[Pharmacoepidemiological research of COVID-19 in the Russian Federation EGIDA-2020].

AIM: An analysis of coronavirus infection in Russia and evaluation of different AVT regimens effectiveness. MATERIALS AND METHODS: The study involved a retrospective analysis of 1082 patient records with laboratory-confirmed COVID-19 in 17 regions of Russia. The number of men and women was equal, mean age 48.718.1 (median 50). Patients with moderate COVID-19 (85%) versus mild COVID-19 (15%) were characterized by higher age (median 54 vs 21 years; p0.001), higher body mass index (27.8 vs 23.4; p0.001), prevalence of chronic diseases (75.3% vs 8.5%; p0.001), including circulatory system diseases (37.8%). Moderate COVID-19 characterized higher intoxication (10.86.1 vs 4.22.7 days; p0.001) and catarrhal symptoms duration (10.25.4 vs 6.14.1 days; p0.001). RESULTS: During hospitalization 92% of the patients received AVT, 77% antibiotics, and 16% corticosteroids. Umifenovir therapy resulted in a significant reduction of intoxication (8.75.5 vs 11.75.5 days; p0.001) and catarrhal symptoms duration (8.85.1 vs 12.04.9 days; p0.001) compared to the group without AVT. The usage of INF reduced intoxication symptoms compared with the group without AVT (8.97.5 vs 11.75.5; p0.05). Therapy with hydroxychloroquine, imidazolylethanamide pentandioic acid, and lopinavir + ritonavir combination did not affect the course of COVID-19. Most of adverse reactions were related to antibiotics. CONCLUSION: Umifenovir therapy and inclusion of interferon in AVT regimens was associated improvement in the clinical manifestation of the disease among patients.

[Features of hemorrhagic fever with renal syndrome with diabetes mellitus].

AIM: Diabetes mellitus (DM) is known to be a risk factor in adverse outcomes and complications in many infectious diseases. In the combination of hemorrhagic fever with renal syndrome (HFRS) and DM there are mutually exclusive pathogenetic States - hyperosmolarity, characteristic of DM is layered on the reduction of osmotic blood pressure in HFRS. Under these conditions, the effect of one disease (DM) on the clinical manifestations of another (HFRS) is not obvious. The aim of the work is to find out the clinical features during hfps in patients with DM. MATERIALS AND METHODS: The study is based on the results of the retrospective studies "case - control" - studied the information contained in medical records of patient (form 003/u), who suffered HFRS in 2006-2018. The Selection of cards produced randomly. In the end, there were formed two groups: the first - 981 patient who suffered HFRS and had no signs of diabetes; the second, 33 patients who suffered HFRS on the background of previously existing (28 people), or the first identified (5) diabetes. RESULTS: With a combination of HFRS and DM, a mild course of the disease is 2.5 times more common, there are no severe forms. Among this group of patients, complications are almost 10 times less common, less likely to develop infectious - toxic shock, acute kidney damage (class F by RIFLE), pulmonary edema. The combination of DM and HFRS is manifested by less high and prolonged fever, less high levels of urea and creatinine in the blood. CONCLUSION: HFRS in combination with DM is easier, apparently, high osmolarity of the blood is a stabilizing factor during the disease.

[The blood coagulation system and microcirculatory disorders in ixodid tick-borne borreliosis caused by Borrelia miyamotoi].

AIM: To study blood coagulation and microcirculatory disorders as a possible cause of transient dysfunctions of organs (the kidney, liver, heart, lung, etc.) in patients with ixodid tick-borne borreliosis caused by Borrelia miyamotoi (Bmt). SUBJECTS AND METHODS; Twenty-four patients with Lyme disease (LD) and 28 Bmt patients treated at Izhevsk City Hospital (Udmurtia) were examined in the study. Platelet counts and the presence of D-dimers were determined; activated partial thromboplastin time, prothrombin time, thrombin time, fibrinogen and antithrombin III levels, and Factor XIIa-dependent fibrin clot lysis time were measured. Slit lamp microscopy of the conjunctiva was. also carried out. Results. Platelet counts'were less than 150,000 per pL of blood in 43% of the Bmt patients. All the Bmt patients had at least one abnormal coagulation parameter of the eight ones that were tested; 64% of them had marked coagulation disorders with three or more abnormal laboratory findings. In contrast, all the eight parameters were normal in 71% of the LD patients. The other seven LD patients had only one or two abnormal coagulation parameters (p < 0.001 in comparison with Bmt patients). Microscopic examination of eye capillary blood flow revealed pathological findings that included aggregates of erythrocytes and obstructed and/or sinuous capillaries in 22 (79%) of the Bmt patients, but none of the LD patients. A total of 14 Bmt patients had both coagulation and microcirculatory abnormalities. Eleven of them also had transient signs of organ dysfunction. CONCLUSION: As far as Borrelia secrete no known toxins, we hypothesized that uncovered disorders of blood coagulation and microcirculation in Bmt patients may contribute to organ dysfunction.

[Clinical presentation of "new" tick-borne borreliosis caused by Borrelia miyamotoi].

AIM: The objective of this study was to confirm the role of B. miyamotoi in the etiology of ITBB-WOEM in Udmurtia and to investigate in detail the clinical presentation of this "new" disease. MATERIALS AND METHODS: 50 adult patients with ITBB-WOEM treated in Republic Hospital for Infectious Diseases, Udmurtia, in 2010-2011 had PCR-confirmed infection by B. miyamotoi. The laboratory evidence of co-infection by other pathogens, including tick-borne encephalitis virus, B. burgdorferi sensu lato, A. phagocytophilum, E. chaffeensis, and E. muris, were absent. RESULTS: All patients had a tick bite from 10 to 18 days before the acute disease onset. The main clinical signs were high fever, fatigue, headache, chill, and sweat. Clinical, biochemical, and instrumental investigations also showed the signs of functional impairment of various organs: the liver (in about half of the patients), kidney (in 10 patients), heart (6 patients), etc. In contrast, acute ITBB with erythema migrans was usually a localized infection without a pronounced intoxication syndrome and impairments of the organs. CONCLUSION: ITBB-WOEM caused by B. miyamotoi is a systemic disease that is clinically closer to relapsing fevers transmitted by argasid ticks than to Lyme borreliosis. The number of B. miyamotoi infections in Russia may be comparable with that of Lyme disease cases, so the investigations of epidemiology, clinical presentation and therapy of this "new" disease are urgently requested.

[Organization of treatment and diagnosis of hemorrhagic fever with renal syndrome in Udmurtiia]. / Organizatsiia lechebno-diagnosticheskoi pomoshchi pri GLPS v Udmurtii.

The paper presents basic parameters that characterize the status of prevention, treatment, diagnosis, and rehabilitation in hemorrhagic fever with renal syndrome (HFRS). The data from the epidemiological surveillance in the republic indicate the poor epidemic situation: with decreased immunization there are rises in morbidity and viral infection from the main source bank voles. The paper suggests possible ways of improving preventive measures. The mechanism of improvement of health care to patients with HFRS is clinically considered. At the same it is recommended that comparative indices in specialized infection hospitals and in the infection units of central district hospitals should be taken into account while analyzing the medical and diagnostic aid to HFRS patients. Comparison of the above criteria for assessing the quality of diagnosis and treatment in different infection units revealed great differences. This paper presents some experience in organizing preventive, therapeutical, and diagnostic work in case of an Udmurtian active natural focus of HFRS.

[The functional activity of neutrophilic granulocytes in hemorrhagic fever with renal syndrome]. / Funktsional'naia aktivnost' neitrofil'nykh granulotsitov pri gemorragicheskoi likhoradke s pochechnym sindromom.

In blood samples taken from 33 patients having hemorrhagic fever with the renal syndrome (HFRS) the capacity of neutrophil granulocytes for the ingestion of bacteria and for the reduction of tetrazolium nitro blue, as well as the content of cation protein in the cytoplasm of neutrophils and the concentration of lysozyme in the blood serum of patients, were studied. The study revealed an increase in the values of the above characteristics in comparison with similar data obtained in healthy subjects. Changes in the characteristics of the functional activity of neutrophils were found to depend on the period of the clinical course of HFRS.

[Determination of free and bound forms of sialic acids in biologic objects]. / Opredelenie svobodnoi i sviazannykh form sialovykh kislot v biologicheskikh ob"ektakh.

A method for simultaneous measurements of free, oligomer-bound and protein-bound sialic acids in the blood serum, saliva, and tissue homogenates is offered. The results of these parameters measurements after stressogenic exposures and in some diseases are presented.

[The determination of free and bound oxyproline in urine]. / Opredelenie svobodnogo i sviazannogo oksiprolina v moche.

A method of measuring urinary free, peptide- and protein-bound hydroxyproline is suggested. Adults were found to excrete 18 mumol of free, 155 mumol of peptide-bound, and 8 mumol of protein-bound hydroxyproline daily. In children daily urinary levels of free and peptide-bound hydroxyproline were higher. Data are presented on changes in various hydroxyproline forms in pneumonia, rheumatic fever, and hemorrhagic fever with the renal syndrome.