Extreme Medicine

ISSN Print 2713-2757 ISSN Online 2713-2765

Extreme Medicine

SCIENTIFIC AND PRACTICAL REVIEWED JOURNAL OF FMBA OF RUSSIA

Log In Registration RU

Baranova NN, Akin'shin AV, Goncharov SF, Meshkov MA, Zelentsov KM, Pys'mennij VP

The aim of this article was to summarize the experience of the National Center for Disaster Medicine “Zashchita” in organizing and performing medical evacuations (including those by air) of patients with COVID-19. Materials and methods used in the study included legal, normative and guidance documents, emergency call forms, methods for preparing for and performing medical transport of patients with COVID-19, EMS safety guidelines. The article lists basic normative documents regulating medical evacuation of patients with infections, including COVID-19, and describes the missions carried out by Zashchita and their outcomes. So fat, the Center has successfully completed 555 medical evacuations, including 64 aeromedical missions. Biosafety of EMS teams involved in medical evacuations was ensured following the existing safety guidelines. For long journeys over 1 h, PPE should be donned upon arrival at the scene before leaving the EMS vehicle. Using patient isolation transport units is mandatory during medical evacuations of COVID-19 patients by air. Prior to starting a mass medical evacuation of patients with COVID-19, their number and condition should be assessed to determine the priority sequence for evacuation and the required oxygen supply.

Received: 2020-06-26

Published online: 2020-08-10

DOI: 10.47183/mes.2020.007

Comments 0

VIEWS 2756

Filin KN, Berzin IA, Bykov VN, Gladkikh VD, Loginova SYa, Savenko SV, Schukina VN

When evaluating the effectiveness of the drug Mefloquine against SARS-CoV-2 coronavirus, in vitro experiments examined its toxicity for African green monkey kidney cell culture - Vero C1008, as well as antiviral activity against SARS-CoV-2, which was evaluated by suppressing the cytopathic effect the virus.A study of the toxicity of the drug Mefloquine showed that the concentration at which the drug exerts a cytopathic effect against 50% of Vero C1008 cells is 4.5 μg / ml. The maximum tolerated concentration (MTD) of Mefloquine is 2.25 μg / ml.A study of the effectiveness showed that 1 day after infection, the antiviral effect of Mefloquine was recorded when the drug was added 24 hours and 1 hour before infection with SARS-CoV-2, as well as when it was added 1 hour after infection, the cell culture was already at a concentration of 0.5 μg / ml Mefloquine at a concentration of 2 μg / ml, added to the Vero C1008 cell culture 1 hour after the introduction of SARS-CoV-2, completely blocked the action of the virus for 2 days after infection.

Received: 2020-06-25

Published online: 2020-08-09

DOI: 10.47183/mes.2020.006

Comments 0

VIEWS 2814

Sevostyanova MS, Selezneva NV, Chernomurova PA, Kharchenko ZS, Glushkova KV, Fetisov AO, Sapova AV, Semichev EV

The paper reports the experience of implementing psychological support measures for healthcare workers of infectious hospitals for patients with COVID-19 during a pandemic. The results of an empirical study of the relationship between the anxiety and depression symptoms prevalence, severity and specificity, and the social status and occupational burnout factors in healthcare workers living in metropolis (Krasnoyarsk) and closed territorial district (Zelenogorsk) or seconded to the Severo-Yeniseysky District of the Krasnoyarsk Territory, are presented. The phases of the psychological support activities implementation are described. A comparative analysis of the employees’ involvement in various infectious diseases hospitals was carried out.<b>Material and methods</b>The survey sample included 126 subjects (21 men and 105 women) engaged in the provision of medical care in three infectious diseases hospitals for patients with COVID-l9 in the Krasnoyarsk Territory. To achieve the goals and objectives of the study, the following methods were used: psychodiagnostic testing using the BDI scale, STAI test and MBI questionnaire, and statistical data processing (Spearman rank correlation coefficient, Wilcoxon-Mann-Whitney U-test). We invited 284 medical workers to participate in the psychological support activities.<b>Results and conclusion</b>The prevalence of sub-threshold depression among medical specialists varied between 5.5 and 30.9% depending on the infectious diseases hospital for patients with COVID-19 location. Severe depressive symptoms were detected in 4.46% of the total number of subjects. A low level of state anxiety was detected in less than 30% of respondents. It was confirmed that younger and less experienced employees were more susceptible to depersonalization and cognitive-affective symptoms of depression. Employees who had no children demonstrated higher level of state and trait anxiety. Moreover, despite the prevalence of alarming and depressive symptoms, the low involvement and unwillingness of healthcare workers to participate in psychological support activities were noted.

Received: 2020-06-25

Published online: 2020-08-06

DOI: 10.47183/mes.2020.005

Comments 0

VIEWS 3049

Samoylov AS, Udalov YuD, Nazaryan SE, Naikina AV

Data from medical records of 144 COVID-19 patients who had completed inpatient treatment were analyzed, as well as the results of the subsequent survey using a modified questionnaire. The relationship between physical activity level, performance, quality of life (prior to infection and after treatment), age, therapeutic exercises execution rate while staying in the hospital, stool problems, high blood pressure episodes after treatment, and the course of the disease was evaluated. The patients were divided into a control and experimental group in accordance with the the initial subjective level of performance. The moderate form of the disease prevailed (69.44%). The mild form was typical for younger patients, the patients over 50 years of age made up 62.49% of the total number of severe cases. Severe patients reported lower quality of life and performance prior to the disease compared to those with moderate and mild course of the infection. The patients (mild and moderate cases) with more active initial lifestyle and higher initial performance who practiced therapeutic exercises while staying in the hospital had a more favorable course of the disease (reduced length of stay in a hospital, fast recovery of performance, reduced number of CT scans). The higher initial physical activity level contributed to milder course of the infection. It is necessary to raise public awareness, especially among the elderly, about the regular physical activity benefits and the correlation between physical activity level and the course of the disease, as well as to introduce exercise therapy at all treatment stages.

Received: 2020-06-17

Published online: 2020-07-28

DOI: 10.47183/mes.2020.004

Comments 0

VIEWS 2868

Poyarkov SV, Makarov VV, Kraevoy SA, Yudin SM

The heterogeneity of the COVID-19 clinical manifestation may be associated with the characteristics of the genome of both humans and the virus. A combination of allelic variants of genes associated with viral life cycle can determine susceptibility to SARS-CoV-2 infection. Allelic variants in genes ACE1, ACE2, TMPRSS2, IL6, SLC6A20, LZTFL1, CCR9, FYCO1, CXCR6, and XCR1 can determine the severity of COVID-19. Analysis of the genomes of COVID-19 patients with different clinical course and development on their basis of model for stratification of people according to the degree of susceptibility and severity of manifestation will make it possible to develop a personalized approach for the prevention and treatment of COVID-19.

Received: 2020-07-01

Published online: 2020-07-27

DOI: 10.47183/mes.2020.003

Comments 0

VIEWS 3099

Lobzin YuV, Ivanov MB, Shustov EB, Rejniuk VL, Fomichev AV, Sosyukin AE, Litvincev BS

The article analyses different stages of COVID-19 pathogenesis that drive development of severe complications, including acute respiratory distress syndrome, multiple organ failure and endotoxicosis. COVID-19 progression is described, from the first moments of infection to the disruption of the alveolar-capillary barrier and acute respiratory distress syndrome. The article looks at the causes initiating pathological processes that lead to acute respiratory distress syndrome. The special focus is on oxidative stress, hyperreactivity of the immune system, endothelial dysfunction, and cytotoxic effects of the virus. The article discusses tentative treatments for COVID-19 at different stages of its pathogenesis.

Received: 2020-06-19

Published online: 2020-07-26

DOI: 10.47183/mes.2020.002

Comments 0

VIEWS 3586

Esaulenko IE, Popov VI, Petrova TN, Goncharov AYu

The article analyzes the recent large-scale outbreak of the novel coronavirus pathogen and the current epidemiological situation both in the world and in Russia that made experts rethink the threat posed by coronaviruses. The article describes the current situation in 6 regions of the Black Earth Belt in central Russia, summarizes and systematizes the obtained data on the dynamic, patterns of spread and progression of COVID-19. Special focus is placed on the situation in Voronezh region, with its epidemiological indices (the daily growth and fatality rates, duration of the disease before death, groups at risk, etc.). The article also analyzes the clinical and epidemiological features of the disease in patients with comorbidities, including the prevalence of severe and moderate forms and the risk of complications in groups at risk. The clinical presentations of COVID-19 make it difficult to differentiate it from other viral infections. The novel coronavirus is highly virulent and the infection tends to have a severe course. Resource mobilization in the wake of the Sars-CoV-2 epidemic revealed that the Russian healthcare system can successfully respond to public health emergencies. New hospitals and wards, rapid deployment of diagnostic and intensive care equipment, quick retraining of medical staff are all compelling evidence of how sufficient human and material resources can minimize the devastating effects of future epidemics, ensure quick decision making and improve the quality of medical care in “times of peace”.

Received: 2020-07-14

Published online: 2020-07-26

DOI: 10.47183/mes.2020.001

Comments 0

VIEWS 2901