[V. N. Vinogradov Faculty Therapy Clinic of Sechenov University: the flagship of the therapeutic service of the Russian Federation. A review].

The history of the Faculty Therapy Clinic of Sechenov University is presented. The stages of the formation of its therapeutic school are discussed. Diagnostic and therapeutic methods first developed and implemented in the clinic are described in detail.

[SECTORS INVOLVED IN PUBLIC HEALTH IN THE RUSSIAN FEDERATION DURING COVID-19 PANDEMIC].

The article develops a research agenda for cross-sectoral collaboration on the issues of public health. The aspects of this collaboration are not scientifically founded during the COVID-19 pandemic. The aim of the research is to study the inventory of the sectors involved in public health in the Russian Federation during the COVID-19 pandemic and to put in perspective their importance. An anonymous survey of 49 experts - health service managers was made. The respondents were asked to identify the inventory of the sectors involved in public health and to voice their opinion on their importance during the COVID-19 pandemic. The results of the survey were compared to the results obtained before the pandemic. The results of the study suggest that 23 sectors should always be involved in public health both during the COVID-19 pandemic and without it. The sectors are of relatively equal importance. However, the sectors of the inventory are ranked differently in the order of importance during the pandemic and without it. A statistically significant difference in the analysed characteristic feature is noted. The article develops a research agenda for further studies and provide implications for health-service managers.

[Risk factors for the early development of septic shock in patients with severe COVID-19].

AIM: In a retrospective study, we evaluated factors associated with the early development of septic shock in patients with severe COVID-19. MATERIALS AND METHODS: We collected medical records of the intensive care unit patients submitted by the local COVID-19 hospitals across Russia to the Federal Center for the Critical Care at the Sechenov First Moscow State Medical University (Sechenov University). Septic shock in crticially ill patients requiring mechanical ventilation was defined as a need in vasopressors to maintain blood pressure. RESULTS: We studied 1078 patients with severe COVID-19 who were admitted to the intensive care units for respiratory support. There were 611 males and 467 females. The mean age was 61.013.7 years. Five hundred twenty five medical records (48.7%) were received from the Moscow hospitals, 159 (14.7%) from the Moscow region, and 394 (36.5%) from the hospitals located in 58 regions of the Russian Federation. In 613 (56.9%) patients, diagnosis of SARS-CoV-2 infection was confirmed by PCR, and in the other cases it was established on the basis of the clinical picture and the results of the chest CT scan. Septic shock developed in 214 (19.9%) of 1078 patients. In the logistic regression model, the risk of septic shock in patients older than 50 years was higher than in patients of a younger age (OR 2.34; 95% CI 1.533.67; p0.0001). In patients with more severe SARS-CoV-2 infection, there was an increase in the prevalence of cardiovascular diseases, including coronary heart disease and atrial fibrillation, type 2 diabetes and malignant tumors. The risk of septic shock in patients with three or more concomitant diseases was higher than in patients without any concomitant chronic diseases (OR 1.76; 95% CI 1.762.70). CONCLUSION: The risk of septic shock in patients with acute respiratory distress syndrome induced by SARS-CoV-2 is higher in patients older than 50 years with concomitant diseases, although a severe course of the disease is also possible in younger patients without any concomitant disorders.