Vol 41, No 3 (2022)

Original articles

Rehabilitation of patients after a new coronavirus infection COVID-19 at the second and third stage

Kovlen D.V., Abuseva G.R., Khoziainova S.S., Kondrina E.F., Podberezkina L.A., Ischuk V.N., Karpova T.N., Konoplyankin I.V., Kovalev A.S., Tolmachev S.V.


BACKGROUND: Patients who have undergone a COVID-19 infection are in need of comprehensive rehabilitation, taking the polysyndromic manifestations of the post- COVID syndrome and comorbidities into account.

AIM: The purpose of this article is the need to evaluate the effectiveness of medical rehabilitation programs for patients who underwent a COVID-19 infection at the second and third stages of medical rehabilitation from the standpoint of evidence-based medicine.

MATERIALS AND METHODS: 330 medical rehabilitation programs for patients who had a COVID-19 infection were examined. All patients underwent functional tests: control of blood oxygen saturation (SpO2), spirometry, Stange and Gench tests, testing on the Borg exercise tolerance scale and the MRC dyspnea scale; the EQ-5D quality of life questionnaire was completed. Patients were divided into 2 representative groups (160 and 170 people). The average duration of treatment was 14 days. The methods of physical and rehabilitation medicine: therapeutic exercises, breathing exercises, inhalation therapy were applied to the patients in the observation group. Patients in the observation group underwent rehabilitation treatment programs depending on comorbidities and severity of symptoms in organs and systems. The survey was conducted on at 2 control points: 1 day (first), 14 day (second).

RESULTS: The observation group showed significantly better recovery results (p < 0.05). The average values of the Stange and Gench samples showed a positive trend. There was an improvement in the subjective assessment of the tolerability of the 6-minute walk test on the Borg scale, a decrease in the severity of dyspnea on the MRC dyspnea scale, and an improvement in the quality of life on the EQ-5D scale.

CONCLUSION: The structure of the rehabilitation programs used in the clinic of medical rehabilitation and recovery treatment was analysed, showing positive results that have indicated the effectiveness of the methods of physical and rehabilitation medicine in patients with various manifestations of post-COVID syndrome.

Russian Military Medical Academy Reports. 2022;41(3):243-249
pages 243-249 views

Fighting SARS-CoV-2 infection: experience and prospects

Zhdanov K.V., Kozlov K.V., Maltsev O.V., Miklush P.I., Sharabhanov V.V., Kasyanenko K.V., Gordienko V.V., Yurkaev I.M.


BACKGROUND: COVID-19 is an international emergency. The Military Medical Academy, including the Department and Clinic of Infectious Diseases (with a course in medical parasitology and tropical diseases) are actively involved in the fight against the COVID-19 pandemic, and are also studying the pathogenesis, diagnosis and treatment of this disease.

AIM: to systematize the work done at the Military Medical Academy in relation to the fight against a new coronavirus infection.

MATERIALS AND METHODS: This article provides a brief description of the studies conducted in relation to COVID-19.

RESULTS: The department’s view of the infection caused by SARS-CoV-2 is presented, the main indicators of the work of the clinic of infectious diseases in the fight against COVID-19 are briefly reflected, and their own research in the field of this infectious disease is demonstrated.

CONCLUSION: Based on our scientific work, our experience in treating patients with a new coronavirus infection, the main conclusions and recommendations are formulated:

  1. It is necessary to take into account the clinical feature of COVID-19 — a long initial period (up to 8 days), which creates the illusion of imaginary well-being and contributes to late hospitalization.
  2. PCR is not an ideal diagnostic method, which creates the possibility of obtaining a false negative result. In this regard, clinical, epidemiological and radiological diagnostics are decisive.
  3. The organization of early active detection of patients with all clinical forms of infection caused by SARS-CoV-2, and their timely hospitalization helps to reduce the risk of developing a severe course, complications and epidemiological danger of patients.
  4. Complex antiviral and anticoagulant therapy should be early (up to 5 days from the clinical manifestation), proactive, aimed at reducing the likelihood of developing pneumonia with respiratory failure and thrombosis of the LA branches.
  5. Anti-inflammatory therapy increases the survival of patients with severe COVID-19 and should be administered as early as possible with a preventive goal at the first minimal clinical and laboratory signs of a hyperinflammatory response.
Russian Military Medical Academy Reports. 2022;41(3):251-259
pages 251-259 views

The effectiveness of the use of mesenchymal stromal cells for the treatment of lacerated wounds under conditions of hypothermia and hypoxia

Volkova M.V., Boyarintsev V.V., Trofimenko A.V., Rybalkin S.P., Kovaleva E.V., Biryukov S.A., Fil'kov G.I., Durymanov M.O.


BACKGROUND: Patients Arctic conditions complicate the pathogenesis of various skin and soft tissue injuries. For the treatment of these diseases, the possibility of using multipotent mesenchymal stromal cells, which promote the proliferation of granular tissue cells, angiogenesis, and reduce the duration of the inflammatory phase during wound healing due to the secretion of cytokines and growth factors, is being considered.

AIM: In order to evaluate the effectiveness of cell therapy, experimental studies were carried out on the model of a lacerated wound in rats under conditions of hypoxia and hypothermia.

MATERIALS AND METHODS: The animals were kept in a climate chamber (15% oxygen, 4°C) for 48 hours. Injury was applied 24 hours after placement in controlled conditions. The introduction of stem cells was carried out a day after the wound was applied. Mesenchymal stromal cells obtained from the red bone marrow of Wistar rats were used for injection. The cell culture used had an immunophenotype corresponding to stem cells and had the ability to differentiate in the osteogenic, chondrogenic and adipogenic directions. During the study, the degree of inflammatory reaction in injured tissues and the presence of possible pathological discharges from the wound canal were assessed in rats, and the thickness of the injured paw was measured.

RESULTS: The stimulating effect of the suspension of mesenchymal stem cells on the dynamics of reducing the edema of the injured hip by 10% was established compared to the control group. To describe the process of inflammation, a histological analysis was performed on the 6th and 21st days after the wound was applied. On the 6th day of the study, a weak infiltration of lymphocytes in the muscle tissue was noted in rats that were injected with MMSC, which may indicate an earlier transition of the wound process to the proliferative phase.

CONCLUSION: The stimulating effect of the suspension of mesenchymal stem cells on the dynamics of reducing the edema of the injured hip by 10% was established compared to the control group.

Russian Military Medical Academy Reports. 2022;41(3):261-268
pages 261-268 views

Analysis of the activities of non-staff units of the Disaster Medicine Service of the Ministry of Defense of the Russian Federation in the liquidation of the medical and sanitary consequences of emergencies and ways to improve it

Ovcharenko A.P., Lemeshkin R.N.


AIM: Analysis of activities and ways to improve the functioning of emergency units of the Disaster Medicine Service of the Ministry of Defense of the Russian Federation in eliminating the medical consequences of emergency situations.

MATERIALS AND METHODS: The materials of the study were various historical documents and available literary sources characterizing the activities of the medical service of the Armed Forces of the Russian Federation (USSR) during the elimination of the medical consequences of emergencies of various peacetime. A content analysis of an array of historical documents was carried out with subsequent meaningful interpretation to identify problematic factors in the practical activities of non-staff units of the Disaster Medicine Service of the Ministry of Defense of the Russian Federation. The identified problematic questions (n = 10) were formulated, grouped and presented in the form of a corresponding questionnaire with a subsequent survey of military medical specialists (n = 440). The findings were compiled into a common research matrix to determine their specific contribution to the activities of healthcare professionals engaged in different teams and were factorally analyzed, allowing the resulting ranked (ordinal) expert responses to be processed for subsequent interpretation. The consistency of respondents’ opinions was estimated using a rank correlation coefficient — the Kendell concordance coefficient (W).

RESULTS: As a result of the study, the most significant problem issue was “the poor equipment of medical workers with medical products, medicines and sanitary equipment necessary for work in the emergency zone”, and the least significant was “the possibility of conducting a safe assessment of environmental objects for indication of the causative agent of infectious nature, chemical contamination and radiation pollution”. Based on the fact that the total number of problematic questions was 10, all of them were narrowed to 3 fundamental internal (hidden) generalizing factors as a result of factor analysis: “comprehensive provision of emergency units of the Disaster Medicine Service of the Ministry of Defense of the Russian Federation” (the factor’s contribution to the general dispersion is 30.3%), “professional activity of emergency units of the Disaster Medicine Service of the Ministry of Defense of the Russian Federation” (12.3%), “level of readiness of emergency units of the Disaster Medicine Service of the Ministry of Defense of the Russian Federation” (10.1%).

CONCLUSION: As a result of the analysis of problematic issues of the professional activities of medical workers from non-staff units of the Disaster Medicine Service of the Ministry of Defense of the Russian Federation, the most significant generalizing factors were identified: «comprehensive provision of non-staff units of the Disaster Medicine Service» (the factor’s contribution to the general dispersion is 30.3%), “professional activity of non-staff units of the Disaster Medicine Service” (12.3%). The obtained results allow making timely decisions by the medical support management bodies of various levels on the organization of the elimination of the medical consequences of emergency situations with the involvement of emergency formations in the form of detachments, brigades, and groups. The main ways to improve the functioning of emergency units of the Disaster Medicine Service of the Ministry of Defense of the Russian Federation in the elimination of the medical consequences of emergency situations should be considered to be the optimization of their organizational and staff structure, improving the quality of equipment with medical and material and technical resources, as well as increasing the level of readiness of military medical specialists for action on purpose.

Russian Military Medical Academy Reports. 2022;41(3):269-276
pages 269-276 views

The application of modern psychophysiological hardware and software complexes in prediction of resistance to combat psychological stress

Chernyavsky E.A., Zelenina N.V., Yusupov V.V., Grigorov A.V.


Modern concepts about the dynamics of states of servicemen following combat mental trauma are presented. Psychological mechanisms of the development of post-traumatic stress disorder are described. The results of psychological examination of servicemen-combatants are briefly summarized. It is shown that 40% of them have negative psychological consequences of combat stress in the form of signs of partial post-traumatic stress disorder, which correlate with manifestations of neurotic disorders. Signs of partial post-traumatic stress disorder in healthy military combatants reduce the self-assessment of the quality of life, but do not significantly affect the professional aspect of social functioning in favorable conditions, that does not allow to identify the presence of negative psychological consequences of combat stress by commander expert assessment.

In addition to the psychological examination, the servicemen underwent stress testing on the “Rehacor” hardware psychophysiological software complex, which consisted in the fact that the subject was alternately presented with stress stimuli consisting of video and audio sequences on the monitor screen and in headphones in accordance with a pre-compiled scenario. In the course of stress testing the physiological parameters of the subject were recorded. In military personnel with signs of partial post-traumatic stress disorder, a decrease in the threshold of sensitivity to stress was found, which in combat conditions can lead to the development of acute stress-induced mental disorders and to be the reason for the growth of violations, mistakes, the adoption of incorrect operational and tactical decisions, the demoralization of personnel, the growth of sanitary and irretrievable losses and losses of military equipment and weapons.

Based on the physiological parameters obtained during stress testing, a method for diagnosing signs of partial post-traumatic disorder has been developed. This method makes it possible to objectify the identification of the negative psychological consequences of combat stress and can be used in the interests of psychological and psychiatric intelligence.

Russian Military Medical Academy Reports. 2022;41(3):277-282
pages 277-282 views

Iniciation and cultivation of multipotent mesenchimal human umbilical stroma cells in a laboratory experiment

Chernov V.E., Sokolova M.O., Ivanova A.K., Buntovskaya A.S., Koreshova E.I., Trandina A.E., Frumkina A.S., Harkevich O.N.


BACKGROUND: Wharton’s jelly of the human umbilical cord is one of the sources of multipotent mesenchymal stromal cells. The cell population obtained from the postpartum biomaterial is characterized by high proliferative and regenerative properties. Isolation of a culture of multipotent mesenchymal stromal cells from the umbilical cord does not pose a threat to the health and life of the donor.

AIM: Optimization of the technique for isolating a reproducible population of multipotent mesenchymal stromal cells from Wharton’s jelly is an urgent task in biomedicine, which can accelerate the process of obtaining donor cells for cell therapy and tissue engineering.

MATERIALS AND METHODS: In the study, the main techniques and methods for isolating the culture of umbilical cord stroma cells were tested, the cultivation process was optimized to increase its efficiency and reduce the time of growth of cell biomass. The effect of the components of the nutrient medium on the cells obtained from Wharton’s jelly of the human umbilical cord was studied. Currently, there is no universal composition of the growth medium; in various studies, nutrient media from different manufacturers are used, which differ in composition. The most discussed issue is the selection of serum, which is part of the nutrient medium.

RESULTS: In the work, a comparative evaluation of five different sera was carried out. It has been shown that the most stable physiological parameters are observed in cell suspension samples with the addition of FBS (SKPK, Russia) and FBS (Capricorn, USA) sera. A study of the effect of hypoxia on cell culture in combination with the most effective sera showed that hypoxic stress acts as an activator of primary cell proliferation. The assessment of the effect of serum and hypoxia on cell culture was carried out visually using microscopy, assessment of changes in cell morphology during cultivation, and the results of testing the action of sera by the intensity of respiration of free and immobilized cells under the action of inhibitors.

CONCLUSION: As a result of the experiments, the influence of the type of serum on the initiation of cell expansion from primary explants and further cell proliferation in vitro was established. Hypoxia during exposure of primary explants enhances the expansion of cells from tissue fragments of Wharton’s jelly tissue.

Russian Military Medical Academy Reports. 2022;41(3):283-291
pages 283-291 views

Directions of the laboratory diagnostics improving of the socially significant hemocontact viral infections in the military medical organizations

Orlova E.S., Bulan'kov Y.I., Sechin A.A.


In this study we have shown the relevance of the nucleic acid testing for the diagnosis of the human immunodeficiency virus infection and hemocontact viral hepatitis in the military medical organizations as well as the experience of majority of the foreign countries that actively apply modern molecular methodologies for the diagnosis of infectious diseases. The possibility of using the rapid tests, molecular biology techniques and an alternative carrier of the biological material — the “dry drop” method, the potential of this method of biological material preparation in infectious diseases diagnostics in case of laboratory remoteness and for follow-up observation of patients with socially significant hemocontact viral infections is shown.

New algorithm of human immunodeficiency virus infection laboratory testing using polymerase chain reaction as an expert test followed by methods of determination of recency of acquisition of human immunodeficiency virus antibodies especially in questionable laboratory result cases are proposed.

Promising molecular genetic methods for implementation in laboratories in military medical organizations such as nester-polymerase chain reaction, loop-mediated isothermal amplification, digital polymerase chain reaction, mass spectrometry of polymerase chain reaction — amplicons, Deoxyribonucleic acid sequence are observed. We have defined the main approaches to improve laboratory diagnostics of social significant hemocontact viral infections in military medical organizations: optimization of logistics of pre-analytical step with expansion of validated biomaterial samples storage and delivery methods (including “dry drop”); reduction in the duration of analytical phase through increase in the clinical use of polymerase chain reaction testing (including isothermic variant); improving the sensitivity and accuracy of serological and molecular diagnostics; development of validation methodology and laboratory tests results interpretation While ensuring military medical expertise. The necessity of specialists training in new diagnostics techniques and result interpretation, improving regulatory framework on examination and registration of human immunodeficiency virus positive military officers, determination of the legal status of cases with unfinished human immunodeficiency virus diagnostic process in order to ensure timely preventive and treatment care events and to objectify statistical recording of this category.

Russian Military Medical Academy Reports. 2022;41(3):293-301
pages 293-301 views

Mitochondrial networks of cumulus cells and oocyte quality

Panferov E.V., Tapilskaya N.I., Masieva K.S., Ob’edkova K.V., Gzgzyan A.M.


BACKGROUND: Mitochondria play vital roles in oocyte functions and they are critical indicators of oocyte quality which is important for fertilization and development into viable offspring. Quality-compromised oocytes in which mitochondrial dysfunction plays a significant role are correlated with infertility, developmental disorders and embryo loss. A significant role in the oocytes of cytoplasmic accumulation and a sufficient amount of the mitochondrial pool of oocytes is played by the cumulus cells surrounding it.

AIM: to conduct a comparative analysis between the state of mitochondrial networks of cumulus cells and the quality of oocytes.

MATERIALS AND METHODS: The study included 22 women aged 28 to 37 years inclusive (mean age 32.3 ± 1.2 years) with tubal infertility. During the assisted reproductive technology procedures, 74 oocytes were obtained. 39 good quality oocytes and their cumulus cells were compared with 35 bad quality oocytes and their cumulus cells respectively. After puncture of ovarian follicles cumulus cells were isolated and stained with fluorescent dye for cell tracing and mitochondrial imaging in vivo. The method of confocal microscopy was used to analyze the three-dimensional organization of mitochondria in 20–30 cells of one pool of follicular fluid. The following parameters were used to evaluate the mitochondrial network: fluorescence decay time and fluorescence intensity.

RESULTS: The decay time of fluorescence in cumulus cells associated with a good quality oocyte was significantly higher (p = 0.032) than in the case of identification of oocytes with negative signs.

CONCLUSION: The structure of mitochondrial networks in cumulus cells correlates (r = 0.76) with the quality of oocytes.

Russian Military Medical Academy Reports. 2022;41(3):303-308
pages 303-308 views


Allogeneic osteoplastic materials for reconstructive surgery of combat injuries

Khominets V.V., Vorobev K.A., Sokolova M.O., Ivanova A.K., Komarov A.V.


The number of operations with the use of osteoplastic materials is increasing annually, which is explained by the increasing number of high-tech operations, reconstructive interventions for bone pathology, oncoorthopedics, bone deformities, as well as tissue defects resulting from combat trauma. Bone as an object of transplantation and is preferable because the use of bone tissue and materials made on its basis creates the necessary conditions for biological restoration of bone as an organ.

The modern trend is the development of regenerative medicine technologies and the development of modified materials with improved and predetermined properties — osteoplastic materials ceased to be static structures and their inertness gave way to functional activity.

The article describes the basic advantages of bone tissue and allogenic osteoplastic materials for their prospective use in reconstructive and reconstructive surgery of the musculoskeletal system. Data on the experience in the use of donor bone tissues for homoplasy at the clinic of military traumatology and orthopedics of the Kirov Military Medical Academy are presented. The advantages of allogeneic decellularized tissues for use in clinical and scientific practice are considered. The importance of preserving the architecture of native tissue for successful bone transplantation is shown. Decellularization is a method that allows the removal of immunogenic agents from tissues and organs, including cells and residual DNA, preserving the natural composition and architecture of the extracellular matrix for the most effective use of allogeneic bone tissue. The use of decellularized allogenic bone tissue purified to a mineral-collagen matrix or demineralized is the most practical option among other osteoplastic materials when large bone fragments need to be replaced.

Russian Military Medical Academy Reports. 2022;41(3):309-314
pages 309-314 views

Functional disorders of the respiratory system after a new coronavirus infection COVID-19

Savushkina O.I., Zaytsev A.A., Kryukov E.V., Cherniak A.V., Malashenko M.M., Kulagina I.T., Chernov S.А., Aseeva N.A.


COVID-19 (Coronavirus disease 2019) is an infectious disease caused by the coronavirus SARS-CoV-2, characterized by a high level of morbidity and mortality. A new coronavirus infection affects all organs and systems and often occurs with lung damage and respiratory failure. In a significant part of patients after the acute period of COVID-19, the symptoms of the disease persist, but the most problematic symptoms are the ones regarding lung damage that persists for a long amount of time.

This review summarizes the results of our research in 2020–2021. The purpose of the conducted studies was to estimate the functional parameters of the respiratory system in patients that have been infected by COVID-19. Along with conventional pulmonary function tests (spirometry, body plethysmography and diffusion test), impulse oscillometry, the multiple-breath nitrogen washout test, determination of the maximum inspiratory and expiratory pressures were performed in all patients. Thus, we evaluated the ventilation and gas exchange function of the bronchopulmonary system, the functional state of the peripheral parts of the lungs, including the small airways, the uniformity of pulmonary ventilation and the strength of the respiratory muscles in different periods of recovery after COVID-19, including the follow-up after medical rehabilitation.

To sum up, comprehensive functional assessment of the respiratory system is an important clinical tool that allows the planning of pharmacotherapy and to create individual programs of medical rehabilitation of patients who had COVID-19.

Russian Military Medical Academy Reports. 2022;41(3):315-323
pages 315-323 views

3D printing and medicine

Peleshok S.A., Golovko K.P.


In modern conditions, the possibilities of using 3D printing in medicine are expanding, and it occupies about 11% of the global additive manufacturing market. At the Kirov Military Medical Academy and the ERA Military Innovation Technopolis, 3D printing is used for training, preoperative planning, the creation of splints, the manufacture of non-invasive functional products, and the creation of COVID-19 prevention aids.

In order to determine the prospects for development, foreign experience in the use of 3D printing in medicine has been studied over the past 5 years.

It is established that a register of clinical data on 3D printing is being created for training, 3D models are being printed to simulate tissue resistance during surgery. With the help of preoperative planning, Siamese twins are separated, doctors are trained in surgical operations on 3D models of elastic resin feet, cardiological models are used to predict the risk of complications during transcatheter implantation of an artificial aortic valve, as well as rehearsals of operations with congenital heart anomalies. Individual implants are manufactured for the lumbar and cervical spine, replacement of the damaged area of the chest and rib, finger phalanges, hip and knee replacements. As auxiliary products, individual surgical instruments for operations with low trauma, orthopedic insoles, elastic stents for the urethra and mesh stents of the trachea are created. New materials made of polyamide (PA11), polyesteresterketone, titanium alloys, absorbable polymer and biocompatible resin are offered for 3D printing. There are new 3D printing software and updates of existing ones. Personalized braces and aligners are printed in dentistry. With the help of 3D printing, individual multi-layered polytablets, smart tablets that release medicinal substances on command from a smartphone, children’s chewing tablets are created. For research purposes, the following devices have been printed: simulating cardiac tissue with sensors to track the effects of drugs and toxins; predicting the individual response of the biopsy tumor material to treatment; diagnosing some infectious diseases using a smartphone and a silicon microfluidic chip.

The use of 3D printing in medicine individualizes and improves the quality of medical care.

Russian Military Medical Academy Reports. 2022;41(3):325-333
pages 325-333 views

Prospects of cell therapy for hematopoietic syndrome of acute radiation sickness

Legeza V.I., Aksenova N.V., Murzina E.V., Pak N.V., Veselova O.M.


Cellular therapy of hematopoietic acute radiation syndrome is currently at the forefront of scientific interest due to the high regenerative potential of stem cells, their anti-inflammatory and antifibrotic effects. Stem cells have a high ability to stimulate the proliferation and differentiation of hematopoietic cells. It has been shown that after administration stem cells are able to migrate to lesions under the influence of chemotactic factors. At the same time, they retain their functions and can differentiate into cells of affected tissues and contribute to their recovery.

The article analyzes the current trends in the use of cellular products for the treatment of hematopoietic acute radiation syndrome. The processes of cell proliferation and differentiation in the blood system are regulated by feedback mechanisms. This occurs in accordance with signals coming from more differentiated pools, as well as signals from other organs and tissues. They come along the nervous and humoral pathways. The hematopoietic microenvironment created by fibroblasts, macrophages, endotheliocytes, lymphocytes and other cells is play an important role in these processes. The influence of this microenvironment can be carried out both through direct contacts between cells and through the production of regulators (cytokines).

At present cellular technologies are one of the most promising areas for the treatment of acute radiation syndrome along with the use of cytokines. Cell therapy of hematopoietic acute radiation syndrome has advantages over the use of cytokines and growth factors. It does not require a basic level of stem and progenitor cells, which are the main target for the cytokine effect.

The presented data testify that cell therapy has been a promising approach in treatment of radiation injury of bone marrow caused by high doses of radiation exposure.

Russian Military Medical Academy Reports. 2022;41(3):335-344
pages 335-344 views


COVID-19 and antimicrobial therapy

Zajcev A.A., Makarevich A.M.


BACKGROUND: One of the problems with managing patients with a new coronavirus infection is the irrational use of antibiotics. Antibacterial drugs are not active against viral infection, including COVID-19. Unfortunately, in actual clinical practice, the level of antibiotic use remains extremely high, reaching 70–80%. Unwanted antibacterial therapy leads to a number of undesirable phenomena that can significantly worsen the patient’s condition, and sometimes lead to life-threatening consequences. In this context, the most important question is the formulation of the diagnosis. In particular, the reference to the term “pneumonia”, in the case of COVID-19, is neither scientifically or clinically feasible. The most correct would be to call this process — viral or virus-associated lung damage. This term will allow you to set priorities in the choice of tactics leading the patient. That is, viral lesion (not pneumonia!) will induce the practical doctor to analyze the situation requiring prescription in the presence of indications of anti-inflammatory (monoclonal antibodies, glucocorticosteroids) and anticoagulation therapy, and will avoid unnecessary in the overwhelming number of antimicrobial prescription situations.

AIM: Formulate criteria for prescribing antibacterial therapy in patients with COVID-19.

MATERIALS AND METHODS: The study is based on a review and analysis of the literature on new coronavirus infection, drawing conclusions and recommendations.

RESULTS: In actual Russian practice, the level of use of antibiotics remains extremely high, reaching 70–80%.

CONCLUSION: The prescription of antibacterial therapy in patients with COVID-19 is justified only if there are convincing signs of bacterial infection — the appearance of purulent sputum, increased procalcitonin of blood more than 0,25–0.5 ng/ml, an increase in blood white count of more than 10 thousand/mcl with an increase in the number band neutrophils more than 10%.

Russian Military Medical Academy Reports. 2022;41(3):345-349
pages 345-349 views

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