Infectious Diseases Hospital Research Articles

Риск распространения COVID-19 среди медицинских работников Самарской области в стационарах различного типа

The purpose of this study was to assess the epidemiological risk for medical workers in the pandemic spread of a new coronavirus infection in various types of medical organizations. Materials and methods. The results of epidemiological surveillance of the staff of the State Budgetary Healthcare Institution of the Samara region «Samara City Clinical Hospital № 2 named after N.A. Semashko» in the number of 631 people, according to the protocols of 132 commissions for the prevention of infections related to the provision of medical care for the period from January 2021 to December 2022. Information from 1318 reports No. 1035 «Monitoring on the number of cases of coronavirus infection, including community-acquired pneumonia, and deaths» in the Samara region from the Rospotrebnadzor information system from April 22, 2020 to December 31, 2022 in terms of the total number of COVID-19 patients per day, the number of infected medical workers per day, the number of infected people in medical organizations. The results of the analysis of 11 scientific articles on the topic of the characteristics of epidemic foci in the teams of medical workers. Results and discussions. The COVID-19 pandemic has demonstrated the importance of developing national bed resources and the human resources of medical workers, taking into account the need for rapid conversion of somatic hospitals. Doctors, mid-level and junior medical personnel are at higher risk of infection both through contact with patients if they do not follow the rules for using PPE, and when interacting with each other. Repurposed somatic hospitals (GBUZ SB «SOKB named after V.D. Seredavina», FGBI VO «Clinics of SamSMU»), in comparison with a specialized infectious diseases hospital (GBUZ SB «GBS № 6»), due to the peculiarities of construction and planning solutions, represent an environment with a higher risk of infection of medical personnel, which requires additional organizational preventive measures. In addition to the general requirements of biological safety in the repurposed red zone, a comprehensive formation of a safe working environment is required, including such components as: organization of rest rooms for staff separately from the residents, development and observance of a meal schedule to eliminate the intersection of personnel flows as much as possible, digitalization of medical documentation, time-limited reception of biomaterial in the laboratory, issuance of the results of research through an electronic information system. Keywords: COVID-19, nosocomial component, epidemic outbreak, medical personnel, PPE, risk of infection, organization of the working environment.

Factors of poor prognosis for new coronavirus infection in patients with cardiovacular pathology

Aim. To assess the structure of cardiovascular pathology in patients with new coronavirus infection (NCI), to identify factors of poor prognosis in these individuals. Material and methods. The study was conducted on the basis of the COVID-19 infectious diseases hospital of the City Hospital No. 33 of Nizhny Novgorod. The study included 284 patients after applying inclusion and exclusion criteria. All subjects were divided into groups: the main group (n = 207) — patients with NCI and cardiovascular diseases (CVD), as well as comorbid diseases, the comparison group (n = 24) with NCI and CVD, the control group (n = 53) with NCI without any comorbid diseases. Demographic indicators, BMI, laboratory parameters, comorbidity and therapy were analyzed. Results. During the study, it was revealed that the most severe course of COVID-19 is characteristic of the main group, and only among them there were fatal outcomes (25% of cases). Analyzing the prevalence of CVD, it turned out that arterial hypertension was the most common in the main group and in the comparison group, coronary heart disease and heart failure were registered somewhat less frequently. The development of acute cardiovascular accidents occurred only in the main group. A mathematical model was developed to determine the risk of death in patients with NCI who are in the hospital. This model is statistically significant (p < 0.001). Conclusion. The older age of patients, the development of acute myocardial infarction, first identified atrial fibrillation and a decrease in saturation contributed to an increased risk of mortality in patients with NCI and CVD. Among drug therapy, the administration of favipiravir, tocilizumab and statins had a beneficial effect on the outcome of diseases.

Prevalence and changing antimicrobial resistance profiles of Shigella spp. isolated from diarrheal patients in Kolkata during 2011-2019.

The primary aim of this study was to investigate the occurrence, characteristics, and antimicrobial resistance patterns of various Shigella serogroups isolated from patients with acute diarrhea of the Infectious Diseases Hospital in Kolkata from 2011-2019. During the study period, Shigella isolates were tested for their serogroups, antibiotic resistance pattern and virulence gene profiles. A total of 5.8% of Shigella spp. were isolated, among which S. flexneri (76.1%) was the highest, followed by S. sonnei (18.7%), S. boydii (3.4%), and S. dysenteriae (1.8%). Antimicrobial resistance against nalidixic acid was higher in almost all the Shigella isolates, while the resistance to β-lactamases, fluoroquinolones, tetracycline, and chloramphenicol diverged. The occurrence of multidrug resistance was found to be linked with various genes encoding drug-resistance, multiple mutations in the topoisomerase genes, and mobile genetic elements. All the isolates were positive for the invasion plasmid antigen H gene (ipaH). Dendrogram analysis of the plasmid and pulsed-field electrophoresis (PFGE) profiles revealed 70-80% clonal similarity among each Shigella serotype. This comprehensive long-term surveillance report highlights the clonal diversity of clinical Shigella strains circulating in Kolkata, India, and shows alarming resistance trends towards recommended antibiotics. The elucidation of this study's outcome is helpful not only in identifying emerging antimicrobial resistance patterns of Shigella spp. but also in developing treatment guidelines appropriate for this region.

Immune Cell Response of the Spleen in COVID-19

Objective. To study the morphometric characteristics and splenic immune cell response in patients with COVID-19.Material and methods. A prospective observational study included 70 patients. Of these, 45 patients admitted to the infectious diseases hospital with Coronavirus infection caused by the SARS-CoV-2 virus diagnosis were included in the COVID-19 group, and 25 patients were included in the acute respiratory viral infection (ARVI) comparison group. Spleen linear dimensions, including length, width, and thickness were assessed using ultrasound imaging, and calculations of the spleen weight and spleen weight coefficient (SWC) were obtained. Additionally leukocyte count and formula, erythrocyte sedimentation rate (ESR) were estimated, and the leukocyte index (LI) and neutrophil-to-lymphocyte ratio (NLR) were calculated.Results. Microsplenia was common in the acute period of COVID-19 with mean SWC value 1.6±0.2. In 17 (37.8%) patients the SWC varied from 1.0 to 1.5, and in 9 (20%) microsplenia was critical with SWC <1.0. Leukocyte count was lower, and ESR — higher in patients with COVID-19, compared to ARVI group (5.4±2.1×10⁹/l and 10.8±4.8×109/l, respectively P<0.00001, and ESR — 36.1±13.8 mm/h and 23.0±5.1 mm/h, respectively P=0.03). The course of COVID-19 was characterized by a slight decrease in LI — from 0.29±0.02 to 0.22±0.01 (P=0.19), and significant increase in NLR from 3.7±0.1 to 4.3±0.12 (P=0.002). Opposite trends were documented in patients with ARVI. On Day 5 since initiation of treatment LI was significantly lower in the COVID-19 vs ARVI group (0.22 [0.16; 0.39] vs. 0.48 [0.29; 0.93], P=0.003), and NLR was significantly higher (4.3 [2.5; 6.1] vs. 2.1 [0.9; 2.9], P=0.002).Conclusion. The course of coronavirus infection caused by the SARS-CoV-2 virus is characterized by significant immunological shifts. Microsplenia verified by ultrasonography stays as one of the pathognomonic signs. This phenomenon is explained by rapid «depletion» of the spleen as a secondary immune organ, and is associated with a high risk of developing acute immune deficiency.

A Comparative Analysis of Liver Injury Markers in Post-COVID Syndrome among Elderly Patients: A Prospective Study.

In the wake of the global COVID-19 pandemic, understanding its prolonged impact on vulnerable populations has become a critical area of investigation. This study aimed to elucidate the distinctive post-acute sequelae of SARS-CoV-2 infection (PASC) and liver injury in Romania's elderly population, hypothesizing unique demographic, clinical, and healthcare factors influencing the manifestation. A longitudinal design was employed, enrolling COVID-19 patients from the Victor Babes Hospital for Infectious Diseases and Pulmonology in Timisoara, Romania. Participants were stratified into three groups based on age and Long COVID status. The study focused on a variety of demographic, clinical, and biological parameters, including liver function tests, to assess the trajectory and severity of liver injury over six months post discharge. Involving 238 participants, the study revealed a significant increase in the duration of hospitalization for those over 65 (15.8 ± 8.2 days) compared to younger groups (p < 0.001). Notably, elderly Long COVID patients exhibited a marked elevation in liver enzymes post discharge, with median ΔALT and ΔAST of 24.1 U/L and 30.2 U/L, respectively, suggesting ongoing liver injury (p < 0.001). Significant metabolic disruptions were observed, with the ΔFasting glucose showing a substantial median decrease of 21.1 mmol/L in the elderly group (p < 0.001). A pronounced reduction in ΔGGT (16.7 U/L) and ΔLDH (48.7 U/L) was noted, indicating a recovery in liver function and reduced tissue damage (p < 0.001). Coagulation profiles and liver fibrosis risk scores, particularly ΔFIB-4 and ΔAPRI, also significantly improved post discharge, indicating a reduced risk of ongoing liver complications. This study confirms the hypothesis of more severe PASC and liver injury among the elderly Romanian population. Significant improvements post discharge suggest a degree of recovery, yet the persistent alterations in liver enzymes, glucose metabolism, and fibrosis risk scores call for continued monitoring and tailored management strategies.

The Dynamic Risk of COVID-19-Related Events in Vaccinated Healthcare Workers (HCWs) from a Tertiary Hospital in Bucharest, Romania: A Study Based on Active Surveillance Data.

Our study describes the frequency and severity of COVID-19 in HCWs and estimates the dynamic risk of COVID-19-related events. We actively surveyed all HCWs from a tertiary infectious disease hospital from 26 February 2020 to 31 May 2023. Of 1220 HCWs, 62.9% (767) had at least one COVID-19 episode. The under 29 years (p = 0.0001) and 40-49 years (p = 0.01) age groups, nurses (p = 0.0001), and high-risk departments (p = 0.037) were characteristics significantly more frequent in HCWs with COVID-19 history. A higher percentage of boosters (53.2%; p < 0.0001) were registered in the uninfected group. The second episode of COVID-19 was significantly milder than the first. Data regarding clinical outcomes from 31 January 2021 to 31 May 2023 were analyzed in a follow-up study to determine the risk of COVID-19-related events. The Cox regression analysis revealed that HCWs with booster shots had a lower risk of COVID-19 across all events, symptomatic events, and moderate to severe events as adjusted hazard ratio (aHR) were: 0.71 (95%CI: 0.54-0.96), 0.23 (95%CI: 0.12-0.46), and 0.17 (95%CI: 0.07-0.43), respectively. Within the vaccinated subgroup, the HCWs with hybrid immunity and booster had aHR for all followed-up events of 0.42 (95%CI: 0.30-0.58), for symptomatic events of 0.52 (95%CI: 0.36-0.74), and 0.15 (95%CI: 0.03-0.66) for moderate to severe events. The risk of COVID-19 clinical events was lower for HCWs with at least one booster than those completely vaccinated.

Efficacy of Lamivudine and Dolutegravir simplification therapy compared with triple therapy in Northeast Brazil (LAMDO Study)

Background: Modern antiretroviral therapy provides numerous effective and well-tolerated treatment options for individuals living with HIV. However, due to medication tolerability, toxicity, and cost optimization associated with the emergence of highly potent drugs, dual therapy has emerged as a new therapeutic alternative for patients with viral suppression. Observational studies worldwide are being conducted to assess the effectiveness of dual therapy in people living with HIV/AIDS. A real-world study is important to validate the findings obtained in controlled studies. Objective: Assess the effectiveness of dual therapy with lamivudine and dolutegravir compared to triple therapy in real-life settings. Methods: The study was conducted at São José Infectious Diseases Hospital, a tertiary referral hospital in the state of Ceará, northeast Brazil, for the treatment of PLWHA. Results: A total of 521 patients were taking double therapy with lamivudine plus dolutegravir and 450 patients were in triple therapy, mostly in the use of association with dolutegravir, were analyzed. Patients on dual therapy had a higher median age compared to those on triple therapy. A statistically significant higher viral suppression was observed in patients on dual therapy compared to triple therapy (p &lt; 0,001). Viral suppression on dual therapy under 200 copies was 97.2%. There was a statistically significant higher percentage of patients with higher CD4/CD8 ratio using triple therapy compared to dual therapy. Conclusion: The current study suggests a higher effective response to dual therapy compared to triple therapy in PLWHA in the real-world, supporting therapy simplification as a sustainable option to maintain virological suppression in patients experiencing toxicity or comorbidities.

Microbial associations for pneumonia causative agents and level of their resistance to antimicrobial drugs during a new coronavirus infection pandemic

Introduction. Bacterial coinfection and secondary bacterial infection are considered critical risk factors for the severity and mortality of SARS-CoV-2-caused pneumonia. The aim of the study was to analyze a pattern of microbial associations between K. pneumoniae and A. baumannii isolated from the lower respiratory tract discharge and sectional material (lung tissue) of patients diagnosed with pneumonia, and to compare resistance level in monoculture and associations during new coronavirus infection pandemic. Materials and methods. A bacteriological study of 2689 sputum and bronchial washing samples from patients at infectious diseases hospitals, and 1411 lung pathological material samples was carried out. Bacterial isolates were identified by mass spectrometry. Antibiotic sensitivity for isolates was determined by the disk diffusion method. Genetic determinants of resistance to beta-lactam antibiotics were detected by PCR. Statistical data processing was performed using SPSS version 22 software. Results. K. pneumoniae and A. baumannii isolates were predominantly found in two- and three-pathogen associations. It was established that the resistance level of K. pneumoniae isolates in association with A. baumannii is significantly higher compared to that in monoculture for all antimicrobial drugs studied. At the same time, K. pneumoniae in combination with Candida spp. vs monoculture showed significantly lower level of resistance to ciprofloxacin, amikacin, cefotaxime, ceftazidime and amoxicillin/clavulanic acid. K. pneumoniae isolates carried resistance determinants to extended-spectrum beta-lactamases: OXA-48 — (22.5%), OXA-51 — (5.6%), OXA-23 — (4.2%), KPC — 70.9%, NDM — 7%. Of these, 14.1% of strains had the ability to co-produce serine carbapenemases OXA-48 and KPC. Sputum and lung tissue A. baumannii isolates exhibited extremely high multiple resistance regardless of their associations with other microorganisms. Microbiome species similarity in the lower respiratory tract and lung tissue discharge was revealed. The proportion of lung tissue vs sputum resistant strains of K. pneumoniae and A. baumannii was significantly higher. Conclusion. The detection of of multiple drug resistant K. pneumoniae and A. baumannii isolates as well as their associations may indicate aggravated pneumonia severity.

ПРОГНОСТИЧЕСКАЯ ЗНАЧИМОСТЬ ИССЛЕДОВАНИЯ УРОВНЕЙ МАРКЕРОВ АПОПТОЗА – БЕЛКОВ P53 И BCL-2 У ПАЦИЕНТОВ ПОЖИЛОГО ВОЗРАСТА С ВИРУСНОЙ ПНЕВМОНИЕЙ, ВЫЗВАННОЙ SARS-COV-2

Abstract. Introduction. Тo date, the prognostic value has been proven for some laboratory biomarkers and biomarker panels for risk stratification in patients with viral pneumonia caused by SARS-CoV-2. In studies related to the research in the leading pathogenetic mechanisms of COVID-19, much attention is paid to apoptosis and its markers, such as proteins P53 and BCL-2. Aim: To study the levels of P53 and Bcl-2 proteins and their prognostic significance in lethal outcomes among elderly patients with viral pneumonia caused by SARS-CoV-2, hospitalized in an infectious hospital. Materials and Methods. For the period December 2021 – February 2022, in accordance with the inclusion criteria, a sample of 67 patients was formed from elderly patients (60-74 years old) hospitalized in the hospital of infectious diseases. During the follow-up, 18 patients (26.9 %) had fatal outcomes and 49 patients (73.1 %) had favorable outcomes. Biochemical markers of apoptosis, P53 and BCL-2, were detected using the enzyme immunoassay method. Results and Discussion. The analysis showed the presence of statistically significant differences when comparing the levels of both proteins, P53 (p=0.001) and BCL-2 (p=0.002) in patients with favorable outcomes, compared to those with fatal outcomes. Threshold values of the P53 and BCL-2 proteins at the cut-off point in case of death of elderly patients with viral pneumonia caused by SARS-CoV-2 were 99.3 pg/ml and 78.9 IU/ml, respectively. The classification tree includes the following lethality predictors: Threshold levels of apoptosis markers, the number of comorbid diseases, and the respiratory failure degree. Five terminal nodes were identified. Terminal nodes 6 and 8 were classified as high risk of death. Lethal outcomes were observed in 75.0 % of patients at these nodes. At terminal node 3, fatal outcome was observed in 8.1 % of patients, while there were no fatal outcomes at terminal node 7; therefore, both were classified as low-risk ones in terms of a fatal outcome. The sensitivity of the resulting model was 66.7 %, while its specificity was 91.8%. The total share of correct predictions made 85.1% among the subjects of this sample (p=0.044). Conclusions. The data obtained indicate the prognostic significance of studying the apoptosis markers, i. e., proteins P53 and BCL-2, in elderly patients with viral pneumonia caused by SARS-CoV-2. The classification tree proposed can be used as an auxiliary algorithm to optimize the personalized stratification of the lethality risk in elderly patients with viral pneumonia caused by SARS-CoV-2.

Cure of hemophagocytic lymphohistiocytosis triggered by Epstein–Barr virus infection after early diagnosis and appropriate treatment with etoposide, dexamethasone, and immunoglobulin

Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threatening condition characterized by uncontrolled activation of T lymphocytes and inappropriate activation of mature macrophages secreting excessive cytokines leading to marked hypercytokinemia. It can also be secondary to neoplasms, rheumatologic diseases, or infections. This was a case report, described in Central Brazil, of a 17-year-old female patient diagnosed with HLH after infection by Epstein–Barr virus (EBV), which eventually improved after early diagnosis and treatment with etoposide, dexamethasone, and immunoglobulin. The early diagnosis and treatment of this condition are of utmost importance owing to its high mortality rate. Therefore, this is a case report of a young patient who developed HLH, after EBV infection, requiring transfer to a reference hospital for infectious diseases, with optimization of diagnosis and early initiation of specific treatment after discussion between a medical team made up of several specialists.

Langkah Taktis Gaya Kepemimpinan Lurah Sunter Jaya Dalam Menghadapi Pandemi COVID-19

At the beginning of 2020 the world was hit by the Coronavirus Disease 2019 (Covid-19) disaster, this virus attacked the human respiratory tract. Covid-19 was first discovered in the city of Wuhan, China. . The first Covid-19 case in Indonesia began with 2 (two) residents of Depok, West Java who were given treatment at the Infectious Disease Hospital (RSPI) Prof. Dr. Sulianti Saroso. The spread of this virus has changed the way of life and conditions of society. In this case, it is a test for the village leader to show the characteristics of the leadership style in dealing with the Covid-19 virus. This research is to determine the tactical steps of the leadership of Lurah Sunter Jaya in dealing with Covid-19. Qualitative research methods are research approaches applied in natural situations, where the researcher acts as the main instrument. Data collection using various techniques combined, and data analysis was carried out with inductive and qualitative approaches to explain research findings related to the role of a village head during the Covid-19 pandemic, exemplifying one's own behavior to subordinates, as a leader you must be the front troop, taking a role in strategic matters, conveying to subordinates that sub-district employees are community servants or the foundation of the community to solve the Covid-19 problem, there must be involvement from the community.

Relationships of doctors and patients of the infection hospital during the 1st and 2nd waves of the COVID-19 pandemic

Aim. To conduct a comparative analysis of the relationship between doctors and patients in a regional infectious diseases hospital to combat the complications of COVID-19 during the 1st and 2nd waves of the pandemic.&#x0D; Materials and methods. The basis of the study was the infectious diseases hospital deployed in the City Clinical Hospital No. 5 in Nizhny Novgorod. The hospital treated patients with complications of coronavirus infection with concomitant therapeutic or surgical pathology. The study was conducted taking into account the principles of robust management through questioning, on issues related to the social characteristics of patients and their subjective assessments of relationships with medical personnel. The scope of the study was 129 people.&#x0D; Results. The study did not reveal any changes in the relationship between medical workers and patients; both in the 1st and in the 2nd wave of the pandemic, they were built on mutual respect and empathy: medical workers do their best to support patients, the latter, in turn, understand the difficulties of staff work in an infectious diseases hospital and feel gratitude. The established facts are convincing proof of the high level of readiness of medical organizations and their employees to work in extreme conditions associated with a tense epidemic situation.&#x0D; Conclusion. Thus, the results of this study indicate the formation in the 1st wave of the pandemic of a model of relationships built on the principles of mutual trust, support and avoidance of conflicts between doctors and patients of the regional infectious diseases hospital and the preservation of this model during the 2nd wave of the pandemic.

Comparative Analysis of COVID-19 Outcomes in Type 1 and Type 2 Diabetes: A Three-Year Retrospective Study.

Background and Objectives: This comprehensive retrospective study assesses COVID-19 outcomes in type 1 (T1D) and type 2 diabetes (T2D) patients across three years, focusing on how these outcomes varied with the evolving pandemic and changes in diabetes management. The study aims to determine if COVID-19 outcomes, including severity, intensive care unit (ICU) admission rates, duration of hospitalization, and mortality, are significantly different between these diabetes subtypes. Materials and Methods: The study analyzed data from patients admitted to the Victor Babes Hospital for Infectious Diseases and Pulmonology with confirmed COVID-19 and pre-existing diabetes, from the years 2020, 2021, and 2022. Results: Among 486 patients (200 without diabetes, 62 with T1D, 224 with T2D), T2D patients showed notably higher severity, with 33.5% experiencing severe cases, compared to 25.8% in T1D. Mortality rates were 11.6% in T2D and 8.1% in T1D. T2D patients had longer hospital stays (11.6 ± 7.0 days) compared to T1D (9.1 ± 5.8 days) and were more likely to require ICU admission (OR: 2.24) and mechanical ventilation (OR: 2.46). Hyperglycemia at admission was significantly higher in the diabetes groups, particularly in T2D (178.3 ± 34.7 mg/dL) compared to T1D (164.8 ± 39.6 mg/dL). Conclusions: The study reveals a discernible difference in COVID-19 outcomes between T1D and T2D, with T2D patients having longer hospital admissions, mechanical ventilation necessities, and mortality risks.

Investigating the Contributing Risk Factors toward Sarcopenia Prevalence and its Development in Human Immunodeficiency Virus (HIV) Patients

Background Human Immunodeficiency Virus (HIV) causes immune system impairment, and antiretroviral therapy (ART) given for HIV may increase the risk of morbidity and adverse health outcomes, including sarcopenia. The prevalence of sarcopenia in patients with HIV in non-Asian countries has been well-documented, but not in Asian countries. Objective The study aimed to investigate the prevalence of sarcopenia and its association with HIV in Thai patients. Methods A cross-section study was designed. This study included 114 patients with HIV from a specialized infectious disease hospital aged 20-75 years and receiving ART for more than a year. Gait speed, muscle strength, and muscle mass were measured using the 6-m walking test, handgrip dynamometer, and bioelectrical impedance analysis, respectively. Patient medical records and Global Physical Health Questionnaire scores were assessed. Logistic regression analysis was used to determine the risk of sarcopenia occurrence. Results The prevalence of sarcopenia was 21.93%. Risk factors for sarcopenia included duration of ART (odds ratio [OR]=16.55), advanced age (≥60 years, OR=13.50), duration of living with HIV (OR=9.44), and female sex (OR=3.79). Besides, low physical activity, which is a modifiable behavioral, had an OR of 2.78. Conclusion The prevalence of sarcopenia in people with HIV was 21.93%. The duration of ART was the most prominent risk factor for sarcopenia in patients with HIV. Patients with HIV should increase their physical activity levels to reduce sarcopenia risk.

Ambient Temperature Effects on Hospitalization Risk Among Farmers: A Time-Series Study on Multiple Diseases in Vietnam.

The aim of the study is to assess the effect of high temperatures on hospitalization for all causes and heat-sensitive diseases among Vietnamese farmers. The Poisson generalized linear model and distributed lag nonlinear model were used to investigate the temperature-hospitalization association for all causes and seven cause-specific disease groups. Every 1°C increase in daily mean temperature above the threshold increased the estimated relative risk (95% CI) of all-cause hospitalization by 1.022 (0.998-1.047) at the country level, 1.047 (1.007-1.089) in the south, and 0.982 (0.958-1.006) in the north. Infectious disease hospitalization was most affected by high temperatures (1.098 [1.057-1.140]). High temperatures significantly increased the risk of all-cause hospitalization for farmers 60 years and younger in three of the six provinces. The findings emphasized the need for health promotion programs to prevent heat-related health issues.

Dynamics of main markers of protein metabolism and microelements in patients with new coronavirus infection

Objective. To study the dynamics of the main markers of protein metabolism and microelements in patients with a new coronavirus infection. Materials and methods. A prospective clinical and laboratory study of the dynamics of the main markers of protein metabolism and microelements was carried out in 62 patients with a new coronavirus infection complicated by the development of pneumonia with a moderate course on the basis of Perm regional clinical hospital of infectious diseases in 2021–2022. On the 1st and 14th days of hospitalization all patients underwent general clinical and biochemical studies. The concentrations of total protein, albumin, transferrin, Fe, Zn and Cu was also determined. Statistic processing of the results was carried out using Microsoft Excel 2000 and “Statistica 10”. Results. A decrease in visceral pool proteins was revealed. It indicated their active consumption and formation of hypermetabolism - hypercatabolism syndrome in a moderate course of the infection. A progressive deficiency of Fe and Zn, correlating with life-threatening complications and deaths was revealed. Conclusions. The course of a new coronavirus infection contributes to the development of metabolic disorders, and the identified deficiency of macro- and microelements is a predictor of a severe course of the infection.

Assessing the Quality of Life, Coping Strategies, Anxiety and Depression Levels in Patients with Long-COVID-19 Syndrome: A Six-Month Follow-Up Study.

This longitudinal study investigates the psychosocial effects of long-COVID Syndrome, a domain still not extensively researched. It specifically evaluates the quality of life, coping mechanisms, anxiety and depression levels in COVID-19 survivors, differentiating between those with and without long-COVID Syndrome. Conducted at the Victor Babes Hospital for Infectious Diseases and Pulmonology in Timisoara, Romania, the study utilized a cohort of patients diagnosed with mild to moderate COVID-19. The following standardized tools: WHOQOL-BREF for quality of life, COPE-60 for coping strategies, and the Hospital Anxiety and Depression Scale (HADS), were employed for the assessment. The sample consisted of 86 patients displaying persistent post-acute symptoms and 432 asymptomatic patients at the 6-month post-discharge mark. Patients with frequent post-acute symptoms reported significantly higher levels of fatigue (8.2 ± 1.4), cognitive difficulties (7.5 ± 1.6), and respiratory challenges (7.8 ± 1.3), along with a markedly lower overall quality of life (7.0 ± 1.5) compared to their asymptomatic counterparts. HADS scores revealed elevated depression (6.8 ± 1.9) and anxiety (7.1 ± 2.3) in the symptomatic group. Quality of life, as evaluated through the use of WHOQOL-BREF, showed lower scores in the symptomatic cohort across physical (58.8 ± 15.8), mental (56.3 ± 16.4), and social domains (50.2 ± 17.5). COPE-60 findings indicated a higher prevalence of disengagement (56.4%) and emotion-focused coping strategies (61.8%) in the symptomatic group, in contrast to 30.1% and 37.0%, respectively, in the asymptomatic group. The study highlights that long-COVID Syndrome significantly deteriorates the quality of life and is associated with increased depression and anxiety levels. The prevalent use of disengagement and emotion-focused coping strategies among patients with persistent symptoms suggests a need for enhanced psychosocial support tailored to this subgroup.

Efficacy of stage I rehabilitation of medical workers with moderate course of interstitial lung damage associated with COVID-19

Aim of the study was to evaluate the effectiveness of early rehabilitation methods for medical workers with severe or moderate lung damage caused by a new coronavirus infection, who are in intensive care units, to improve lung ventilation, gas exchange and bronchial clearance, correct muscle weakness, increase overall physical endurance, mobility, psycho-emotional stability.Material and methods. We examined 53 COVID-19 women with moderate lung injury at stage I of rehabilitation, divided into two groups: main (n = 31, medical personnel) and control (n = 22, working outside of contact with pulmotropic risk factors, including no risk of SARS-CoV-2 infection). Early rehabilitation was carried out in the intensive care unit and in the infectious diseases hospital of City Clinical Hospital No. 2, for patients with COVID-19 rehabilitation plan was drawn up in accordance with temporary guidelines for the medical rehabilitation of a new coronavirus infection.Results and discussion. It was established, that rehabilitation in the conditions of the intensive care unit and the specialized department can significantly reduce the severity of dyspnea, anxiety and depression, positively affects the increase in exercise tolerance, and helps to reduce the activity of systemic inflammation. In patients who have industrial contact with patients with COVID-19, the effectiveness of rehabilitation measures is lower than in the comparison group.Conclusions. To increase the effectiveness of stage I of the rehabilitation of medical workers with COVID-19 and lung damage, it is necessary to conduct more intensive and longer rehabilitation than indicated in the current guidelines.

Erectile function in men with COVID-19 six months after recovery

Background. Based on the results of epidemiological studies, it was found that coronavirus disease 2019 (COVID-19) affects men more often than women. Among COVID-19 complications, erectile dysfunction is considered a marker of endothelial dysfunction and one of the main factors for the development of cardiovascular diseases. Lower total and free testosterone levels are predictors of adverse prognosis in males with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Testosterone deficiency syndrome is considered an independent risk factor of cardiometabolic disorders. The purpose of the study is to investigate the state of erectile function in men who suffered from COVID-19 six months after recovery. Materials and methods. Seventy-two men suffering from COVID-19 and being treated in an infectious disease hospital were examined 6.90 ± 0.29 months after recovery. Their average age was 45.23 ± 3.01 years. The control group included 18 conditionally healthy men aged 43.18 ± 2.90 years. The state of erectile function was assessed using the International Index of Erectile Function (IIEF). The concentration of testosterone was determined by the enzyme-linked immunosorbent assay with DRG (Germany) and DiaMetra (Italy) kits. All measurements were performed on the Stat Fax 3200 analyzer. Statistical comparison of the obtained results between groups was performed according to the Student’s test. A value of p &lt; 0.05 was considered to be signifi­cant. Results. In addition to erectile dysfunction, as evidenced by a reduced corresponding integrative indicator “erectile function” of IIEF-15 in men with COVID-19, a decrease in sexual desire was found, as well as a deterioration of sensations in the form of a decrease in ejaculation frequency and orgasmic sensations during sex contacts. The average serum level of total testosterone was 10.9 nmol/l and was significantly reduced compared to that in the control group. Analysis of individual indicators showed that testosterone level was decreased in 10 patients and was within the normal range in 13 men with COVID-19. The average serum concentration of total testosterone in the examined men after the disease was 10.73 ± 1.07 nmol/l and was significantly reduced compared to that of the control group. Conclusions. There was an erectile dysfunction in men who suffered COVID-19, it was confirmed by a probable decrease in IIEF-15 score and integrative indicators of erectile function. A significant decrease in the blood concentration of total testosterone was detected in the examined men, which may be one of the causes of erectile dysfunction. Large-scale prospective, randomized, controlled trials in patients infected with SARS-CoV-2 are needed to provide an understanding of the molecular mechanisms that cause erectile dysfunction.

Economic Burden of Invasive Meningococcal Infection in Children in the Republic of Belarus

Relevance Invasive meningococcal infection (IMI) is a significant clinical problem and is associated with a high probability of severe complications and death. Vaccination programs against meningococcus can achieve significant clinical effectiveness and require significant financial costs. This makes it relevant to study the economic burden of meningococcal infection in the conditions of modern healthcare in order to obtain basic data for subsequent research in the field of evaluation of medical technologies.Aims. To assess the economic burden of IMI in children in the conditions of healthcare in the Republic of BelarusMaterial and methods: a retrospective study using the "cost of illness" method was conducted for 22 children hospitalized in the city children's infectious clinical diseases hospital in 2018-2019. All values are presented in belarusian rubles. The average ± standard deviation, minimum – maximum values, median [Q1, Q3], cost shares (%) are calculated for the cost values. The minimum– maximum values and median [Q1, Q3] were calculated for the age of the patients.Results: taking into account the costs of treatment in healthcare organizations of all patients studied, the share of direct costs of hospitalization was 29.0%, the share of direct costs of diagnosis – 7.2%, the share of direct costs of pharmacotherapy - 8.3%. A significant part of the costs accounted for observations after discharge and amounted to 55.4%.Conclusion: a retrospective study of the economic burden of MI in the Republic of Belarus using the "cost of illness" method in patients hospitalized in a public health organization demonstrates a significant economic burden of this disease, which in the long term is primarily due to the presence of complications in the patient, as well as the impact of the patient's death on the value of total costs. The data obtained can be used in conducting national research on the evaluation of medical technologies.