SOCIAL FEATURES OF CORONAVIRUS INFECTION PREVENTION IN THE STUDENT ENVIRONMENT: ACCORDING TO THE RESULTS OF SOCIOLOGICAL SURVEY

В работе рассматриваются результаты авторского социологического исследования, проведённого в мае 2021 г. Опрос был проведен среди студентов, обучающихся в медицинском институте ФГБОУ ВО «Майкопский государственный технологический университет» («МГТУ»), с целью изучения отношения студенческой молодежи к необходимости соблюдения мер профилактики коронавирусной инфекции, а также к вакцинации населения и отношения к ним студентов медицинских специальностей в период локдауна и после него. Результаты проведённого исследования показали высокую степень ответственности студентов - будущих медиков за своё здоровье и здоровье окружающих. В то же время часть опрошенных демонстрировала в этот период нигилизм по отношению к мерам профилактики COVID-19. Вместе с тем участники опроса продемонстрировали высокий уровень толерантности по отношению к студентам - гражданам других государств, обучающимся вместе с ними. Ответы студентов медицинских специальностей на вопросы анкеты показывают понимание параметрики, смысла и содержания ограничений, введённых в период пандемии, и необходимости соблюдения жителями региона мер, рекомендованных Роспотребнадзором для профилактики и нераспространения коронавирусной инфекции. The work examines the results of the author's sociological study conducted in May 2021. The survey was conducted among students learning at the Medical Institute of the Maykop State University of Technology in order to study the attitude of students to the need to comply with measures to prevent coronavirus infection, as well as to vaccinate the population and the attitude of medical students to them during the lockdown period and after it. The results of the study showed a high degree of responsibility of students - future medical experts for their health and that of others. At the same time, some respondents demonstrated nihilism towards COVID-19 prevention measures during this period. At the same time, the survey participants showed a high level of tolerance towards students - citizens of other states studying with them. The answers of medical students to the questions of the questionnaire show an understanding of the parameters, meaning and content of the restrictions introduced during the pandemic, and the need for residents of the region to comply with the measures recommended by Rospotrebnadzor for the prevention and non-proliferation of coronavirus infection.

THE STRUCTURE OF THE MECHANISM FOR STRENGTHENING THE TRUST OF THE AUTHORITIES: THEORETICAL AND METHODOLOGICAL ANALYSIS

В статье представлена структура механизма укрепления доверия власти. Исследование механизма укрепления доверия власти актуально, так как в условиях распространения коронавирусной инфекции COVD-19 наблюдается снижение доверия населения к основным социальным институтам, в том числе политическим. Актуальность рассматриваемого вопроса связана с важностью выявления информационных, организационных, правовых и управленческих технологий формирования доверия, которые могут быть реализованы региональными органами власти. При этом доверие как социальный феномен интерпретируется с позиций трех базовых оснований: «позитивных ожиданий», «позитивного настроя» и «доверительных отношений». Посредством обобщения исследовательского опыта представителей структурно-функционального подхода в статье определены основные элементы механизма укрепления власти: субъект, объект, базовые нормы взаимодействия, средовые условия, взаимодействие, планируемый и реальный результат. На основе проведенного теоретического исследования делается вывод о том, что укрепление доверия власти предполагает взаимодействие между субъектами социально-политических процессов, представленными управленческими группами, средствами массовой информации, общественными объединениями и группами, гражданами, результатом которого становится гармонизация отношений общественных структур и органов власти. The paper presents the structure of the mechanism for strengthening the trust of the authorities. The study of the mechanism of strengthening the trust of the authorities is relevant, since in the conditions of the spread of coronavirus infection, there is a decrease in public confidence in the main social institutions, including political ones. The relevance of the issue under consideration is related to the importance of identifying information, organizational, legal and managerial technologies for building trust that can be implemented by regional authorities. The work defines the main elements of the mechanism: subject, object, basic norms of interaction, environmental conditions, interaction, planned and real result. Basing on a theoretical study, we conclude that strengthening the trust of the authorities involves interaction between the subjects of socio-political processes, represented by management groups, the media, public associations and groups, citizens, which results in the harmonization of relations between social structures and authorities.

Association of lipid profile parameters, atherogenic index of plasma, anthropometric parameters with the severity of the COVID-19 course in Novosibirsk women

Background: Our study aimed to assess the relationship between the parameters of the lipid profile, atherogenic index of plasma (AIP), anthropometry influence with the severity of the new coronavirus infection COVID-19 in women. Material and methods. The study design was a cross-sectional study. The research included 138 women aged 29–82 years who had undergone a new coronavirus infection COVID-19 at least two months ago. Participants were divided into three groups by severity of infection: mild (n = 61), moderate (n = 70) and severe (n = 7). Body mass index, waistline and hip circumference, waistline circumference to hip circumference index, total cholesterol, triglycerides, HDL, LDL, AIP were calculated. Statistical processing of the obtained results was carried out using the SPSS software package (version 20.0) using the Mann-Whitney test, univariate logistic regression analysis, Pearson chi-squared test. Results. The levels of HDL-cholesterol were significantly lower in group 3 compared with the level of HDL-cholesterol in women in group 2 (p2-3 = 0.046). BMI was higher in the moderately severe group compared to the mild one (26.32 [23.305; 30.4] versus 28.78 [24.72; 34.77], p1-2 = 0.026). Hip circumference was higher in patients with severe COVID-19 than in patients with mild course (104 [98; 112] versus 114 [109.5; 126], p1-3 = 0.039), AIP was higher in women with severe course compared to women with moderate and mild course (p1-3 = 0.043, p2-3 = 0.04). The results of the logistic regression analysis showed that the moderate course of COVID-19 is associated with BMI (OR = 1.09, 95 % CI 1.019–1.166, p1-2 = 0.012), and the severe course with WC (OR = 1.041, 95 % CI 1.001–1.084, p1-3 = 0.046), AIP value ≥ 0.11 (OR = 13.824, 95 % CI 1.505–126.964, p1-3 = 0.02; OR = 11,579, 95 % CI 1,266–105,219, p2-3 = 0.03) and HDL level < 40 mg/dl (OR = 14,750, 95 % CI 2,317–93,906, p1-3 = 0.004; OR = 8,000, 95 % CI 1,313– 48,538, p1-3 = 0.024). Conclusion. Patients from the group with moderate and severe course of the new coronavirus infection have higher body mass index, hip circumference, AIP, lower HDL values. The chance of a moderate course of COVID-19 is associated with an increased BMI value, and a severe course with WC, AIP ≥ 0.11 and HDL level < 40 mg/dl.

Damage to the Cardiovascular System in Patients with SARS-CoV-2 Coronavirus Infection. Part 1: Predictors of the Development of an Unfavorable Prognosis

Aim. To evaluate the effect of sinus tachycardia and reduced left ventricular ejection fraction (LVEF) on the prognosis of patients with a verified diagnosis of a new coronavirus infection SARS-CoV-2.Material and methods. The study included 1,637 patients with a verified diagnosis of a new coronavirus infection SARS-CoV-2. The average age of the patients was 58.8±16.1 years. More than half of the patients admitted to the hospital had a history of cardiovascular diseases: hypertension was diagnosed in 915 (56%) patients, coronary artery disease – in 563 (34%), chronic heart failure – in 410 (25%). 294 (17.9%) patients suffered from diabetes mellitus. The unfavorable course of new coronavirus infection was assessed by the fact of being in the intensive care unit (ICU), the use of mechanical ventilation and death.Results. An unfavorable course of coronavirus infection was observed in 160 (9.8%) patients. Statistical analysis revealed that 341 (20.8%) patients with COVID-19 were diagnosed with sinus tachycardia, which required the appointment of pulse-reducing therapy. The occurrence of sinus tachycardia in patients with COVID-19 significantly increased the risk of death (odds ratio [OR] 1.248, confidence interval [CI] 1.038-1.499, p=0.018), increased the likelihood of mechanical ventilation use (OR 1.451, CI 1.168-1.803, p<0.001) and stay in the ICU (OR 1.440, CI 1.166-1.778, p<0.001).In 97 (5.9%) patients during hospital stay during echocardiography, a decrease in LVEF of less than 50% was diagnosed. A decrease in myocardial contractile function in patients with COVID-19 with high reliability increased the risk of death (OR 1.744, CI 1.348-2.256, p<0.001), increased the likelihood of using the mechanical ventilation (OR 1.372, CI 1.047-1.797, p=0.022) and stay in the ICU (OR 1.360, CI 1.077-1.716, p=0.010).Conclusion. The appearance of sinus tachycardia and reduced LVEF are in dependent predictors of the unfavorable course of COVID-19 in relation to factors such as death, the use of mechanical ventilation and the stay of patients in the ICU. Early pharmacological correction of cardiovascular lesions should be one of the goals of the management theese patients.

The outpatient medical care in patients with chronic diseases under dispensary supervision in the conditions of the COVID-19 pandemic. Temporary guidelines. Version 2

Guidelines were approved at the meeting of the academic council of the National Medical Research Center for Therapy and Preventive Medicine, Moscow (Protocol No. 10 of 19.10.2021).The aim of these guidelines is to provide primary care physicians with scientifically based algorithms for the implementation of dispensary monitoring in patients with chronic non-communicable diseases in the conditions of the new coronavirus infection (COVID-19) pandemic, including the use of telemedicine technologies.The organization and conduct of high-quality medical follow-up are the most important tasks aimed at both reducing the risks of developing complications of chronic non-communicable diseases and reducing overall mortality, especially in the current conditions of the COVID-19 pandemic. The guidelines contain clinical aspects of dispensary follow-up, general principles of tactics for managing patients with various chronic non-communicable diseases in COVID-19 conditions, in addition, brief checklists with options for interviewing patients with various chronic non-communicable diseases are presented, topical aspects of the interaction of drugs used in the treatment of chronic non-communicable diseases with antiviral drugs are considered.The guidelines are intended for general practitioners, district therapists, general practitioners (family doctors), as well as doctors of other specialties providing primary health care.

Changes in the microcirculation of the oral mucosa in post-COVID-19 patients not receiving anti-coagulant therapy

Introduction. The outbreak of a new coronavirus infection has become a challenge for the global health system. The COVID-19 infection is directly related to various disorders of the cardiovascular system, including the microcirculatory bed, caused by thrombotic events and deteriorations of blood rheology. Aims. The paper reports on the results of a study of Doppler sonographic parameters changes in patients with a novel coronavirus infection over the past 6 months. Materials and methods. We assessed the oral mucosa microcirculation in three segments using the high-frequency ultrasound dopple-rography. Results. We recorded the linear and volumetric blood flow rates and the Gosling and Purselo indexes in the course of our work. When comparing the obtained average statistical parameters of blood flow velocity, the linear and volumetric blood flow rates in patients of both groups were found to be lain in the same range and the mean values of Vas, Vam, Qas were equal. The mean values of the Purselo resistance index were closer to 1,0 in patients with COVID-19, and the values of the Gosling pulsation index (PI) were on average 53.3 % higher than in the control group. Conclusion. We evaluated the screening capabilities and potential of high-frequency ultrasound dopplerography for use in patients of different age groups and different somatic status.

‘Long Covid’ (post-covid syndrome): Mechanism of occurrence, diagnosis and rehabilitation

The article is devoted to the study of an urgent problem of modern humanity – the fight against a pandemic caused by a new coronavirus infection, namely: the study of the mechanism of development of ‘long Covid’ (post-covid syndrome), a new clinical and laboratory method of its diagnosis, issues of drug and non-drug rehabilitation of patients who have suffered COVID‑19. The paper describes the etiopathogenesis of post-covid syndrome (PS), the distinctive features of which are the defeat of the cardiovascular, respiratory, nervous, digestive, immune systems of the body, ENT organs and musculoskeletal system. For the diagnosis of post-covid syndrome, a monochrome nanoparticle analyzer (MAN) has been tested for the first time in the Russian Federation, which allows determining pathophysiological shifts in the homeostasis system. It was found that the MAN method has a sufficiently high diagnostic sensitivity (78%), and shifts in the homeostasis system in post-covid syndrome are statistically significant (p < 0.001). A fundamentally important point of this study is that an algorithm has been developed for noninvasive diagnosis of PS by saliva (oropharyngeal flushes), based on the detection of a high contribution to the scattering of laser radiation in the mid-frequency range of the spectrum on nanoparticles ranging in size from 119 to 121 nm. The article also pays special attention to medicinal and non-medicinal methods of treatment of patients with ‘long Covid’ experiencing the consequences of a new coronavirus infection. It has been established that the best effect is provided by complex treatment combining methods of the traditional European school (drug therapy with the use of cardiovascular drugs, nootropic agents, chondroprotectors, vitamins and mineral complexes, hormones, hepatoprotectors, biostimulants, sedatives and anti-inflammatory drugs and other drugs) and non-drug methods of restorative treatment practiced by Oriental medicine (acupuncture, hirudotherapy, massage, osteopathy, etc.).

Study of the retina and optic nerve microvascular bed using optical coherence tomography-angiography in post-COVID-19 patients

Introduction. Signs of angioretinopathy are revealed in 7–27.7 % of post-COVID-19 patients. Optical coherence tomographyangiography (OCT-A) allows performing life-time evaluation of structural and microvascular retinal changes in patients after the new coronavirus infection. Aim. To investigate and to compare main microcirculatory parameters of capillary retinal and optic nerve plexuses using OCT-A in patients after COVID-19 of different severity degree. Materials and methods. The main group consisted of 54 people (108 eyes), who recovered from COVID-19 during 3 preceding months. According to the COVID-19 course severity degree, patients were divided into 3 sub-groups. 22 healthy volunteers (44 eyes) were included in the control group. All patients underwent OCT-A. In the angiography regimen, entire vascular density (VD) and that of every sector in the limits of superficial (SCP) and deep (DCP) capillary plexuses, radial peripapillary capillaries (RPC), and in the foveal avascular zone (FAZ). Results. All over parameters investigated no significant differences between control group patients and those of the sub-group with mild COVID-19 course. In patients with moderately severe infectious process course a significant decrease in VD SCP (P<0.01), as well as decrease in VD RPC (P<0.01). In patients with severe and critically severe disease course there was an decrease of VD DCP in the foveal area (P=0.016) and VD FAZ (P<0.01). VD indices correlations with thickness of retinal layers, in which these vascular plexuses are located. In any of the groups, there was no statistically significant enlargement of the FAZ area and no structural optic disc changes. Conclusion. In post-COVID-19 patients, there are signs of capillary blood flow reduction in retinal SCP and RPC, which is proportional to the prior infection severity degree. Associated to COVID-19 microangiopathy is a significant ophthalmologic sign of the new coronavirus infection. Microvascular changes of the retina could play a role of of a new biomarker reflecting the severity degree of the entire vascular system impairment in COVID-19.

Systemic endotheliitis in terms of novel coronavirus infection COVID-19: gender-related and perinatal risks

The review considers some physiological features that reflect gender differences in the susceptibility to a novel coronavirus infection. Up-to-date information on the impact of COVID-19 on the course of pregnancy and perinatal outcomes is presented. The debatable issues of the possibility of vertical transmission of the SARS-CoV-2 virus are highlighted based on the analysis of available literature data and recommendations of international professional communities.