Treatment Of Coronavirus Infection Research Articles

Assessment of the therapeutic effect of the drug Molixan in the treatment of Syrian hamsters experimentally infected with the SARS-CoV-2 virus

Background. Studying the characteristics of the course of coronavirus infection caused by SARS-CoV-2 remains relevant due to the high mutagenicity of the virus and the prevalence of the disease in the world. The search for new drugs to eliminate clinical manifestations of COVID-19, as well as against its agent, is essential. During the pandemic caused by SARS-CoV-2, dexamethasone was recognized as the only effective anti-inflammatory drug for the treatment of patients with severe form of the disease, but its use leads to a large number of side effects.The aim. To study the therapeutic effect of the drug Molixan in the treatment of coronavirus infection in model animals – Syrian hamsters.Methods. To assess the effectiveness of the drug Molixan, we carried out a visual assessment of the condition of the lungs using light microscopy and the morphometry of the lung tissue of experimentally infected Syrian hamsters on the day 6 after infection under different Molixan treatment regimens and during dexamethasone therapy. The test drug was administered using three different doses (22.2 mg/kg, 44.4 mg/kg and 88.8 mg/kg, which are equivalent to doses of 3 mg/kg, 6 mg/kg and 12 mg/kg of human body weight) once daily or dividing the dose into two within 12 h interval in case of multiple (5 days) intramuscular administration. Dexamethasone (comparison drug) was administered at a dose of 20 mg/kg once daily for 5 days.Results. The studies showed statistically significant effectiveness of using Molixan at a dose of 44.4 mg/kg, divided into two doses, during 5 days. When compared with untreated hamsters, this treatment regimen reduces the degree of generalization and severity of the inflammatory process in the lungs; and the pathomorphological picture is similar to that observed during treatment with Dexamethasone.Conclusion. The studied drug Molixan is effective as an anti-inflammatory drug in the treatment of the disease caused by SARS-CoV-2.

Tying the knot: Unraveling the intricacies of the coronavirus frameshift pseudoknot.

Understanding and targeting functional RNA structures towards treatment of coronavirus infection can help us to prepare for novel variants of SARS-CoV-2 (the virus causing COVID-19), and any other coronaviruses that could emerge via human-to-human transmission or potential zoonotic (inter-species) events. Leveraging the fact that all coronaviruses use a mechanism known as -1 programmed ribosomal frameshifting (-1 PRF) to replicate, we apply algorithms to predict the most energetically favourable secondary structures (each nucleotide involved in at most one pairing) that may be involved in regulating the -1 PRF event in coronaviruses, especially SARS-CoV-2. We compute previously unknown most stable structure predictions for the frameshift site of coronaviruses via hierarchical folding, a biologically motivated framework where initial non-crossing structure folds first, followed by subsequent, possibly crossing (pseudoknotted), structures. Using mutual information from 181 coronavirus sequences, in conjunction with the algorithm KnotAli, we compute secondary structure predictions for the frameshift site of different coronaviruses. We then utilize the Shapify algorithm to obtain most stable SARS-CoV-2 secondary structure predictions guided by frameshift sequence-specific and genome-wide experimental data. We build on our previous secondary structure investigation of the singular SARS-CoV-2 68 nt frameshift element sequence, by using Shapify to obtain predictions for 132 extended sequences and including covariation information. Previous investigations have not applied hierarchical folding to extended length SARS-CoV-2 frameshift sequences. By doing so, we simulate the effects of ribosome interaction with the frameshift site, providing insight to biological function. We contribute in-depth discussion to contextualize secondary structure dual-graph motifs for SARS-CoV-2, highlighting the energetic stability of the previously identified 3_8 motif alongside the known dominant 3_3 and 3_6 (native-type) -1 PRF structures. Using a combination of thermodynamic methods and sequence covariation, our novel predictions suggest function of the attenuator hairpin via previously unknown pseudoknotted base pairing. While certain initial RNA folding is consistent, other pseudoknotted base pairs form which indicate potential conformational switching between the two structures.

Эпидемиологические аспекты формирования новых рисков заболеваемости и лечения туберкулеза среди населения.

In accordance with the instruction of the Minister of Health of the Russian Federation No. 19 dated 02/07/2023, specialists currently face several important tasks: from 2015 to 2025, to reduce the incidence of tuberculosis, as well as the number of deaths from tuberculosis by 75%. To do this, it is necessary to identify all the risk factors that may create difficulties in achieving these goals. Purpose of the study is to characterize the epidemiological aspects of the formation of new risks of morbidity and treatment of tuberculosis among the population. Materials and methods. An analysis was carried out among newly identified patients with tuberculosis by molecular genetic (n=1682) and bacterial (n=1630) research methods in the period from 2017 to 2020 according to drug resistance indicators. Results. It was found that in the period from 2015 to 2017, the indicators of drug resistance in tuberculosis patients were almost at the same level. The leading antimicrobial drugs in demand among the population were ceftriaxone, azithromycin, levofloxacin, moxifloxacin. The maximum increase in sales in 2020 relative to 2019 data to 150% was determined among quinolone derivatives of moxifloxacin and levofloxacin, which began to be used in the treatment of coronavirus infection. At the same time, these drugs are traditionally used to treat tuberculosis, but in 2020, an alarming trend was revealed, which was that drug resistance was detected in patients with tuberculosis to these drugs. Among newly diagnosed tuberculosis patients, from 2018 to 2020, an increase in the proportion of patients with primary drug resistance to levofloxacin and moxifloxacin was established by 189-480%; whereas for other antibiotics, the increase averaged up to 60.8%. Findings. The findings suggest an alarming scenario in which drug resistance develops towards highly virulent and highly resistant to antibacterial drugs genotypes.

Antiviral drug recognition and elevator-type transport motions of CNT3.

Nucleoside analogs have broad clinical utility as antiviral drugs. Key to their systemic distribution and cellular entry are human nucleoside transporters. Here, we establish that the human concentrative nucleoside transporter 3 (CNT3) interacts with antiviral drugs used in the treatment of coronavirus infections. We report high-resolution single-particle cryo-electron microscopy structures of bovine CNT3 complexed with antiviral nucleosides N4-hydroxycytidine, PSI-6206, GS-441524 and ribavirin, all in inward-facing states. Notably, we found that the orally bioavailable antiviral molnupiravir arrests CNT3 in four distinct conformations, allowing us to capture cryo-electron microscopy structures of drug-loaded outward-facing and drug-loaded intermediate states. Our studies uncover the conformational trajectory of CNT3 during membrane transport of a nucleoside analog antiviral drug, yield new insights into the role of interactions between the transport and the scaffold domains in elevator-like domain movements during drug translocation, and provide insights into the design of nucleoside analog antiviral prodrugs with improved oral bioavailability.

Clinical features and treatment strategy for patients with multiple myeloma during the COVID-19 pandemic

Background. In March 2020, doctors faced the problem of severe COVID-19 coronavirus infection in patients with multiple myeloma. This required a review of issues related to the selection of patients, the development of new preventive and therapeutic tactics aimed at treating infectious and immunological complications in patients of this category, depending on the nature and status of the underlying disease and the timing of treatment.Aim. To assess the severity of multiple myeloma, the most common complications and features of the COVID-19 course in patients with multiple myeloma at different therapy stages (disease onset, remission, maintenance therapy, progression/refractory disease).Materials and methods. From March 2020 to May 2022, 89 patients diagnosed with multiple myeloma and coronavirus infection caused by the SARS-CoV-2 virus were hospitalized at City Clinical Hospital No. 52 (Moscow). After assessing the severity, a decision was made on patient management, and if necessary, according to indications, the patient received specific antitumor therapy for multiple myeloma and treatment of coronavirus infection simultaneously.Results. Treatment for coronavirus infection was carried out in accordance with the clinical recommendations of the Russian Ministry of Health at that time. It included antiviral, anticoagulant therapy, transfusions of fresh frozen convalescent plasma with a high titer of antibodies, genetically engineered biological drugs and monoclonal antibodies; if necessary, patients received antibacterial and antifungal, hormonal therapy. Specific chemotherapy was also administered according to indications.Conclusion. Patients with multiple myeloma are at higher risk of severe COVID-19 infection. Today, the problem of developing adequate therapeutic tactics for managing patients with multiple myeloma and coronavirus infection still remains relevant. It is necessary to develop an optimal protocol for the management of such patients, including an assessment of prognostic factors, identification of clearly defined indications and contraindications for chemotherapy, and a description of supportive therapy.

Vibroacoustic therapy in the treatment of patients with COVID-19 complicated by respiratory failure: a pilot randomized controlled trial.

Coronavirus infection is a dangerous airborne disease that can lead to serious lung damage. Data on the effectiveness of low-frequency chest vibrations in the treatment of lung diseases are available; however, not so many of them exist. Vibroacoustic pulmonary therapy is a component of physiotherapy that improves lung perfusion and drainage without requiring active patient participation. This study aimed to increase statistical efficiency through maximizing the relevant information obtained from the clinical data. Calculating the sample size to determine the power of subsequent studies was also necessary. A pilot randomized parallel trial involving 60 patients was conducted. The patients were divided into two equal groups, where they received sessions of vibroacoustic pulmonary therapy using the "VibroLung" device in two modes "acute respiratory distress syndrome (ARDS)" and "Pneumonia," with identical treatment. The patients were > 18 years old with detected COVID-19 by PCR and grade 2 and 3 lung lesions detected by computer tomography (CT). Blood sampling was performed in the morning at the same time before and after the hardware massage to determine PaO2, PaCO2, and P/F. As a result of the test, the following data were obtained: on the first day in the group using the "ARDS" mode, PaO2 indicators averaged 65, CI 95% [58.6-73.2] and on average 77.5, CI 95% [69.8-85.2], "before" and "after," respectively, which indicates improved oxygenation after the procedure. However, in the second group with the "Pneumonia" mode after its use, PaCO2 was higher after the session, on average 48.7, CI 95% [40.8-56.6], whereas before that, the following indicators had, on average 43.6, CI 95% [37.2-50]. Thus, the data obtained yielded ambiguous results, which are the basis for further study in future randomized controlled trials. As the treatment of coronavirus infection has no etiological treatment, even small shifts in the therapy of this category of patients can be significant. ClinicalTrials.gov, identifier NCT05143372.

Drug repurposing screens identify Tubercidin as a potent antiviral agent against porcine nidovirus infections

The emergence of new coronaviruses poses a significant threat to animal husbandry and human health. Porcine epidemic diarrhea virus (PEDV) is considered a re-emerging porcine enteric coronavirus, which causes fatal watery diarrhea in piglets. Currently, there are no effective drugs to combat PEDV. Drug repurposing screens have emerged as an attractive strategy to accelerate antiviral drug discovery and development. Here, we screened 206 natural products for antiviral activity using live PEDV infection in Vero cells and identified ten candidate antiviral agents. Among them, Tubercidin, a nucleoside analog derived from Streptomyces tubercidicus, showed promising antiviral activity against PEDV infection. Furthermore, we demonstrated that Tubercidin exhibited significant antiviral activity against both classical and variant PEDV. Time of addition assay showed that Tubercidin displayed a significant inhibitory effect on viral post-entry events but not during other periods. Molecular docking analysis indicated that Tubercidin had better docking efficiency and formed hydrophobic interactions with the active pocket of RNA-dependent RNA polymerase (RdRp) of PEDV and other nidoviruses. Additionally, Tubercidin can effectively suppress other porcine nidoviruses, such as SADS-CoV and PRRSV, demonstrating its broad-spectrum antiviral properties. In summary, our findings provide valuable evidence for the antiviral activity of Tubercidin and offer insights into the development of new strategies for the prevention and treatment of coronavirus infections.

Remdesivir-Loaded Nanoliposomes Stabilized by Chitosan/Hyaluronic Acid Film with a Potential Application in the Treatment of Coronavirus Infection.

An object of the present study was the development of liposomes loaded with the medicine Veklury® (remdesivir) stabilized by electrostatic adsorption of polysaccharide film formed from chitosans with different physicochemical characteristics and hyaluronic acid. The functionalization of the structures was achieved through the inclusion of an aptamer (oligonucleotide sequence) with specific affinity to the spike protein of the human coronavirus HCoV-OC43. The hydrodynamic size, electrokinetic potential and stability of the structures were evaluated at each step in the procedure. The encapsulation efficiency and loaded amount of remdesivir (99% and 299 µg/mL) were estimated by UV-vis spectroscopy. Our investigations showed manifestation of promising tendencies for prolonged periods of the drug release and increased effectiveness of its antiviral action. Among all studied versions of the delivery system, the most distinguished and suitable in a model coronavirus therapy are the liposomes formed from chitosan oligosaccharides. The cytotoxicity of the liposomes was determined against the HCT-8 cell line. A cytopathic effect inhibition test was used for the assessment of the antiviral activity of the compounds. The virucidal activity and the effect on the viral adsorption of the samples were reported by the end-point dilution method, and the alteration in viral titer was determined as Δlgs compared to untreated controls. The redox-modulating properties of the nanoparticles were studied in vitro in certain/several/a few chemical model systems. Our investigations showed a manifestation of promising tendencies for a prolonged effect of the drug release and increased effectiveness of its antiviral action.

European and National measurements of Molecular and Immunological aspects of Diagnosis, Prevention, and Treatment of Coronavirus infection

The SARS-CoV-2 coronavirus infection pandemic, which spread worldwide in 2019, has caused a large number of deaths in the population. Research on the diagnosis, prevention, and treatment of this disease requires further investigation and generalization of meaningful rules to prevent the future spread of COVID-19 and to ensure societal preparedness for such epidemics. This article reviews the problems of prevention, diagnosis and treatment of coronavirus infection within the global scientific community. The aim of the research work is to investigate the variability of diagnostic methods of COVID-19, means of prevention of the disease and main discourses for treatment of the disease. Theoretical (analysis, systematization and generalization of scientific sources) and empirical (retrospective analysis) research methods were used to study the aspects of diagnosis, prevention and treatment of coronavirus infection. Using the method of theoretical analysis, the peculiarities of the treatment of molecular-immunological aspects of diagnosis and treatment of COVID-19 were studied, and using the method of systematization and generalization, the scientific sources devoted to the issue of prevention of future coronavirus infection spread were investigated. In the article, using retrospective analysis, literature sources on the European and national view of coronavirus research were collected and systematized. As a result of the scientific research, the basic principles of coronavirus diagnostic technologies, the main stages of treatment and prevention of SARS-CoV-2 infection were analyzed.

The use of antibacterial drugs in the treatment of coronavirus infection in children in real outpatient clinic practice

Introduction. In light of the available data on the unjustified use of antibiotics in children with acute respiratory viral infections, the frequency of prescribing antibacterial drugs to children with a new coronavirus infection in real clinical practice is of great practical and scientific interest.The aim of the study was to study the frequency of antibiotic therapy and identify factors that increase the risk of needing antibiotics in children with coronavirus infection at the outpatient stage.Materials and methods. A retrospective cross-sectional study was conducted on the basis of children's polyclinics in Samara from November 2021 to July 2022, which included a survey of parents and an analysis of outpatient records of 100 children who were under outpatient observation and treatment for COVID-19. An analysis was made of the frequency of prescribing antibiotics to them and potential factors predisposing to their prescribing to children with COVID-19. The obtained data were subjected to statistical processing using the IBM SPSS Statistics 25 program and a comparative analysis.Results. The frequency of use of antibiotic therapy according to the results of the study was 11 % and did not exceed the Russian average data (14.3 %). When analyzing the factors influencing the doctor's decision to prescribe an antibiotic to a child with coronavirus infection, the most important were a history of recurrent respiratory infections (children from the FIC group), as well as the presence of concomitant diseases and background conditions in children, primarily chronic bronchopulmonary diseases. and nervous system.Discussion. The prescription of antibiotics for children with a new coronavirus infection at the outpatient stage remains empirical due to the limitations of the use of laboratory and instrumental methods for additional examination of the child, which objectifies the likelihood of a secondary bacterial infection. Despite this, the frequency of antibiotic use according to the results of the study was 11 % and did not exceed the Russian average data (14.3 %), as well as the average frequency of antibiotic use for acute respiratory viral infections in children in the Russian Federation (21.5-23.3 %).

Use of Quercetin for Therapeutic Purposes in COVID-19 Infections: The Opinion of the Geriatrician Doctor

The COVID-19 epidemic has put health systems around the world in distress, at the same time stimulating global research in an attempt to discover new therapeutic strategies against this virus. In this opinion we analyze the characteristics of a flavonoid, quercetin, trying to better understand its usefulness in the treatment of coronavirus infection.

Clinical and Immunological Considerations of Monoclonal Antibody Therapy in COVID-19 A Review

Currently, effective methods for the prevention and treatment of coronavirus infections have not been developed. This could be attributed to the unique pathogenesis of the coronavirus infection and the rapid global spread of the pandemic, which have posed challenges to ongoing research efforts. Similar to other viral infections, coronavirus infection leads to the development and dissemination of the inflammatory process, resulting in viremia or the systemic spread of the infection. This uncontrolled inflammatory response is characterized by elevated levels of cytokines such as IFNy, IL-1, IL-6, and IL-12 in the bloodstream, transitioning the initial inflammatory reaction into a phase known as the cytokine storm. The cytokine storm is marked by severe clinical and laboratory manifestations. Consequently, it is crucial to implement appropriate therapies that target the uncontrolled inflammation induced by the virus rather than viremia itself. Hence, the aim of our study was to investigate the impact of monoclonal antibodies, specifically the medication "Kazirivimab + Imdevimab," which is a combination of recombinant monoclonal antibodies targeting the S-protein, on the clinical progression and laboratory parameters in patients with COVID-19.

The problem of formation of new risks of medicinal resistance of patients with tuberculosis in condition of active use of antibiotics by population under COVID-19

In pandemic conditions, situation of active and uncontrolled use by population of antimicrobial preparations treating COVID-19 occurs. So, new risks of development of medication resistance among patients with various infectious diseases, tuberculosis included, appear. The purpose of the study is to characterize prevalence of antimicrobial preparations use by population in relationship with development of medication resistance in patients with tuberculosis during COVID-19 pandemic. Material and methods. The analysis of sales of antimicrobial medicines was implemented on the basis of published official data from the joint-stock company DSM Group presenting monthly audit of the Russian pharmaceutical market. The determination of primary antibiotic resistance was carried out in 2018-2020 on 3312 patients with tuberculosis. The modified method of proportions on liquid nutrient medium in system with automated accounting of microorganisms growth, the method of absolute concentrations and the method of polymerase chain reaction with real-time detection were applied. The results of the study. It was established that the most demanding antimicrobial medications among population were ceftriaxone, azithromycin, levofloxacin, moxifloxacin, azithromycin. At the same time, the maximum increase in sales in 2020 up to 150% as compared with of 2019 was determined in medications derived from quinolone moxifloxacin, levofloxacin, which began to be used in treatment of coronavirus infection. At the same time, these medications are traditionally used in tuberculosis treatment. But in 2020, alarming trend was established that limits treatment of tuberculosis patients. The primary resistance of mycobacteria was also established in newly diagnosed tuberculosis patients, also for the same antimicrobial medications of quinolone derivatives, and increasing in proportion of patients with primary medication resistance to levofloxacin, moxifloxacin in 2020 as compared to 2018 was 189-480%. At the same time, increasing of resistance to other antibiotics made up to 60.8% on average. Conclusion. The study results imply alarming scenario of medication resistance shifts towards very virulent and highly medication-resistant genotypes. This trend can result in conditions of successful transmission of deadly medication-resistant mutants that can seriously undermine effectiveness of implemented programs of struggle with tuberculosis worldwide.

A clinical case of coinfection of COVID-19 and tropical malaria

The global outbreak of the new coronavirus infection COVID-19 is still ongoing, leading to coinfections such as malaria and COVID-19 and others. As evidenced by the increase in various reports of coinfections. In recent years, Uzbekistan has achieved epidemiological stability for malaria and in 2018 received an official World Health Organization certificate confirming the country’s “malaria-free” status. At the present stage during the COVID-19 pandemic, imported malaria from abroad is relevant for our republic and, therefore, there is a constant danger of renewed transmission from imported cases. In this article presented the clinical case of coinfection of COVID-19 and malaria in a patient. From the epidemiological data, the patient was a citizen of Cameroon. During treatment of coronavirus infection, the patient noted intermittent chills all over the body and sweating, clinical symptoms of tropical malaria began to appear. Microscopy of a thick drop and a thin blood smear confirmed the presence of Pl. falciparum. The patient was prescribed antimalarial therapy with mefloquine, resulting in clinical recovery.

Clinical and Immunological Aspects of the Use of Monoclonal Antibodies in the New Coronavirus Infection Covid-19

To date, methods of prevention and treatment of coronavirus infections have not been developed in essence. One of the reasons for this situation may be the peculiarities of the pathogenesis of coronavirus infection and the rapid development of the pandemic, which could hinder the effectiveness of ongoing research. As with any viral infection, with the development and spread of the inflammatory process, viremia develops, that is, the generalization of infection, cytokine secretion becomes uncontrolled, and the concentration of IFNy, IL-1, IL-6, IL-12 in the blood serum significantly increases, in other words, the primary inflammatory reaction enters a new phase — the cytokine storm phase, which manifests itself violently even according to clinical and laboratory parameters. In this regard, adequate therapy aimed at stopping the uncontrolled process induced not so much by viremia as by the associated inflammation is crucial. In this regard, the aim of our study was to study the effect of monoclonal antibodies, in particular the drug "Kazirivimab + Imdevimab"— a combination of recombinant monoclonal antibodies directed against S-protein on the clinical course and laboratory data in patients with a new coronavirus infection –Covid-19.

Staged treatment of abdominal sepsis in a puerpera with COVID-19 and pancreatonecrosis after cesarean section: case report

The aim of the study. Description of the medical history and discussion of treatment tactics in a puerperal woman after a caesarean section against the background of pancreatic necrosis, panmetritis, abdominal sepsis, COVID-19.Material and methods. A 30-year-old pregnant woman (30–31 weeks) was hospitalized in a perinatal center 5 days after the onset of girdle pain in the abdomen and uncontrollable vomiting, which did not bring relief. She had a history of caesarean sections 10 and 5 years ago. Sterile pancreatic necrosis was diagnosed. Successful caesarean section was performed. During the revision of the abdominal cavity, multiple plaques of fatty necrosis, omentobursitis were found in the upper abdomen. The treatment included pancreatic abdominization, cholecystostomy, abdominal drainage. Clinical roentgenologic examination and PCR-test verified COVID-19.Infected pancreatonecrosis developed, complicated with necrotic omentitis, abscess of the omental bursa (Enterococcus faccilis 107 CFU, Acinobacter baumani 106 CFU), abdominal sepsis, successfully treated. During vaginal examination, hemorrhagic discharge appeared (Klebsiella pneumoniae 105 CFU, Pseudomonas aeruginosa 105 CFU). Extirpation of the uterus revealed the defect of the anterior wall, thrombosis of the uterine arteries and veins, peripheral vessels. The patient recovered. The body build index was 26.03 kg/m2 at admission, 18.22 kg/m2 – at discharge, 23.61 kg/ m2 – 3 months later.Conclusion. 1. During the COVID-19 pandemic, pregnant women are often targeted by SARS-CoV-2. Prevention, diagnosis and treatment of coronavirus infection should be carried out according to the recommendations approved by the authorized health organ. 2. In the presented case report, the pathogenesis of complicated sterile pancreatonecrosis, cesarean section, abdominal sepsis were significantly influenced by changes due to organ ischemia in the result of peripheral vessels thrombosis. 3. The severity of the patient’s condition was certainly determined by the miscellaneous microbial profile – association of four agents of aggressive in-hospital infection in high concentration.

Effectiveness of the immunomodulator thymalin in experimental coronavirus infection

The situation with the COVID-19 pandemic in the world is still tense. Due to the peculiarities of its pathogens, there is a low efficiency in the use of available specific etiotropic drugs, which leads to the need to search for new active means of combating this dangerous infectious disease. Since the function of T-cell immunity is significantly impaired in COVID-19, it is advisable to find out the effect of correcting this part of the immune response on the course of coronavirus infection. For this purpose, a screening study was conducted to determine the effectiveness of the thymus preparation thymalin in an experiment on laboratory mice infected with murine hepatitis virus, which belongs to the same subgroup of coronaviruses that includes SARS-CoV-2, the causative agent of the COVID-19 pandemic. It was found that the study drug significantly protected infected mice at the level of 45.0–60.0 % compared to the controls and increased the average life expectancy of the test animals by 2.6–5.6 days compared to the control group, which in percentage terms is 51–110 %. The results obtained can serve as the basis for conducting regulated clinical trials with the aim of using this official medicinal product in clinical practice for the prevention and treatment of coronavirus infections in humans, including COVID-19.

Quercetin in the Prevention and Treatment of Coronavirus Infections: A Focus on SARS-CoV-2.

The COVID-19 outbreak seems to be the most dangerous challenge of the third millennium due to its highly contagious nature. Amongst natural molecules for COVID-19 treatment, the flavonoid molecule quercetin (QR) is currently considered one of the most promising. QR is an active agent against SARS and MERS due to its antimicrobial, antiviral, anti-inflammatory, antioxidant, and some other beneficial effects. QR may hold therapeutic potential against SARS-CoV-2 due to its inhibitory effects on several stages of the viral life cycle. In fact, QR inhibits viral entry, absorption, and penetration in the SARS-CoV virus, which might be at least partly explained by the ability of QR and its derivatives to inhibit 3-chymotrypsin-like protease (3CLpro) and papain-like protease (PLpro). QR is a potent immunomodulatory molecule due to its direct modulatory effects on several immune cells, cytokines, and other immune molecules. QR-based nanopreparations possess enhanced bioavailability and solubility in water. In this review, we discuss the prospects for the application of QR as a preventive and treatment agent for COVID-19. Given the multifactorial beneficial action of QR, it can be considered a very valid drug as a preventative, mitigating, and therapeutic agent of COVID-19 infection, especially in synergism with zinc, vitamins C, D, and E, and other polyphenols.

Experience of Military Medicine in the Fight against the New Coronavirus Infection.

The results achieved by the medical service of the Armed Forces of the Russian Federation to overcome the new coronavirus infection are presented. The high efficiency of the established unified system of biological safety and strict ranking of the priorities of anti-epidemic measures is shown. The experience of organizing traveling medical and nursing teams, as well as temporary military medical units on the territory of Russia, as well as in foreign countries, is demonstrated. Among the priority scientific results of military doctors, especially noteworthy is the study of the world’s first COVID-19 vaccine Sputnik V, its immunogenicity, the effectiveness of its use in previously ill patients and revaccination, as well as the use of immune plasma from those who have been ill and vaccinated. By the examples of organized military groups and the general population, the features of the formation of herd immunity have been studied. Military doctors were the first in the country to show the effectiveness of hormone therapy in the treatment of coronavirus infection and to study its effects. They carried out ultrastructural studies of the life cycle of the virus. It is shown that the system of comprehensive measures implemented by military medicine determined a lower incidence of new coronavirus infection among the personnel of the Ministry of Defense of Russia and a lower mortality among the military.

ВИРУСНЕЙТРАЛИЗУЮЩИЕ МОНОКЛОНАЛЬНЫЕ АНТИТЕЛА ПРИ COVID-19: МЕХАНИЗМ ДЕЙСТВИЯ И РЕЗУЛЬТАТЫ ИССЛЕДОВАНИЙ

The COVID-19 vaccination has become a way of effective prevention of the decease for most people globally. However, there is a cohort of patients who are not able to form a full-fledged immune response due to primary or secondary immunodeficiency conditions caused by genetic disorders, severe course of chronic diseases, due to their age or the use of drugs that suppress the immune response. The use of monoclonal viral antibodies for immunocompromised patients is the most efficient method of pre- and post-contact and even long-term prevention, as well as the treatment of coronavirus infection. Monoclonal antibodies are obtained from B-lymphocytes of patients recovered from COVID-19. As a result of further modification aimed at increasing of the efficiency and reducing the risk of unwanted phenomena in the use, the virus-neutralizing recombinant monoclonal antibodies of the IgG1 class were designed to implement preventive and therapeutic schemes for COVID-19. Treatment of a new coronavirus infection with drugs with direct etiotropic action is most effective when prescribing in the early stages of the disease, which is especially relevant in patients at risk for a severe/critical clinical course of the disease and can be performed as outpatient clinical procedures. The article analyzes the results of clinical studies of efficacy and safety of mono- and combined drugs of monoclonal antibodies to SARS-CoV-2 in patients with the new coronavirus infection, as well as potential possibilities for their use for the treatment of COVID-19 caused by the new SARS-CoV-2 strains with multiple mutations on the example of the Omicron strain.