The issues of effective treatment of ischemic stroke (IS) are relevant, since it leads to a high percentage of disability and mortality throughout the world. The article presents 4 cases of patients with various pathogenetic variants of IS that developed against the background of a new coronavirus infection COVID-19 (degree of lung damage: CT-0 and CT1). Due to the presence of symptomatic occlusion of a large artery, these patients successfully underwent cerebral angiography followed by mechanical thrombus extraction (MTE), after which a significant improvement in neurological symptoms was observed. Results of the pathohistochemical examination of intraoperative material are presented. Patients were followed-up for 3 months. Despite the successful outcome of MTE in these cases, the impact of COVID-19 on the long-term prognosis of stroke patients after MTE remains to be determined. The results of treatment of patients with IS and COVID-19 who underwent MTE should be presented in larger and preferably prospective and multicenter studies.
Вопросы эффективного лечения ишемического инсульта (ИИ) являются актуальными, так как он приводит к высокому проценту инвалидизации и смертности во всем мире. В статье представлены 4 клинических случая пациентов с различными патогенетическими вариантами ИИ, развившимися на фоне новой коронавирусной инфекции COVID-19 (степень поражения легких: КТ-0 и КТ-1). В связи с наличием симптомной окклюзии крупной артерии этим пациентам была успешно проведена церебральная ангиография с последующей механической тромбэкстракцией (МТ), после которой наблюдалось значимое улучшение неврологической симптоматики. Представлены данные патогистохимического исследования интраоперационного материала. Длительность наблюдения за пациентами составила 3 мес. Несмотря на успешный исход МТ в представленных клинических случаях, влияние COVID-19 на долгосрочный прогноз пациентов с инсультом после тромбоэкстракции еще предстоит определить. Результаты лечения пациентов с ИИ и COVID-19, перенесших МТ, должны быть представлены в более крупных и предпочтительно проспективных и многоцентровых исследованиях.

The spread of the coronavirus infection has led to significant changes in people\'s lives. Prolonged isolation, fear of infection, frustration, changing the usual stereotype life style, lack of information, loss of revenues, and fear of stigmatization, as well as the disease itself have all influenced people\'s emotional and physical well-being. The impact of the viral infection itself on the human body, as well as the perception of a new reality, in some cases led to the formation of reactive, organic, or the exacerbation of existing chronic mental disorders. People with mental health problems are most susceptible to environmental influences and react acutely to rapidly changing circumstances. Often in critical situations, in a state of despair, patients see only one way to solve all problems - voluntary retirement committing taking own life. In this article, we present clinical cases that are descriptive in nature and are intended to illustrate the connection between depressive experiences and suicidal behavior amongst patients in a crisis situation when external circumstances were the reason for suicide attempts: loneliness as a result of restrictive measures, fear of infection or the disease itself, and the reason was a mental disorder that debuted earlier or re-emerged as a result of a viral infection. We have presented three clinical cases. All patients suffered from a new coronavirus infection of various severities and were treated in a psychiatric hospital, where they were transferred from an infectious diseases hospital or hospitalized directly in connection with suicidal actions. In each case, attention was paid to the organizational measures carried out, with an emphasis on the need for earlier screening of mental disorders, prevention of suicidal behavior in providing assistance to this contingent, and the development of the interaction between general medical and psychiatric services by the type of integrative care. The study is of interest to a wide range of specialists providing care to patients with COVID-19 or similar pathologies.
Повсеместное распространение коронавирусной инфекции привело к возникновению значительных изменений в жизни людей. Длительная изоляция, страх инфицирования, разочарование, изменение привычного образа жизни, дефицит информации, денежные потери и боязнь стигматизации, а также само заболевание — все эти факторы оказали влияние на эмоциональное и физическое благополучие людей. Воздействие самой вирусной инфекции на организм человека, а также восприятие новой реальности в ряде случаев приводили к формированию реактивных, органических или обострению имеющихся хронических психических расстройств. Лица, имеющие проблемы в области психического здоровья, наиболее подвержены влиянию окружающей среды и остро реагируют на быстро меняющиеся обстоятельства. Часто в критических ситуациях, в состоянии безысходности пациенты видят только один способ разрешения всех проблем — добровольный уход из жизни. В данной статье нами представлены клинические случаи, которые носят описательный характер и направлены на иллюстрацию связи депрессивных переживаний и суицидального поведения пациентов в ситуации кризиса. Когда поводом для попыток самоубийства явились внешние обстоятельства: одиночество в результате ограничительных мероприятий, страх заражения или сама болезнь, а причиной — дебютировавшее ранее или вновь возникшее вследствие вирусной инфекции психическое расстройство. Нами представлено три клинических случая. Все пациенты страдали новой коронавирусной инфекцией различной степени тяжести и проходили лечение в психиатрическом стационаре, куда были переведены из инфекционной больницы или госпитализированы напрямую в связи с суицидальными действиями. В каждом конкретном случае уделялось внимание проведенным организационным мероприятиям с акцентом на необходимость осуществления более раннего скрининга психических расстройств, профилактики суицидального поведения при оказании помощи данному контингенту, развития взаимодействия между общемедицинской и психиатрической службами по типу интегративной помощи. Исследование представляет интерес для широкого круга специалистов, оказывающих помощь пациентам с COVID-19 или аналогичной патологией.

On 7 December 2022, the State Council of China released \'Measures to Further Optimize the Implementation of the Prevention and Control of the New Coronavirus Epidemic\'. The previous three-year dynamic zero epidemic prevention policy was then replaced with a full liberalization policy. On 5 May 2023, the World Health Organization declared that COVID-19 no longer constituted a \'public health emergency of international concern.\' However, given the ongoing prevalence of coronavirus, emerging mutations, and the liberalization of restrictions, there are increased risks of vulnerable people contracting new variants. Low vaccination coverage among older people with compromised immune systems, puts them at further risk. The policy shift will increase pressure on already stretched health infrastructure and medical resources. This short article adds to the current debate arguing that the Chinese government should take commensurate preventive measures, including strengthening medical facilities and equipment and targeting ongoing vaccination in older people.
Paper ContextThe COVID-19 pandemic has disproportionately affected older people.This short paper discusses the consequences of China’s liberalization policy on the older population.It suggests that the Chinese government should have taken targeted measures to mitigate health risks occurring under the changed circumstances.

A description of a COVID-19 patient with the development of exudative pericarditis complicated by cardiac tamponade is provid. A peculiarity of this case is the presence of an underlying disease in the patient (chronic lymphocytic leukemia), which was in remission for 1.5 years after chemotherapy. Another feature of the patient was the relatively small area of lung damage and the hemorrhagic nature of the pericardial effusion, which persisted for a long time. The insignificant activity of inflammatory markers was noteworthy. Possible mechanisms of development and features of the course of exudative pericarditis in the described patient, issues of diagnosis and treatment of this category of patients are discusse.
Приводится описание больной COVID-19 с развитием экссудативного перикардита, осложненного тампонадой сердца. Особенностью данного случая является наличие у пациентки фонового заболевания (хронический лимфолейкоз), которое в течение 1,5 лет находилось в фазе ремиссии после химиотерапии. Другой особенностью больной была относительно небольшая площадь поражения легких и геморрагический характер перикардиального выпота, который длительно сохранялся. Обращала на себя внимание незначительная активность воспалительных маркеров. В описании клинического наблюдения обсуждаются возможные механизмы развития и особенности течения экссудативного перикардита, вопросы диагностики и лечения данной категории пациентов.

The Omicron variant has a weaker pathogenicity compared to the Delta variant but is highly transmissible and elderly critically ill patients account for the majority. This study has significant implications for guiding clinical personalized treatment and effectively utilizing healthcare resources.
The study focuses on 157 patients infected with the novel coronavirus Omicron variant, from December, 2022, to February, 2023. The objective is to analyze the baseline data, test results, imaging findings and identify risk factors associated with severe illness.
Among the 157 included patients, there were 55 cases in the non-severe group (all were moderate cases) and 102 cases in the severe group (including severe and critical cases). Infection with the Omicron variant exhibits significant differences between non-severe and severe cases (baseline data, blood routine, coagulation, inflammatory markers, cardiac, liver, kidney functions, Chest CT, VTE score, etc.). A multifactorial logistic regression analysis showed that neutrophil percentage >75%, eosinophil percentage <0.4%, D-dimer >0.55 mg/L, PCT >0.25 ng/mL, LDH >250 U/L, albumin <40 g/L, A/G ratio <1.2, cholinesterase<5100 U/L, uric acid >357 mole/L and blood calcium<2.11 mmol/L were the most likely independent risk factors for severe novel coronavirus infection.
Advanced age, low oxygenation index, elevated neutrophil percentage, decreased eosinophil percentage, elevated PCT, elevated LDH, decreased albumin, decreased A/G ratio, elevated uric acid, decreased blood calcium, and elevated D-dimer are independent prognostic risk factors for non-severe patients progressing to severe illness. These factors should be closely monitored and actively treated to prevent or minimize the occurrence of severe illness.

The pandemic of a new coronavirus infection has made certain adjustments to modern emergency medicine. Systemic endothelial dysfunction following COVID-19 largely determines hemostatic disorders. Numerous studies revealed that intense platelet adhesion followed by platelet aggregates in COVID-19 patients and functional disorders of fibrinolysis system are combined with activation and severe endothelial dysfunction. The last one inevitably leads to thrombosis and adverse vascular events. There are a lot of studies devoted to deep vein thrombosis and fatal massive pulmonary embolism under COVID-19 infection. However, there are no descriptions of mesenteric thrombosis followed by intestinal wall necrosis. Our experience is based on the treatment and follow-up of 14 patients with venous gangrene of small intestine under COVID-19-induced severe endothelial dysfunction. We present a 40-year-old man with coronavirus infection complicated by ileum gangrene and subsequent favorable outcome.
Пандемия новой коронавирусной инфекции внесла определенные коррективы в современную ургентную медицину. Доказано, что системная дисфункция эндотелия, развивающаяся при COVID-19, во многом определяет и нарушения системы гемостаза. Многочисленными исследованиями показано, что интенсивная адгезия и агрегация тромбоцитов с формированием тромбоцитарных агрегатов, которые выявляются у больных с COVID-19, нарушения функциональной активности системы фибринолиза сочетаются с активацией и тяжелой дисфункцией эндотелия, которая неизбежно приводит к магистральному тромбообразованию и неблагоприятным сосудистым событиям. В современной литературе описаны многочисленные исследования, посвященные флеботромбозам глубоких магистральных вен и фатальной массивной тромбоэмболии легочной артерии на фоне COVID-19. Однако случаев тромбоз-ассоциированных поражений мезентериальных вен с венозным некрозом тонкой кишки нет. Нашей клиникой накоплен существенный опыт лечения и последующего наблюдения пациентов (14 случаев) с венозной гангреной тонкой кишки на фоне выраженной дисфункции эндотелия, провоцируемой COVID-19. Мы представляем клинический случай гангрены подвздошной кишки на фоне перенесенной накануне коронавирусной инфекции у мужчины 40 лет с благоприятным исходом.

BACKGROUND: There are publications about the impact of a new coronavirus infection (COVID) on the lower urinary tract, including the development of overactive bladder (OAB) or COVID-associated cystitis. The cause of dysuria in patients with COVID is not fully understood.
METHODS: A total of 14 consecutive patients after COVID with complaints of frequent urination with urgency were included in the study. The main inclusion criterion was the development or worsening of OAB symptoms after resolution of COVID, confirmed by the eradication of SARS-CoV-2 by a polymerase chain reaction. The severity of OAB was assessed using the International Scale of Symptoms (Overactive Bladder Symptom Score, OABSS).
RESULTS: Three (21.4%) out of fourteen patients had OAB symptoms prior to COVID, while in 11 (78.6%) patients OAB symptoms developed in post-COVID period. In 4 patients (28.6% of the entire cohort and 36.4% of patients in de novo group) urge urinary incontinence and urgency developed. The average score on the OABSS scale in patients with baseline OAB was 6.7+/-0.8, which corresponded to the moderate severity. In this group, one patient developed urge urinary incontinence and urgency, which were not present prior to COVID. In a retrospective evaluation of symptoms before the COVID, their average score on the OABSS scale was 5.2 +/- 0.7, i.e., past COVID led to an increase in OAB symptoms by 1.5 points. In patients with OAB de novo, the symptoms were less pronounced, with a score of 5.1+/-0.6 points, that is between mild and moderate OAB. At the same time, urinalysis in 9 patients did not have signs of inflammation: in 5 cases, 5-7 white blood cells per field of view was seen only once. A follow-up urine test was normal, suggesting contamination. None of the cases revealed bacteriuria over 102 CFU/ml. All patients were prescribed trospium chloride at a dose of 30 mg per day. The choice of the drug was due to the absence of a negative effect on the central nervous system, which is very important both during COVID and in post-COVID period, since the neurotoxicity of SARS-CoV-2 has been proven.
CONCLUSIONS: A past history of COVID led to an increase in OAB symptoms by 1.5 points in patients who had OAB prior to infection. In 11 patients, after the treatment of COVID, the moderate symptoms of OAB developed de novo. Our small study showed the importance of focusing the attention of internists and infectious disease doctors on urination disorders in patients with COVID and timely referral to a urologist. For the treatment of post-COVID OAB, trospium chloride is the drug of choice, as it does not aggravate the potential neurotoxicity of SARS-CoV-2.

OBJECTIVE: To evaluate the effectiveness of the Cytoflavin in patients with dyscirculatory encephalopathy (DE) who had a new coronavirus infection.
METHODS: 82 patients were examined: 16 (19.5%) men and 66 (80.5%) women aged 58 to 80 years, mean age 69±6 years and 70±6 years, respectively. All patients had moderate vascular cognitive impairment (less than 26 points according to the MoCA test), a history of COVID-19 in the period from 3 to 12 months before the start of the study. Patients before COVID-19 were registered with a neurologist with chronic cerebrovascular diseases with non-demented cognitive impairment of vascular origin. Patients of the main group (MG) received the Cytoflavin from the 1st to the 25th day of observation, inclusive, 2 tablets 2 times a day against the background of standard basic therapy. Patients in the comparison group received only standard basic therapy.
RESULTS: It was found that during therapy with Cytoflavin, patients noted a positive trend in the form of a decrease in the symptoms of cognitive impairment, improved orientation and working memory, concentration of attention and counting. Also, patients in MG noted a decrease in fatigue and depressive disorders, an increase in motivation and a positive attitude, the emergence of interest in life, an improvement in the emotional background of mood, an increase in physical activity and working capacity. Comparing the mechanisms of development of vascular dysfunction, a pathogenetic commonality between DE and the development of consequences in the form of cognitive impairment caused by COVID-19 was noted.
CONCLUSIONS: Cytoflavin therapy at a dosage of 2 tablets 2 times a day for 25 days can be recommended as part of complex therapy for patients with DE and a COVID-19.
UNASSIGNED: Оценить эффективность применения препарата Цитофлавин у пациентов с дисциркуляторной энцефалопатией (ДЭ), перенесших новую коронавирусную инфекцию.
UNASSIGNED: Обследованы 82 пациента (16 (19,5%) мужчин и 66 (80,5%) женщин) в возрасте от 58 до 80 лет (средний — 69±6 и 70±6 лет соответственно). Все пациенты имели умеренные сосудистые когнитивные нарушения (КН, значения по Монреальской шкале оценки когнитивных функций (MoCA <26 баллов), в анамнезе — COVID-19 за 3—12 мес до начала исследования. Пациенты до заболевания COVID-19 наблюдались у невролога с хроническими цереброваскулярными заболеваниями с недементными КН. Пациенты основной группы (ОГ) получали Цитофлавин с 1-х по 25-е сутки наблюдения по 2 таблетки 2 раза в сутки на фоне стандартной базисной терапии. Пациенты группы сравнения получали только стандартную базисную терапию.
UNASSIGNED: На фоне терапии Цитофлавином у пациентов ОГ отмечалась положительная динамика в виде уменьшения выраженности КН (улучшение ориентации, оперативной памяти, концентрации внимания и счета), снижение утомляемости и депрессивных нарушений, улучшение эмоционального фона настроения, повышение физической активности и работоспособности. Отмечена патогенетическая общность развития ДЭ и последствий COVID-19 в виде КН.
UNASSIGNED: Применение Цитофлавина по 2 таблетки 2 раза в сутки в течение 25 сут может быть рекомендовано в составе комплексной терапии пациентам с ДЭ и перенесенным COVID-19.

The novel coronavirus pandemic has significantly increased the workload of surgical service worldwide. Restrictive measures led to postponement of elective surgical and diagnostic interventions and reduced the number of emergency manipulations around the world. Large-scale studies identified optimal period for postponing surgical procedures and advisability of this postponement. The authors present opinions of surgeons and their views on treatment strategy for various elective and emergency surgical interventions in abdominal surgery, traumatology-orthopedics and oncology. The main factors reducing perioperative mortality in patients with a new coronavirus infection are observance of anti-epidemic measures by patients and medical personnel, competent use of personal protective equipment, as well as adherence to protocols and algorithms for the treatment of these patients.
Пандемия новой коронавирусной инфекции значительно увеличила нагрузку на хирургическую службу. Введение ограничительных мероприятий привело к переносу плановых хирургических и диагностических вмешательств, снижению количества экстренных манипуляции у пациентов во всем мире. Проведенные крупные исследования показали, на какой временной отрезок необходимо переносить хирургические манипуляции и стоит ли их переносить. В статье проанализированы позиции хирургов, их взгляды на тактику лечения при различных плановых и экстренных хирургических вмешательствах в абдоминальной хирургии, травматологии-ортопедии, онкологии. Основными факторами снижения смертности хирургических пациентов с новой коронавирусной инфекцией являются соблюдение противоэпидемических мероприятий, обеспечивающих безопасность больных и медицинского персонала, грамотное использование средств индивидуальной защиты, а также соблюдение протоколов и алгоритмов лечения данной категории больных.

This review discusses the importance of the main psychoemotional risk factors for the development of chronic noncommunicable diseases. Current data on the prevalence of anxiety and depressive disorders in patients with cardiovascular disease (CVD) are presented. Data on the relationship between the development of psychoemotional disorders and CVD are summarized and the prospects for managing such patients within the framework of interdisciplinary cooperation are discussed. The main pathogenetic mechanisms for the development of complications, including CNS damage in COVID-19, are considered. The significance of the selection of pathogenetic therapy for patients with comorbid somatic and mental diseases in the context of the COVID-19 pandemic is discussed. Results from multicenter placebo-controlled studies of the use of fluvoxamine in patients with COVID-19 of varying severity are addressed.