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Aim: To evaluate the efficacy and safety of riamilovir in the treatment of COVID-19 in adults., Materials and Methods: The study included 180 patients with a laboratory-confirmed diagnosis of COVID-19 which fully meet the criteria for inclusion, non-inclusion and exclusion, signed a voluntary informed consent to participate in a clinical trial., Results: The efficacy, good tolerability and safety of the drug riamilovir in the treatment of COVID-19 have been established., Conclusion: As a result of a multicenter randomized double-blind clinical trial, the effectiveness of the drug riamilovir for therapeutic use in patients with COVID-19 according to the 1250 mg/day scheme (250 mg capsules 5 times per day) for 10 days was established. The drug riamilovir in a daily dose of 1250 mg for 10 days does not differ in safety from placebo.

Aim: Study the impact of various combinations of comorbid original diseases in patients infected with COVID-19 later on the disease progression and outcomes of the new coronavirus infection., Materials and Methods: The ACTIV registry was created on the Eurasian Association of Therapists initiative. 5,808 patients have been included in the registry: men and women with COVID-19 treated at hospital or at home., Clinicaltrials: gov ID NCT04492384., Results: Most patients with COVID-19 have original comorbid diseases (oCDs). Polymorbidity assessed by way of simple counting of oCDs is an independent factor in negative outcomes of COVID-19. Search for most frequent combinations of 2, 3 and 4 oCDs has revealed absolute domination of cardiovascular diseases (all possible variants). The most unfavorable combination of 2 oCDs includes atrial hypertension (AH) and chronic heart failure (CHF). The most unfavorable combination of 3 oCDs includes AH, coronary heart disease (CHD) and CHF; the worst combination of 4 oCDs includes AH, CHD, CHF and diabetes mellitus. Such combinations increased the risk of lethal outcomes 3.963, 4.082 and 4.215 times respectively., Conclusion: Polymorbidity determined by way of simple counting of diseases may be estimated as a factor in the lethal outcome risk in the acute phase of COVID-19 in real practice. Most frequent combinations of 2, 3 and 4 diseases in patients with COVID-19 primarily include cardiovascular diseases (AH, CHD and CHF), diabetes mellitus and obesity. Combinations of such diseases increase the COVID-19 lethal outcome risk.

Aim: An analysis of coronavirus infection in Russia and evaluation of different AVT regimens effectiveness., Materials and Methods: The study involved a retrospective analysis of 1082 patient records with laboratory-confirmed COVID-19 in 17 regions of Russia. The number of men and women was equal, mean age 48.718.1 (median 50). Patients with moderate COVID-19 (85%) versus mild COVID-19 (15%) were characterized by higher age (median 54 vs 21 years; p0.001), higher body mass index (27.8 vs 23.4; p0.001), prevalence of chronic diseases (75.3% vs 8.5%; p0.001), including circulatory system diseases (37.8%). Moderate COVID-19 characterized higher intoxication (10.86.1 vs 4.22.7 days; p0.001) and catarrhal symptoms duration (10.25.4 vs 6.14.1 days; p0.001)., Results: During hospitalization 92% of the patients received AVT, 77% antibiotics, and 16% corticosteroids. Umifenovir therapy resulted in a significant reduction of intoxication (8.75.5 vs 11.75.5 days; p0.001) and catarrhal symptoms duration (8.85.1 vs 12.04.9 days; p0.001) compared to the group without AVT. The usage of INF reduced intoxication symptoms compared with the group without AVT (8.97.5 vs 11.75.5; p0.05). Therapy with hydroxychloroquine, imidazolylethanamide pentandioic acid, and lopinavir + ritonavir combination did not affect the course of COVID-19. Most of adverse reactions were related to antibiotics., Conclusion: Umifenovir therapy and inclusion of interferon in AVT regimens was associated improvement in the clinical manifestation of the disease among patients.

Most subjects with the COVID-19 experience mild to moderate symptoms, but approximately 10% of cases suffer from severe course of disease. IL-6 inhibitors are actively used to neutralize and prevent the cytokine storm. Olokizumab is a humanized monoclonal antibody belonging to the G4/Kappa immunoglobulin isotype that selectively binds to human IL-6 and effectively neutralizes it., Aim: To evaluate the efficacy and safety of Artlegia (olokizumab) for the treatment of subjects with a disease caused by the SARS-COV-2 virus in a real-world clinical setting., Materials and Methods: The analysis included data of 610 subjects aged 55.0812.68 years who received olokizumab at a single dose of 160 mg/mL 0.4 mL subcutaneously as a preemptive anti-inflammatory therapy. The comparison group included 511 subjects aged 55.2311.23 years who received standard therapy without IL-6 inhibitors. Control Endpoints: 1. Positive clinical changes on Day 7. 2. Changes in the CRP levels on Days 1, 2, and 7. 3. Duration of oxygen therapy. 4. Number of days in hospital. 5. Number of adverse events. 6. Disease outcome., Results: If a cytokine storm occurs, immune regulatory events will trigger the development of either a protective immune response or an exacerbated inflammatory response. The use of preemptive anti-inflammatory therapy has both a short-term and, most importantly, a long-term effect on the T and B parts of the immune process. These aspects definitely require further research and observation., Conclusion: The use of olokizumab to treat the new COVID-19 coronavirus disease has demonstrated a positive effect on clinical and laboratory parameters. Primarily, it affects the severity of clinical parameters by improving the general condition already on the first day of observation, and decreasing body temperature to normal values. The changes in the C-reactive protein levels show a significant effect of the IL-6 inhibitor on the systemic inflammatory response.

The review gives data that reveal the role of succinic acid in providing cells with energy and oxygen under hypoxic conditions. It presents the results of clinical and experimental studies to evaluate the efficacy of succinate-containing drugs in the combination therapy of infectious diseases. The spectrum of biological effects of these drugs, which is provided by the synergy of their active ingredients, is considered.

Insulin supply of the body, activity of hormonal and nonhormonal insulin antagonists were studied and compared in subjects of different age with disordered carbohydrate tolerance. The role of hormonal and non-hormonal antagonists in the genesis of glucose intolerance was found to be different in different age periods in the presence of hyperinsulinemia and the reduced insulin-glucose index common to all the groups examined. Young age is marked by a distinct increase in glucocorticoid and, to a less degree, in androgenic functions of the adrenals. The elderly manifest activation of the angiotensin-renin-aldosterone system and more pronounced hypercholesterolemia and triglyceridemia in the presence of the changed body sensitivity to insulin. It is suggested that age-associated changes in the mechanisms of the glucose homeostasis control may be of importance in the formation of the features of individual patterns of diabetes mellitus.

Combined examination of 117 patients with insulin-dependent diabetes mellitus revealed the clinical and hormonal features of stable and labile diseases. Emphasis is laid on the complexity of the lability phenomenon; evidence is given for the necessity of differentiating between genuine lability and that of the iatrogenic type. The importance of hormonal shifts (depletion of the secretory capability of the insulin-producing apparatus and reduction of contrainsular effects) for the origin of destabilization of glucose homeostasis is discussed.

Short- (3-4 week) and long-term (1-4 yrs) results of the use of intensive insulin therapy schemes were used in 37 patients with severe forms of type I diabetes mellitus. Its beneficial effect on metabolism, remaining secretory beta-cell function, the frequency and expression of hypoglycemic reactions, manifestations of peripheral and visceral neuropathy, diabetic encephalopathy was proved.