Relevance. The development of antimicrobial drugs and alternative methods, technologies and means of prevention, diagnosis and treatment of human infectious diseases caused by antibiotic-resistant microorganisms is one of the priorities of ensuring the biological safety of the country. Aims. To evaluate the bactericidal activity of tetrapyrrole macroheterocycles (porphyrins) at different light irradiation durations in relation to staphylococci, in vitro. Materials and methods. Studied strains of microorganisms: museum strains of microorganisms – S. aureus ATCC 29213, S. epidermidis ATCC 14990 and antibiotic-resistant strains of bacteria of the genus Staphylococcus (n=18) isolated from clinical biomaterial and from environmental objects in a medical organization. The studied chemical compounds are three different compounds of water-soluble asymmetrically substituted porphyrins containing heterocyclic fragments on the periphery of the porphyrin cycle (residues of benzoxazole, N-methylbenzimidazole and benzothiazole). Results. The activity of all three porphyrin compounds in relation to museum strains of staphylococcus and 77.8% of clinical antibiotic-resistant strains (n=14; 95% CI 20.1-97.5) turned out to be maximal (complete lysis) after 10 minutes of irradiation. Conclusions. The tested tetrapyrrole macroheterocycles (porphyrins) exhibit bactericidal activity against museum and clinical strains of staphylococcus, with different levels of antibiotic resistance, which determines Keywords: antibiotic resistance, water-soluble porphyrin, photodynamic inactivation, photosensitizer, photochemistry, staphylococci No conflict of interest to declare.

Relevance. To investigate the characteristics of the COVID-19 pandemic and introduce timely and effective measures, there is a need for models that can predict the impact of various restrictive actions or characteristics of disease itself on COVID-19 spread dynamics. Employing agent-based models can be attractive because they take into consideration different population characteristics (e.g., age distribution and social activity) and restrictive measures, laboratory testing, etc., as well as random factors that are usually omitted in traditional modifications of the SIR-like dynamic models. Aim. Improvement of the previously proposed agent-based model [23,24] for modeling the spread of COVID-19 in various regions of the Russian Federation. At this stage, six waves of the spread of COVID-19 have been modeled in the Nizhny Novgorod region as a whole region, as well as in its individual cities, taking into account restrictive measures and vaccination of the population. Materials and Methods. In this paper we extend a recently proposed agent-based model for Monte Carlo-based numerical simulation of the spread of COVID-19 with consideration of testing and vaccination strategies. Analysis is performed in MATLAB/ GNU Octave. Results. Developed multicentral model allows for more accurate simulation of the epidemic dynamics within one region, when a patient zero usually arrives at a regional center, after which the distribution chains capture the periphery of the region due to pendulum migration. Furthermore, we demonstrate the application of the developed model to analyze the epidemic spread in the Nizhny Novgorod region of Russian Federation. The simulated dynamics of the daily newly detected cases and COVID-19-related deaths was in good agreement with the official statistical data both for the region as whole and different periphery cities. Conclusions. The results obtained with developed model suggest that the actual number of COVID-19 cases might be 1.5–3.0 times higher than the number of reported cases. The developed model also took into account the effect of vaccination. It is shown that with the same modeling parameters, but without vaccination, the third and fourth waves of the epidemic would be united into one characterized by a huge rise in the morbidity rates and the occurrence of natural individual immunity with the absence of further pandemic waves. Nonetheless, the number of deaths would exceed the real one by about 9–10 times.

The aim of the investigation is to study the possibility of applying commercial wound coatings for treating infected wounds as a carrier matrix for bacteriophages. Materials and Methods. Twelve varieties of commercial wound coverings based on biopolymers of natural and synthetic origin, a biological preparation Staphylophag produced by scientific-industrial association Microgen (Russia), registration certificate P N001973/01, and the S. aureus 3196 test strain (GenBank JARQZO000000000) isolated from a patient with a burn wound have been used in our work. The ability of commercial biological wound coatings to absorb solutions was examined by immersing them in a physiological solution (pH 7.0-7.2) followed by weighing. The lytic activity of three bacteriophage series against the test strain was studied using the Appelman method and a spot test. The lytic activity of the bacteriophage in the wound samples was studied within 7 days after its absorption by the wound coatings. Results. The greatest volume of fluid was absorbed by the LycoSorb, NEOFIX FibroSorb Ag, Biatravm, and Chitocol-S wound coatings. All bacteriophage series have been found to have a high lytic activity against the test strain. It has also been shown that Chitocol-S, Collachit-FA, Algipran, and Aquacel Ag Extra possessed their own inherent antibacterial activity under in vitro conditions stable for 7 days; moreover, the lysis zones of the test strain increased after their saturation with bacteriophage. On day 0, a high level of bacteriophage lytic activity with the maximum size of the test strain lysis zones from 49 to 59 mm have been found to remain in all samples of the wound coverings. The bacteriophage activity persisted for 1 day in the samples of Hydrofilm, Polypran, and NEOFIX FibroCold Ag coatings, up to 4 days in Algipran, Nano-Aseptica, and Biatravm coatings; and for 7 days in the Chitocol-S, Collachit-FA, Opsite Post-Op Visible, NEOFIX FibroSorb Ag, Aquacel Ag Extra, and LycoSorb samples. Conclusion. Modern commercial wound dressings based on chitosan-collagen complex (Chitocol-S, Collachit-FA), polyurethane (Opsite Post-Op Visible, LycoSorb, NEOFIX FibroSorb Ag), and Hydrofiber (Aquacel Ag Extra) have a sufficient level of bacteriophage solution absorption, provide a stable preservation of the bacteriophage lytic activity under in vitro conditions up to 7 days. Thus, the in vitro studies prove the possibility of their use as a carrier matrix for bacteriophages.

Objective: To find wound dressings which could incorporate solutions of bacteriophages and lactobacilli and could have potential to overcomemicroorganism resistance to antibiotic therapy. Material and methods. Physicochemical and biological properties of 12 samples of wound coverings of different structures and properties which had been used for combustion wounds were analyzed. Wound dressings differed in their keystone structure (biopolymers of natural and artificial origin) and in biodegradability. The following properties of wound dressings were studied in vitro: absorption, biological inertness and duration of viability / lytic activity of staphylococcal bacteriophage and antagonistic activity of L. plantarum inoculum. In addition, own antibacterial activity of wound dressings against S. aureus culture was studied too. Research results. Among the studied wound dressings, the largest mass of liquid can be absorbed by the following wound dressings: Likosorb®, Fibrosorb®, Biatraum®, Hitokol-S®. All studied wound coverings are biologically inert towards the staphylococcal bacteriophage (they ensure the formation of zones of S. aureus lysis). Viability of L. plantarum inoculum was promoted by wound coverings OPSITE® Post-Op Visible, Fibrosorb®, Algipran®, Biatraum®. Wound coverings OPSITE® Post-Op Visible, Fibrosorb®, Likosorb® maintain the lytic activity of staphylococcal bacteriophage up to 7 days. L. plantarum viability for up to 2 days was registered in Fibrosorb® wound covering, up to 3 days – in OPSITE® Post-Op Visible. Wound coverings Chitokol-S®, Kollakhit® FA, Algipran® and Aquacel Ag® have their own antibacterial activity against S. aureus; when they were saturated with staphylococcal bacteriophage solution, their antibacterial activity increased. Conclusion. Wound coverings with sponge structure based on chitosan and polyurethane exhibit the greatest absorption level of inoculum solutions of L. plantarum and staphylococcal bacteriophage maintaining their viability / lytic activity.

Aim of study To study the effect of local phage therapy alone and in combination with systemic antibiotic therapy on the dynamics of microflora colonizing the skin of the periwound area during surgical treatment of infected burn wounds.Material and methods Scientific hypothesis: the use of local phage therapy in monotherapy in the treatment of burn wound infections reduces the risk of colonization of the skin of the periwound area by bacteria of the ESKAPE group. The experimental study analyzed the results of microbiological studies of washings from the skin surface of 40 animals with infected burn wounds, in the course of phage therapy in monotherapy and in combination with systemic antibiotic therapy.Results In the group of animals receiving phage therapy alone, the proportion of ESKAPE group bacteria colonizing the skin of the periwound area at the time of completion of the course of antimicrobial therapy was 9%, while in the group receiving phage therapy in combination with systemic antibiotic therapy it was 43% (p=0.011).Conclusion The use of local phage therapy in single mode during the surgical treatment of infected burn wounds reduces the risk of colonization of the skin of the peri-wound area by pathogens of the ESKAPE group. At the same time, systemic antibiotic therapy causes an imbalance of resident and transient skin microbiota in the periwound area and an increase in the frequency of its colonization by pathogens of the ESKAPE group.

During a prospective multicenter non-interventional observational study, a comparative assessment was made of the serotype structure of pneumococci circulating among healthy children under the age of 5 years and children of the same age group with signs of respiratory infections in the periods 2016-2018 and 2020-2022. Data on the serotype structure of pneumococci in the period from 2016-2018 were obtained from our previous works. In 2020-2022 the study included 2066 healthy children and 603 children with respiratory infections. Streptococcus pneumoniae and their DNA were detected in nasopharyngeal swabs by classical culture and molecular methods. Typing was carried out by molecular methods. On the territory of the Russian Federation, pneumococci belonging to the serotypes included in the 13-valent vaccine are being forced out of circulation and replaced by non-vaccine serotypes. Before the introduction of mass antipneumococcal vaccination (until 2015), the 13-valent conjugate vaccine covered from 66.2% to 92% of pneumococci, after the start of mass anti-pneumococcal vaccination in the period 2016-2018, coverage decreased to 57.3%. Between 2020 and 2022, coverage was less than 40%. The main “non-vaccine” serotypes/serogroups circulating in the Russian Federation are 15AF, 11AD, 23A, 9LN and 16F.

Цель -оценить клиническую и микробиологическую эффективность системной антибиотикотерапии и местной фаготерапии инфекции ожоговых ран после выполнения радикальной и частичной некрэктомии.Материал и методы.Экспериментальное исследование выполнено на крысах (n=90).У животных 1-й группы (n=30) моделировали контактный ожог кожи 5% поверхности тела, после чего выполняли радикальную некрэктомию.Во 2-й группе (n=30) после моделирования контактного ожога 5% поверхности тела и выполнения радикальной некрэктомии в края постнекрэктомической раны вшивали кольцо из медицинской стали.У животных 3-й группы (n=30) моделировали контактный ожог кожи 20% поверхности тела, выполняли частичную фасциальную некрэктомию, в края образованной постнекрэктомической раны вшивали кольцо из медицинской стали.На этапе выполнения некрэктомии раны контаминировали P. aeruginosa.Через 3 сут от момента контаминации всем животным для лечения раневой инфекции проводили 7-дневный курс противомикробной терапии.По 10 животных из каждой группы в качестве этиотропной противомикробной терапии получали: системную антибиотикотерапию (терапия «А»), местную фаготерапию (терапия «Ф») и их комбинацию (терапия «АФ»

Numerous literature data and our observations testify to the widespread permanent growth of combined infections, especially new ones, as well as combined infectious diseases with somatic ones. This is a new scientific direction in medicine, which we have designated as «complex comorbidity», and which can be considered as one of the main trends in the evolution of infectious pathology in general. The article presents an analysis of scientific articles on comorbidity with COVID-19 in children, taking into account clinical and epidemiological features in the pandemic (2020—2021) and pre-pandemic (2015—2019) periods. It has been estab- lished that the emergence of a new subtype of coronavirus at the end of 2019. An unfavorable epidemiological situation for seasonal coronavirus infection preceded by a pronounced trend towards an increase in the proportion of cases of diseases associated with coronavirus from 10.5% in the 2014—2015 epidemic season. up to 32.8% in the 2018—2019 season. The pandemic period was characterized by a lower susceptibility of children compared to adults, as well as a high proportion of «asymptomatic» and mild forms of infection. In turn, in the pre-pandemic period, «seasonal» coronaviruses preferred to infect, for the most part, precisely children's contingents with moderate onset of the disease.

Aim . To analyze newly diagnosed diseases and features of the post-COVID course in patients after a coronavirus disease 2019 (COVID-19) within 12-month follow-up. Material and methods . A total of 9364 consecutively hospitalized patients were included in the ACTIV registry. Enrollment of patients began on June 29, 2020, and was completed on March 30, 2021, corresponding to the first and second waves of the pandemic. Demographic, clinical, and laboratory data, computed tomography (CT) results, information about inhospital clinical course and complications of COVID-19 during hospitalization were extracted from electronic health records using a standardized data collection form. The design included follow-up telephone interviews with a standard questionnaire at 3, 6, and 12 months to examine the course of post-COVID period. Results . According to the ACTIV registry, 18,1% of patients after COVID-19 had newly diagnosed diseases (NDDs) over the next 12 months. Hypertension (HTN), type 2 diabetes and coronary artery disease (CAD) prevailed in the NDD structure. Comparison of the age-standardized incidence of NDDs (HTN, CAD, diabetes) in the post-COVID period in the ACTIV registry with NDD incidence in 2019 according to Rosstat and the expected incidence of NDDs according to the EPOHA study revealed that HTN, diabetes, CAD in patients after COVID-19 were registered more often as follows: HTN by 7,0 and 4,4 times, diabetes by 7,3 and 8,8 times, CAD by 2,3 and 2,9 times, respectively. NDDs most often developed in patients aged 47 to 70 years. Comparison of the actual and expected number of cases of newly diagnosed HTN, CAD and diabetes depending on age showed that the actual number of cases in the population of patients in the ACTIV register is significantly higher than expected for patients aged 45-69 years and for patients with hypertension or diabetes and aged <45 years. Patients with NDDs, compared with patients without NDDs, had a more severe acute COVID-19 course. Statistically significant independent predictors of NDD occurrence (HTN and/or diabetes and/or CAD) within 1 year after hospital discharge were age (direct relationship), body mass index (direct relationship) and glucose levels upon admission to hospital (direct relationship). Conclusion . Available evidence suggests that a strategy for managing COVID-19 survivors should include mandatory screening for early detection of cardiovascular disease and diabetes, which will be key to reducing the risk of further COVID-19 consequences.

BACKGROUND. There is enough evidence of the negative impact of excess weight on the formation and progression of res piratory pathology. Given the continuing SARS-CoV-2 pandemic, it is relevant to determine the relationship between body mass index (BMI) and the clinical features of the novel coronavirus infection (NCI). AIM. To study the effect of BMI on the course of the acute SARS-COV-2 infection and the post-covid period. MATERIALS AND METHODS. AKTIV and AKTIV 2 are multicenter non-interventional real-world registers. The АКТИВ registry (n=6396) includes non-overlapping outpatient and inpatient arms with 6 visits in each. The АКТИВ 2 registry (n=2968) collected the data of hospitalized patients and included 3 visits. All subjects were divided into 3 groups: not overweight (n=2139), overweight (n=2931) and obese (n=2666). RESULTS. A higher BMI was significantly associated with a more severe course of the infection in the form of acute kidney injury (p=0.018), cytokine storm (p<0.001), serum C-reactive protein over 100 mg/l (p<0.001), and the need for targeted therapy (p<0.001) in the hospitalized patients. Obesity increased the odds of myocarditis by 1,84 times (95% confidence interval [CI]: 1,13–3,00) and the need for anticytokine therapy by 1,7 times (95% CI: 1,30–2,30).The patients with the 1st and 2nd degree obesity, undergoing the inpatient treatment, tended to have a higher probability of a mortality rate. While in case of morbid obesity patients this tendency is the most significant (odds ratio — 1,78; 95% CI: 1,13-2,70). At the same time, the patients whose chronical diseases first appeared after the convalescence period, and those who had certain complaints missing before SARS-CoV-2 infection, more often had BMI of more than 30 kg/m2 (p<0,001).Additionally, the odds of death increased by 2,23 times (95% CI: 1,05-4,72) within 3 months after recovery in obese people over the age of 60 years CONCLUSION. Overweight and/or obesity is a significant risk factor for severe course of the new coronavirus infection and the associated cardiovascular and kidney damage Overweight people and patients with the 1st and 2nd degree obesity tend to have a high risk of death of SARS-CoV-2 infection in both acute and post-covid periods. On top of that, in case of morbid obesity patients this tendency is statistically significant. Normalization of body weight is a strategic objective of modern medicine and can contribute to prevention of respiratory conditions, severe course and complications of the new coronavirus infection.

Probiotics can promote wound healing by stimulating the production of immune cells, activation of reparative regeneration processes as well as show antagonism against pathogenic microflora. The data presented in this review of the literature indicate that the local use of probiotics to enhance the microbiota of the skin in the fight against pathogens of wound infection is a scientifically sound direction demonstrating clinically significant positive results. The results of laboratory and experimental studies can form the basis for further development and development of methods for the clinical use of probiotics in the treatment of patients with infected wounds.

Aim. To investigate on post-COVID period in patients of the Eurasian region.Material and methods. A total of 9364 consecutively hospitalized patients were included in ACTIV registry. Enrollment of patients began on June 29, 2020, and was completed on March 30, 2021, corresponding to the first and second waves of the pandemic. Demographic, clinical, and laboratory data, computed tomography (CT) results, information about inhospital clinical course and complications of COVID-19 during hospitalization were extracted from electronic health records using a standardized data collection form. The design included follow-up telephone interviews with a standard questionnaire at 3, 6, and 12 months to examine the course of post-COVID period.Results. According to ACTIV register, 63% of patients after COVID-19 had new adverse symptoms or exacerbations of the existing symptoms lasting for up to 1 year. After hospital discharge, 79,8% of patients sought unscheduled medical attention in the first 3 months, 79,1% at 4-6 months, and 64,8% at 7-12 months. Readmission rate was 11,8% in the first 3 months, 10,9% at 4-6 months, and 10,1% at 7-12 months. The most common reasons for unscheduled treatment in the first 3 months were uncontrolled hypertension, decompensated type 2 diabetes, destabilization of coronary artery disease, gastrointestinal disease, AF episodes, exacerbation of asthma and chronic obstructive pulmonary disease, decompensated heart failure (HF). The 12-month mortality of COVID-19 survivors after the discharge was 3,08%. Multivariate analysis showed that independent risk factors for fatal outcome were age (direct correlation), the levels of hemoglobin (inverse correlation), oxygen saturation (inverse correlation), and aspartate aminotransferase (direct correlation), as well as class III-IV HF, prior stroke, cancer, inhospital acute kidney injury. Based on these identified risk factors, a nomogram was constructed to determine the 3-month mortality risk after discharge.Conclusion. Analysis of ACTIV register showed that end of the acute phase of COVID-19 does not imply a complete recovery.

Aim To study specific features of the clinical course of novel coronavirus infection and the effect of concurrent diseases on the outcome in hospitalized patients with SARS-CoV-2 infection during the first and the second pandemic waves. Material and Methods To evaluate features of the course of COVID-19 in the Eurasian region, international registries ACTIV-1 and ACTIV-2 were created during the first and second pandemic waves, respectively. 5397 patients were enrolled to the ACTIV-1 registry from June 29, 2020 through October 29, 2020 and 2665 patients were enrolled to ACTIV-2 from November 01, 2020 through March 30, 2021. Results In-hospital mortality decreased during the second pandemic wave to 4.8 % vs. 7.6 % during the first wave. During the second wave, patients were older, had more concurrent diseases, were admitted in a more severe condition, and had a higher level of polymorbidity. During the second pandemic wave, the incidence of bacterial pneumonia and sepsis increased, but deep vein thrombosis and "cytokine storm" were observed less frequently. The most unfavorable predictors of mortality were the following combinations of concurrent diseases: arterial hypertension (AH) + chronic heart failure (CHF) + diabetes mellitus (DM) + obesity; AH + ischemic heart disease (IHD) + CHF + DM; and AH + IHD + CHF + obesity. Conclusion During the second pandemic wave, patients had more extensive damage of the lungs, more frequent febrile fever, higher levels of C-reactive protein and troponin, and lower levels of hemoglobin and lymphocytes. Perhaps, these changes were due to different tactics of hospitalization during the first and second waves in the participant countries that have contributed to ACTIV-1 and ACTIV-2 registries.

One of the main features of modern medicine is the fact that the majority of somatic diseases lose their mononosological nature and acquire the status of comorbidity. Examining complex comorbidity is a priority for specialists in various medical disciplines. Accomplishing scientific research and obtaining nessesary data as well as their further comprehension allowed to formulate major directions for investigating a comorbidity issue. Primarily, it concerns studying rate and general patterns for combination of pathologies, determining features of clinical course and strategy for using drug therapy. Comorbidity issue is rarely considered among infectious diseases. It should be understood that a term “comorbidity” refers to the state of the concomitant detection of several diseases. This terminology may and should be applied to combined somatic and infectious pathology envisioned as a complex pathological condition, but with some additions. The term “complex comorbidity”, in our opinion, is also valid both in case of either simultaneous or sequential presence of psychosomatic pathology and monoetiological infection, as well as somatic pathology and polyetiological infection. After H. pylori was discovered, over the past decades a significant number of studies have emerged regarding a role of helicobacter in etiology and pathogenesis of a large number of somatic diseases. The accumulated knowledge has determined that Helicobacteriosis is the most common bacterial infection in human, and H. pylori is considered as the cause for developing pathology of the gastrointestinal tract as well as other host organs and systems. At the current stage in the development of medicine, H. pylori is not only associated with occurrence of gastric and duodenal ulcers, because the microbe-linked pathogenic effect is not limited only to diseases of the gastroduodenal area. Helicobacter pylori infection can be considered as a trigger in emerging somatic pathology such as chronic gastritis, gastric and duodenal ulcer, MALT lymphoma, and gastric adenocarcinoma. These conditions may be referred to the status of complex comorbidity. To date, association links between Helicobacter pylori and idiopathic iron deficiency anemia, as well as idiopathic thrombocytopenic purpura, have been reliably determined. Thus, various clinical aspects of H. pylori infection are heterogeneous and have a wide range of pathological conditions, which evidence base is replenished with data both in terms of pathogenesis and clinical components.

Water-soluble asymmetrically substituted porphyrins containing the heterocyclic fragments (benzoxazole, N -methylbenzimidazole, and benzothiazole residues) at the periphery of the porphyrin ring were synthesized using the C-H-activation method. The compounds were identified by electron absorption spectroscopy, 1 H NMR spectroscopy, and mass spectrometry. The quantum yields of singlet oxygen generation and complexation ability of the synthesized porphyrins with respect to albumin were determined. The affinity of albumin to the porphyrins with the N -methylbenzimidazole and benzoxazole residues was shown to be nearly two times higher than the affinity to the porphyrin with the benzothiazole fragment. The synthesized porphyrins can efficiently interact with proteins. The bactericidal activity of the synthesized porphyrins to archival strains of microorganisms was studied. The lytic activity for gram-positive Staphylococcus spp. bacteria under photoirradiation conditions was revealed.

Relevance. Currently, there is a significant increase in the combination of infectious and non-infectious pathology. as well as increasing the attention of researchers to this problem. The purpose. of this article is to review scientific data on the combination of the new coronavirus infection COVID-19 with infectious and non-infectious pathology and to assess the phenomenon of complex comorbidity in relation to this new infection. Results. It was found that patients 60 years and older - all have complex comorbidity, which increases the risk of death by more than 7 times, and the presence of two or more comorbid diseases in patients compared with patients who had no more than one disease, the risk of death increased by 9 times. Conclusion. A high potential of combination with COVID-19 is shown, primarily with tuberculosis, HIV infection, hepatitis B and C, as well as with a large group of opportunistic infections.

Aim. To study the lipid profile in hospitalized patients with coronavirus disease 2019 (COVID-19) depending on the outcome of its acute phase according to the AKTIV international registry.Material and methods. The AKTIV registry included men and women over 18 years of age with a diagnosis of COVID-19, who were treated in a hospital. A total of 9364 patients were included in the registry, of which 623 patients were analyzed for levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C) and triglycerides on days 1-2 of hospitalization. The level of high-density lipoprotein cholesterol (HDL-C) was calculated using the Friedewald equation.Results. We found that a decrease in LDL-C level was significantly associated with an unfavorable prognosis for hospitalized patients with COVID-19. This pattern persisted in both univariate and multivariate analyses. LDL-C levels in the final multivariate model had a significant relationship with the prognosis (an increase in the death risk by 1,7 times with a decrease per 1 mmol/l). In addition, we found that the survival of patients with an indicator level of <2,45 mmol/l is significantly worse than in patients with an LDL-C level ≥2,45 mmol/l. All patients with high LDL-C ((≥4,9 mmol/l) survived, while among patients with low LDL-C (<2,45 mmol/l. All patients with high LDL-C ((≥4,9 mmol/l) survived, while among patients with low LDL-C (<1,4 mmol/l), mortality was 13,04%, which was significantly higher than in patients with LDL-C ≥1,4 mmol/l (6,32%, p=0,047).Conclusion. A decrease in LDL-C in the acute period is significantly associated with an unfavorable prognosis for hospitalized patients with COVID-19. Determination of LDL-C can be included in the examination program for patients with COVID-19. However, the predictive value of this parameter requires further study in prospective clinical studies.

Aim To study the effect of regular drug therapy for cardiovascular and other diseases preceding the COVID-19 infection on severity and outcome of COVID-19 based on data of the ACTIVE (Analysis of dynamics of Comorbidities in paTIents who surVived SARS-CoV-2 infEction) registry.Material and methods The ACTIVE registry was created at the initiative of the Eurasian Association of Therapists. The registry includes 5 808 male and female patients diagnosed with COVID-19 treated in a hospital or at home with a due protection of patients’ privacy (data of nasal and throat smears; antibody titer; typical CT imaging features). The register territory included 7 countries: the Russian Federation, the Republic of Armenia, the Republic of Belarus, the Republic of Kazakhstan, the Kyrgyz Republic, the Republic of Moldova, and the Republic of Uzbekistan. The registry design: a closed, multicenter registry with two nonoverlapping arms (outpatient arm and in-patient arm). The registry scheduled 6 visits, 3 in-person visits during the acute period and 3 virtual visits (telephone calls) at 3, 6, and 12 mos. Patient enrollment started on June 29, 2020 and was completed on October 29, 2020. The registry completion is scheduled for October 29, 2022. The registry ID: ClinicalTrials.gov: NCT04492384. In this fragment of the study of registry data, the work group analyzed the effect of therapy for comorbidities at baseline on severity and outcomes of the novel coronavirus infection. The study population included only the patients who took their medicines on a regular basis while the comparison population consisted of noncompliant patients (irregular drug intake or not taking drugs at all despite indications for the treatment).ResultsThe analysis of the ACTIVE registry database included 5808 patients. The vast majority of patients with COVID-19 had comorbidities with prevalence of cardiovascular diseases. Medicines used for the treatment of COVID-19 comorbidities influenced the course of the infectious disease in different ways. A lower risk of fatal outcome was associated with the statin treatment in patients with ischemic heart disease (IHD); with angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor antagonists and with beta-blockers in patients with IHD, arterial hypertension, chronic heart failure (CHF), and atrial fibrillation; with oral anticoagulants (OAC), primarily direct OAC, clopidogrel/prasugrel/ticagrelor in patients with IHD; with oral antihyperglycemic therapy in patients with type 2 diabetes mellitus (DM); and with long-acting insulins in patients with type 1 DM. A higher risk of fatal outcome was associated with the spironolactone treatment in patients with CHF and with inhaled corticosteroids (iCS) in patients with chronic obstructive pulmonary disease (COPD).Conclusion In the epoch of COVID-19 pandemic, a lower risk of severe course of the coronavirus infection was observed for patients with chronic noninfectious comorbidities highly compliant with the base treatment of the comorbidity.

Aim. To analyse an epidemic process of community-acquired mycoplasma pneumonia in the Volga Federal District and the Nizhny Novgorod Region.Materials and Methods. We retrospectively analysed statistical reporting forms and electronic databases for 2012-2019 which included 443 cases of community-acquired mycoplasma pneumonia (349 foci and 4 outbreaks). In 2020, we assessed aetiology of community-acquired pneumonia in hospitalized patients of all ages who were diagnosed with a radiologically confirmed pneumonia (152 cases). In 2021, we carried out a microbiological study of pneumonia-causing pathogens in the nasopharynx among the healthy population (325 cases).Results. Average long-term incidence of community-acquired pneumonia in Nizhny Novgorod Region for 2012-2019 was 3.4 per 100,000 population (95% CI = 0.3-6.5, p < 0.001), with a pronounced upward trend. In general, the aetiology of community-acquired pneumonia in the Nizhny Novgorod Region in 2019 was established at 25.81 ± 0.7% cases. M. pneumoniae accounted for 8.00 ± 0.43% cases (56.72 ± 2.53%) of all aetiologically defined communityacquired pneumonias. In children, the aetiology was determined in 93.1 ± 2.5% cases, of which M. pneumoniae accounted for 13.8 ± 3.5% cases (14.6 ± 3.74% of all community-acquired pneumonias).Conclusion. Mycoplasma pneumonia is responsible for a significant proportion of all community-acquired pneumonias in Nizhny Novgorod Region. Notably, there is a low detection rate of mycoplasma pneumonia in certain territories that might explain an uneven distribution of associated morbidity.

Using bacteriophages to overcome the increasing resistance of microorganisms to antibiotics is a novel research venue of clinical importance. Among other challenges, this technique is expected to create and maintain an adequate local concentration of bacteriophages at the site of application. In addition, the possibility of combining the phage preparation with antioxidants and anesthetics may provide new options for stimulating the reparative process. The aim of the study was to assess the viability and lytic activity of bacteriophages incorporated into a hydrogel-based wound dressing that contains polyvinyl alcohol, phosphate buffer, with optional additions of succinic acid and lidocaine. Materials and Methods A technique for incorporating bacteriophages into the complex hydrogel wound dressing ex tempore has been proposed. The bacteriolytic activity of phages inside the hydrogel was determined using standard microbiological techniques. Specifically, we used nutrient media with lawn cultures of Staphylococcus aureus added with the following antibacterial combinations: bacteriophages + succinic acid, bacteriophages + lidocaine, and bacteriophages + succinic acid + lidocaine. The lytic activity of bacteriophages was assessed within 1 to 7 days after the formation of the hydrogel. Results In all samples containing bacteriophages, the presence of viable and lytically active phages was noted within 1 to 7 days, as evidenced by the “negative colonies” on the culture lawns. On days 1 to 3, no secondary growth was recorded in the phage-containing samples. In hydrogel samples containing phages, succinic acid, and lidocaine, secondary bacterial colonies were detected starting from day 4 indicating some reduction in the lytic activity. Conclusion The results suggest that bacteriophages immobilized in the hydrogel maintain their viability and lytic activity, and this activity persists when the phages are combined with succinic acid and lidocaine.