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Vol 27, No 2 (2022)

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A method for predicting the effectiveness of glucocorticoid therapy in patients with moderate COVID-19 based on simple clinical and laboratory data

Efremov D.O., Beloborodov V.B.


BACKGROUND: In patients hospitalized with coronavirus infection (COVID-19), methods for predicting the effectiveness of anti-inflammatory therapy have important practical implications for optimizing treatment and outcomes. To date, several indicators of COVID-19 patients (age, comorbidities, and laboratory criteria for the intensity of inflammation) have been identified to indicate a high probability of a severe course and a risk of an adverse outcome. However, the problem of predicting the effectiveness of anti-inflammatory therapy in patients with moderate COVID-19 is not well understood.

AIM: This study aimed to develop a predictive model to determine the effectiveness/failure of anti-inflammatory therapy with glucocorticosteroids (GCS) in patients with moderate COVID-19 to improve the treatment outcomes of hospitalized patients.

MATERIALS AND METHODS: This study retrospectively analyzed electronic medical record data of all patients admitted consecutively from October 1, 2020, to January 31, 2021. The study included 71 patients with probable (clinically confirmed) and confirmed (laboratory) COVID-19 of moderate course, with characteristic changes in the lungs according to computed tomography of the chest organs (CT-CCT). Given the severity of the course, all study patients were prescribed GCS in accordance with the current version of the Interim Guidelines of the Ministry of Health of the Russian Federation.

RESULTS: A total of 71 patients were studied, and 53 (74.7%) of them did not require an escalation of anti-inflammatory therapy, which is regarded as an effective use of corticosteroids as an anti-inflammatory therapy (group 1). In the remaining 18 patients, the use of corticosteroids for an average of 5.5 (3–6) days did not have a definite clinical effect and required the additional use of monoclonal antibodies (MCA) to interleukin-6 (IL-6) or to its receptor (group 2). Using logistic regression analysis and receiver operating characteristic analysis, a mathematical model was developed and evaluated to predict the outcome of anti-inflammatory corticosteroid therapy in patients with moderate COVID-19. As risk factors, indicators that had significant differences in the studied groups before GCS initiation were selected: number of lymphocytes, platelets, and body temperature. The quality of the constructed model is assessed as very good, and the optimal cutoff point is 0.697. The sensitivity index of the model is 81.1%, and the specificity index is 72.2%.

CONCLUSIONS: The mathematical model makes it possible to predict the effectiveness of GCS therapy according to the number of lymphocytes, platelets, and body temperature. The mathematical model is adequate and has a high sensitivity and specificity.

Epidemiology and Infectious Diseases. 2022;27(2):75-88
pages 75-88 views

Monitoring results of the incidence of non-polio enterovirus infection in the pre-pandemic and pandemic periods

Danshina E.A., Mironov A.Y., Suranova T., Kuyarov A.V.


BACKGROUND: The study presents the results of monitoring the incidence of non-polio enterovirus infection in the pre-pandemic and pandemic periods in Khanty–Mansi Autonomous Okrug–Yugra (2011–2021).

AIM: To analyze the incidence of non-polio EVI in the urban population of Khanty–Mansi Autonomous Okrug–Yugra for 2011–2021.

MATERIALS AND METHODS: A retrospective analysis of the manifestations of the epidemic process of non-polio enterovirus infection was conducted, and the results of virological monitoring were presented.

RESULTS: The total incidence of EVI was predominantly shared by the urban population with predominance of children aged <6 years and school children. In the period 2020–2021, the low incidence of EVI was due to ongoing anti-epidemic measures against COVID-19 and was accompanied by the spread of enterovirus CVA6 serotype, which can effectively implement the aspiration mechanism of the transmission of the infectious agent and cause respiratory and exanthemic diseases. The spread of CVA6 was affected by an increase in the migration activity of the population, due to the partial lifting of restrictions and an increase in the non-immune stratum of the population and a decrease in the incidence of EVI in 2020. The results of the study will contribute to the adoption of measures leading to a decrease in the incidence of EVI in the Khanty–Mansiysk Autonomous Okrug and rational planning of preventive measures by improving the information and diagnostic subsystems of epidemiological surveillance.

CONCLUSION: To solve the tasks, further investigation of the spectrum of enteroviruses circulating in the Khanty–Mansiysk Autonomous Okrug, frequency of their occurrence in subclinical forms of EVI and as etiological agents of enteroviral meningitis, development of a molecular genetic typing technique using the technology of mass parallel high-throughput sequencing, and study of molecular genetic characteristics is necessary. These will reduce the risks of EVI in the post-pandemic period, ensure the sanitary and epidemiological well-being of the population, and prevent EVI spread in the Khanty–Mansiysk Autonomous Okrug.

Epidemiology and Infectious Diseases. 2022;27(2):89-97
pages 89-97 views

Detection and registration of infections related to medical care in the Ural and Siberian Federal Districts in 2021

Smirnova S.S., Egorov I.A., Malkova E.V., Zhuikov N.N., Shelkova E.S., Zainagabdinova Y.R., Semenov A.V.


BACKGROUND: Despite the important advances in the development of healthcare and the introduction of new and safe diagnosis and treatment technologies of various diseases, the problem of preventing health care-associated infections (HAIs) does not lose its relevance.

AIM: This study aimed to examine the features of the detection and registration of HAIs in the Ural and Siberian Federal Districts in 2021, to conduct a rating assessment of the quality of detection and registration of infections, followed by ranking of subjects to assess the functions of the epidemiological surveillance system of HAIs.

MATERIALS AND METHODS: The article presents a data analysis of the officially registered HAI cases within medical organizations of Ural and Siberian Federal Districts. The analysis was conducted based on the data from Federal Statistical Observation Forms No. 2 “Information on infectious and parasitic diseases” and No. 23–17 “Information on outbreaks of infectious diseases” and additional request materials “Information on medical manipulations and contingents treated” for 2021 and changes within 7 years (2015–2021) in comparison with indicators for the whole Russian Federation.

RESULTS: Statistical data were provided by the Departments of Rospotrebnadzor from Irkutsk, Kemerovo, Kurgan, Novosibirsk, Omsk, Sverdlovsk, Tomsk, Tyumen, Chelyabinsk regions; Altai, Transbaikal, Krasnoyarsk Territory; republics of Altai, Buryatia, Tyva, Khakassia; Khanty–Mansi Autonomous Okrug–Yugra, and Yamalo-Nenets Autonomous Okrug. Data for the Russian Federation were provided by the Federal Center for Hygiene and Epidemiology of Rospotrebnadzor according the duties of Ural–Siberian Scientific and Methodological Center for the Prevention of Health Care-associated Infections.

CONCLUSION: Based on the analysis results, the rating assessment of HAI’s detection and registration quality in Ural and Siberian Federal Districts and the ranking of subjects taking into account the functioning activities of the HAI epidemiological surveillance system were conducted. The information presented in the article is intended for employees of Rospotrebnadzor bodies and organizations, medical organizations, educational organizations, and executive authorities in healthcare.

Epidemiology and Infectious Diseases. 2022;27(2):98-127
pages 98-127 views

Identification of additional ways to reduce the incidence of tuberculosis in patients with human immunodeficiency virus infection

Frolova O.P., Sharkova T.I., Butylchenko O.V., Severova L.P., Abramchenko A.V.


BACKGROUND: According to official statistics from the Russian Federation in 2021, human immunodeficiency virus (HIV) infection was more often registered in the general population than in vulnerable groups.

AIMS: This study aimed to determine the characteristic patient cohorts with tuberculosis (TB) and HIV coinfection in dynamic epidemiological environments and propose additional organizational approaches to reduce TB incidence in patients with HIV.

MATERIALS AND METHODS: We investigated the complete medical data of patients with TB and HIV coinfection in three Russian regions. Additionally, we analyzed the cohort of patients with TB and HIV coinfection through sexual transmission. Furthermore, confidential interviews with patients with TB and HIV coinfection were undertaken. Specifically, reasons for refusing clinical examination at a Russian Federal AIDS Center (RFAIDSC) were clarified.

RESULTS: Among patients with TB and HIV coinfection, parenteral transmission remains the primary HIV infection route. Moreover, patients who acquired infection through sexual contact are also primarily socially disadvantaged, leading to the refusal of clinical examination and a consequent late detection of TB. On the contrary, patients who are unemployed report that they do not have the financial means to travel to the regional RFAIDSC. Widespread, rapidly progressive MDR TB infections more often occurred in patients with TB and HIV coinfection than in patients with TB but without HIV. Considering that every fourth patient with TB in Russia has been diagnosed with HIV. Moreover, there are specific features regarding the development and course of TB, and the generally accepted criteria for assessing the quality of TB without HIV care often become biased for patients with coinfection. This can lead to unreasonably negative assessments of the antituberculosis system and its work.

CONCLUSIONS: In view of the above, it is important to modify regulatory documents regarding informing patients about the importance of seeking timely medical help and solve the issue of travel for patients who are unemployed to medical examinations and in emergency cases. It is also important to introduce adjustments for the criteria in assessing the quality of TB care, thereby accounting for the pathogenesis of TB in patients with HIV coinfection.


Epidemiology and Infectious Diseases. 2022;27(2):128-135
pages 128-135 views


Human dirofilariosis (D.repens) in the subcutaneous tissues of the head: Clinical case in the department of neurosurgery of the Interregional Clinical and Diagnostic Center of Kazan

Pichugin A.A., Karimova E.R., Filimonova O.A., Koviazina R.R., Abdulkhaev F.A., Sharafutdinova V.I., Alekseev A.G., Khayrullin R.N.


Human dirofilariasis is a zoonosis caused by thin nematodes of Dirofilaria species (D. repens, D. immitis, D. tenuis and D. ursi) that belong to the Onchocercidae family. Larval stages of Dirofilaria usually occur in their primary hosts, such as cats and dogs, and rarely invade incidental hosts — human. The study described a clinical case of a patient with skull base meningioma who was admitted to the neurosurgical department for elective surgical treatment. The dense nodule was palpated in the subcutaneous tissue of the frontal area of the head. During the removal of the subcutaneous node, a thin white alive worm was evacuated during the surgery. The microscopical examination verified D. repens. Human dirofilariasis is a rare disease in the Republic of Tatarstan, Russia. However, the number of dirofilariasis cases is increasing in the recent years. Thirty-seven patients with dirofilariasis were diagnosed in the Republic of Tatarstan from 2010 to 2022.

Epidemiology and Infectious Diseases. 2022;27(2):136-143
pages 136-143 views

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