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Background: During the COVID pandemic, research has shown an increase in candidemia cases following severe COVID infection and the identification of risk factors associated with candidemia. However, there is a lack of studies that specifically explore clinical outcomes and mortality rates related to candidemia after COVID infection., Objectives: The aim of this international study was to evaluate the clinical outcomes and identify factors influencing mortality in patients who developed candidemia during their COVID infection., Patients/methods: This study included adult patients (18 years of age or older) admitted to the intensive care unit (ICU) and diagnosed with COVID-associated candidemia (CAC). The research was conducted through ID-IRI network and in collaboration with 34 medical centres across 18 countries retrospectively, spanning from the beginning of the COVID pandemic until December 2021., Results: A total of 293 patients diagnosed with CAC were included. The median age of the patients was 67, and 63% of them were male. The most common Candida species detected was C. albicans. The crude 30-day mortality rate was recorded at 62.4%. The logistic regression analysis identified several factors significantly impacting mortality, including age (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02-1.07, p < .0005), SOFA score (OR 1.307, 95% CI 1.17-1.45, p < .0005), invasive mechanical ventilation (OR 7.95, 95% CI 1.44-43.83, p < .017) and duration of mechanical ventilation (OR 0.98, 95% CI 0.96-0.99, p < .020)., Conclusions: By recognising these prognostic factors, medical professionals can customise their treatment approaches to offer more targeted care, leading to improved patient outcomes and higher survival rates for individuals with COVID-associated candidemia., (© 2024 The Authors. Mycoses published by Wiley-VCH GmbH.)

In March 2020 the World Health Organization (WHO) declared a pandemic of the novel coronavirus infection (COVID-19) caused by the SARS-CoV-2 respiratory virus. The high spread rate of the virus and the severity of the course of the disease are of great clinical and epidemiological significance, making it relevant for ophthalmologists to study the mechanisms of how SARS-CoV-2 infects ocular structures, as well as possible clinical manifestations of the infection in the organ of vision. This review contains analysis, systematization, and generalization of epidemiological and clinical data on SARS-CoV-2 ocular lesions and was carried out with the data found in scientific abstract databases. The article presents main clinical ophthalmic manifestations of COVID-19, lists the utilized schemes of etiotropic and symptomatic therapy, recommended preventive measures, and considers the possible ophthalmic complications after vaccination against COVID-19.

Background: Data on patients with COVID-19 who have pulmonary tuberculosis (TB) are limited. In this study, we compared the clinical characteristics of patients with COVID-19/TB and patients with COVID-19 only. In addition, we analyzed the links between the severity of COVID-19 disease and the clinical characteristics of patients with COVID-19/TB., Methods: We conducted a retrospective, anonymized, cross-sectional study of 111 patients who met inclusion criteria for analysis (75 patients with COVID-19/TB and 36 patients with COVID-19)., Results: Patients in both groups (COVID-19/TB vs COVID-19) mainly suffered from fever (72.0% vs 100%, p < 0.001), fatigue (76.0% vs 94.4%, p  =  0.018), chest pain (72.0% vs 36.1%, p < 0.001), followed by cough (60.0% vs 97.2%, p < 0.001) and dyspnea (44.0% vs 63.9%, p  =  0.05). In group COVID-19/TB the most frequently reported co-morbidities were chronic liver disease (17 [22.7%]), cardiovascular diseases (25 [33.3%]), and diseases of the nervous system (13 [17.3%]). Female gender, fever, dyspnea, pulmonary bilateral TB lesion, and three or more co-morbidities have a statistically significant positive effect on the severity of the disease among patients with COVID-19/TB., Conclusion: It is important to perform rapid molecular testing and computed tomography to correctly distinguish COVID-19 and TB because of the similar clinical characteristics of both diseases. Bilateral pulmonary TB lesion and co-morbidity should be considered risk factors for severe COVID-19., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

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.

Clinical Question: What is the role of drugs in preventing covid-19? WHY DOES THIS MATTER?: There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19., Recommendation: The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty)., How This Guideline Was Created: This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach., Understanding the New Recommendation: The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19., Updates: This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline., Readers Note: This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity., Competing Interests: Competing interests: All guideline panel members have completed the WHO interest disclosure form. All authors have completed the BMJ Rapid Recommendations interest of disclosure form. The WHO, MAGIC, and The BMJ judged that no panel member had any financial conflict of interest. Professional and academic interests are minimised as much as possible, while maintaining necessary expertise on the panel to make fully informed decisions. MAGIC and TheBMJ assessed declared interests from other co-authors of this publication and found no conflicts of interests., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Coronaviruses are known to cause acute respiratory infections. Antiviral therapy, including for COVID-19, is based on clinical practice, experimental data and trial results. The purpose of this review is to: provide and systematize actual preclinical data, clinical trials results and clinical practice for antiviral agent umifenovir (Arbidol). Databases Scopus, Web of Science, RSCI and medRxiv were used for publication searching from 2004. A meta-analysis of clinical trials results was performed. Umifenovir is antiviral agent, it belongs to fusion inhibitors, interacts with SARS-CoV-2 spike protein. Umifenovir the impede the trimerization of spike glycoprotein and inhibit host cell adhesion, at the level of the coronaviruses S-protein of interaction with ACE2 receptor. Preclinical studies in vitro and on animals show umifenovir activity against a number of coronaviruses, including SARS-CoV, MERS-CoV, SARS-CoV-2, and others. Umifenovir, in combination with other antiviral drugs, symptomatic or traditional medicine, was used in China to treat patients with COVID-19, resulting in reduced mortality, virus elimination, the frequency of more severe course and complications in middle severity. However, antiviral therapy for the treatment of severe patients, with ARDS, did not lead to improved outcomes. In comparative clinical studies, umifenovir showed similar effectiveness with other antiviral drugs, and lower frequency of adverse reactions. Therapy with umifenovir, led to an increase percentage of patients with negative results of PCR tests on days 714 (I2=69.8%, RR 0.48, 95% CI 0.190.76; p=0.001). The efficacy and safety of antivirals against SARS-CoV-2 still requires clinical investigation. Moderate forms of COVID-19 could be effectively treated by antivirals, but severe forms of COVID-19, characterized by pulmonary immunopathology, require different approaches to treatment.

Analysis of the frequency of transmission SARS-CoV2 in different age groups and locations allows to identify risks of transmission, influencing on the spread of COVID-19 in the population and to strengthen the control on pandemic Epidemiological analysis of contacts with primary cases of COVID-19 and secondary cases of infection for 6 months of 2020 in the different age groups was performed on the data of epidemiological surveillance system in 190,856 COVID-19 patients and 146,996 their contacts Patients with mild form of disease had the main proportion of contact - 50.6 %, moderate form - 45.8%. The proportion of contacts in patients with severe form was only 3.6%. Group aged 41-64 years had the highest number of cases (44.4%) and contacts (44,5%), aged 18-40 years - 30.2% of cases and 34.2% of contacts; 0-6 years - 2.7% of cases and 1,9% of contacts, 7-17 - 4,0 % of the cases and 3.1% of the contact. The number of contact persons was directly related to the number of secondary cases of the disease in all age groups: at the age of 0-6 years - 3.5 %, 7-17 years - 5,8 %, 18-40- 33,9%, 41-64 - 42,1%, 65 and older -14.7%. Patients of all age groups mainly contacted with healthy people in domestic focuses: the age group 0-17 years accounted for 65.9% of contacts, 18-40 years - 63.9%, 41-64 years - 64.2% over 65 years - 65.18%, respectively. The frequency of contacts at work was the highest at the age of 18-40 years – 9.0% and 41-64 years - 9.0%, but were significantly less than contacts in everyday (family) life - 63.8% and 64.2%, respectively. The most active transmission of infection is carried out by patients aged 18-64 years, carrying the disease in mild and moderate-severe form. Secondary transmission of COVID-19 most of all is active in household foci in all age groups. In the age groups of 18-64 years, the transmission of infection in the workplace is also important. These results of analysis can be used to optimize prevention measures against COVID-19. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic poses a challenge for the medical community to study the peculiarities of patient management, particularly to refine the risk of a severe course of disease, depending on the presence of comorbidities. Aim of study: identification of factors affecting the likelihood of developing a severe course of COVID - 19 in comorbid patients. A retrospective study of hospitalized patients diagnosed with COVID-19 with a comorbid background in the period from January to November 2020 in the Russian Federation. An analysis of the severity of the course was carried out depending on the comorbid background with the calculation of OR and CI 95%, significant factors influencing the development of a severe course of the disease were identified. Of 67567 patients, 22545 had comorbidities. 7025 (31.2%) of them had severe course of illness, 15520 (68.8%) - mild/moderate. 45,022 patients had no comorbidity: severe course was in 2558 (5.7%) patients, mild/moderate – in 42464 (94.3%). Calculating from the total number of patients: comorbidity and severe course was recorded in 10.4%; comorbidity and mild/moderate course - in 23%; severe course without comorbidity was in 3.8%; mild/moderate course without comorbidity was in 62.8%. The comorbidity increased the risk of developing a severe course by 7.514 times, compared with patients without a comorbid background (95% CI: 7.156-7.890). The presence of comorbidities of the respiratory system was detected in 3042 patients (4.5% of the total) and increased the risk of developing a severe course by 1.618 times (95%, CI: 1.478-1.771); cardiovascular system - 12706 (18.8%), risk increased by 5.015 times (95% CI: 4.788-5.253), endocrine - 2314 (3.4%), risk increased by 3.274 times (95%, CI: 2.995-3.579), oncology - 944 (1.4%), risk increased by 4.072 times (95% CI: 3.567-4.648). These indicators are statistically significant (p <0.001). Diseases of the gastrointestinal tract (p = 0.213) and urinary system (p = 0.12) were statistically insignificant. The results indicate an increasing risk of severe course of COVID-19 in patients with comorbidities.. Additional diagnostic measures to search for a comorbid background will allow medical professionals to make more accurate predictions for each individual patient. [ABSTRACT FROM AUTHOR]

During COVID-19 pandemic, the total number of patients is periodically growing, including the number of those requiring hospitalization. The factors that increase the risk of hospitalization with COVID-19 remain poorly understood. identification of factors influencing on the likelihood of hospitalization in COVID-19 patients with comorbidity. A retrospective cohort study of 74314 COVID-19 patients with a comorbidity within March-November 2020 in Russia. Using multivariate logistic regression, significant factors influencing hospitalization were identified. As a result, a logistic function was obtained that included 16 factors out of 21, which was statistically significant. In accordance with R2 Nigelkirk coefficient of determination, composition of the factors are 46.6%. Based on the regression coefficient values, the age of the patients, the sex of the patients, the severity of the disease, cardiovascular diseases, respiratory diseases, endocrine pathology, oncology and other diseases, fever, dyspnea and late address for medical care (after 5 day of disease) are factors that increase the likelihood of hospitalization. Rhinitis, loss of taste, belonging to contact with contact with COVID-19 patient, early seeking for medical care had an inverse relationship with the risk of hospitalization. The chances of hospitalization of patients with oncology is increased 1.496 times (95% CI:1.159-1.932), with endocrine diseases - by 1.573 times (95% CI:1.238 -1.999), in patients with cardiovascular pathology - by 1.502 times (95% CI:1.185-1.903),), in patients with bronchopulmonary pathology - by 1.439 times (95% CI:1.133-1.828), with other comobidities - by 1.501 times (95% CI:1.184-1.904), in patients with moderate the course of the disease - by 8.353 times in comparison with patients with a mild course (95% CI:8,000-8.721), in patients with a severe course of the disease risk is increased by 68.291 times (95% CI:59.279-78.673), risk of hospitalization in men compared with women is increased 1.393 times (95% CI: 1.348-1.438), in patients with fever - 1.14 times (95% CI: 1.09-1.20), with dispnoea - 1.526 (95% CI: 1.495- 1.596). The chances of hospitalization with an increase in age by 1 year increased 1.012 times (95% CI: 1.010-1.013). These factors will help healthcare workers with the decisions regarding hospitalization of patients. [ABSTRACT FROM AUTHOR]

Studying the pathogenesis of COVID-19 is necessary to developing of perspective predictors of severe course of disease and unfavorable prognosis. The macrophage activation syndrome observed in severe form of COVID-19 can potentially be used as a marker of poor prognosis, which makes it relevant to measure the levels of macrophage inflammatory proteins MIP-1a and MIP-1b. Study included 80 patients (43 men and 37 women) aged 24 -90 years (mean = 58.3 years) with laboratory confirmed COVID-19 admitted Infectious Diseases Hospital in Moscow during April - August 2020. Patients were divided into 2 groups: group 1 included patients with a moderate form (N = 30), group 2 (N = 50) included patients with a severe form of COVID-19. Serum levels of MIP-1a and MIP-1b were assessed by ELISA. An increase of the MIP-1a level was observed in 3 patients in group 1 (10%) and in 42 patients in group 2 (84%). At the same time, the average concentration of MIP-1a was 3.71 pg/ml and 156.79 pg/ml in groups 1 and 2, respectively (p < 0.01). MIP-1b level above baseline was detected in 11 patients in group 1 (36.7%) and in 48 patients in group 2 (96%). The mean MIP-1b concentrations were 7.53 pg/ml and 152.62 pg/ml in groups 1 and 2, respectively. Similarly with MIP-1a, the difference in mean MIP-1b concentrations between the two groups was statistically significant (p < 0.01). A statistically significant correlation between the concentrations of MIP-1a and MIP-1b was observed for whole study population, the Pearson's correlation coefficient (r) is 0.756 (p < 0.01). At the same time, there were no statistically significant differences related to gender and age. Taken together, these data suggest the potential of serum concentrations of MIP-1a and MIP-1b as markers of the disease severity. COVID-19 is accompanied by an increase in the level of macrophage inflammatory proteins. The severe disease in most cases was associated with significant increase in the concentrations of MIP-1a and MIP-1b in the blood serum, which makes it possible to consider these proteins as potential markers of the severe COVID-19. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is accompanied by a high incidence of community-acquired pneumonia (CAP). Patients with a new coronavirus infection have an increased risk of developing hospital-acquired pneumonia. Aim: to study the etiological structure of CAP during the epidemic spread of COVID-19, to assess the risks of joining the pathogens of pneumonia associated with the provision of medical care. Biological material from 1085 hospitalized patients with CAP was conducted from August 2020 - June 2021 in Rostov-on-Don (Russia). Verification of respiratory viruses including SARS-CoV-2 RNA was performed by polymerase chain reaction in nasopharyngeal smears. Bacteriological analysis of sputum was performed via classical methods, identification of isolated pathogens was carried out using time-of-flight mass spectrometry on an Autoflex (Bruker Daltonics) with BioTyper 3.0 software. Cases of type 3 parainfluenza virus (7.8±0.9%), other types of coronaviruses (HKU-1, OC43, HL-63 and 229Е) (2.7±0.5%), respiratory syncytial virus (1.9±0.5%) were detected in patients with COVID-19. Fungi of the genus Candida (35.6±1.8%) and Staphylococcus aureus (9.1±1.1%) were prevailing in the microbiota structure. Should be noted that the number of Streptococcus pneumoniae cultures decreased from 5.5 % in August 2020 to 1.1 % in June 2021, possibly due to pneumococcal vaccination. Gramm-negative enterobacteria were presented predominantly by Klebsiella pneumoniae (3.5±0.7%), Escherichia coli (2.9±0.6%), and non-fermenting Gramm-negative bacteria – Pseudomonas aeruginosa (1.5±0.5%) and Acinetobacter baumannii (1.2±0.4%). In 30.6% of patients treated in the hospital there was a secondary infection probably associated with compromised immune system and the transmission of infection from the hospital environment. Secondary infection with Candida spp., non-fermenting Gramm-negative bacteria (A. baumannii, and P. aeruginosa) and K. pneumoniae, including those characterized by multiple drug-resistance, prevailed. The most frequently registered resistance to penicillins, cephalosporins of 3rd generation. A feature of CAP in patients with laboratory-confirmed COVID-19 is a higher incidence of mixed infection of both viral and bacterial etiology. Patients with COVID-19 represent a high risk group for the development of mycotic lung lesions, possibly against the background of treatment with antibacterial drugs. There is a significant risk of the formation of nosocomial infections in patients. [ABSTRACT FROM AUTHOR]

The current COVID-19 pandemic affects all strata of the population. Particular interest is the study of the course of this pathology in people with comorbidity. The purpose of our research is to study the features of the course of a COVID-19 people living with HIV (PLHIV). We conducted a retrospective analysis of the epidemiological, clinical and laboratory data of 121 patients with HIV infection treated for COVID-19 in 2020. Among PLHIVS, 87.6% were treated with antiretroviral therapy for HIV infection an average of 5.8 years. It was found that 45.5% were women and 54.5% were men. The average age was 41 years old (IQR: 20-78 years). The greatest number of cases was observed among both men and women in the age category of 30-49 years (74.2% and 72.7%, respectively). In the studied group, in 63.4%, in addition to HIV infection, patients suffered from other concomitant diseases, the most frequent of which were chronic lung diseases (22.3%), hypertension (18.2%), metabolic disorders (13.2%). In all cases, the COVID-19 disease occurred with a clinical manifestation. The most common symptoms were fever (76.0%), cough (63.6%) and sore throat (56.2%), loss of taste and smell was detected in 49.6% of cases. In 48.8%, COVID-19 in PLHIV was mild. In 88.1%, the duration of the disease did not exceed 14 days. Moderate forms were noted in 40.5% of cases. 10.7% of cases have severe form of COVID-19. The fatal outcomes were recorded in 8 patients, while in the group of patients receiving antiretroviral therapy, the mortality rate was 3.8%, and in the group without antiretroviral therapy therapy - 26.7%. We estimated that the proportion of deaths in patients with HIV infection is higher than in the general population (2.2%). PLHIV are a vulnerable group in relation to the risk of death from COVID-19. [ABSTRACT FROM AUTHOR]