Pandemic Of Coronavirus Infection Research Articles

Территориальные особенности оказания экстренной хирургической помощи сельскому населению (на примере Республики Северная Осетия-Алания).

The need to modernize healthcare dictates the study of healthcare organization at all levels. Special attention is paid to the territorial accessibility of medical care, including to the rural population, which differs in many specific features. The purpose of the study: to study the territorial features of providing emergency surgical care to the rural population, taking into account the number, density of population settlement, road infrastructure, and transport security in the Republic of North Ossetia-Alania. Research methods. Analytical and statistical research methods were used. The performance indicators of surgical departments of rural district hospitals for 2019–2022 have been studied. The analysis of the obtained data was carried out by the method of their structural description according to the selected main characteristics affecting territorial accessibility. Results. The Republic of Ossetia-Alania is characterized by high density and compactness of population settlement in rural areas. The creation of a modern transport infrastructure ensures the territorial accessibility of medical care. The republic has a fairly high level of provision with surgeons (2,53 per 10 thousand population) and a surgical bed fund (4,7 per 10 thousand population). However, there is a need to increase the efficiency of using the bed stock of rural surgical hospitals. The organization of surgical care in the republic in 2020–2021 was extremely negatively affected by the pandemic of coronavirus infection COVID‑19. The reduction of surgical and anesthesiological teams, beds and the volume of planned care due to the opening of additional infectious diseases hospitals has reduced the availability and quality of emergency surgical care. In rural district surgical departments, the bed function decreased from 283 days in 2019 to 243 days in 2020, and surgical activity up to 38,8%. In 2020–2021, planned medical care in the «surgery» profile has significantly decreased. The share of emergency hospitalizations increased to 79,7%. Negative trends in the growth of emergency hospitalization for surgical beds led to an increase in the hospital mortality rate compared to 2019 from 0,6% to 3,1% in 2021. The postoperative mortality rate has increased by more than 5 times. Our data correlate with similar trends of 33% increase in hospital mortality in the Russian Federation during the pandemic. Due to the creation of modern road transport infrastructure in the republic, high availability of surgical beds and surgeons, there is a potential to improve the quality indicators of rural surgical hospitals by improving the material and technical equipment and qualifications of surgical personnel.

Reduced Immunogenicity of COVID-19 Vaccine in Obese Patients with Type 2 Diabetes: A Cross-Sectional Study.

The global pandemic of coronavirus infection 2019 (COVID-19) was an unprecedented public health emergency. Several clinical studies reported that heart disease, lung disease, diabetes, hypertension, dyslipidemia, and obesity are critical risk factors for increased severity of and hospitalization for COVID-19. This is largely because patients with these underlying medical conditions can show poor immune responses to the COVID-19 vaccinations. Diabetes is one of the underlying conditions most highly associated with COVID-19 susceptibility and is considered a predictor of poor prognosis of COVID-19. We therefore investigated factors that influence the anti-SARS-CoV-2 spike IgG antibody titer after three doses of vaccination in patients with type 2 diabetes. We found that obesity was associated with low anti-SARS-CoV-2 spike IgG antibody titers following three-dose vaccination in type 2 diabetics. Obese patients with type 2 diabetes may have attenuated vaccine efficacy and require additional vaccination; continuous infection control should be considered in such patients.

Factors predicted metabolic syndrome among health care workers exposed to coronavirus disease 2022 in Erbil, Iraq

Background and objective: There have been a recent concern about life style and stress exposure among health care workers during corona virus infection pandemic. This study aimed to investigate the lifestyle of the staff working in public hospitals in Erbil city during the years of 2021-2022. Methods: This is a survey involving data of the available hospital staff from 1st of January 2021 to 1st of April 2022. The hospital staff were including the reception staff, logistic staff, doctors and medical assistances working at the hospitals during the COVID-19 pandemic. In this study, 313 hospital staff are taken conveniently from the working hospitals. Demographic data and laboratory investigations were taken from all the participants. Results: During COVID19 metabolic syndrome was high among staffs. Females shown to have higher prevalence of metabolic syndrome (28.9%) than males (12%). Have a car (19.9%), living in rural area (21.7%) primary education (33.3%) have highest prevalence of metabolic syndrome. Furthermore, regarding the occupation of staffs, operation assistants have highest prevalence of metabolic syndrome (37.2%) followed by reception staff (28.6%) and pharmacists (25%). Association with male sex (p value<0.001), marriage (p value=0.01) with metabolic syndrome was statistically significant. Conclusions: During COVID19 pandemic metabolic syndrome was common among staffs. Aging, sex, education, occupation, smoking, fatty diet, marriage, family history of diabetes and cardiac disease are the main risk factors for metabolic syndrome. People with these risk factors should be assessed for metabolic syndrome and educated about the risks and possible consequences in the future.

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.

Dynamics of hospital mortality in COVID-19 pandemia

Background. During the pandemic of coronavirus infection (COVID-19) caused by a virus SARS-CoV-2 there has been significant variability in symptoms of the disease over time, severity of the course and in particular hospital mortality. Several SARS-CoV-2 variants have been identified such as Alpha, Delta, Omicron and others.
 Aim. To investigate the hospital mortality in patients with different strain variants during the period from April 2020 to April 2022. All included patients had moderate to severe COVID-19-associated pneumonia requiring hospitalization.
 Materials and methods. In this retrospective, conclusive, non-randomized, non-controlled study 4854 clinical records of hospitalized patients with Alpha (n=2400, April – December 2020), Delta (n=1722, 2021) and Omicron (n=627, January – April 2022) variants were investigated.
 Results. Hospital mortality is 6% in Alpha variant patients (6%), 5.7% in Delta and significantly lower in Omicron (1.5%; p0,001). Cardiovascular disease (arterial hypertension, coronary heart disease, chronic heart failure), diabetes mellitus and chronic kidney disease were risk factors for death in Alpha and Delta, but not in Omicron. There was also a significant decrease in the duration of hospitalization with strains Delta [7 days (5; 9)] and Omicron [7 (5; 11)] compared with Alpha [11 (9; 13); p0,001], and differences in factors the risk of mortality between the tested COVID variants.
 Conclusion. Thus, differences in mortality and risk factors for death between COVID-19 variants could be shown in our cohort.

Mental disorders of non-psychotic level during the pandemic of coronavirus infection

The coronavirus infection (COVID-19) is a pressing problem of the 21st century, since in a short period of time the epidemic of this infection rapidly developed into the pandemic with ensuing medical and socio-economic consequences. The impact of the pandemic on the mental health of the population is explained both by the direct biological impact of the virus on the human body and by associated psychosocial factors. The purpose of our work is to study the clinical picture and dynamics of non-psychotic mental disorders caused by the COVID-19 pandemic. Materials. An analysis of 991 archival medical records of the patients who were treated in the Psychotherapy Department, Altai Regional Clinical Psychiatric Hospital named after Yury Karlovich Erdman, for 2021–2022 was carried out. Of these, 246 patients (24.8 %) had a history of COVID-19 or associated the occurrence of mental disorders with this infection. In addition, a clinical study and follow-up of 45 patients was carried out in the same department. Results. COVID-19 is a significant factor in the development of non-psychotic mental disorders. Initial use of mental health care accounts for 42 %. The mean age of the patients was 47 years. It has been found that women are more susceptible to such disorders than men. After suffering from COVID-19 infection, the level of anxiety doubled, and a significant increase in depressed mood (from 57.1 to 85.7 %), sleep disturbances (from 67.8 to 82.1 %), phobias (from 71.4 up to 78.6 %), as well as asthenic symptoms, was noted. At the end of the treatment, a reduction in mental disorders was noted. Conclusion. The study convincingly showed the high prevalence of non-psychotic mental disorders associated with COVID-19. People of working age with pre-existing neurotic disorders are more vulnerable to the effects of the pandemic than others. In the clinical picture, three main psychopathological syndromes were identified: anxious-depressive, asthenic-depressive, and anxious-phobic. Complex treatment (psychopharmacotherapy, psychotherapy) in the psychotherapy department of a 24‑hour psychiatric hospital showed high effectiveness.

ИССЛЕДОВАНИЕ РАСПРОСТРАНЕНИЯ ВИРУСА COVID-19 В КРУПНОЙ ГОРОДСКОЙ АГЛОМЕРАЦИИ С ПОМОЩЬЮ ДИФФЕРЕНЦИАЛЬНОЙ ЭПИДЕМИОЛОГИЧЕСКОЙ МОДЕЛИ И ПОТЕНЦИАЛ ЕE ПРИМЕНЕНИЯ В ПРОГРАММНОМ ОБЕСПЕЧЕНИИ

In this article, the authors considered a differential model that is used to analyze epidemiological data and predict the development of a pandemic of coronavirus infection. The real data were data on the spread of morbidity in Moscow, a large agglomeration with a high population density, a city of federal significance. In addition, the potential of using the model in special software is described.

Інфекційна еритема та феномен Рейно в дитини після перенесеної коронавірусної хвороби: опис клінічного випадку

Purpose - to analyze practice cases with an atypical course associated with comorbid pathology; to acquaint pediatricians and family physicians with the diagnostic search algorithm. The article summarizes literature data, and describes a clinical case of erythema infectiousum in combination with Raynaud's phenomenon, which occurred in a 9-year-old child І. with coronavirus disease in anamnesis. It was established that the nature of the pathological changes: periodic hyperemia of the cheeks and auricles, “slapped cheeks”, and, at the same time, palleness of the nasolabial triangle, a pronounced change in color, marbling of the skin on the limbs and on the buttocks, with a lacy pattern of vessels, which are provoked by exposure to cold air or psycho-emotional excitement, clearly indicate both the manifestations of parvovirus infection, and the Raynaud's phenomenon mentioned above. On the other hand, post-covid syndrome is also often accompanied by non-specific changes in the skin and its derivatives (up to 20.4% of cases) in the form of urticaria, erythema, and frostbite. In the same group of patients, there are maculopapular rashes and livedo reticularis, those could be Conclusions. During the pandemic of coronavirus infection, the issues of comorbid pathological conditions in pediatrics, which have a blurred clinical picture, an atypical course, common links of pathogenesis, in particular microcirculation disorders, and require an interdisciplinary approach to the management of these diseases, rehabilitation measures, are becoming more and more relevant. interpreted both as a manifestation of systemic vasculitis, and as independent disease. Thus, the patient was diagnosed with infectious erythema caused by parvovirus B19 in combination with Raynaud's phenomenon, probably caused by a history of coronavirus disease. The multicomponent nature of the patient's symptoms is highlighted, and the diagnostic search algorithm is shown. The study was conducted in accordance with the principles of the Declaration of Helsinki. An informed parental consent was obtained for the study in children. No conflict of interests was declared by the authors.

Assessing changes in the pattern of healthcare-associated infectious agents in intensive care units during a novel coronavirus infection pandemic (COVID-19)

Introduction. The novel coronavirus infection (COVID-19) pandemic has been a major challenge to the global healthcare system, affecting more than 32 million patients worldwide. Unprecedented anti-epidemic measures carried out in hospitals allowed clinicians to hope for a decrease of hospital infection, however, the pandemic exacerbated the problem of the spread and circulation of multidrug-resistant bacteria in hospitals. The goal of study to conduct a comparative assessment of changes in the microbial landscape and the level of antibiotic resistance of the main pathogens of lower respiratory tract infections in ICU patients who were in different epidemiological conditions during the COVID-19 pandemic in comparison with the “pre-Covid” period. Materials and methods. A multicenter retrospective observational cohort study was conducted, which included the ICU of 4 hospitals in Yekaterinburg, which were in different epidemiological situations during the COVID-19 pandemic, as well as a comparative analysis of the length of stay of patients in the ICU, the frequency and duration of mechanical ventilation, the resuscitation mortality rate, and also the results of microbiological examination of sputum with an assessment of the structure of pathogens and the level of their antibiotic resistance. Results. The structure of pathogens in sputum in ICU patients of the “green zone” has not fundamentally changed. In the “red zone” there was an increase in the number of documented infections of the lower respiratory tract and blood flow, while hospitals showed differences in changes in the microbial landscape. The microbiological situation in the ICU of the “red zone” was characterized by a decrease in the number of isolated strains of Enterobacterales and non-fermenting Gram-negative bacteria by the end of the pandemic, as well as a significant increase fungi in sputum. In hospitals, where there was an alternation of periods of work in the “red” and “green” zones, there was a decrease of Enterobacterales, an increase in non-fermenting Gram-negative bacteria and a fungi. Among the microflora isolated by bacteriological methods in patients with COVID-19, gram-negative bacteria and fungi predominated, mainly Klebsiella pneumonia, Acinetobacter baumanii and fungi of the Candida spp. A significant increase in the proportion of fungi in sputum was noted in ICU patients in infectious diseases hospitals during the pandemic period. An increase in the level of antibiotic resistance of the main pathogens of lower respiratory tract infections was revealed with the appearance of multi-resistant and extremely resistant strains of Klebsiella pneumoniae and Acinetobacter baumanii. Discussion. Changes in the microbial landscape may indirectly reflect the features of immune damage in patients with a new coronavirus infection COVID-19, which, combined with the severity of the disease and the characteristics of its therapy, led to an increase in complications in the form of a secondary bacterial infection. The reasons for the increase in HAI cases include: an increase in the number of patients with severe comorbidities in an artificial closed ecosystem - the “red zone”; features of the methods of treatment (glucocorticosteroids, genetically engineered biological products - IL-6 inhibitors, etc.); high frequency of unreasonable use of antibacterial drugs; increase in the duration ofuse of various invasive devices and mechanical ventilation; changing the structure and practice of staffing hospitals, increasing the number of inexperienced medical workers and volunteers; inadequate hand hygiene, use of unsuitable individual protection means with a lack of developed methods for their processing in the new conditions. Conclusion. The results obtained indicate the importance of the work of a multidisciplinary with a microbiologist, epidemiologist, clinical pharmacologist in order to improve the quality of care for patients, especially in a difficult epidemiological situation. Surveillance over the spread of HAI pathogens should be attributed to the most progressive form of anti-epidemic activity. Microbiological monitoring and its results can serve as the basis for making managerial decisions to combat and prevent hospital infections. It is the main method for assessing the etiology, phenotype, mechanisms of resistance to antimicrobial drugs, allows you to identify epidemiological relationships between diseases, reasonably prescribe antibiotic therapy, and conduct targeted purchases of drugs (antibiotics) for the needs of this hospital.

Long-term mortality in different COVID-19 variants: 18-month follow-up

The viral infection and pandemic of coronavirus infection 2019 (COVID-19) was characterized not only by high morbidity and in-hospital mortality, but also by an increase in the mortality of patients after hospital discharge. At the same time, differences were noted in hospitalization rate, the number of complications and mortality of patients, and mortality rate between different pandemic waves from 2020 to 2023.Aim. To compare the 18-month post-hospital mortality rate of patients between three COVID-19 variants (Alpha, Delta and Omicron).Material and methods. In this prospective, single-center, non-randomized continuous study, 2400 medical records of patients with the Alpha variant (2020), 1826 with the Delta variant (2021) and 997 with the Omicron variant (2022) were analyzed. The end point was all-cause mortality during the follow-up period.Results. There were following differences in clinical and demographic characteristics in the context of COVID-19 strains: more women were hospitalized in the Delta and Omicron waves; in the Omicron wave, patients were older. Also, comorbid patients were more common with the Delta and Omicron variants than with the Alpha (in chronic obstructive pulmonary disease, hypertension and heart failure), but chronic kidney disease was more common with the Alpha and Omicron variants. The groups differed significantly in mortality, with the maximum being with Delta and the minimum with Omicron, and the maximum mortality with Delta was observed in the first 90 days after discharge. Between 12 and 18 months, survival estimates decreased most for patients hospitalized in the Delta wave, which is determined by the risk of long-term cardiovascular consequences.Conclusion. Clinical and demographic differences between patients with different COVID-19 variants, as well as a significant difference in the mortality rate of patients of different waves, emphasize the importance of a personalized approach to treatment and long-term post-hospital monitoring.

Thyroid dysfunction and autoantibodies among patients infected with Covid 19 in Erbil city /IRAQ

Background and objectives: Autoimmune thyroid diseases or specifically Anti-thyroid peroxidase antibodies increasing after corona virus infection pandemic. This study investigating Anti-thyroperoxidase, anti-thyroid stimulating receptor antibodies in conjunction with traditional thyroid markers after corona virus infection hoping that this would aid in reduction of enduring morbidity and associated health concerns. Methods: This cross-sectional study was conducted in Rizgary Teaching Hospital and Erbil Teaching Hospital in Erbil, Iraq, within the period of February to September 2022. The study comprised hundred patients; 80 females and 20 males, these patients had clinical symptoms suspecting thyroid abnormalities and were suspected for having a sort of thyroid disease. They had abnormal thyroid function tests, with investigating thyroid autoantibodies and corona virus infection. Investigations include thyroid function test and antithyroid antibodies. Results: The level of Anti-thyroid peroxidase antibodies was positive among 75 hypothyroidism patients than among hyperthyroidism cases 2, p-value 0.012. Positive Anti-thyroperoxidase antibodies and hypothyroidism were significantly more common among corona virus infected cases, p-value 0.012 and 0.0109 respectively. However; anti-thyroid stimulating hormone receptor antibody was positive only among hyperthyroidism group (18%); p-value was significant 0.019. Conclusions: This study confirmed the correlation between thyroid function test, Anti-thyroperoxidase antibodies values and corona virus infection. Autoimmune thyroid diseases are more common among female cases, in addition; antithyroid antibodies especially Anti-thyroperoxidase antibodies were more common among female patients. There was high prevalence of both hypothyroidism and positive anti-TPO Ab in COVID-19 cases.

Социально-экономическое развитие регионов Российской Федерации: проблемы и тенденции

The article examines the process of dynamics of differentiation in the socio-economic regional development of the economy, which intensified during the period of economic reforms in the post-Soviet period. Regional economies in the period under review from 2011 to 2020 demonstrated high sensitivity and a sharp decline after the introduction of the first wave of economic sanctions and the slowdown in economic processes against the backdrop of the new coronavirus infection pandemic. Conducted analysis of statistical indicators of socio-economic development of regions of the Russian Federation 2011–2020 allows us to talk about the presence of a high level of asymmetry in the development of regions. As a result, the differentiation of GRP per capita values in the regions of the Russian Federation for 2011–2020 was revealed, as was the emerging trend of a slight reduction in regional disparities. A study of the main socio-economic indicators of 2020 was carried out for federal districts (in % compared to 2011), and groups of regions were identified that in 2020 showed the best and worst results by type of economic activity. The results indicate that, despite the decline in economic indicators of the Russian Federation in 2014–2015, the economies of many regions have demonstrated rapid recovery from external shocks. Despite this, there remains a significant imbalance of development between different regions, which is based on the economy’s orientation toward the export of resources. The level of GRP per capita in regions rich in natural resources is 17 times higher than the level of other subjects, and the number of those lagging behind is 3 times higher than prosperous regions in Russia. Throughout the entire period under review, fluctuations in these ratios remain virtually unchanged. All this is a source of tension in society, increasing social discontent and, as a consequence, narrowing the range of means of state regulation.

Poststroke Mania During the COVID-19 Pandemic.

The pandemic of coronavirus infection 2019 (COVID-19) is stressing people's daily lives and making them more susceptible to various mental illnesses. Depression and suicide attempt as well as, strangely enough, manic patients are on the rise. The main complication of COVID-19 infection is ischemic stroke. Multiple lacunar infarcts in the white matter of the right middle cerebral artery region induce an imbalance of blood flow in the left and right cerebral cortex and risk causing mania. The increase in mania during the COVID-19 must be considered not only a primary increase due to stress but also poststroke mania secondary to COVID-19 infection.

Negative pressure booth with HEPA filter reduces the risk of airborne infection associated with transoesophageal echocardiography

Abstract Background The pandemic of coronavirus infection 2019 has persisted, despite reductions in disease severity and deaths. Transoesophageal echocardiography (TOE) is one of the aerosol-generating procedures and increases the risk of airborne infection. However, the effective strategy to reduce the risk has not been fully established. Purpose To evaluate the effectiveness of negative-pressure booth with high-efficiency particulate air (HEPA) filter in control of aerosol generated by TOE. Methods and Results In the TOE examination room, we installed negative-pressure booth. This booth has an air supply port on the ceiling and exhaust port on the head side of examination table, and the airflow is controlled by a push-pull method (Figure 1). The air changes per hour (ACH) for the entire room with was only 8, but 38 inside the booth, meeting the CDC recommended standard for airborne infection isolation room (ACH≥12). Visualization of the airflow by laser light scattering showed that the airflow in the booth bent the trajectory of particulates produced by the patient's cough and sent them to the exhaust port (Figure 2A). The size-specific quantifications for >0.3μm-, >0.5μm-, >1.0μm-diameter particles by a particle counter revealed that the peak particle concentrations within the booth were reduced by approximately 70% after 7 min of ventilation (Figure 2B) in unattended situation. In clinical setting, we monitored particle counts during TOE in 70 cases. Echocardiologists were at greater risk of aerosol exposure than assistants. Multiple regression analysis revealed that patients’ discomfort level during TOE and less experienced echocardiologists were independently correlated with increased particle counts (β=0.376, p=0.003 and β=0.355, p=0.005, respectively). However, aerosols generated in the early time of TEE were almost eliminated by the end of the examination by negative pressure booth. Conclusion The negative pressure booth effectively and quickly reduces small particles equating aerosols. It might be effective to reduce the risk of airborne infection and shorten the patients turnover time of TOE room even in the pandemic of infectious diseases.Figure 1Figure 2

COVID-19 as a multidisciplinary problem: impact on reproductive health (Literature review)

COVID-19 is an infectious disease which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). According to the WHO, on March 11, 2020, COVID-19 was declared a global pandemic. Undoubtedly, no one will deny that infectious pathology occupied and is occupying a significant place among all diseases of different age groups. The ongoing pandemic of coronavirus infection is a vivid proof of this.There is probably no such person in the world who would never “has his own little war” with infectious pathogens. Therefore, the disease is constantly looking for means that would give it an advantage in the fight against pathogens. Research in recent years indicates that COVID-19 affects not only the respiratory, circulatory and nervous systems, but also the reproductive system, in particular the female one.The article is devoted to a review of scientific publications that describe the impact of COVID-19 on women’s reproductive health. The COVID-19 pandemic has sparked debate in the scientific community focusing on the risk of menstrual changes in women with COVID-19, such as disorders in the duration, frequency, regularity, and volume of menstruation (including increased bleeding and clotting), increased severity of dysmenorrhea, and premenstrual syndrome. However, there is not enough data or information about the impact of COVID-19 on reproductive health.The problem of remote potential negative impact of the COVID-19 pandemic on women’s reproductive health is becoming more and more relevant in the practice of gynecologists. It is important to emphasize the need for high-quality work of gynecologists, which includes early diagnosis of reproductive disorders, adequate diagnosis and treatment in order to prevent complications in case of ovarian-menstrual cycle disorders, infertility and miscarriage.Unfortunately, to date there are no unambiguous data on the impact of SARS-CoV-2 on the reproductive system. Therefore, further research into the long-term consequences of the transferred coronavirus infection in women of reproductive age is critically important.

PECULIARITIES OF THE COURSE OF PREGNANCY IN WOMEN OF DIFFERENT POPULATION GROUPS BURDENED WITH ANEMIA AND HELICOBACTERIOSIS

Peculiarities of the course of pregnancy in women of different ethnic groups are burdened with anemia and helicobacteriosis in modern living conditions after the pandemic of coronavirus infection, the state of constant stress of the war in Ukraine. The purpose of the study was to determine the characteristics of the course of pregnancy in women of different population groups burdened with anemia and helicobacteriosis
 Materials and Methods. 30 pregnant women of reproductive age, burdened with anemia, residents of the city of Odesa (group I) and countries of Southeast Asia (group II) were under our observation. All women were registered at the women’s clinic. The monitoring algorithm included clinical and laboratory studies of Helicobacter pylori infection (total antibodies (IgG, IgM, IgA) to Helicobacter pylori antigens).
 Results. The presence of infectious processes in the body of women is one of the etiological factors of gestational complications, including the progression of the severity of anemia in pregnant women. The clinical severity of anemia in pregnant women was consistent with a high coefficient of positivity of total antibodies (IgG, IgM, IgA) to Helicobacter pylori antigens and a low level of hemoglobin, the level of ferritin, folic acid, cyanocobalamin, the vital trace element iron. Indicators of the clinical course of pregnancy in group I and group II had a significant difference (p<0.05), respectively: early toxicosis (mild, moderate, severe) – 20.0 %, 0 %, 0 % and 26.7 %, 20.0 %, 0 %; syndrome of the threat of early miscarriage - 13.3 % and 33.3 %; late miscarriage threat syndrome – 6.7 % and 20.0 %; secondary placental dysfunction – 0 % and 20.0 %; fetal growth retardation syndrome (FGRS) – 0 % and 6.7 %; intranatal fetal distress – 0 % and 6.7 %. The postpartum period in 13.3 % of women in the 2nd group had a lochiometer.
 Conclusions. Peculiarities of the course of pregnancy in women of different population groups burdened with anemia and helicobacteriosis consisted in the progression of the severity of the clinical and laboratory course of anemia and gestational complications during the trimesters. The clinical severity of anemia in pregnant women was consistent with a high ratio of total antibodies (IgG, IgM, IgA) to Helicobacter pylori antigens and a low level of hemoglobin, the level of ferritin, folic acid, cyanocobalamin, the vital trace element iron. It is recommended to determine the ratio of total antibodies (IgG, IgM, IgA) to Helicobacter pylori antigens in the blood of pregnant women with anemia and at the stage of pregnancy planning. Positive results are an indication for examination of all family members.

Influence of medical and social factors on parents' attitude to specific prevention of infectious diseases in children of the Saratov region during the new coronavirus infection pandemic

Objective: to analyze the influence of medical and social factors on the attitude of parents to the specific prevention of infectious diseases in children during the pandemic of a new coronavirus infection. Material and methods. Anonymous questioning of parents on the attitude to vaccination was conducted. A specially designed questionnaire included questions about attitudes towards vaccines included in the National Immunization Schedule, as well as those not included in it, in particular, the desire of parents to vaccinate their children against COVID-19 was assessed. In total, 153 people aged 17 to 42 took part in the survey — parents of children aged 1 to 14 years. Results. All parents under 18 years of age support vaccination in accordance with the National Vaccination Calendar; 52.1% of parents aged 18—25 years (p < 0.001), 55.6% of parents aged 26—35 years (p < 0.001 compared to parents under 18 years old), and 66.7% of parents over 35 years old (p < 0.001 compared to parents under 18 years old and parents 18—35 years old). Conclusion. The main medical and social factors associated with the refusal to carry out preventive vaccinations for their children are: the age of parents under 35, incomplete higher education and trust in information received on the Internet. The results obtained indicate the need to determine the «risk group» among parents who express doubts about the need for vaccination. It is necessary to conduct educational programs for them in order to form a positive attitude towards the specific prevention of infectious diseases.

Comparative Analysis of the Pathogen Structure in Patients with Community-Acquired and Nosocomial Pneumonia in Medical Organizations of the Rostov, Tyumen Regions and Khabarovsk Territory at the Current Stage of a New Coronavirus Infection Pandemic

The aim of the study was to conduct a comparative analysis of the spectrum and antibiotic resistance of secondary pneumonia pathogens isolated in the territories of the Rostov, Tyumen Regions and Khabarovsk Territory against the background of a new coronavirus infection pandemic.Materials and methods. We investigated sputum samples from coronavirus-positive and coronavirus-negative patients with community-acquired pneumonia from medical organizations using bacteriological method, PCR mass spectrometry.Results and discussion. The study of the etiological structure of secondary pneumonia agents isolated from patients in medical organizations of the Southern, Ural and Far Eastern Federal Districts has revealed that the dominant cultures in SARS‑CoV‑2 “+” and SARS‑CoV‑2 “–” patients were yeast and yeast-like fungi. It has been found that under diversity of isolated fungi, Candida albicans species prevailed. The bacterial microflora is represented by a variety of gram-positive and gram-negative bacteria, of which Staphylococcus aureus and Klebsiella pneumoniaе were most often present in sputum. It has also been established that even before hospitalization of patients, community-acquired pneumonia could be caused by microorganisms of the ESKAPE group (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniaе, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp.), which are usually considered as polyantibiotic-resistant pathogens of nosocomial infections. Moreover, in coronavirus-positive patients with secondary community-acquired pneumonia, those pathogens were isolated 2–3 times more frequently than in coronavirus-negative ones. Assessment of sensitivity/resistance of isolated strains to antibacterial drugs has revealed a general trend: the majority of the strains, regardless of the type, were characterized by a narrow spectrum of sensitivity, having 3 or more markers of antibiotic resistance. This confirms the necessity and expediency of microbiological support of the patient during the entire infectious process. The most adequate drugs of choice, providing activity against 60–70 % of strains of the Enterobacteriaceae family, are amikacin and cefoperazone/sulbactam.

АНАЛИЗ ЗАБОЛЕВАЕМОСТИ ГРИППА, ОРВИ И КОРОНА-ВИРУСНОЙ ИНФЕКЦИИ В КЫРГЫЗСКОЙ РЕСПУБЛИКЕ

Acute respiratory viral infections in the Kyrgyz Republic occupy a high proportion among the overall structure of infectious morbidity, over 61.0%. The purpose of this work is to study the epidemiological features of influenza, SARS and coronavirus infections in different climatogeographic regions of the Kyrgyz Republic. The materials were the reporting data of the republican headquarters for the fight against coronavirus infection, DDPSSES and E-health center. The incidence of influenza and SARS have a pronounced seasonality. During the analyzed period from 2014 to 2022 in the republic, it was noted that the highest incidence of influenza and SARS is recorded in the period from November to February and the indicators vary from 371.2 to 702.1 per 100 000 population. In the dynamics of morbidity during a pandemic of coronavirus infection, the traditional seasonality, as with influenza and SARS, is not traced. The incidence of influenza, SARS and coronavirus infection in different climatogeographic regions have differences, which is associated with population density, average annual atmospheric air temperature and the level of migration of the population. The dynamics of the coronavirus pandemic has shown that the rise in incidence is associated with the level of population immunity and compliance with preventive measures.

REGULATORY REGULATION OF THE HEALTHCARE SYSTEM AT THE LEGISLATIVE LEVELS IN AN EMERGENCY

The article examines the problems of organizing the health care system in the Republic of Kazakhstan in the context of a pandemic of coronavirus infection and other infectious diseases. Based on general and special scientific methods, the discourse of the legal regulation of the health care system in a pandemic is presented. The coronavirus factor has exacerbated the need to legitimize the transformation of the legal regulation of public relations in a pandemic, since the current regulatory framework has demonstrated the imperfection of the legal mechanisms responsible for ensuring the regulation of health systems. The effective use of legal mechanisms depends on the level of democracy of the legislative framework based on international legal and constitutional principles. The main scientific hypotheses of the study justify the problems of the health care system that require regulatory solutions at the managerial and legislative levels in emergency situations. The legislation of the Republic of Kazakhstan on the state of emergency, on the sanitary and epidemiological well-being of the population was analyzed. It was revealed that there is no direct connection between the norms of legislation on the sanitary and epidemiological well-being of the population and the norms of legislation on the state of emergency in terms of direct indication of the possibility of applying measures and implementing the requirements of a sanitary and epidemiological nature in emergency situations. It was concluded that the decisive role of law as a universal regulator of public relations during the spread of coronavirus infection is justified; the need to use the resources of law in the prevention of pandemics in the future is justified. The national health care system of Kazakhstan, as well as the system of public administration as a whole, has demonstrated the inability to ensure a timely response to challenges and threats by creating subordinate legislation in pursuance of legislative acts has led to negative results. This circumstance is the basis for taking measures to create an effective set of measures for the legal regulation of public relations in an emergency.