVID-19 had higher numbers of lethality in comparison to non-severe course of infection without cerebrovascular accidents. A comparative analysis of morphological changes in lungs of deceased patients who died in different periods of first clinical symptoms is to be conducted. Objective. Description of pathomorphological changes in deceased patients during the period of reconvalescence. Patients and methods. The analysis of 15 fatal cases which took place in Botkin Hospital with the diagnosis of ischemic stroke and new coronavirus infection in the previous 2-4 months has been held. Macro and microscope examination of brain, lungs, brachiocephalic arteries, kidneys and liver has been carried out. Results. All patients had morphological features of ischemic damage of grey matter in the brain. Beside necrosis of neurocytes with diffuse infiltration in the grey matter, hematoxylin cycles were found, in some cases they were placed in a perivascular way in choroid plexus. Also 5 patients suffered a myocardial infarction up to 3 days. 10 patients had structures disorganisation in areas of lung parenchyma with hystoacrchitectonic changes because of the fibrosis. Alveoli in some places collaborated mostly with single airway clearance. The fact that most patients had lung hemosiderosis can prove coronavirus infection suffered earlier with microcirculatory bed damage. Conclusion. Thus, morphological changes seen in the period of reconvalescence of COVID-19 is a result of pathomorphosis of changes described earlier for acute period of coronavirus infection and affect not only lungs, but also other organs and tissues. This proves systematic characteristic of the infection. Key words: COVID-19, acute cerebrovascular accidents, stroke, pathomorphological changes in the brain
{"title":"Pathomorphological changes in some organs and tissues of COVID-19 convalescent patients","authors":"V. Akimkin, O. Levin, A. Ploskireva, A. Gorelov, A. Komarova, A. Litvinenko, N. Krivosheeva, I. O. Tinkova","doi":"10.20953/1729-9225-2022-2-16-22","DOIUrl":"https://doi.org/10.20953/1729-9225-2022-2-16-22","url":null,"abstract":"New coronavirus infection (COVID-19) is highly contagious viral disease caused by SARS-CoV-2 leading to the pandemic. The autopsy of COVID-19 patients often showed features of previous brain diseases including neurodegeneration, previous strokes, demyelinating diseases and atherosclerosis. Patients with acute cerebrovascular accidents and severe COVID-19 had higher numbers of lethality in comparison to non-severe course of infection without cerebrovascular accidents. A comparative analysis of morphological changes in lungs of deceased patients who died in different periods of first clinical symptoms is to be conducted. Objective. Description of pathomorphological changes in deceased patients during the period of reconvalescence. Patients and methods. The analysis of 15 fatal cases which took place in Botkin Hospital with the diagnosis of ischemic stroke and new coronavirus infection in the previous 2-4 months has been held. Macro and microscope examination of brain, lungs, brachiocephalic arteries, kidneys and liver has been carried out. Results. All patients had morphological features of ischemic damage of grey matter in the brain. Beside necrosis of neurocytes with diffuse infiltration in the grey matter, hematoxylin cycles were found, in some cases they were placed in a perivascular way in choroid plexus. Also 5 patients suffered a myocardial infarction up to 3 days. 10 patients had structures disorganisation in areas of lung parenchyma with hystoacrchitectonic changes because of the fibrosis. Alveoli in some places collaborated mostly with single airway clearance. The fact that most patients had lung hemosiderosis can prove coronavirus infection suffered earlier with microcirculatory bed damage. Conclusion. Thus, morphological changes seen in the period of reconvalescence of COVID-19 is a result of pathomorphosis of changes described earlier for acute period of coronavirus infection and affect not only lungs, but also other organs and tissues. This proves systematic characteristic of the infection. Key words: COVID-19, acute cerebrovascular accidents, stroke, pathomorphological changes in the brain","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","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":"67728218","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}
Pub Date : 2022-01-01DOI: 10.20953/1729-9225-2022-1-52-56
U. Kuimova, V. Belyaeva, A. Kravtchenko, E.I. Kulabuhova, M. Goliusova, V. Kanestri, A. Pokrovskaya, A. Andreev
Objective. To analyze the parameters characterizing various aspects of quality of life, adherence to treatment and satisfaction with it in patients receiving a regimen of ART consisting of domestic medications. Patients and methods. A questionnaire survey of 49 patients with HIV infection was conducted. All respondents received ART for 48 weeks, which included domestic medications: 2 nucleoside reverse transcriptase inhibitors (phosphazide + lamivudine in one tablet) and a non-nucleoside reverse transcriptase inhibitor (elsulfavirine). Conclusion. The data obtained at week 48 of ART with domestic medications phosphazide/lamivudine (Phosphaladine) and elsulfavirine showed that most patients were satisfied with the treatment they received, its convenience and severity of side effects. The adherence rate to this regimen was high. Key words: antiretroviral therapy, HIV infection, quality of life
{"title":"Quality of life and treatment satisfaction in patients with HIV infection: a questionnaire survey of patients receiving a domestic antiretroviral therapy regimen","authors":"U. Kuimova, V. Belyaeva, A. Kravtchenko, E.I. Kulabuhova, M. Goliusova, V. Kanestri, A. Pokrovskaya, A. Andreev","doi":"10.20953/1729-9225-2022-1-52-56","DOIUrl":"https://doi.org/10.20953/1729-9225-2022-1-52-56","url":null,"abstract":"Objective. To analyze the parameters characterizing various aspects of quality of life, adherence to treatment and satisfaction with it in patients receiving a regimen of ART consisting of domestic medications. Patients and methods. A questionnaire survey of 49 patients with HIV infection was conducted. All respondents received ART for 48 weeks, which included domestic medications: 2 nucleoside reverse transcriptase inhibitors (phosphazide + lamivudine in one tablet) and a non-nucleoside reverse transcriptase inhibitor (elsulfavirine). Conclusion. The data obtained at week 48 of ART with domestic medications phosphazide/lamivudine (Phosphaladine) and elsulfavirine showed that most patients were satisfied with the treatment they received, its convenience and severity of side effects. The adherence rate to this regimen was high. Key words: antiretroviral therapy, HIV infection, quality of life","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67727711","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}
Pub Date : 2022-01-01DOI: 10.20953/1729-9225-2022-3-7-16
M. Savenkova, E. N. Vetrova, E. Isaeva, G. Kraseva, N. A. Abramova, M. Shabat, R. Dushkin, S. Fadeeva, S. Kontio
This study compared the efficacy of different therapies for ARVI during the COVID-19 pandemic. Objective. To compare clinical efficacy of Cycloferon and Ingavirin in children aged 4–17 years treated in outpatient facilities during the epidemic season of СOVID-19. Patients and methods. This study included 101 patients who provided 143 oro- and nasopharyngeal swabs tested using certified PCR tests. Of them, 128 samples (89.5%) were positive, whereas 15 samples (10.5%) were negative. We identified the most common viruses circulating in January–May 2021, including (seasonal) coronaviruses (35.9%), rhinoviruses (20.3%), and other viruses. We also analyzed respiratory viruses that have circulated in Moscow during the last 6 years and found higher levels of seasonal coronaviruses. The most common ARVI symptoms in 2021 were fever, rhinitis, pharyngeal hyperemia, and fatigue. Fewer children had headache, cough, and enlarged lymph nodes. Results. We compared ARVI treatment with broad-spectrum antivirals in children aged between 4 and 17 years. Children in group 1 (n = 51) received Cycloferon®, while children in Group (n = 50) received Ingavirin®. Study participants were diagnosed with ARVI and moderate nasopharyngitis. Children from the Cycloferon group demonstrated a more significant dynamics of such clinical symptoms as headache (p < 0.05), cough (p < 0.01), rhinitis (p < 0.01), abundant mucus (p < 0.001), and enlarged lymph nodes (p < 0.001) than children from the Ingavirin group (there was a significant difference in the duration of these symptoms). Only 2 children from group 1 required antibiotics (3.4%), whereas in group 2, 11 children needed antibacterial therapy (22%). Key words: children, acute respiratory viral diseases (ARVI), COVID-19, PCR diagnostics, clinical manifestations, Cycloferon, Ingavirin
{"title":"Comparing the efficacy of meglumine acridon acetate and pentanedioic acid imidazolyl ethanamide in the outpatient treatment for ARVI during the COVID-19 pandemic","authors":"M. Savenkova, E. N. Vetrova, E. Isaeva, G. Kraseva, N. A. Abramova, M. Shabat, R. Dushkin, S. Fadeeva, S. Kontio","doi":"10.20953/1729-9225-2022-3-7-16","DOIUrl":"https://doi.org/10.20953/1729-9225-2022-3-7-16","url":null,"abstract":"This study compared the efficacy of different therapies for ARVI during the COVID-19 pandemic. Objective. To compare clinical efficacy of Cycloferon and Ingavirin in children aged 4–17 years treated in outpatient facilities during the epidemic season of СOVID-19. Patients and methods. This study included 101 patients who provided 143 oro- and nasopharyngeal swabs tested using certified PCR tests. Of them, 128 samples (89.5%) were positive, whereas 15 samples (10.5%) were negative. We identified the most common viruses circulating in January–May 2021, including (seasonal) coronaviruses (35.9%), rhinoviruses (20.3%), and other viruses. We also analyzed respiratory viruses that have circulated in Moscow during the last 6 years and found higher levels of seasonal coronaviruses. The most common ARVI symptoms in 2021 were fever, rhinitis, pharyngeal hyperemia, and fatigue. Fewer children had headache, cough, and enlarged lymph nodes. Results. We compared ARVI treatment with broad-spectrum antivirals in children aged between 4 and 17 years. Children in group 1 (n = 51) received Cycloferon®, while children in Group (n = 50) received Ingavirin®. Study participants were diagnosed with ARVI and moderate nasopharyngitis. Children from the Cycloferon group demonstrated a more significant dynamics of such clinical symptoms as headache (p < 0.05), cough (p < 0.01), rhinitis (p < 0.01), abundant mucus (p < 0.001), and enlarged lymph nodes (p < 0.001) than children from the Ingavirin group (there was a significant difference in the duration of these symptoms). Only 2 children from group 1 required antibiotics (3.4%), whereas in group 2, 11 children needed antibacterial therapy (22%). Key words: children, acute respiratory viral diseases (ARVI), COVID-19, PCR diagnostics, clinical manifestations, Cycloferon, Ingavirin","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","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":"67729051","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}
Pub Date : 2022-01-01DOI: 10.20953/1729-9225-2022-3-50-58
P. Khodkevich, K. V. Kulikova, I. Deev, O. S. Fedorova, E. S. Kulikov
Objective. To analyze the vaccination coverage and adherence to the vaccination schedule among premature newborns with a birthweight of <2,500 g. Patients and methods. This study included 119 children aged 5 to 6 years followed up within the "National prospective multicenter cohort study of newborns" in Tomsk. The experimental group comprised 96 children born prematurely, including 36 low-birthweight (LBW), 25 very low-birthweight (VLBW), and 36 extremely low-birthweight (ELBW) children. The control group included 23 healthy children born full-term. We analyzed their clinical data and information on vaccination. Results. The number of children who had completed their vaccination by the age of 5 years varied across the groups: 34.8% of controls; 16.7% of LBW children; 28% of VLBW children; and 17.1% of ELBW children (p > 0.05). Thirteen percent of controls and 5.6% of LBW children were timely vaccinated, whereas none of the VLBW and ELBW children had their vaccination in time. We observed no differences in the vaccination profiles (types of administered vaccines) between the VLBW children and controls; vaccination profiles of the LBW and ELBW children were similar. ELBW children were less likely to be vaccinated against tuberculosis, pertussis, diphtheria, tetanus, and polio than controls (p < 0.01). None of the ELBW children received vaccines against hepatitis B, pertussis, diphtheria, and tetanus, as well as third vaccine against polio at birth. In the rest of the groups, the proportion of timely vaccinated children did not exceed 20%. Parents in the control group were less likely to refuse vaccination for their children than those in the experimental group. Non-adherence to the vaccination schedule was more common in the LBW children. VLBW and ELBW children had medical exemptions more frequently than LBW children and controls. Conclusion. We observed low vaccination coverage among premature newborns for all vaccines caused both by medical exemption and non-adherence to the vaccination schedule. Key words: vaccination, premature newborns, extremely low birth weight
{"title":"Vaccination of premature newborns: real clinical practice","authors":"P. Khodkevich, K. V. Kulikova, I. Deev, O. S. Fedorova, E. S. Kulikov","doi":"10.20953/1729-9225-2022-3-50-58","DOIUrl":"https://doi.org/10.20953/1729-9225-2022-3-50-58","url":null,"abstract":"Objective. To analyze the vaccination coverage and adherence to the vaccination schedule among premature newborns with a birthweight of <2,500 g. Patients and methods. This study included 119 children aged 5 to 6 years followed up within the \"National prospective multicenter cohort study of newborns\" in Tomsk. The experimental group comprised 96 children born prematurely, including 36 low-birthweight (LBW), 25 very low-birthweight (VLBW), and 36 extremely low-birthweight (ELBW) children. The control group included 23 healthy children born full-term. We analyzed their clinical data and information on vaccination. Results. The number of children who had completed their vaccination by the age of 5 years varied across the groups: 34.8% of controls; 16.7% of LBW children; 28% of VLBW children; and 17.1% of ELBW children (p > 0.05). Thirteen percent of controls and 5.6% of LBW children were timely vaccinated, whereas none of the VLBW and ELBW children had their vaccination in time. We observed no differences in the vaccination profiles (types of administered vaccines) between the VLBW children and controls; vaccination profiles of the LBW and ELBW children were similar. ELBW children were less likely to be vaccinated against tuberculosis, pertussis, diphtheria, tetanus, and polio than controls (p < 0.01). None of the ELBW children received vaccines against hepatitis B, pertussis, diphtheria, and tetanus, as well as third vaccine against polio at birth. In the rest of the groups, the proportion of timely vaccinated children did not exceed 20%. Parents in the control group were less likely to refuse vaccination for their children than those in the experimental group. Non-adherence to the vaccination schedule was more common in the LBW children. VLBW and ELBW children had medical exemptions more frequently than LBW children and controls. Conclusion. We observed low vaccination coverage among premature newborns for all vaccines caused both by medical exemption and non-adherence to the vaccination schedule. Key words: vaccination, premature newborns, extremely low birth weight","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","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":"67728667","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}
Pub Date : 2022-01-01DOI: 10.20953/1729-9225-2022-1-107-119
N. Skripchenko, G. F. Zheleznikova, L. A. Alekseeva, E. V. Makarenkova, T. V. Bessonova
This review summarizes the available information on the condition of two systems that regulate immune responses, namely the hypothalamic–pituitary–adrenal axis and hypothalamic–pituitary–thyroid axis, in children with neuroinfections or sepsis. We used the Pubmed and eLibrary databases to prepare this review. Serum cortisol is a well-studied biomarker of neuroinfections. Its elevated level is known to be associated with disease severity and outcome in both adults and children. A critical condition in patients with sepsis and septic shock is usually accompanied by critical illness-related corticosteroid insufficiency (CIRCI) and non-thyroidal illness syndrome (NTIS), whose pathogenetic role is unclear and is being actively studied. There is a close correlation between cortisol and cytokine levels in adult patients with neuroinfections or sepsis; however few studies demonstrated this correlation in children. Further investigation of the interaction between neuroendocrine and immune mechanisms will clarify the real need for corticosteroid therapy which is widely used in children with severe infections now. The causal therapy for severe neuroinfections with sepsis and septic shock should include drugs with metabolic and endothelium-protective action (such as cytoflavin), since it can alleviate the disease. Key words: infection, neuroendocrine system, sepsis, hormones, glucocorticoid receptor, cytokines, children, cytoflavin
{"title":"Hormones and cytokines as biomarkers of severe infections in children","authors":"N. Skripchenko, G. F. Zheleznikova, L. A. Alekseeva, E. V. Makarenkova, T. V. Bessonova","doi":"10.20953/1729-9225-2022-1-107-119","DOIUrl":"https://doi.org/10.20953/1729-9225-2022-1-107-119","url":null,"abstract":"This review summarizes the available information on the condition of two systems that regulate immune responses, namely the hypothalamic–pituitary–adrenal axis and hypothalamic–pituitary–thyroid axis, in children with neuroinfections or sepsis. We used the Pubmed and eLibrary databases to prepare this review. Serum cortisol is a well-studied biomarker of neuroinfections. Its elevated level is known to be associated with disease severity and outcome in both adults and children. A critical condition in patients with sepsis and septic shock is usually accompanied by critical illness-related corticosteroid insufficiency (CIRCI) and non-thyroidal illness syndrome (NTIS), whose pathogenetic role is unclear and is being actively studied. There is a close correlation between cortisol and cytokine levels in adult patients with neuroinfections or sepsis; however few studies demonstrated this correlation in children. Further investigation of the interaction between neuroendocrine and immune mechanisms will clarify the real need for corticosteroid therapy which is widely used in children with severe infections now. The causal therapy for severe neuroinfections with sepsis and septic shock should include drugs with metabolic and endothelium-protective action (such as cytoflavin), since it can alleviate the disease. Key words: infection, neuroendocrine system, sepsis, hormones, glucocorticoid receptor, cytokines, children, cytoflavin","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","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":"67727329","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}
Pub Date : 2022-01-01DOI: 10.20953/1729-9225-2022-1-57-62
O. E. Chernova, A. Kalyshenko, G.A. Vertogradova
Objective. To analyze the features of the course of chronic hepatitis С virus (HCV) and effectiveness of its treatment in patients with HIV infection. Patients and methods. The study was conducted on the basis of the State Budgetary Health Institution “Samara Regional Clinical Center for AIDS Prevention and Control”. Twenty-two HIV-infected patients with HCV genotype 2 and 3 and HCV-related liver cirrhosis were observed. All patients had compensated cirrhosis (class A according to the Child-Pugh classification). Patients were aged between 33 and 65 years, with an average age of 46.5 years. There were 17 (77.3%) male and 5 (22.7%) female patients. Results. The effectiveness of antiviral therapy (AT) for HCV with progression to liver cirrhosis and the dynamics of clinical and laboratory parameters in 22 HIV-infected patients were assessed. HCV genotypes were distributed as follows: genotype 3 was detected in 20 patients (91%), genotype 2 – in 2 patients (9%). According to the results of elastometry, the stages of fibrosis were distributed as follows: F0–F2 – in 0 (0.0%) patients, F3 – in 3 (13.6%) patients, F4 – in 19 (86.4%) patients. Serum levels of HCV RNA prior to treatment averaged 310,335 copies/mL (1,020 to 795,000 copies/mL). After 8 and 12 weeks of antiviral therapy for HCV, all 22 patients had no HCV RNA in the blood. However, in one patient HCV RNA levels reached 53,856 copies/mL 24 weeks after the end of antiviral therapy (reinfection due to the injection of psychoactive substances). Conclusion. Thus, all 22 treated patients with HIV infection and HCV with progression to liver cirrhosis achieved sustained virologic response 12 (SVR12) after an 8-week course of antiviral therapy for HCV (glecaprevir/pibrentasvir). Hepatitis C virus eradication is likely to reduce the risk of fibrosis progression, decompensated cirrhosis, and hepatocellular carcinoma formation. In turn, laboratory manifestations in the form of hepatocyte cytolysis syndrome (AST/ALT) and intrahepatic cholestasis (GGT) ceased by the end of treatment. Against the background of antiviral therapy for HCV, CD4 cell count tended to increase in patients, which would subsequently reduce the risk of severe opportunistic infections and complications. There were no adverse events during treatment with glecaprevir/pibrentasvir (neither clinical symptoms nor change in clinical and biochemical blood tests), which confirms the safety of the chosen treatment regimen. The only problem remains the adherence to treatment of such a complex group of patients as HCV/HIV co-infected, as well as the possibility of HCV reinfection through sexual contact with HCV patients and/or through injecting psychoactive substances. Key words: antiretroviral therapy, HIV infection, direct-acting antivirals, chronic hepatitis C, liver cirrhosis
{"title":"Analysis of HCV antiviral therapy outcomes in HIV-infected patients with liver cirrhosis","authors":"O. E. Chernova, A. Kalyshenko, G.A. Vertogradova","doi":"10.20953/1729-9225-2022-1-57-62","DOIUrl":"https://doi.org/10.20953/1729-9225-2022-1-57-62","url":null,"abstract":"Objective. To analyze the features of the course of chronic hepatitis С virus (HCV) and effectiveness of its treatment in patients with HIV infection. Patients and methods. The study was conducted on the basis of the State Budgetary Health Institution “Samara Regional Clinical Center for AIDS Prevention and Control”. Twenty-two HIV-infected patients with HCV genotype 2 and 3 and HCV-related liver cirrhosis were observed. All patients had compensated cirrhosis (class A according to the Child-Pugh classification). Patients were aged between 33 and 65 years, with an average age of 46.5 years. There were 17 (77.3%) male and 5 (22.7%) female patients. Results. The effectiveness of antiviral therapy (AT) for HCV with progression to liver cirrhosis and the dynamics of clinical and laboratory parameters in 22 HIV-infected patients were assessed. HCV genotypes were distributed as follows: genotype 3 was detected in 20 patients (91%), genotype 2 – in 2 patients (9%). According to the results of elastometry, the stages of fibrosis were distributed as follows: F0–F2 – in 0 (0.0%) patients, F3 – in 3 (13.6%) patients, F4 – in 19 (86.4%) patients. Serum levels of HCV RNA prior to treatment averaged 310,335 copies/mL (1,020 to 795,000 copies/mL). After 8 and 12 weeks of antiviral therapy for HCV, all 22 patients had no HCV RNA in the blood. However, in one patient HCV RNA levels reached 53,856 copies/mL 24 weeks after the end of antiviral therapy (reinfection due to the injection of psychoactive substances). Conclusion. Thus, all 22 treated patients with HIV infection and HCV with progression to liver cirrhosis achieved sustained virologic response 12 (SVR12) after an 8-week course of antiviral therapy for HCV (glecaprevir/pibrentasvir). Hepatitis C virus eradication is likely to reduce the risk of fibrosis progression, decompensated cirrhosis, and hepatocellular carcinoma formation. In turn, laboratory manifestations in the form of hepatocyte cytolysis syndrome (AST/ALT) and intrahepatic cholestasis (GGT) ceased by the end of treatment. Against the background of antiviral therapy for HCV, CD4 cell count tended to increase in patients, which would subsequently reduce the risk of severe opportunistic infections and complications. There were no adverse events during treatment with glecaprevir/pibrentasvir (neither clinical symptoms nor change in clinical and biochemical blood tests), which confirms the safety of the chosen treatment regimen. The only problem remains the adherence to treatment of such a complex group of patients as HCV/HIV co-infected, as well as the possibility of HCV reinfection through sexual contact with HCV patients and/or through injecting psychoactive substances. Key words: antiretroviral therapy, HIV infection, direct-acting antivirals, chronic hepatitis C, liver cirrhosis","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","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":"67728108","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}
Pub Date : 2022-01-01DOI: 10.20953/1729-9225-2022-3-26-34
G. Martynova, A. Savchenko, M. Stroganova, Ya. A. Bogvilene, L. A. Ikkes, V. Belenyuk, E.O. Shavrina
The clinical efficacy of recombinant IFN-α2b in therapy for COVID-19 in children is the basis for studying the parameters of the cytokine production activity of immune system cells and will allow to optimize antiviral therapy regimens. Objective. To study the effect of recombinant IFN-α2b on serum IFN-α and IFN-γ concentrations and their synthesis by immune system cells in children with COVID-19. Materials and methods. Peripheral blood samples from 100 patients aged 1 to 17 years (1–7 years – 50 people, 8–17 years – 50 people) with a moderate course of COVID-19 were examined. Patients in the study group received recombinant IFN-α2b as Вклюpart of complex therapy. Patients in the comparison group received antiviral therapy with Arbidol®. Multiplex analysis was used to determine serum IFN-α and IFN-γ concentrations and the level of their synthesis by immune system cells. The enzyme-linked immunosorbent assay (ELISA) was used to determine serum concentrations of antibodies to IFN-α. Results. Combination therapy with recombinant IFN-α2b in children of both age groups led to an increase in serum IFN-α concentrations compared to baseline values prior to treatment, in children in the control group and patients with COVID-19 after treatment with Arbidol. There were no significant changes in serum IFN-α and IFN-γ concentrations and their synthesis in intact and PHA-stimulated cells in children of both age groups during treatment with Arbidol. Serum concentrations of antibodies to IFN-α during treatment with recombinant IFN-α2b did not depend on the age of children and remained within the reference range. Conclusion. A significant increase in serum IFN-α concentrations and restoration of its synthesis level induced by PHA to reference values indicate that the use of recombinant interferon medications with their antiviral and immunomodulatory effects should become an integral part of COVID-19 therapy. Key words: children, COVID-19, recombinant interferon IFN-α2b, serum IFN-α concentrations, IFN-α synthesis levels
{"title":"Effect of recombinant interferon alfa-2b on cytokine production activity of immune system cells in children with COVID-19","authors":"G. Martynova, A. Savchenko, M. Stroganova, Ya. A. Bogvilene, L. A. Ikkes, V. Belenyuk, E.O. Shavrina","doi":"10.20953/1729-9225-2022-3-26-34","DOIUrl":"https://doi.org/10.20953/1729-9225-2022-3-26-34","url":null,"abstract":"The clinical efficacy of recombinant IFN-α2b in therapy for COVID-19 in children is the basis for studying the parameters of the cytokine production activity of immune system cells and will allow to optimize antiviral therapy regimens. Objective. To study the effect of recombinant IFN-α2b on serum IFN-α and IFN-γ concentrations and their synthesis by immune system cells in children with COVID-19. Materials and methods. Peripheral blood samples from 100 patients aged 1 to 17 years (1–7 years – 50 people, 8–17 years – 50 people) with a moderate course of COVID-19 were examined. Patients in the study group received recombinant IFN-α2b as Вклюpart of complex therapy. Patients in the comparison group received antiviral therapy with Arbidol®. Multiplex analysis was used to determine serum IFN-α and IFN-γ concentrations and the level of their synthesis by immune system cells. The enzyme-linked immunosorbent assay (ELISA) was used to determine serum concentrations of antibodies to IFN-α. Results. Combination therapy with recombinant IFN-α2b in children of both age groups led to an increase in serum IFN-α concentrations compared to baseline values prior to treatment, in children in the control group and patients with COVID-19 after treatment with Arbidol. There were no significant changes in serum IFN-α and IFN-γ concentrations and their synthesis in intact and PHA-stimulated cells in children of both age groups during treatment with Arbidol. Serum concentrations of antibodies to IFN-α during treatment with recombinant IFN-α2b did not depend on the age of children and remained within the reference range. Conclusion. A significant increase in serum IFN-α concentrations and restoration of its synthesis level induced by PHA to reference values indicate that the use of recombinant interferon medications with their antiviral and immunomodulatory effects should become an integral part of COVID-19 therapy. Key words: children, COVID-19, recombinant interferon IFN-α2b, serum IFN-α concentrations, IFN-α synthesis levels","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","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":"67728411","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}
Pub Date : 2022-01-01DOI: 10.20953/1729-9225-2022-1-120-126
V. Akimkin, A. V. Tutelyan, N. I. Shulakova
Infectious diseases caused by fungi (mycoses) are one of the significant problems of modern medicine Worldwide, more than 300 million people suffer from severe and chronic mycoses, 25 million patients are at risk of disability or death. Due to changes in treatment strategies and the wider use of antifungal prevention in recent years, the epidemiology of fungal infections has changed and has become particularly relevant due to a significant increase in cases of invasive mycoses. Deep, visceral mycoses, sometimes associated with HIV infection, oncohematological pathology, organ transplantation, nursing of newborns, have become more frequent, while the role of fungi that were previously considered apatogenic increases. In the context of the COVID-19 pandemic, risk factors for these infections continue to increase, and therefore it is likely that the incidence of fungal infections, including those associated as nosocomial, will increase in the coming years. The increasing role of fungi in the etiology of hospital infections, the introduction into clinical practice of a significant number of new drugs was inevitably accompanied by the formation of resistance of fungi to antimycotics. According to literature data, the rate of emergence of pathogenic fungi resistant to a limited number of widely used antifungal agents is unprecedented. Thus, in modern conditions associated with the increase in resistance of pathogenic fungi, the key measures should be aimed at developing optimal strategies for containing resistance to antifungal drugs. Key words: mycoses, fungal infections, antimycotics, resistance, risk factors, pandemic, COVID-19
{"title":"Medical mycological iceberg: recent trends in the epidemiology of mycoses","authors":"V. Akimkin, A. V. Tutelyan, N. I. Shulakova","doi":"10.20953/1729-9225-2022-1-120-126","DOIUrl":"https://doi.org/10.20953/1729-9225-2022-1-120-126","url":null,"abstract":"Infectious diseases caused by fungi (mycoses) are one of the significant problems of modern medicine Worldwide, more than 300 million people suffer from severe and chronic mycoses, 25 million patients are at risk of disability or death. Due to changes in treatment strategies and the wider use of antifungal prevention in recent years, the epidemiology of fungal infections has changed and has become particularly relevant due to a significant increase in cases of invasive mycoses. Deep, visceral mycoses, sometimes associated with HIV infection, oncohematological pathology, organ transplantation, nursing of newborns, have become more frequent, while the role of fungi that were previously considered apatogenic increases. In the context of the COVID-19 pandemic, risk factors for these infections continue to increase, and therefore it is likely that the incidence of fungal infections, including those associated as nosocomial, will increase in the coming years. The increasing role of fungi in the etiology of hospital infections, the introduction into clinical practice of a significant number of new drugs was inevitably accompanied by the formation of resistance of fungi to antimycotics. According to literature data, the rate of emergence of pathogenic fungi resistant to a limited number of widely used antifungal agents is unprecedented. Thus, in modern conditions associated with the increase in resistance of pathogenic fungi, the key measures should be aimed at developing optimal strategies for containing resistance to antifungal drugs. Key words: mycoses, fungal infections, antimycotics, resistance, risk factors, pandemic, COVID-19","PeriodicalId":37794,"journal":{"name":"Infektsionnye Bolezni","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":"67727473","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}
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