Various pneumococcal vaccines are available worldwide, differing in the range of serotypes coverage and type of vaccine, which determine different mechanisms of action and postvaccinal immunity. Vaccination  against  pneumococcal infection is recommended for both children and adults. Based on information from public sources, we analyzed recommendations for vaccination of adult patients in various countries. The information was summarized in the main blocks: the availability of government funding and vaccination programs for all persons depending on age; availability of government funding and vaccination programs for all patients with risk factors; availability of vaccination recommendations depending on age and risk factors, not funded by the state. The collected data also was analyzed according to vaccination schedules and recommended types of pneumococcal vaccines. In fact, few countries have included vaccination of adults in their preventive vaccination schedules. Pneumococcal disease vaccination in adults is primarily the prerogative of economically developed countries. Currently, there is a clear transition from mono-vaccination with the polysaccharide pneumococcal vaccine PPV23 and combined vaccination regimens with a 13or 15-valent pneumococcal conjugate vaccine with revaccination with PPV23 to monovaccination with a 20-valent pneumococcal conjugate vaccine. Taking into account the spectrum of detected pneumococcal serotypes and molecular epidemiology data available in our country, the use of PCV20 can be considered justified.

Potentiation of chronic inflammation and oxidative stress by a new infectious agent in patients with type 2 diabetes mellitus can cause a severe course of the infectious disease. However, the study of the manifestations of oxidative stress in patients with hyperglycemia and infectious diseases is not widespread. This review reveals the features of the state of the antioxidant system in patients with type 2 diabetes mellitus and is devoted to identifying possible biochemical markers that predict severe infections among such patients.

Purpose: determination of the clinical course; laboratory and instrumental examination data; and analysis of the effectiveness of COVID-19 treatment in obese children.

Materials and methods. 50 children with COVID-19 who were obese and 50 children with this infection who had a normal body weight were under observation. All patients underwent general clinical physical examination; laboratory studies (PCR analysis of smears from the mouth and nasopharynx for SARS-CoV-2 RNA; clinical and biochemical blood tests; general urine analysis; coagulogram; blood test for proteins of the acute  phase  of  inflammation);  instrumental  studies (pulsoximetry; CT of organs chest). In addition; weight; height and body mass index were determined for all children. Statistical processing of the obtained results was carried out using the nonparametric Mann-Whitney test and the parametric Student t-test for independent samples.

Summary. 34% of obese patients had a history of other various background diseases. In this group; 76% of children had contact with acute respiratory infections in the family or organized groups. In both groups; all children had fever and intoxication; sore throat and rhinitis – in 24-36%; vomiting and diarrhea – in 10-12%. Significantly more often in obese patients; symptoms of respiratory tract damage such as cough (98% vs. 62%) and shortness of breath (36% vs. 2%) were observed. The duration of fever; intoxication; cough and shortness of breath in the group of obese patients was significantly higher compared to children in the comparison group. Obese patients had significantly higher CRP levels during hospitalization (18;6 vs. 8;4 mg/l); whereas by the time of discharge the differences had already been leveled (5;5 vs. 1;9 mg/l). In the observation group; the ferritin content was significantly higher relative to the comparison group both upon admission to the hospital (195;1 vs. 62;5 ng/ml) and after the end of the course of treatment (166;7 vs. 54;6 ng/ml). Lung damage according to CT studies in obese patients with COVID-19 was significantly more common than in the comparison group – 59;0±7;0% vs. 8;0±3;8%. They also developed grade I of respiratory failure more often; because the minimum SpO₂ was lower than normal and lower relative to children with normal body weight (94;8±2;0% vs. 98;3±0;8%). Obese children required significantly longer treatment of COVID-19 relative to the comparison group for all types of therapy they received. As a result; these patients spent significantly more bed days in the hospital – 9;3±3;6 vs. 6;2±2;0.

Conclusion. COVID-19 in obese children is more severe than in patients with normal body weight; which required long-term complex treatment in a hospital.

Objective of the study is to investigate immune-endocrine dysfunctions in children with acute respiratory viral infections manifested during post-COVID period.

Materials and methods. The main group included 22 children with acute respiratory viral infections manifested after mild COVID-19 infection 2–6 months before their hospitalization the comparison group included 7 children with acute respiratory viral infections without COVID-19 in their medical history; and the control group – 15 apparently healthy children. The level of cortisol; thyrotrophic hormone; triidothyronine; thyroxin; total immunoglobulin; cytokines was investigated in addition to standard indicators.

Results. Lymphocytes predominated in the blood test in the main group at the admission to the hospital; whereas neutrophils predominated in children of the comparison group. In comparison with the controls the children of the main group had significant decrease of the level of 25 cytokines and the level of only 4 cytokines was increased (CTACK; Eotaxin; SDF-1a; PDGF-BB); the tendency of immunoglobulin M decrease was noted. The level of cortisol in the main group was 2 times lower compared with the comparison group and did not differ from the control one; the level of triidothyronine and thyroxin was reliably decreased during the whole period of observation. During acute period there was determined positive correlated relation of cortisol with the number of neutrophils; granulocytic colony-stimulating factor; macrophage inflammatory protein; and a negative relation with the number of lymphocytes; factor-stromal cells. During acute period there were positive correlated relations between the level of triidothyronine and the number of platelets; immunoglobulin M; and during reconvalescence period the level of triidothyronine and thyroxin positively correlated with the number of neutrophils; and negatively with the number of lymphocytes.

Conclusion. During post-COVID period children after acute respiratory viral infections had identified immuneendocrine dysfunctions giving evidence to inhibition of the synthesis of hormones of adrenal gland cortex and thyroid system; synthesis of most cytokines; insufficient activation of congenital immunity that is likely to occur due to COVID-19 that proves the necessity of immune-corrective therapy.

Substantiation: Monitoring adverse events (AEs) among outpatients is an important clinical problem; as they may be the cause of treatment interruption. In this situation; using telemedicine technologies (TMT) is rational to prevent these events and ensure continuity of medical care.

The aim of the study was to investigate the possibility of using TMT to register AEs and prevent unjustified treatment interruption in patients with chronic hepatitis C (CHC); who receiving antiviral therapy (AVT).

Methods: 84 patients with HCV (genotype 1b) were included in the study. Patients were divided into two groups with and without the use of TMT (54 and 30 subjects; respectively). Patients with CHC (genotype 1b) were included under our observation. Patients were divided into two groups depending on the use of TMT. All patients received antiviral therapy (AVT) with a combination of ombitasvir; paritaprevir; dasabuvir and ritonavir. We studied the main laboratory parameters before start of therapy and after 12 weeks. The achievement of SVR after 12 weeks of therapy was also evaluated. Registration of cases of adverse events was performed by interviewing the patient

Results: All patients in the study sample achieved complete elimination of HCV within the specified time frame; no statistically significant difference between the groups was found (p>0.05). Analyzing the cases of AEs; 10 cases of AEs in 7 patients in the first subgroup and 12 cases of AEs in 7 patients from the second subgroup. In all cases treatment withdrawal was not required. The incidence of AEs was comparable in both populations (p>0.05).

Conclusion: The use of TMT allows to register cases of AEs in patients with CHC with a sufficient degree of accuracy; prevent independent treatment withdrawal and; as a consequence; contribute to the achievement of SVR.

Purpose of the study: to analyze the influence of dietary habits and the use of biologically active additives (BAAs) as a factor influencing the risk of COVID-19 in medical workers.

Materials and methods: A longitudinal online study was conducted from March to April 2022. Incidence was assessed as the percentage of COVID-19 cases among the total number of respondents. Characteristics of methods for studying actual nutrition were carried out using the method of retrospective recording of nutrition (method of analysis of frequency of consumption).

Results: respondents who took vitamin D in a prophylactic dosage were less likely to get sick with COVID-19 (confirmed SARS-CoV-2) – 35.9% did not get sick with SARSCoV-2; and those who didn’t take it – only 5.85%; p <0. 0001. Taking vitamin D reduced the odds (OR) of developing COVID-19 by 9.011 times (95% CI 4.581–17.710); and the relative risk of developing the disease by 46.5%. Prophylactic use of multivitamin complexes did not affect the risk of COVID-19 (p=0.14). It was found that the use of vegetables in the daily diet reduces the chance (OR) of the occurrence of clinical manifestations of a new coronavirus infection by 1.948 times (95% CI 0.845–4.492); and when consuming more than 400 grams per day – by 2.530 times (95% CI 1.015– 6.306). Daily consumption of green salads reduces the risk of disease by 29.5%.

Conclusion: impaired nutritional status leads to dysregulation of inflammation and oxidative stress; increasing susceptibility to infection and the risk of worsening the disease. The role of proper nutrition should not be overlooked and the use of vitamin D as a non–specific prophylaxis supports the immune system.

Introduction. Polymorphic variants of interferon receptor genes determine cell sensitivity to interferons and the antiviral immune response.

The study aimed to assess the impact of polymorphic variants of interferon receptor genes on humoral immunity to influenza and frequency of acute respiratory viral infections; taking into account vaccination status.

Methods. We conducted a cross-sectional study involving adult residents of Arkhangelsk who do not receive vaccination against influenza; N=156; and those who receive vaccination annually; N=70. The research procedure included a survey; assessment of concentration of immunoglobulin G to influenza A virus and determination of specific polymorphic variants of interferon receptor genes.

Results. Among those receiving vaccination annually; the proportion of seropositive individuals was higher (70;0%) compared to the non-vaccinated group (53;8%). In non-vaccinated individuals with the TT genotype of the polymorphic marker rs2229207 in the IFNAR2 gene; specific immunoglobulins G to influenza A virus were determined more frequently. The proportion of participants receiving annual influenza vaccination who experienced acute respiratory viral infections more than twice a year was 21;4%; while this proportion in non-vaccinated individuals was 32;7%. Among those vaccinated against influenza annually; the odds of frequent acute respiratory viral infections were four times higher in individuals with the GGTC haplotype (rs2257167 IFNAR1 + rs2229207 IFNAR2) compared to other haplotypes.

Conclusion. The associations between polymorphic variants of interferon receptor genes and humoral immunity to influenza and frequency of acute respiratory viral infections can be used to identify risk groups and for the development of personalized approaches for the specific prevention of viral infections.

Objective: to evaluate the effect of COVID-19 on the development of endocrine pathology in the studied adult patients

Materials and methods: Clinical and laboratory studies were conducted in 166 patients aged 18-65 years with a confirmed diagnosis of coronavirus infection U07.1 (COVID-19); with moderate (140 patients) and severe (26 patients) course of the disease. The control group included 35 practically healthy individuals aged 18 to 65 years.

Results: In the acute period of COVID-19; the development of subclinical hypothyroidism; low T3 syndrome; subclinical thyrotoxicosis; as well as hypoand hypercortisolemia was revealed. 6 months after discharge from the hospital on an outpatient basis; the development of thyroid pathology in 6 patients and diabetes mellitus in 5 patients was revealed in COVID-19 convalescents.

The aim of study – to identify predictors of unfavorable outcomes in patients with co-morbidities of multidrug-resistant tuberculosis (MDR-TB); HIV infection; and viral hepatitis C (HCV) to optimize care.

Materials and Methods. A total of 132 patients with MDRTB/HIV/HCV triple infection were included in the study: 112 individuals with favorable outcomes and 20 patients with unfavorable outcomes. To assess predictors of unfavorable outcomes; odds ratios and 95% confidence intervals were calculated. 95% confidence interval were calculated; and a prognostic model was built using logistic regression.

Results. Generalization tuberculosis process increased the chance of unfavorable outcome by 8.13 times (95% CI: 2.252 – 29.354; p<0.001); treatment with chemotherapy regimens without the inclusion of the new highly effective antituberculosis drugs – 5.333 times (95% CI: 0.059 – 0.597; p=0.002); undesirable adverse drug reactions – 4.263 times (95% CI: 0.938 to 19.370; p=0.044); severe adverse drug reactions – 6.429 times (95% CI: 1.889 – 21.878; p=0.001); level of CD4-lymphocyte count less than 50 cells/µL – 7 times (95% CI: 2.180 – 22.482; p<0.001); stage 4B HIV infection – 4.1 times (95% CI: 1.527 – 11.007; p=0.003).

Conclusion. The results obtained indicate the need to further study the problem of HIV-associated MDR-TB in combination with HCV in order to develop evidence-based algorithms for the management of this category of patients; taking into account the identified predictors of unfavorable treatment outcomes.

A trigger mechanism plays a leading role in the pathogenesis of hemorrhagic syndrome in COVID-19. On one hand; the development of heparin-induced coagulopathy is not excluded; on the other hand; the development of critical conditions is accompanied by the release of proinflammatory factors into the bloodstream. SARS-CoV-2 – associated endotheliopathy is considered as an additional link in the pathological process.

The aim of the study is to determine main risk factors and mechanisms of development of surgical hemorrhagic complications in COVID-19 patients on the basis of a comprehensive clinical; laboratory and instrumental examination; including pathomorphological and immunohistochemical studies.

The study included 115 patients with recurrent gastrointestinal bleeding and 24 patients with spontaneous hemorrhages in soft tissues. It was found that with high reliability (p<0.05); the development of surgical hemorrhagic complications of COVID-19 correlated with an increase in INR; a decrease in PTI; the presence of COPD; as well as the development of gas syndrome and sepsis. An immunohistochemical study using monoclonal antibodies to CD31 and CD34 receptors expressed on the surface of the endothelium revealed an alteration of the endothelial monolayer; contributing to the occurrence of a hemorrhagic event.

Thus; it can be assumed that an increase in the frequency of gastrointestinal bleeding and spontaneous hemorrhages in soft tissues of various anatomical locations in COVID-19 patients may be associated with the direct cytopathic effect of the SARS-CoV-2 virus on endotheliocytes (destruction of the vascular wall due to degradation of the endothelial layer); which determines the formation of a single pathogenetic mechanism of development hemorrhages in COVID-19.

Traveler apps for mobile devices such as smartphones are becoming more widely available. This study aimed to identify traveler infectious disease self-monitoring implementation strategies on a mobile application. It analyzed 73 journals from the PubMed database using the descriptive-analytic method. The records used in this exploration study were those released between 2018 and 2023 that were collected based on the keywords “travelers’ application;” or “infectious disease”. Data analysis was conducted using the VOS viewer software analytical tools.

According to the findings; studies on traveler application domination with pandemic COVID-19 travel apps used. The study on mobile applications for traveler applications on infectious disease revealed four clusters of dominant themes: information about the COVID-19 outbreak; application related to diagnosis for travelers; measurement community mortality and risk; and respondent risk assessment. This study also looked at research patterns throughout time. Current research themes concern travel risk applications that can raise people’s knowledge of endemic areas; health risk avoidance; and early identification of infectious illness signs to recommend beginning management. Through bibliometric analysis and network visualization; the researchers summarized current developments in infectious disease for traveler’s research to shed light on their research frontier; trends; and hot themes. These findings could be useful for future research and views in this quickly evolving subject.

This clinical case describes a rare clinical complication of infectious mononucleosis associated with Epstein-Barr virus in a 19-year-old patient. The current literature sources; medical history; examination data and discharge epicrisis of the patient are analyzed. Rupture of the spleen is an extremely rare complication that develops in 1% of patients against the background of infection. At the same time; the diagnosis of the complication is not very difficult – it is necessary to conduct ultrasound of the abdominal organs in dynamics in the event of a rupture clinic (critical days of the disease are especially important – 10-20 days). But due to its rarity; many clinicians forget about the possibility of developing this complication. The main purpose of the work is to attract attention and alertness to the potentially fatal complication of infectious mononucleosis.

Tularemia is a bacterial disease of humans; wild and domestic animals. The causative agent of tularemia is Francisella tularensis; which is a gram-negative bacterium in the form of a coccobacillus. This disease has multiple clinical manifestations depending on the path of infection; the virulence of the infecting bacterial strain and the underlying health status of infected individuals. Systemic infections (for example; pulmonary and typhoid forms) and complications are rare; but can be life-threatening. Most people suffer from a local infection (for example; skin ulcers; conjunctivitis or pharyngitis) with regional lymphadenopathy; which develops to suppuration in about 30% of patients and a chronic course of infection. The disease is spread through vectors such as mosquitoes; horseflies; deer flies and ticks. People can become infected with this disease through direct contact with sick animals; eating infected animals; drinking or direct contact with contaminated water and inhaling aerosols containing bacteria. There are natural foci of tularemia on the territory of the Republic of Crimea; which; combined with low awareness of the population; creates prerequisites for the formation of an unfavorable epidemic situation on the peninsula. The purpose of this study is to study the features of the clinical course of tularemia. A retrospective analysis of the patient’s medical history with the final diagnosis was carried out: tularemia; glandular form; moderate severity. The following keywords were used to search for literary sources: “tularemia”; “natural foci of tularemia in the Crimea”. The eLibrary search engine was used to search for literature.ru — scientific electronic library”; the PubMed search engine was used to search for English-language literature.