Acute Viral Infections Research Articles

Влияние барьерных методов профилактики острых респираторных вирусных инфекций на функциональное состояние назального цилиарного эпителия у детей с рецидивирующей бронхиальной обструкцией

Aim. Study effect of cellulose powder on the functional state of the ciliary epithelium in children with bronchial obstruction. Design. Open prospective non-randomized clinical study. Material and methods. The study involved 60 children from 3 to 11 years, with a history of frequent acute respiratory viral infections (ARVI), occurring with bronchial obstruction or exacerbation of bronchial asthma. Motor activity of the ciliary epithelium was registered with the digital high-speed videomicroscopy method initially and 3 months after the start of the three-month course of its application. Patients were also assessed for the frequency of acute respiratory viral infections; the objective and subjective symptoms of ARVI episodes were evaluated with a point scale during the follow-up period. Results. After completing the three-month course of cellulose powder with wild garlic extract usage, it was revealed that 55 (91.7%) children did not get ARVI during follow-up, 5 (8.3%) children had ARVI once. There was a reduction in the duration of the disease, a decrease in the severity of symptoms compared with those in previous years, on the scale of severity assessment of symptoms in patients with ARVI: in previous years — 17 (16; 18) points, when interviewed after the use of the studied drug — 9 (7; 10) points (p < 0.05). Of the five children who were ill, only one child developed obstructive bronchitis on the background of a viral infection. The relative number of cells with motile cilia: the middle nasal concha (MNC) — 25% (20%; 30%), the inferior nasal concha (INC) — 25% (15%; 30%); 3 months after the start of taking the cellulose powder: MNC — 40% (30%; 45%), INC — 35% (35%; 45%) (p < 0.01). Ciliary beat frequency in patients initially: MNC — 4.7 (4.2; 5.9) Hz, INC — 4.9 (4.2; 5.7) Hz; 3 months after MNC — 5.9 (5.7; 7.9) Hz (p < 0.01), INC — 6.2 (5.5; 7.2) Hz (р < 0.05). Conclusion. The use of cellulose powder for preventive purposes prevents infection with ARVIs, protects against reinfection, and also helps to reduce the duration and the severity of the disease manifestations. There is a positive dynamics in the functional status of the ciliary epithelium of the upper respiratory tract, which may reflect a more complete restoration of the mucosa against the background of the absence of ARVI. Keywords: ciliary epithelium, cilia, prevention of acute respiratory viral infections, children, fine cellulose powder.

The effect of topical drugs on the course of ARVI in children in modern conditions

The purpose of the study. To evaluate the results of using a drug based on benzidamine hydrochloride in the treatment regimens of acute respiratory viral infections in children today. Materials and methods. The study included 875 children aged 3 to 18 years with acute respiratory viral infections, which occurred in mild or moderate forms, and were treated on an outpatient basis. During the non-interventional study, a retrospective analysis of information from medical records was made. The main group included 318 children who were recommended therapy with a drug based on benzidamine hydrochloride, the comparison group included 557 children who received other topical drugs. Results. Recovery was statistically significantly earlier in the group receiving benzidamine hydrochloride: from the moment of initiation of therapy, the disease period in the main group was 6.78±1.72 days, while in the comparison group it was 1.34 days longer – 8.12±3.32. It was found that benzidamine hydrochloride significantly reduces the period of tickling and sore throat from 5.10±1.38 in the comparison group to 4.08±1.41 in the main group, hyperemia of the posterior pharyngeal wall – from 8.11±3.27 in the comparison group to 6.68±1.6 days in the main group, hyperemia of the tonsils – from 7.85±1.84 in the comparison group to 6.86±1.77 in the main group. Relief of dry cough was recorded in the group receiving benzidamine hydrochloride at 4.23±1.66 days, and in the group where other drugs were used – at 4.64±1.85 days. According to other indicators, no significant differences were found between the compared groups. Conclusion. The administration of a drug based on benzidamine hydrochloride as part of complex therapy statistically significantly, on average, reduces the total duration of acute respiratory viral infections in children from 3 years old by 1.34 days, reduces the period of tickling and sore throat by 1.08 days; by 1.43 days – visual manifestations of pharyngitis, by 1.0 days – tonsillitis; reduces the duration of dry cough.

Итоги открытого многоцентрового неинтервенционного наблюдательного проспективного исследования влияния на качество жизни препарата Кипферон®, применяемого у детей 0–7 лет с острыми респираторными вирусными инфекциями в условиях рутинной амбулаторно- поликлинической практики

Objective. To evaluate the dynamics of the quality of life of children aged 0 to 7 years with acute respiratory viral infections (ARVI) of mild and moderate severity when adding the drug Kipferon® (a mixture of normal human immunoglobulin and recombinant interferon α-2b) to standard therapy, as well as to determine the effect of this drug on the infectious morbidity of patients during 3 months following the course of treatment. Patients and Methods. A multicenter observational clinical study conducted at 19 clinical centers in Russia in routine outpatient and polyclinic practice included 855 children aged 0 to 7 years; the mean age was 3.5 ± 1.7 years. There were 460 (53.8%) boys and 395 (46.2%) girls. There were 89 children aged 0 to 1 year; older children were 766. Patients were divided into 2 groups: the main group (n = 656), children from which received Kipferon® (rectal suppositories, according to the instructions for use) for 7 days in addition to standard symptomatic therapy, and the control group (n = 199). The children were examined on admission, on the 3–5th and 6-8th day from the beginning of treatment; 1 and 3 months after the end of the course of therapy. The severity of the main clinical symptoms was evaluated using a 10-point system. The legal representatives of all patients signed informed consent. Statistical analysis of the results was performed using the methods of descriptive and variation statistics, Student and Mann–Whitney criteria; differences were considered reliable at p < 0.05. Results. The initial general level of discomfort, as well as the degree of severity of 11 main symptoms of acute respiratory infection were comparable in both groups and significantly improved by the end of the treatment course. On the 3-5th day from the beginning of treatment in patients receiving Kipferon® preparation, statistically significant (p < 0.05) improvement in all leading manifestations of ARVI was revealed, while in the control group improvement was registered only in 8 symptoms out of 11. In infants of the main group by the 3–5th day of treatment, difficulties in feeding and falling asleep significantly (p < 0.05) decreased; older patients significantly better ate and slept, and were more physically active. Bacterial complications of ARVI in the main group developed 2 times less frequently: 36 (5.7%) cases vs. 20 (10.3%); the differences are reliable (p = 0.026) according to the χ2 criterion. Repeated acute respiratory viral infections during 3 months of follow-up were significantly (p < 0.05) more frequent in children who did not receive Kipferon® (47.5% vs. 20.3%). No serious adverse events were detected during the use of Kipferon® preparation. Adverse events were recorded in 2 patients, none of them was classified as related to the use of the study drug; serious adverse events were absent during the entire observation period. Conclusion. The efficacy and safety of the immunomodulating drug Kipferon® allows us to recommend it as an important addition to symptomatic agents in the treatment of acute respiratory infections in pediatrics. Key words: children, interferons, Kipferon®, acute respiratory viral infections

Effects of Coronavirus Disease 2019 on Prevalence of Acute Respiratory Viruses: Changes during the Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic may have influenced the prevalence and seasonality of acute respiratory viral infections. The aim of the study was to investigate the prevalence of all viruses causing acute viral respiratory infections before and after social distancing measures were lifted. Cross-sectional study where outpatients and inpatients at Kyunghee University Hospital were examined. From January 2021 to December 2022, respiratory samples were analyzed using multiplex reverse transcriptase real-time polymerase chain reaction. Of 3953 samples obtained, 412 (10.42%) were positive for acute respiratory viral infection, and 502 viruses were detected. The number of viral infections increased from 184 in 2021 to 318 in 2022. Human metapneumovirus was detected from August to November 2022. Human bocavirus (HBoV) was frequently detected from April to June 2021; however, in 2022, HBoV was frequently detected from July to October. Human parainfluenza virus 3 was rarely detected after its initial frequent detection from October to December 2021 but was continuously observed after frequent detection in September 2022. Co-infection occurred in 78 (18.9%) cases. The most common combination of simultaneous infections was human rhinovirus-HBoV (n = 30, 38.5%). During the COVID-19 pandemic, the incidence of acute respiratory viral infection decreased significantly but increased in 2022 when measures were lifted. The prevalence and seasonality of respiratory viral infections have changed since the pandemic. Our findings contribute to the prediction of an effective response to changes in the prevalence of respiratory viruses.

Interleukins in the pathogenesis of influenza and other acute respiratory viral infections.

Influenza and other acute respiratory viral infections (ARVIs) are among the most common human diseases. In recent decades, the discovery of cytokines and their significance in the pathogenesis of diseases has led to extensive research on these compounds in various pathologies including ARVIs. The aim of the research was to study the cytokine profile in patients with ARVIs. The cases of 30 patients were investigated. Etiological diagnosis was performed by polymerase chain reaction. Different classes of cytokines in the serum were defined by the enzyme-linked immunosorbent assay (ELISA). The level of cytokines depended on the number of pathogens. The highest levels of pro-inflammatory interleukins and the lowest levels of anti-inflammatory IL-4 were observed in patients with a combination of five or more viruses compared to those with a monoinfection. Analysis of the data showed that in the acute phase, the levels of all studied pro-inflammatory cytokines - IL-2, IL-6, and TNF-α - increased by 8, 39, and 9 times, respectively, compared to those in healthy individuals. In the acute phase of ARVI, the levels of pro-inflammatory cytokines were significantly higher and depended on the severity of the disease. The imbalance of cytokines in the serum has been established in cases of ARVIs, depending on the severity of the disease.

The role of ω-3 polyunsaturated fatty acids in child development

ω-3 polyunsaturated fatty acids (PUFAs) are incorporated in cell membranes and play an important role in the development and functioning of organs. Consolidation of data on the role of ω-3 PUFAs in child development may increase the professional's awareness, help to plan clinical studies, and develop recommendations for supplementation. The aim of the research was to analyze literature data on the effect of ω-3 PUFAs on the central nervous system, immune system, and vision in children. Material and methods. 86 literature sources have been analyzed, a keyword search was carried out in the PubMed, Scopus, Elsevier, eLibrary and Google Scholar databases. Results. ω-3 PUFAs (alpha-linolenic, docosahexaenoic and eicosapentaenoic acids) are not synthesized in the human organism, and should be obtained from food. The need for ω-3 PUFAs is especially high during periods of rapid growth (the first years of life and adolescence). ω-3 PUFAs play an important role in the anatomical and functional development of the brain, affecting the maturation and functioning of neurons, participating in the processes of neurogenesis, migration, synaptogenesis, and neurotransmission. The results of clinical studies on the effect of ω-3 PUFAs on the cognitive functions of healthy children and patients with attention deficit hyperactivity disorder are contradictory, which requ ires further research. PUFAs are substrates for the synthesis of bioactive compounds and take part in the control of acute and chronic inflammation, and also have a regulatory effect on immune cells. ω-3 PUFAs supplementation decreases the frequency and duration of acute respiratory viral infections in children. This indicates the potential effectiveness of ω-3 PUFAs in the prevention of acute respiratory viral infections. Сlinical studies demonstrated positive effects of ω-3 PUFAs on retinal development in premature infants. Conclusion. Adequate intake of ω-3 PUFAs is essential for the development and functioning of the central nervous system, immune system and vision in children. The body content of ω-3 PUFAs is closely related to the nutrition. In the Russian Federation, consumption of fish and other products containing ω-3 PUFAs is traditionally low. The majority of the Russian population has a deficiency in ω-3 PUFA consumption. With an unbalanced diet, supplementation of ω-3 PUFAs is necessary.

Острые респираторные вирусные инфекции: фокус на тяжесть течения. Блиц-обзор

This concise examination of international and domestic research on the impact of respiratory viruses and age-specific characteristics of the immune response in young children on the severity of influenza and other acute respiratory viral infections (ARVIs) is designed to highlight the importance of timely and effective therapy for these diseases. When selecting therapy for ARVIs in children, particularly those of a younger age, it is advisable to adopt a balanced approach that ensures adequate antiviral protection and rapid elimination of the virus, while also considering the necessity for effective and safe therapy to prevent an inadequate immune response. Furthermore, the review addresses the findings on a representative of the group of "Biological medicines produced using gradual processing technology" (State Pharmacopoeia of the Russian Federation, XV ed.), namely the domestic antiviral drug Anaferon® for children in drops for oral administration. The drug has been demonstrated to have antiviral activity, to provide a significant effect on reducing the duration of fever, and the severity of the disease course, and to have the favorable safety profile. Additionally, it is administered in a convenient, physiological manner, allowing for its wide application in the treatment of acute respiratory infections of the upper respiratory tract in children from 1 month to nearly 4 years (3 years, 11 months, and 29 days inclusive). KEYWORDS: ARVI, acute respiratory viral infection, acute respiratory infection of the upper respiratory tract, common cold, severity of course, treatment. FOR CITATION: Zaplatnikov A.L., Geppe N.A., Blokhin B.M., Kondyurina E.G. Acute respiratory viral infections: focus on severity. A brief overview. Russian Journal of Woman and Child Health. 2024;7(3):270–275 (in Russ.). DOI: 10.32364/2618-8430-2024-7-3-11.

High seroprevalence of IgM antibodies against chikungunya among patients with acute febrile illness seeking healthcare in a malaria-endemic area in the Afar Region, Northeast Ethiopia.

Chikungunya is a disease caused by Aedes mosquito-borne chikungunya virus infection. This disease is becoming one of the emerging/re-emerging viral diseases in tropical and subtropical countries but is neglected by public health systems. This study assessed the seroprevalence of chikungunya virus infection among patients with acute febrile illness seeking healthcare in a malaria-endemic area in the Afar Region, Northeast Ethiopia. An institution-based cross-sectional study was employed from September 2022 to March 2023 to assess the seroprevalence of chikungunya virus infection among malaria-suspected febrile patients attending health institutes in the Afar Region. Sociodemographic, clinical features, and venous blood were collected from each study participant. Blood films were prepared and examined for plasmodium infection using microscopy. Sera were separated and screened for anti-chikungunya virus IgM and IgG antibodies using an enzyme-linked immunosorbent assay. Data were entered into Epi Data 3.1 and analyzed using Stata/SE 14.2. In this study, 368 malaria-suspected febrile patients (55.4% female, aged 5-80 years old, mean ± SD = 27.28 ± 14.0) participated. The prevalence of anti-chikungunya virus IgM antibodies, indicating acute infection, was 47.8%, while the prevalence of IgG antibodies, indicating previous exposure, was 6.3%. Nonmarried participants were found to be more likely to have acute chikungunya virus infection (AOR = 2.34, 95% CI: 1.141-4.964), and back pain was associated with higher likelihood of acute infection (AOR = 1.785; 95% CI: 1.078-2.954). About 10.6% of the participants tested positive for Plasmodium parasite infection, with P. falciparum (84.6%) being the most common, followed by P. vivax (10.3%) and mixed (5.1%) infections. The study revealed a high seroprevalence of acute chikungunya virus infection among febrile patients in the Afar Region, highlighting the importance of regular screening for arbovirus infection in febrile patients to control and mitigate chikungunya spread.

Deep RNA sequencing of muscle tissue reveals absence of viral signatures in dermatomyositis.

Objective: To explore a possible connection between active viral infections and manifestation of dermatomyositis (DM). Methods: Skeletal muscle biopsies were analyzed from patients diagnosed with juvenile (n=10) and adult (n=12) DM. Adult DM patients harbored autoantibodies against either TIF-1γ (n=7) or MDA5 (n=5). Additionally, we investigated skeletal muscle biopsies from non-diseased controls (NDC, n=5). We used an unbiased high-throughput RNA sequencing (HTS) approach to detect viral sequences. To further increase sequencing depth, a host depletion approach was applied. Results: In this observational study, no relevant viral sequences were detected either by native sequencing or after host depletion. The absence of detectable viral sequences makes an active viral infection of the muscle tissue unlikely to be the cause of DM in our cohorts. Discussion: Type I interferons (IFN) play a major role in the pathogenesis of both juvenile and adult DM. The IFN response is remarkably conserved between DM subtypes classified by specific autoantibodies. Certain acute viral infections are accompanied by a prominent type I IFN response involving similar downstream mechanisms as in DM. Aiming to elucidate the pathogenesis of DM in skeletal muscle tissue, we used deep RNA sequencing and a host depletion approach to detect possible causative viruses.

Activated Gab1 drives hepatocyte proliferation and anti-apoptosis in liver fibrosis via potential involvement of the HGF/c-Met signaling axis.

Chronic liver diseases are caused by hepatic viral infection, chemicals, and metabolic stress. The protein Grb2-associated binder 1 (Gab1) binds to various growth factor receptors, and triggers cell differentiation/survival signaling pathways. To identify signaling molecules involved in the progression of liver diseases, we performed reverse-phase protein microarray (RPMA)-based screening of hepatocytes isolated from humanized mice after acute HCV infection. Acute viral infection in humanized liver mice significantly decreased the level of hepatocyte p-Gab1. Moreover, hepatoma cells upon HCV infection decreased Gab1 mRNA at later times of infection (D3 to D5) and p-Gab1 level was inversely related to the production of TGF-β. In contrast, the level of p-Gab1 was increased in CCL4-induced fibrotic liver. Hepatoma cells showed elevation of p-Gab1, along with an increase in STAT3 and ERK activation, upon treatment with HGF (ligand of HGF receptor/c-Met) and CCL4. In Gab1 knockdown hepatoma cells, cell proliferative signaling activity was reduced but the level of activated caspase-3 was increased. These findings suggest that hepatocyte Gab1 expression may play a role in promoting liver fibrosis progression by triggering ERK activation and inhibiting apoptosis. It implies that the Gab1-mediated signaling pathway would be a promising therapeutic target to treat chronic liver diseases.

Miosite e rabdomiolisi da virus dell’influenza

Myositis during acute viral infections, also known as acute benign myositis of childhood (MBAI), is a clinical picture well described in the literature. Influenza virus (A and B) is one of the most common viral etiologies. The diagnosis is clinical, based on symptoms such as lower extremity pain with limitation of walking, and is combined with laboratory data such as elevation of blood creatine kinase (CK). Identifying patients who develop a myositis picture in the course of influenza infection is important not only for proper management of those, albeit rare, cases that may go on to complications, but also because of the need to reassure the family about the almost certainly benign evolution of the condition. During the 2023-2024 winter season, the association between influenza virus infection and myositis appeared particularly frequent; here we describe its clinical aspects and main pathogenetic hypotheses.

Vaccine and antiviral drug promise for preventing post-acute sequelae of COVID-19, and their combination for its treatment.

Most healthy individuals recover from acute SARS-CoV-2 infection, whereas a remarkable number continues to suffer from unexplained symptoms, known as Long COVID or post-acute COVID-19 syndrome (PACS). It is therefore imperative that methods for preventing and treating the onset of PASC be investigated with the utmost urgency. A mathematical model of the immune response to vaccination and viral infection with SARS-CoV-2, incorporating immune memory cells, was developed. Similar to our previous model, persistent infection was observed by the residual virus in the host, implying the possibility of chronic inflammation and delayed recovery from tissue injury. Pre-infectious vaccination and antiviral medication administered during onset can reduce the acute viral load; however, they show no beneficial effects in preventing persistent infection. Therefore, the impact of these treatments on the PASC, which has been clinically observed, is mainly attributed to their role in preventing severe tissue damage caused by acute viral infections. For PASC patients with persistent infection, vaccination was observed to cause an immediate rapid increase in viral load, followed by a temporary decrease over approximately one year. The former was effectively suppressed by the coadministration of antiviral medications, indicating that this combination is a promising treatment for PASC.

Thrombocytopenia and Coagulopathy in Covid-19 Manifesting as Upper Gastrointestinal Bleed and Epistaxis

COVID-19 is an acute febrile illness and the common manifestations are cough, flu and fever. COVID19 infection with severe thrombocytopenia and coagulopathy is a rare life threatening presentation. We are presenting a case of a gentleman in 20's with history of positive animal contact, who presented to emergency department (ED) with history of fever of more than a week and nasal bleed. Relevant examination showed unstable vitals, anterior nasal packing in place, left lower zone crackles and ongoing black stool. Laboratory workup revealed bicytopenia with platelet count of (6X109), low hemoglobin, deranged INR, low fibrinogen levels. The patient was managed for viral hemorrhagic fever leading to disseminated intravascular coagulation (DIC). He was managed with antipyretics, antibiotics. resuscitated with blood products, admitted to inpatient facility. His blood counts started improving favoring the possibility of thrombocytopenia secondary to viral illness, and later discharged in stable condition. COVID-19 is acute viral infection. Any patient with fever and bleeding should be kept on high suspicion for other viral illness as well. Treatment approach can be conservative. Thrombocytopenia and coagulopathy with 2 organ bleed is the first case reported to the best of our knowledge.

����� ����ղ����� �����: ����������, �ֲ��� ���������� ��������, ��² ����������� �����ò��ί ����ϲ� ��ֲ��Ҳ�

According to general estimates, from 3�5 % and up to 10 % of patients with asthma have a severe course of the disease, which often continues to remain uncontrolled, despite the maximum use of inhaled corticosteroids and additional controller drugs. Severe asthma creates a large physical, mental, emotional, social and economic burden for patients and is often associated with multimorbidity. The heterogeneity of asthma drives research aimed at defining asthma phenotypes that ultimately reflect different underlying disease mechanisms, including pathogenetic processes and response to environmental factors. The clinical phenotypes of asthma are closely related to the underlying inflammatory processes in this disease and therefore can be divided into 2 main inflammatory phenotypes determined by the dominant immunological pathways that determine the pathology of bronchial asthma: eosinophilic and non-eosinophilic. Phenotyping patients is important for the differential diagnosis of asthma, risk assessment, treatment selection, and monitoring response to treatment. Accurate identification of the phenotype is particularly important for the selection of a biological drug for the treatment of severe asthma and for predicting the response to treatment with it. But these phenotypes are not fixed and can change over time in response to new environmental triggers (viral infections, inhaled allergens, smoking, air pollution). The main cytokines in the T2 type of inflammation in the airways, which is characteristic of severe asthma, are IL-4, IL-5 and IL- 13, IL-17, but an equally significant role in this process is also played by alarmins (inflammation mediators produced, in particular, cells of the bronchial epithelium), which include IL-33, IL-25 and thymic stromal lymphopoietin (TSLP). Clinical features of asthma associated with TSLP include: 1) degree of severity; 2) risk and frequency of exacerbations; 3) the degree of lung function decline; 4) decrease in the patient's response to glucocorticosteroids; 5) decrease in immune response and susceptibility to acute respiratory viral infections; 6) potential remodulation of the respiratory tract; 7) bronchial hyperreactivity and mucus blockage. Therefore, the role of TSLP in the pathogenesis of severe asthma is very significant, so its therapeutic effect (anti-TSLP therapy using tezepelumab) can be considered a new promising direction of biological therapy for patients with bronchial asthma, especially in its severe form. Key words: bronchial asthma, severe form, type 2 inflammation, biomarkers of inflammation, thymic stromal lymphopoietin, biological therapy, tezepelumab.

Investigating neighbourhood environmental risk factors associated with childhood acute respiratory infection symptoms in Ethiopia mixed effect and multilevel logistic regression analysis based on EDHS 2016.

Acute respiratory infection is an infectious illness caused by acute viral or bacterial infection. According to a 2018 WHO report, exposures to indoor and ambient air environmental pollution were contributing factors to a higher risk of respiratory problems following 7 million deaths of children under five globally. Housing conditions such as wall material, roof type, kitchen location, sanitation condition, and cooking fuel type are household-level predictors of acute respiratory disease among children under five years of age. This research used EDHS-2016 secondary data, which are nationally representative. The data collection period was from January 18, 2016, to June 27, 2016. Among the 16,650 total surveys, 10,006 households that had children below 5 years of age. The outcome variable for this study was acute respiratory infection symptoms. Analyses were performed using STATA Version 17.1. The data were weighted before performing analysis to reinstate the representativeness of the sample. In the bivariable analysis, a p value <0.2 was used to screen for multivariable. Multicollinearity was checked using the variance inflation factor. Then, a multilevel multivariable regression model was used in this study for the analysis of acute respiratory infection symptoms and possible predictor variables. Variables with a p value <0.05 in multivariable regression analysis were considered statistically significant predictors. Most (95.00%) households commonly used solid fuel for cooking, and household main construction materials: 81.44 and 91.03% of floors and walls of households were constructed with unprocessed natural materials, respectively. The prevalence of acute respiratory infection symptoms among children under five years of age was 7.955% (7.397, 8.551%). The findings indicated that acute respiratory infection symptoms among children under five years of age were significantly linked with the age of the children, diarrhea status, residence, region, fuel type, stool disposal, wall material, and floor material. Interventions should target modifiable factors such as proper stool disposal of the youngest child, informing the health effects of poor housing conditions such as improving wall and floor construction material to reduce acute respiratory infection symptoms among children under five years of age.

СРАВНИТЕЛЬНАЯ ОЦЕНКА ЗАБОЛЕВАЕМОСТИ ПАЦИЕНТОК ОТДЕЛЕНИЯ ПАТОЛОГИИ БЕРЕМЕННОСТИ С РАЗЛИЧНЫМИ СПОСОБАМИ ЗАЧАТИЯ

Significance. Despite the availability and effectiveness of assisted reproductive technologies, a significant share of the population still has a biased attitude towards in vitro fertilization. Considering a rising prevalence of in vitro fertilization, a comparative morbidity assessment of patients with different types of conception in the department of pregnancy pathology is a relevant research topic. The purpose of the study is to conduct a comparative assessment of morbidity among patients with different methods of conception in the department of pregnancy pathology with a breakdown on age. Material and methods. Using the copy-pair method, data were copied from 1640 forms No. 003/u on patients in the pregnancy pathology department of the perinatal center of St. Petersburg State Pediatric Medical University. Each patient who overcame infertility with the help of in vitro fertilization, was paired with a peer whose pregnancy occurred naturally based on age, marital status and place of residence. The significance of differences in indicators was assessed using Student's t-test. Differences were considered significant at p&lt;0.05. Statistical data processing was carried out using the MS Office-2016 and StatSoft-Statistica 10.0 software packages. Results. In patients of the Department of Pregnancy Pathology who overcame infertility using in vitro fertilization, compared to their peers with natural conception, there was a higher prevalence of preeclampsia, complications caused by acute respiratory viral infections and Covid-19, isthmic-cervical insufficiency, pathology of the placenta, anemia, diseases of the endocrine system, disorders of the hemostasis system and uterine fibroids. At the same time, the frequency of oligohydramnios, polyhydramnios, varicose veins and diseases of the genitourinary system was lower. There were no significant differences in the incidence of gestational diabetes mellitus and myopia between the two groups. Assessment of the effect of age on the morbidity of patients whose pregnancy occurred with the help of in vitro fertilization showed that for most diseases there were no significant differences between women aged 35 and older and pregnant women under 35. It was found that older in vitro fertilization patients had significantly fewer complications caused by infectious diseases, and yet were more likely to experience preeclampsia, polyhydramnios, varicose veins, disorders of the hemostatic system and uterine fibroids. Conclusion. A comparative assessment of the frequency of pregnancy complications and extragenital pathology in patients with different methods of conception in the pregnancy pathology department showed reliable significant differences in the prevalence of individual diseases. The influence of age on morbidity that complicated pregnancy in patients of the pregnancy pathology department was established. Scope of application. The information obtained can be used by obstetricians-gynecologists and health administrators to improve care delivery to women who have overcome infertility with the use of assisted reproductive technologies.

Влияние вакцинации против гриппа, пневмококковой инфекции и SARS-CoV-2 на заболеваемость и тяжесть течения COVID‑19 у медицинских работников отдельного учреждения (эпидемиологические исследования)

Objective. To study the effect of influenza, pneumococcal and SARS-CoV-2 vaccination on the incidence and severity of COVID-19 course in health care workers. Patients and Methods. We examined 547 health care workers divided into group 1 (no history of influenza and pneumococcal vaccination, n = 281) and groups vaccinated between August and October 2020 (before SARS-CoV-2 epidemic II): Group 2 against influenza (n = 98), Group 3 against pneumococcal infection (n = 60), and Group 4 against influenza and pneumococcus (n = 108). Between March and August 2021 (before the SARS-CoV-2 epidemic III outbreak), 98.6% of all employees were vaccinated against COVID-19. We compared COVID-19 incidence rates during Periods II and III epidemic rises (2020–2022) as a function of influenza and pneumococcal vaccination. Results. It was found that with combined vaccination against influenza and pneumococcal infection in the group of medical workers at high risk of infection, the risk of COVID-19 morbidity within 4–5 months was 2 times lower (1.6% vs. 13.2%, p &lt; 0.05) compared to the unvaccinated. Comparative data on COVID-19 incidence in the II and III periods of epidemic rises showed that COVID-19 in medical workers in the III period was registered 36.1% lower in comparison with the index in the II period – 11.2 and 7.1%, respectively (p &lt; 0.05). We found that when comparing II and III periods of epidemic rises among medical workers, the proportion of persons with COVID-19 with moderate forms of disease who received combined vaccination against influenza and pneumococcal infection decreases more than 2-fold (p &lt; 0.05), including in the category with a high risk of infection. Conclusion. The presented data indicate a positive effect of combined vaccination against pneumococcal infection and influenza on the incidence and severity of COVID-19. The proposed approach can be used in public health practice as a method of nonspecific prevention of COVID-19 and other acute respiratory viral infections. Key words: influenza vaccine, pneumococcal vaccine, combined vaccination, epidemic rise, COVID-19

Single-cell RNA sequencing reveals the dynamics and heterogeneity of lymph node immune cells during acute and chronic viral infections.

The host immune response determines the differential outcome of acute or chronic viral infections. The comprehensive comparison of lymphoid tissue immune cells at the single-cell level between acute and chronic viral infections is largely insufficient. To explore the landscape of immune responses to acute and chronic viral infections, single-cell RNA sequencing(scRNA-seq), scTCR-seq and scBCR-seq were utilized to evaluate the longitudinal dynamics and heterogeneity of lymph node CD45+ immune cells in mouse models of acute (LCMV Armstrong) and chronic (LCMV clone 13) viral infections. In contrast with acute viral infection, chronic viral infection distinctly induced more robust NK cells and plasma cells at the early stage (Day 4 post-infection) and acute stage (Day 8 post-infection), respectively. Moreover, chronic viral infection exerted decreased but aberrantly activated plasmacytoid dendritic cells (pDCs) at the acute phase. Simultaneously, there were significantly increased IgA+ plasma cells (MALT B cells) but differential usage of B-cell receptors in chronic infection. In terms of T-cell responses, Gzma-high effector-like CD8+ T cells were significantly induced at the early stage in chronic infection, which showed temporally reversed gene expression throughout viral infection and the differential usage of the most dominant TCR clonotype. Chronic infection also induced more robust CD4+ T cell responses, including follicular helper T cells (Tfh) and regulatory T cells (Treg). In addition, chronic infection compromised the TCR diversity in both CD8+ and CD4+ T cells. In conclusion, gene expression and TCR/BCR immune repertoire profiling at the single-cell level in this study provide new insights into the dynamic and differential immune responses to acute and chronic viral infections.

Оториноларингологическая помощь детям с хроническим риносинуситом

Chronic rhinosinusitis (CRS) is a common disease that has a significant impact on the health and life quality of children. CRS occurs when the disease lasts for more than 12 weeks and it can lead to serious complications. Specialized ENT care is crucial for the diagnosis, treatment and rehabilitation of patients with CRS. This review presents the system of providing specialized ENT care to children in Russia, as well as the organization of medical and social support for children with CRS. Special attention is paid to the prevention of CRS exacerbations in children, including the prevention and timely treatment of acute and recurrent respiratory viral infections, reduction of bacterial load, improvement of mucociliary clearance and follow-up. It is also noted that the formation of a Health School for children with CRS will help teach children to recognize the signs of CRS exacerbations and take action at the first deterioration signs. KEYWORDS: specialized ENT care, chronic rhinosinusitis in children, Health School, medical and social support for children, respiratory viral infection FOR CITATION: Dvornikova T.A., Alexandrova O.Yu. ENT care for children with chronic rhinosinusitis. Russian Medical Inquiry. 2024;8(8):499–504 (in Russ.). DOI: 10.32364/2587-6821-2024-8-8-9.

Effects of Cranberry on Outpatients with Mild to Moderate COVID-19 Infection

COVID-19 disease is an acute viral infection illness of the airway system resulting from the SARS-CoV-2 virus. Cranberry is an evergreen group of dwarf shrubs of the Vaccinium Oxycoccus. The most important pharmacological effects of cranberry are related to its composition liking of quercetin, flavonols, and proanthocyanidins. cranberry had numerous pharmacological activities encompassing antioxidant, cardioprotective, antibacterial, anticancer, antiviral, and regulated glucose levels. This research aimed to estimate the potential activity of cranberry to enhance the efficacy of standard therapy for COVID-19 infection. A total of 30 patients with age ≥ 18 years suffering from mild to moderate COVID-19 pneumonia volunteered to do this study, allocated into two groups. The first group managed standard treatment only according to the National Institutes of Health, while the second group managed standard treatment plus cranberry 1000 mg capsule per day for 7 days. Each patient was assessed individually and follow up for 10 days. Cranberry significantly enhanced the effect of standard COVID – 19 therapies by rapidly relieving clinical symptoms of COVID – 19 infections and significantly lowered the count of WBC, CRP, D-Dimer, and ferritin in comparison with patients who only received STD therapy at P&lt;0.05. In conclusion, Cranberry significantly improved STD therapy by reducing the inflammatory response and enhancing lung function via maintaining normal SPO2% level and relieving clinical symptoms of COVID-19 infection.