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Currently, all countries of the world are summing up preliminary results on mortality for 2020. At the same time, there are a large number of problems in determining the underlying cause of death (UCD) in multimorbid pathology in the context of the COVID-19 pandemic when filling out a medical certificate of death (MCC). Objective. To study the impact of the COVID-19 pandemic on preliminary mortality rates in the constituent regions of the Russian Federation. Material and methods. The data of Rosstat were used available on 02.02.21. Unstandardized all-cause mortality rates were compared with the averages for similar periods for 2017—2019. for the constituent entities of the Russian Federation. The difference is defined as a percentage of the previous period. The comparison of mortality rates was carried out for the year, as well as from April to December, since it was from April 2020 that Rosstat began to publish data for the constituent entities of the Russian Federation, taking into account the indication in the MSS of the presence of COVID-19 in four groups. Results. The absolute value of excess deaths was 306,862 cases (or +17% in relation to the average value for 2017—2019). The Republic of Dagestan (+29.7%) and the Chechen Republic (+42.3%) significantly differed from other regions in terms of excess mortality. Only in St. Petersburg, the number of deaths with any mention of COVID-19 exceeded the number of excess deaths in April— December 2020.The regional average share of deaths with COVID-19 as UCD for 2020 was 4.1±2.8% (in April—December 5.3±3.5%);any mention of COVID-19 in the MCC — 6.4±3.3%. The proportion of deaths indicating COVID-19 as UCD from the number of excess deaths for the entire 2020 was 33.9±22.4% (for April—December 30.9±19.9%);with any mention in the MSS — 52.3±22.0% (for April—December 47.4±21.9%;minimum 2.6% in the Republic of Bashkortostan, maximum 98.7% in the Republic of Tyva and 97.7% in Moscow). No correlation was found between excess mortality in 2020 and the proportion of deaths from COVID-19 as PPP. Conclusions. The COVID-19 pandemic has led to excess mortality in all regions of the Russian Federation. The causes of excess mortality need to be clarified, there is no evidence of an unambiguous and direct effect of COVID-19 on excess mortality. Clarification of the reasons for regional differences is necessary for the correction of prevention programs and the organization of medical care. (English) [ABSTRACT FROM AUTHOR] Ð’ наN

Objective Assessment of COVID-19 contribution to the mortality rate of the Russian Federation (RF) in January-June 2020 Material and methods Rosstat data on natural population movement were used For 2017-2019, monthly (January-June) were calculated the average number of deaths from all causes and compared with 2020 Values of «excessive» number of deaths from all causes were determined Taking into account that the methodological recommendations of the Ministry of Health of Russia on coding causes of death under conditions of COVID-19 were published only at the end of May 2020, the analysis of COVID-19-related deaths was carried out in May and June 2020 in 24 subjects of the Russian Federation with a population of more than 2 million people, indicating COVID-19: a) as the main cause of death;b) as the cause of death;c) if the virus was identified but had no significant impact on the outcome Results In January-April 2020 in Russia the number of deaths from all causes has decreased compared to the average for the previous 3 years (2017-2019);in May and June 2020 The «excessive» number of deaths was 8 4 and 12 2% respectively In January 2020 «excessive» number of deaths was recorded in 12 regions, in February - in 24, in March - in 10, in April - in 22, in May - in 43, in June - in 62 The largest number of «excessive» deaths was registered in May and June in Moscow, St Petersburg, Leningrad and Moscow regions and the Republic of Dagestan (in May) There was no increase in mortality in 3 regions during any of the 6 months Unstable dynamics was determined in the majority of RF regions, and no region revealed any monthly increase in the number of deaths as compared to the previous 3 years In general for the Russian Federation the proportion of deaths with any mention of COVID-19 on the medical certificate of death (MSD) in both May and June 2020 was 7 3 and 4 3%, respectively, as the main cause of death, varying significantly in the regions In May 55 3% of «excessive» deaths and in June 39 7% of cases were due to COVID-19 as the main cause of death (in Moscow 47 5 and 43 5%;in Moscow region 52 2 and 60 4%;in St Petersburg 50 and 69 3% respectively) In some regions, deaths from COVID-19 were recorded as the main cause of death without an «excessive» number of deaths, while in others the opposite situation was observed When comparing regions according to the data specified in the MSD, the variability of the fraction of causes of death was revealed: a) from COVID-19 as the main cause of death (with an identified and unidentified virus), b) as the cause contributing to death;c) not affecting the cause of death in the regions under consideration Conclusions The received results testify to the expressed variability of influence COVID-19 on «excessive mortality» in subjects of the Russian Federation, differences in approaches to definition of a cause of death Similar data are registered in other countries of the world Цель исследования Оценка вклада COVID-19 в смертность населения Российской Федерации (РФ) за январь-июнь 2020 г Материал и методы Использованы данные Росстата о естественном движении населения За 2017-2019 г помесячно (январь-июнь) рассчитаны средние значения числа умерших от всех причин и проведено сравнение с 2020 г Определены значения «избыточного» числа умерших от всех причин Учитывая, что методические рекомендации Минздрава России по кодированию причин смерти в условиях COVID-19 опубликованы только в конце мая 2020 г , анализ случаев смертей, связанных с COVID-19, проведен за май и июнь 2020 г в 24 субъектах РФ с численностью населения более 2 млн человек с указанием COVID-19: а) в качестве основной причины;б) причины, способствующей смерти;в) если вирус идентифицирован, но не оказал существенного влияния на исход Результаты В январе-апреле 2020 г в России отмечено снижение числа смертей от всех причин по сравнению со средним значением за 3 предыдущих года (2017-2019);в мае и в июне 2020 г «избыточное» число смертей составляло 8,4 и 12,2% соответственно В январе 2020 г «избыточное» число смертей зафиксировано в 12 регионах, в феврале - в 24, в марте - в 10, в апреле - в 22, в мае - в 43, в июне - в 62 Наибольшее число «избыточных» смертей зарегистрировано в мае и июне в Москве, Санкт-Петербурге, Ленинградской, Московской областях и Республике Дагестане (в мае) В 3 регионах не наблюдалось роста смертности ни за один из 6 мес В большинстве субъектов РФ определялась неустойчивая динамика, ни в одном регионе не выявлено ежемесячного увеличения числа умерших по сравнению с предыдущими 3 годами В целом по РФ доля случаев смертей с любым упоминанием COVID-19 в медицинском свидетельстве о смерти (МСС) и в мае, и в июне 2020 г составила 7,3 и 4,3% соответственно в качестве основной причины смерти, значительно варьируя в регионах В мае 55,3% случаев «избыточных» смертей, в июне - 39,7% случаев обусловлены COVID-19 как основной причиной смерти (в Москве 47,5 и 43,5%;в Московской области 52,2 и 60,4%;в Санкт-Петербурге 50 и 69,3% соответственно) В некоторых регионах случаи смерти от COVID-19 в качестве основной причины регистрировались без «избыточного» числа смертей, в других наблюдалась противоположная ситуация При сравнении регионов по данным, указанным в МСС, выявлена вариабельность долей причин смерти: а) от COVID-19 в качестве основной причины смерти (с идентифицированным и неидентифицированным вирусом), б) в качестве причины, способствующей смерти;в) не оказавшей влияние на причину смерти в рассматриваемых регионах Заключение Полученные результаты свидетельствуют о выраженной вариабельности влияния COVID-19 на «избыточную смертность» в субъектах РФ, различии в подходах к определению причины смерти Аналогичные данные регистрируются и в других странах мира

The article provides information on changes in the activity of centers of public health and medical prevention in conditions of CO-VID-19 pandemic Examples of response to the coronavirus outbreak of the world medical community are given, the developed strategies and the most effective restrictive measures are listed The result of a survey of 72 regions of the Russian Federation on changes in the work of public health and medical prevention centers that have occurred since the announcement of the pandemic and the establishment of the Coronavirus operation headquarters is presented The information about the development of new information materials, speeches in mass media, holding online events and live broadcasts for patients, providing medical and psy-chological assistance to the population at home and on the phone, organizing methodological assistance to medical organizations on the prevention of risk factors for chronic non-communicable diseases in COVID-19 conditions is listed Receiving new data on changes in the work of different spheres of health care system during the global pandemic will allow developing new algorithms of response in such situations and optimizing the functions of public health and medical prevention centers © 2020, Media Sphera Publishing Group All rights reserved

Objective To describe the methodology for creating and the first results of the prospective hospital registry of patients with suspected or confirmed coronavirus infection (COVID-19) and community-acquired pneumonia (TARGET-VIP) Material and methods The registry included all patients admitted to the National Medical and Surgical Center named after N I Pirogov from April 6 to June 2, 2020 with suspected or confirmed coronavirus infection and community-acquired pneumonia All patients’ data were taken from medical records An additional survey of patients was performed (in the hospital or during the first 30 days of post-hospital period) in order to clarify data on risk factors, history of somatic and infectious diseases, pre-hospital drug therapy At the outpatient stage, it is planned to collect data about the dynamics of clinical status and long-term outcomes in patients enrolled into the registry For this purpose, a special survey of patients or their relatives during telephone contact 1-2, 6, 12 and 24 months after discharge from the hospital will be performed Results The registry included 1 130 patients (age 57 5±12 8 years, 51 2% men) COVID-19 was diagnosed in 60 7% of cases when PCR-tests were positive, and community-acquired pneumonia was confirmed in 94 2% of patents, cardiovascular diseases (CVD) were diagnosed in 52 9% of cases Among chronic non-cardiac diseases the incidence of digestive diseases (22 1%) and diabetes (16 3%) was maximal, but those with bronchial asthma and anemia - were minimal (3 1 and 3 5%, respectively) CVDs or non- CVDs were revealed in 75 8% of cases Data on the values of height and body weight were available in the medical records in 97% of cases, but the calculation of body mass index (BMI) was practically not used The incidence of obesity according to clinical diagnosis was 6 1% while BMI≥30 kg/m2 was revealed in 35 2% of cases Hydroxychloroquine was administrated in 84 3% of patients, anticoagulants - in 84 2%, antibiotics - in 70 0%, glucocorticoids - in 15 2%, antiviral drugs - in 5 9%, immune-suppressants - in 8 6% of patients The rate of prescriptions of ACE-inhibitors/angiotensin receptor blockers (53 7%) and beta-blockers (45 6%) was bigger than those of other components of cardiovascular pharmacotherapy in 598 patients with CVD The hospital mortality rate was 4 2% Among the age group 65 years and older mortality (9 7%) was 6 times higher than among younger patients (1 6%) Patients who died were 16 years older than survivals The proportion of patients with coronary artery disease, atrial fibrillation and chronic kidney disease was significantly bigger in non-survivals than in survivals (Odds Ratio after adjustment to age and sex was 2 2, 5 0 and 4 1, respectively;p

The emergence of a new coronavirus infection (COVID-19) has put before doctors the task to find not only new antiviral drugs, but also other approaches to the treatment and prevention of this disease In April 2020, assumptions were formulated about the prospects for using a helium-oxygen mixture (heliox) in the complex therapy of patients with COVID-19 That was reflected in 6th version of the Federal Interim Guidelines for the Diagnosis, Prevention and Treatment of COVID-19 This article analyzes scientific publications on the assessment of the use of Heliox in respiratory pathology and in healthy persons in order to assess the possible uses of the mixture during an epidemic of acute respiratory viral infection, including COVID-19 Появление новой коронавирусной инфекции (COVID-19) поставило перед врачами задачу поиска не только новых противовирусных препаратов, но и других подходов к лечению и профилактике этой патологии В апреле 2020 г были сформулированы предположения о перспективах использования гелиево-кислородной смеси (гелиокс) в комплексной терапии пациентов с COVID-19 Это нашло отражение в 6-й версии Федеральных временных методических рекомендаций по диагностике, профилактике и лечению COVID-19 В настоящей статье анализируются научные публикации, посвященные оценке использования гелиокса при респираторной патологии и у здоровых людей с целью описания возможных вариантов применения смеси во время эпидемии острой респираторной вирусной инфекции, включая COVID-19

Consensus of experts of the Interregional Public Organization "Society of Gastroenterologists and Hepatologists "North-West", Russian Society for Prevention of Noncommunicable Diseases and the Profile Commission on Therapy and General Medical Practice of the Russian Ministry of Health Консенсус экспертов Межрегиональной общественной организации «Общество гастроэнтерологов и гепатологов «Северо-Запад», Российского общества профилактики неинфекционных заболеваний и Профильной комиссии по терапии и общей врачебной практике Минздрава России

Medical equipment, in particular ultrasound machines, is in close contact with patients and therefore has a high risk of infecting working surfaces through contamination of viral particles, especially against the background of a large number of studies The is-sue of safety of medical manipulation is more relevant than ever, and even a simple and safe ultrasound examination can cause coronavirus infection To reduce the risk of patients being infected, the indications for any imaging study should be carefully con-sidered Echocardiographic studies are only advisable in symptomatic patients who require correction of therapy and subsequent intervention Scheduled examinations during the pandemic are not only useless, but even dangerous Focus echocardiography is the most preferred method for heart and lung ultrasound in the pandemic era, given its rapidity, simplicity and informative na-ture In addition, the short duration of the study will ensure the maximum possible safety of patients and medical staff during ultrasound examinations of the heart and lungs