Aim. To evaluate the clinical effectiveness, safety and compare the incidence of hospitalization during treatment with antiviral drugs with a direct mechanism of action (riamilovir and umifenovir) in people with acute respiratory viral infections (ARVI) in an outpatient setting. Materials and methods. The study included 150 outpatients with ARVI aged 18–27 years: 50 patients received riamilovir 250 mg 3 times a day for 5 days, the second group included 50 patients who received umifenovir 200 mg 4 times a day for 5 days, 50 individuals received only pathogenetic treatment. Results. The use of direct-acting antiviral drugs was characterized by the least severity of pain and aches in the body, general weakness, and in the group of patients receiving riamilovir, the lowest severity of rhinitis, cough, and the lowest morning body temperature were recorded compared to other groups. In riamilovir group reduction in the duration of the disease was observed. The lowest frequency of ARVI pathogens detection was observed on the 6th day in riamilovir group. Outpatient treatment with riamilovir was accompanied by a minimal number of cases of the disease requiring hospitalization. Conclusion. The use of direct antiviral drugs contributes to the rapid relief of ARVI symptoms in patients receiving medical care on an outpatient basis. The antiviral drug riamilovir showed the most pronounced effectiveness (clinical and laboratory).

Введение. На долю гриппа и острой респираторной вирусной инфекции приходится около 90% всей инфекционной заболеваемости населения. Ежегодно только в России регистрируется от 27 до 41 млн случаев этих заболеваний, а по данным Всемирной организации здравоохранения каждый взрослый человек в среднем заболевает острой респираторной вирусной инфекцией от 2 до 4 раз в год. Острые респираторные вирусные инфекции представляют собой этиологически разнородную группу инфекционных болезней, протекающих с поражением респираторного тракта, характеризующихся относительно легким и непродолжительным течением. На сегодняшний день на фармацевтическом рынке максимально представлены специфические противовирусные препараты, в том числе против гриппа. Тем не менее до настоящего времени не создано универсальное противовирусное средство широкого спектра действия, способное предотвратить распространение острой респираторной вирусной инфекции. В этой связи на первый план выходит разработка новых противовирусных лекарственных средств. Цель работы. Оценить эффективность и безопасность противовирусных препаратов (энисамия йодид и умифеновир) в условиях реальной клинической практики у пациентов с острой респираторной вирусной инфекцией (за исключением SARS-CoV-2). Материалы и методы. В рамках исследования ретроспективно проанализированы 265 медицинских карт пациентов с инфекцией, вызванной различными возбудителями респираторных вирусных инфекций (за исключением SARS-CoV-2). Все медицинские карты пациентов были разделены на три группы в соответствии с назначенной этиотропной терапией. В группу сравнения были включены пациенты, которым не назначались противовирусные средства. Для изучения эффективности сравниваемых схем лечения проведена оценка продолжительности госпитализации и длительности основных клинических проявлений острой респираторной вирусной инфекции, а также выраженности синдрома общей инфекционной интоксикации по данным анамнеза и динамики заболевания, извлеченным из медицинской документации. Результаты. Продолжительность госпитализации пациентов, получавших противовирусную терапию энисамия йодидом, была достоверно меньше, чем у пациентов, получавших умифеновир (p < 0,05) и не получавших противовирусную терапию (p < 0,001). Достоверно большая длительность лихорадки выявлена в группе пациентов, не получавших противовирусную терапию (p < 0,05). Длительность основных синдромов поражения респираторного тракта у пациентов из группы не получавших этиотропное лечение достоверно выше (p < 0,05). Заключение. Показана высокая терапевтическая эффективность и хороший профиль безопасности препарата энисамия йодид. Это позволяет рассматривать его как перспективное универсальное противовирусное средство для лечения пациентов с гриппом и острой респираторной вирусной инфекцией (за исключением SARS-CoV-2). Background. Influenza and acute respiratory viral infection account for about 90% of all infectious morbidity in the population. Every year in Russia alone, from 27 to 41 million cases of these diseases are registered, and according to WHO, every adult on average gets sick with acute respiratory viral infection 2 to 4 times a year. Acute respiratory viral infection s are an etiologically heterogeneous group of infectious diseases affecting the respiratory tract, characterized by a relatively mild and short course. Today, specific antiviral drugs, including those against influenza, are widely represented on the pharmaceutical market. However, to date, no universal broad-spectrum antiviral agent has been created that can prevent the spread of acute respiratory viral infection. In this regard, the development of new antiviral drugs comes to the fore. Objective. To evaluate the effectiveness and safety of antiviral drugs (enisamia iodide and umifenovir) in real clinical practice in patients with acute respiratory viral infection, with the exception of SARS-CoV-2. Materials and methods. As part of the research work, 265 medical records of patients with infections caused by various pathogens of respiratory viral infections, with the exception of SARS-CoV-2. All medical records of patients were divided into 3 groups in accordance with the prescribed etiotropic therapy. The comparison group included patients who were not prescribed antiviral drugs. To study the effectiveness of the compared treatment regimens, we assessed the duration of hospitalization and the duration of the main clinical manifestations of acute respiratory viral infection, as well as the severity of the general infectious intoxication syndrome according to the anamnesis and the dynamics of the disease extracted from medical records. Results. The duration of hospitalization of patients receiving antiviral therapy enisamia iodide was significantly less than that of patients receiving umifenovir (p < 0.05) and not receiving antiviral therapy. A significantly longer duration of fever was detected in the group of patients who did not receive antiviral therapy (p < 0.05). The duration of the main syndromes affecting the respiratory tract in patients from the group that did not receive etiotropic treatment was significantly longer (p < 0.05). Conclusion. The drug enisamia iodide has been shown to have high therapeutic efficacy and a good safety profile. This allows us to consider it as a promising universal antiviral agent for the treatment of patients with influenza and acute respiratory viral infection (with the exception of SARS-CoV-2).

BACKGROUND: The introduction into clinical practice of drug therapy with anthelmintic drugs from the carbamate-benzimidazole group has reduced the need for aggressive surgical interventions in the initial stages of parasitic cyst development. However, no consensus has been reached in which cases and for what size of cysts the use of monotherapy with carbamate benzimidazoles will be sufficient and in which cases a combination of surgical and therapeutic treatment methods is necessary. Experimental studies with human participants are impossible to solve this problem. AIM: To evaluate the proximity of the developed experimental model of liver echinococcosis to real clinical practice, including the response to the use of carbamate benzimidazoles. MATERIALS AND METHODS: Modeling of liver echinococcosis in laboratory animals was performed by suturing a part of an echinococcal bladder (Echinococcus granulosus) to the liver capsule. The model provides a high survival percentage of laboratory animals, in which after 60 days a typical hydatid cyst forms in the liver. The effects of albendazole and praziquantel were studied using this echinococcus model. One group of animals (n = 10) received albendazole through an intragastal tube for 28 days and the other (n = 10) received praziquantel for 15 days, after which the animals were autopsied. RESULTS: When using albendazole, destructive changes were microscopically determined in the structure of the walls of the echinococcal cyst on day 28 of therapy. Similar changes were observed when using praziquantel; however, they were characterized by more massive cellular infiltration of all cyst layers. CONCLUSIONS: The developed experimental model of liver echinococcosis in laboratory animals allowed us to experimentally examine the effect of various drugs on the larval stages of E. granulosus development and evaluate their effectiveness.

In Russia, cases of HIV transmission related to medical care are registered annually, including cases related to hemotransfusion. A clinical case of an artificial coinfection with human immunodeficiency and hepatitis C viruses in the course of medical care, as well as its clinical, social, legal and economic consequences, is presented. This clinical case is noteworthy for its relevance from both the perspective of examining the clinical course and treatment of illnesses, as well as analyzing the medical and legal implications of a iatrogenically acquired infection. The recurrence of such incidents of infection with significant social diseases in the 1990s and 2000s necessitated a serious reorganization of the national blood transfusion system and blood components. At present, with strict adherence to legal requirements in place, the risk of infection has been minimized.

Relevance: the annual incidence of acute respiratory infections (ARI) is in the lead in the structure of infectious pathology in the Russian Federation. One of the main issues is the development of optimal strategies for prevention of these diseases in high-risk groups.Aim: to evaluate the preventive and clinical efficacy as well as safety of various dosage forms of interferon alpha-2b in relation to ARI in young adults from organized groups.Materials and methods: our study included 300 volunteers aged 18 to 20 years, 100 of them were prescribed interferon alpha-2b in the form of a gel in addition to non-specific methods for the prevention of ARVI, 100 participants received interferon alpha-2b in the form of an ointment, 100 participants did not receive antiviral drugs.Results: the use of interferon alpha-2b ointment for prevention of ARI in organized groups significantly reduced the number of people who had ARVI and cases of ARI during the observation period. Among those who used interferon alpha2b no pneumonias occurred, the duration of hospitalization was statistically significantly reduced compared to the group of volunteers who used only non-specific prophylaxis methods. Participants who received interferon alpha-2b ointment had ARVI mainly in a mild form. No adverse events that could be associated with the use of the study drug were recorded during the observation period.Conclusion: the use of interferon alpha-2b in the form of ointment showed preventive and clinical efficacy against ARI in young adults from organized groups.

Aim. To evaluate the efficacy of the antiviral drug riamilovir (trade name – «Triazavirin®») for the prevention of SARS-CoV-2 infection (COVID-19) and other acute respiratory viral infections in young people from organized groups. Materials and methods. The study involved 386 individuals aged 18–22 years: 199 received riamilovir at a daily dose of 250 mg for 15 days, while 187 did not receive prophylactic drugs. For 30 days, disease occurrence was monitored among volunteers. In case of illness, the duration, severity of clinical manifestations, complications, and pathogen elimination dynamics were assessed via PCR from nasopharyngeal and oropharyngeal swabs. Results. During riamilovir administration, a statistically significant reduction in cases of acute respiratory viral infections of non-coronavirus etiology was observed, with no COVID-19 cases reported, confirmed by the absence of SARS-CoV-2 RNA in this group. The shortest duration of acute respiratory viral infections was noted in patients taking the prophylactic drug. Conclusion. Riamilovir (trade name – «Triazavirin®») showed statistically significant prophylactic efficacy during its administration in an organized group. Its use decreased the frequency of detection of viral pathogens and resulted in milder acute respiratory disease, likely due to reduced viral load in individuals.

Aim. To study the efficacy and safety of Riamilovir in patients diagnosed with acute respiratory viral infection using several dosage regimens of the drug.Material and Methods. The clinical efficacy and safety of Riamilovir were evaluated based on the results of a study, that included 150 patients in three comparative groups, 50 patients each. The research groups received etiotropic antiviral therapy with 1 capsule (250 mg) of Riamilovir 3 times per day for 5 days in the first group; in the second group, patients received Riamilovir off-label — 1 capsule (250 mg) 5 times per day for 5 days; and the third group included 50 patients who received only pathogenetic treatment.Results. As a result of the study, Riamilovir demonstrated a high safety profile regardless of the dosage regimen; no adverse events were registered. It was shown that Riamilovir use, regardless of the dosage regimen, led to a statistically significant reduction in the duration of inpatient treatment. It should be noted that the shortest periods of hospitalization were observed in patients who received the studied drug at increased daily dosages. Riamilovir was found to reduce the duration and severity of general infectious signs of the disease, while complete elimination of ARVI pathogens occurred by the 6th day of hospitalization; the shortest total duration of fever and a number of respiratory tract syndromes was registered among patients receiving Riamilovir at a daily dose of 1250 mg for 5 days.Conclusion. The etiotropic antiviral drug Riamilovir has shown clinical efficacy when used in both treatment regimens in patients with acute respiratory viral infections, as well as a good safety profile.

Summary Post- COVID syndrome refers to the long-term consequences of a new coronavirus infection COVID-19, which includes a set of symptoms that develop or persist after COVID-19. Symptoms of gastrointestinal disorders in post- COVID syndrome, due to chronic infl ammation, the consequences of organ damage, prolonged hospitalization, social isolation, and other causes, can be persistent and require a multidisciplinary approach. The presented clinical practice guidelines consider the main preventive and therapeutic and diagnostic approaches to the management of patients with gastroenterological manifestations of postCOVID syndrome. The Guidelines were approved by the 17th National Congress of Internal Medicine and the 25th Congress of Gastroenterological Scientifi c Society of Russia.

Аim: diagnosis and treatment algorithms in the clinical recommendations intended for general practitioners, gastroenterologists, infectious disease specialists, hepatologists on the of chronic hepatitis C are presented.Summary. Chronic viral hepatitis C is a socially significant infection, the incidence of which in the Russian Federation remains significantly high. Over the past 10 years, great progress has been made in the treatment of hepatitis C — direct acting antiviral drugs have appeared. The spectrum of their effectiveness allows to achieve a sustained virological response in more than 90 % of cases, even in groups that were not previously considered even as candidates for therapy or were difficult to treat — patients receiving renal replacement therapy, after liver transplantation (or other organs), at the stage of decompensated liver cirrhosis, HIV co-infected, etc. Interferons are excluded from the recommendations due to their low effectiveness and a wide range of adverse events. The indications for the treatment have been expanded, namely, the fact of confirmation of viral replication. The terms of dispensary observation of patients without cirrhosis of the liver have been reduced (up to 12 weeks after the end of therapy). Also, these recommendations present approaches to active screening of hepatitis in risk groups, preventive and rehabilitation measures after the end of treatment.Conclusion. Great success has been achieved in the treatment of chronic hepatitis C. In most cases, eradication of viral HCV infection is a real task even in patients at the stage of cirrhosis of the liver, with impaired renal function, HIV co-infection, after solid organs transplantation.

Aim. To evaluate the clinical efficacy and safety of antiviral drug riamilovir in patients with acute respiratory viral infections (ARVI) of non-coronavirus (SARS-CoV-2) etiology with different dosing regimens. Materials and methods. The study included 150 patients with ARVI aged 18–27 years (50 patients received riamilovir in the regimen of 250 mg 3 times a day for 5 days, 50 patients received riamilovir in the off label regimen of 250 mg 5 times a day for 5 days, 50 patients received only pathogenetic treatment). Results. The use of riamilovir in both treatment regimens led to a reduction in the duration of inpatient treatment. The shortest periods of hospitalization were noted in patients who received the study drug at higher daily dosages. The use of riamilovir reduced the duration and severity of general infectious manifestations of the disease, while the shortest total duration of fever and a number of respiratory tract syndromes was registered among people who received riamilovir in the regimen of 1250 mg per day for 5 days, no adverse events were registered, additionally, 100% elimination of ARVI pathogens was noted in 1250 mg per day group. Conclusion. Riamilovir has shown clinical efficacy and a good safety profile in in both treatment regimens. The dosage regimen of 1250 mg per day led to more significant clinical effects and to 100% elimination of ARVI pathogens in the study group by the 6th day of hospitalization.

Crimean haemorrhagic fever (Crimean-Congo haemorrhagic fever) – an important public health problem due to the wide geographical spread, the ability to cause epidemic outbreaks of disease and high mortality. Evidence that human infection in some cases may occur in direct contact with the patient (bypassing the vector) indicates a high risk of contamination of surrounding people. This article presents a case of severe Crimean haemorrhagic fever in combination with tick-borne borreliosis with different clinical manifestations of the disease with many complications developed due to both direct and indirect effects of virus not only on blood cells, the system of hemostasis and vascular component with the development of hemorrhagic syndrome, but also on many organs and systems of the body. The possibility of long-term persistence of the Crimean haemorrhagic fever virus in the human body against the background of the inhibition of the immune system of the body and the severe course of the disease associated with the development of life-threatening complications, leads to a high risk of death, prolonged restorative treatment and extended hospitalization.

Assessment of viral load levels in various biological samples taken from the respiratory tract can be an indicator of an ongoing process of active viral replication and may be used to monitor severe respiratory viral infections. The study of the relationship between SARS-CoV-2 viral load and immunological laboratory parameters is an important step in the search for clinical markers of COVID-19.The aim of this research was to quantify viral load in patients with COVID-19 and to identify the relation-ship between viral load and changes in the parameters of the cellular component of the immune system.A laboratory examination was carried out on 74 patients diagnosed with COVID-19, they were divided into 3 groups based on the severity of the disease: mild, moderate, severe. Total viral load in clinical samples was determined by the number of SARS-CoV-2 RNA copies per 100 copies of the reference RNaseP gene. A comprehensive assessment of the cellular component of the immune system was performed using flow cytometry and direct monoclonal antibodies, and the IL-6, and C-reactive protein concentrations were determined.We revealed a relationship between the development of serious clinical conditions in the patients with COVID-19, and the levels of viral load. High levels of viral RNA in biological samples correlate with main indicators of the T cell component of the immune system associated with disease severity. In a subgroup of patients with an extremely high viral load, strong positive correlations were found between the relative numbers of cytotoxic lymphocytes (CD3+CD8+), activated T lymphocytes (CD3+HLA-DR+), as well as absolute and relative numbers of activated B lymphocytes and NK cells (CD3-CD25+).Laboratory monitoring of the cellular component of the immune system, along with the assessment of viral loads, should improve early assessment of clinical condition in the patients with COVID-19. Changes in expression levels of activation markers on immune cells can be potentially viewed as indicators of recovery during COVID-19.

The article describes a clinical case of atypical severe course of parvovirus B19 infection, similar in its manifestations to meningococcal infection, with combined infection with Meningococcus, Hemophilus bacillus, influenza A virus. A patient hospitalized with acute respiratory disease and toxicoderma had new symptoms within 24 hours: headache, hemorrhagic rash, decrease in blood pressure to 80/50 mm Hg, fever up to 39.8 0C. Based on the symptoms, a preliminary clinical diagnosis was made: “Meningococcal infection, generalized form – meningococcemia, severe course. Infectious-toxic shock of the 2nd degree.” During laboratory examination of clinical samples of the patient by bacteriological, serological and molecular genetic methods, there was no growth of bacterial microflora in liquor, blood and smears from the pharynx and nose. Genetic material (DNA and RNA) of Neisseria meningitides, Haemophilus influenza and influenza A/H3N2 was detected in a smear from the nasal cavity. At the same time, parvovirus B19 DNA was isolated in the patient’s cerebrospinal fluid and blood in a high viral load (Ct 21.1 and Ct 4.9, respectively). The patient was found to have not only IgG, but also IgM antibodies to parvovirus B19, which is a confirmation of acute parvovirus B19 infection. A pronounced allergic reaction was confirmed by a high index of total IgE (1068 units/ml). Thus, we have described an atypical case of laboratoryconfirmed parvovirus B19 infection in the presence of bacterial-viral mixed infection and an allergic reaction in the patient.

BACKGROUND An important area of effective control of the coronavirus disease 19 (COVID-19) pandemic is the study of the pathogenic features of severe acute respiratory syndrome coronavirus 2 infection, including those based on assessing the state of the intestinal microbiota and permeability.AIM To study the clinical features of the new COVID-19 in patients with mild and moderate severity at the stage of hospitalization, to determine the role of hepatobiliary injury, intestinal permeability disorders, and changes in the qualitative and quantitative composition of the microbiota in the development of systemic inflammation in patients with COVID-19.METHODS The study was performed in 80 patients with COVID-19, with an average age of 45 years, 19 of whom had mild disease, and 61 had moderate disease severity. The scope of the examination included traditional clinical, laboratory, biochemical, instrumental, and radiation studies, as well as original methods for studying microbiota and intestinal permeability.RESULTS The clinical course of COVID-19 was studied, and the clinical and biochemical features, manifestations of systemic inflammation, and intestinal microbiome changes in patients with mild and moderate severity were identified. Intestinal permeability characteristics against the background of COVID-19 were evaluated by measuring levels of proinflammatory cytokines, insulin, faecal calprotectin, and zonulin.CONCLUSION This study highlights the role of intestinal permeability and microbiota as the main drivers of gastroenterological manifestations and increased COVID-19 severity.

The aim of the analysis was to describe the results of administration of pan-genotype antiviral therapy (glecaprevir / pibrentasvir, GLE / PIB) in real-world setting in three clinical centers in St. Petersburg within the city program for the treatment of chronic hepatitis C. Materials and methods. A retrospective analysis of the GLE / PIB usage of in the period from 2019 to 2022 within the city program for the treatment of chronic hepatitis C in St. Petersburg was carried out. Results. The analysis included 464 patients treated in three clinical centers of St. Petersburg: St. Petersburg State Medical Institution “Clinical Infectious Diseases Hospital named after S. P. Botkin”, St. Petersburg State Medical Institution “Center for the Prevention and Control of AIDS and Infectious Diseases” and the Clinic of Infectious Diseases of the Military Medical Academy named after S. M.Kirov”. Overall 452 out of 464 patients (97 %) achieved SVR12. According to the duration of treatment, SVR12 rates were the following: 8 weeks – 97.7 % (419 / 429), 12 weeks – 92.9 % (26 / 28) and 16 weeks – 100 % (7 / 7). The effectiveness according to fibrosis stage was as follows: F0 – 97 % (142 / 146), F1 – 100 % (74 / 74), F2 – 100 % (59 / 59), F3 – 98 % (57 / 58), F4 (CP-A, B) – 94 % (118 / 125). SVR12 according to HCV genotypes and subtypes was the following: genotype 1b – 100 % (63 / 63), genotype 1a – 91 % (21 / 23), genotype 1 unspecified – 100 % (23 / 23), genotype 2 – 98 % (50 / 51), genotype 3 – 97 % (292 / 301). In patients with an indeterminate genotype, the efficacy was 100 % (7 / 7). Antiviral therapy was well tolerated, there were no cases of discontinuation of therapy, as well as cases of the development of serious adverse events. Conclusion. GLE / PIB has demonstrated high effectiveness in the real-world setting in patients infected with prevalent genotypes of HCV, including those with genotype 3 and compensated liver cirrhosis. The results of our analysis fully correspond to the data obtained earlier in clinical trials andreal-world setting.

Monoclonal antibodies IL-6 inhibitors (olokizumab) and IL-6 receptor inhibitors (tocylisumab, levilimab) are most widely used for proactive anti-inflammatory therapy in patients with COVID-19. A decrease in blood oxygen saturation after 12–72 hours of anticytokine therapy has been recently observed in some patients treated with MAB. Unfortunately, little attention is paid to this problem. As a rule, the deterioration of the patient’s condition is attributed to the natural course of the disease. The purpose of the study is to identify predictors of reduced blood oxygen saturation against the administration of IL-6 inhibitors and its receptors in patients with new coronavirus infection (COVID-19). Material and methods. The study included 54 patients with COVID-19 who were treated permanently between 2020 and 2021 and were given IL-6 inhibitors or receptors (tocilizumab, olokizumab or levililmab). The results of clinical examination, laboratory and instrumental research were evaluated. Results and conclusions. Clinical-laboratory parameters reliably correlated with decreased blood oxygen saturation against the administration of IL-6 inhibitors and its receptors are as follows: administration of MAB after 2 days of inpatient treatment (OR = 3.52; 95% CI 1.026–12.073; p = 0.04), the presence of hypertonic disease in combination with ischemic heart disease or obesity (OR = 4.0; 95% CI 1.0–16.925; p = 0.049 and OR = 7.353; 95% CI 1.429–37.848; p = 0.009 respectively), increase in the number of monocytes greater than 0.6 × 109/l (OR = 4.929; 95% CI 1.327–18.307; p = 0.014), the decrease of albumin less than 35.1 g/l (OR = 30.0; 95% CI 1.410–638.186; p = 0.033), glucose of venous blood 5.9 mmol/l and above (OR = 11.556; 95% CI 1.223–109.19; p = 0.018). Based on the data obtained in this study, it is recommended to evaluate the predictors listed above before conducting targeted anti-inflammatory therapy, and, if they are available, to dynamically monitor patients for reduced blood oxygen saturation.

OBJECTIVES. Evaluation of the effect addition helium-oxygen mixture (HOM) in adult patients with pneumonia compared with standard therapy. MATERIALS AND METHODS. Literature was searched in PubMed databases; Google Scholar and eLIBRARY.RU. The following factors were analyzed: the effect of HOM on mortality, SpO2 level, SpO2 recovery, C-reactive protein (CRP), ferritin, D-dimers, frequency of transfer to artificial lung ventilation, duration of stay in the intensive care unit (ICU), hospitalization, cough. Quality assessment, statistical data processing was performed in the Review Manager program, version 5.4.1. The reliability of evidence was evaluated using the GRADE approach using the GRADEpro GDT online program. RESULTS. The meta-analysis included 8 studies with a total of 1097 patients. In 4 out of 10 studied effects (mortality, ventilator rate, length of stay in the ICU, ferritin level), the results did not show the effect of adding HOM to standard therapy. A general meta-analysis of HOM effect showed an increase on SpO2 levels (MD: 1.68; 95% CI: 1.13–2.24; p < 0.001); the maximum effect was on 3–5 days and lasted up to 7 days. Positive effect HOM led to a faster recovery of SpO2 (MD: −2.91; 95% CI: −3.72 … −2.10; p < 0.001). Positive effect HOM led to reduction duration of hospitalization (MD: −3.40; 95% CI −6.05 … −0.76; p = 0.01), cough duration (MD: −3.00; 95% CI: −4.41 … −1.59; p < 0.001), CRP (MD: −16.83; 95% CI: −25.69 … −7.98; p = 0.0002), D-dimer (SMD: −0.48; 95% CI: −0.84 … −0.13; p = 0.007). CONCLUSIONS. The data obtained indicate that the addition of KGF to traditional therapy can improve oxygenation. The inclusion of HOM in therapy can reduce the duration of cough, as well as reduce the level CRP and D-dimers. There was no decrease in mortality, frequency of transfer to mechanical ventilation, duration of stay in the ICU.

BACKGROUND: COVID-19 is an international emergency. The Military Medical Academy, including the Department and Clinic of Infectious Diseases (with a course in medical parasitology and tropical diseases) are actively involved in the fight against the COVID-19 pandemic, and are also studying the pathogenesis, diagnosis and treatment of this disease. AIM: to systematize the work done at the Military Medical Academy in relation to the fight against a new coronavirus infection. MATERIALS AND METHODS: This article provides a brief description of the studies conducted in relation to COVID-19. RESULTS: The departments view of the infection caused by SARS-CoV-2 is presented, the main indicators of the work of the clinic of infectious diseases in the fight against COVID-19 are briefly reflected, and their own research in the field of this infectious disease is demonstrated. CONCLUSION: Based on our scientific work, our experience in treating patients with a new coronavirus infection, the main conclusions and recommendations are formulated: It is necessary to take into account the clinical feature of COVID-19 a long initial period (up to 8 days), which creates the illusion of imaginary well-being and contributes to late hospitalization. PCR is not an ideal diagnostic method, which creates the possibility of obtaining a false negative result. In this regard, clinical, epidemiological and radiological diagnostics are decisive. The organization of early active detection of patients with all clinical forms of infection caused by SARS-CoV-2, and their timely hospitalization helps to reduce the risk of developing a severe course, complications and epidemiological danger of patients. Complex antiviral and anticoagulant therapy should be early (up to 5 days from the clinical manifestation), proactive, aimed at reducing the likelihood of developing pneumonia with respiratory failure and thrombosis of the LA branches. Anti-inflammatory therapy increases the survival of patients with severe COVID-19 and should be administered as early as possible with a preventive goal at the first minimal clinical and laboratory signs of a hyperinflammatory response.

AIM:To evaluate clinical efficacy of nucleoside analogues in therapy of moderate COVID-19 in in-patients.MATERIALS AND METHODS:Retrospective processing of 108 completed clinical cases with moderate novel coronavirus disease was carried out for the period 2020-2021. The duration of the disease at the time of admission did not exceed three days. Experimental group consisted of 53 patients who, in addition to standard therapy, were prescribed "off-label" riamilovir at a daily dosage of 1250 mg for 5 days by the decision of the medical commission. Comparison group included 55 patients who received a combination of umifenovir and ribavirin as antiviral therapy for 5 days. The duration of the main clinical manifestations of the disease, the indicators of clinical and biochemical blood tests, results of the SARS-CoV-2 virus RNA study using the nucleic acid amplification method (NAAT diagnostics).RESULTS:Significantly faster achievement of clinical improvement in the group of patients treated with riamilovir was shown, as well as faster sanitation from SARS-CoV-2 virus based on the results of etiological testing.CONCLUSION:The use of riamilovir for the treatment of patients with moderate novel coronavirus infection (COVID-19) resulted in a significant reduction of general infectious syndromes and respiratory symptoms. Patients from the experimental group significantly faster achieved clinical recovery and sanitation from the pathogen according to the results of NAAT diagnostics.