The problem of lung damage in viral infection caused by COVID-19 due to high frequency is relevant for anesthesiologists, resuscitators and epidemiologists. According to scientific research, when a patient is on a ventilator, the risk of an adverse outcome can reach 42 %. This is determined by the widespread use of invasive diagnostic manipulations in patients with COVID-19, which may be associated with bacterial and viral contamination of the environment. This article presents the results of a study of the influence of exogenous risk factors on the development of nosocomial pneumonia in 164 patients infected with COVID-19 in intensive care units and departments of surgical and therapeutic profile of a large multidisciplinary hospital. The number of exogenous risk factors for nosocomial pneumonia among patients infected with COVID-19 in intensive care units exceeded by 7.3 times their presence in surgical departments with a predominance of artificial lung ventilation (90.2 %), tracheostomy (87.8 %), oxygen therapy (68.3 %). The negative impact was determined by the untimely change of air filters during artificial lung ventilation — 16.2 % and tracheal sanitation –8.1 %, poor hand treatment of medical personnel,before tracheal sanitation — 39.2 %.

The article urgues that absence of Gubarev's valve is the key factor of pathogenesis of gastroesophageal reflux disease (GERD). Authors suggest operative technique of the valve reconstruction in a posterior mediastinum for the patients with GERD, associated with cardiac hiatal hernia. The method did not cause complicatations in the form of postoperative dysphagia and recurrece of disease in the longterm periods.