Herpes viruses are widespread in the human population, they are able to infect almost all organs and systems of the body. Currently, 8 serotypes of herpesviruses pathogenic for humans are known: herpes simplex viruses of the 1st and 2nd type, chickenpox-herpes zoster, cytomegalovirus, Epstein-Barr virus, 6th, 7th and 8th human herpes viruses. Primary infection with herpes viruses in 60-90% of cases occurs in early childhood, and, as a rule, is not accompanied by typical clinical manifestations. Due to the lack of mandatory registration of the incidence of herpes virus infections in our country, the true number of patients is unknown. It is believed that about 20 million people are infected every year in Russia and the CIS countries. Herpes viruses, to a greater or lesser extent, can be considered hepatotropic. A large number of studies are devoted to the problem of cytomegalovirus infection, one of the manifestations of which is hepatitis. Most often, cytomegalovirus hepatitis occurs in immunocompromised individuals or in patients receiving immunosuppressive therapy, cases of cytomegalovirus hepatitis and in immunocompetent individuals are also described. With liver transplantation without antiviral therapy, cytomegalovirus infection manifests itself in 11-28,5% of recipients and can lead to the development of liver failure, loss of transplant and death of the recipient. Performing diagnostic studies using both serological and molecular biological methods at different periods after liver transplantation allows to detect cytomegalovirus infection timely and initiate treatment, thereby avoiding graft rejection and the death of the recipient.

In December 2019, in Wuhan (PRC), there was an outbreak of a new coronavirus infection (COVID-19) caused by coronavirus type 2 (SARS-CoV-2), which has a zoonotic origin. The World Health Organization announced the COVID-19 pandemic on March 11, 2020. In most cases, the disease is asymptomatic or mild. However, up to 15% of patients require hospitalization, and 5% develop a critical condition. To date, no effective antiviral drug COVID-19 has been found that can reduce mortality. Pathological changes in the lungs are manifested by diffuse alveolar damage, which is clinically manifested by increasing respiratory failure, accompanied by a decrease in saturation and oxygen concentration in arterial blood. It is assumed that autoimmune reactions play an important role in the development of multiple organ failure. Generalized inflammation is characterized by an increase in the concentration of C-reactive protein, ferritin, interleukin-1 and interleukin-6, and other markers. At the stage of development of infection in the form of a cytokine storm, proinflammatory cytokines can themselves become pathogenetic factors in the development of critical conditions, multiple organ failure and deaths. Therefore, a key challenge in treating hospitalized patients with COVID-19 is to control generalized inflammation. Glucocorticosteroid hormones (GCS) are widely used as anti-inflammatory drugs in the clinic of infectious diseases. However, until recently, there was no convincing data on the effectiveness of GCS in patients with COVID-19. Recently published results of a large randomized clinical trial (RECOVERY) showing the efficacy of GCS (dexamethasone) in the treatment of critically ill patients with COVID-19. At the same time, the feasibility and effectiveness of GCS in patients with COVID-19 outside critical conditions, the pathogenetic mechanisms that determine the effectiveness/ineffectiveness of these drugs and the validity of their use remain insufficiently studied.

The article describes a clinical case of co-infection with COVID-19 and tropical malaria. Patient Z., 37 years old, arrived from the Central African Republic with a diagnosis of "New coronavirus infection COVID-19, confirmed (PCR RNA SARS-CoV-2 "+" from 27.01.22) mild form." During an objective examination, the subictericity of the sclera and skin integuments attracted attention, during thermometry - an increase in body temperature to 39.00C. Consciousness at the level of somnolence. Hemodynamics is unstable, episodes of arterial hypotension. Heart rate 96 per minute. Respiratory rate 24 in 1 minute, SpO2 95%, inspiratory dyspnea. According to a laboratory study, severe thrombocytopenia, pronounced signs of hepatic and renal insufficiency, hyperbilirubinemia, an increase in the concentration of C-reactive protein, procalcitonin were revealed. A differential diagnostic search was carried out between acute viral hepatitis and malaria. Blood microscopy revealed young trophozoites of Plasmodium falciparum (++++) using thick drop method. Antimalarial therapy was prescribed with Malacur, which was then replaced with parenteral Quinine followed by mefloquine. In parallel, extracorporeal detoxification operations were carried out. Against the background of adequate etiotropic therapy, complex intensive care measures, the patient's condition was stabilized, on the 40th day the patient was discharged from the hospital with the restoration of health.

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, a number of indicators of COVID-19 patients (age, comorbidities, laboratory criteria for the intensity of inflammation) have been identified that 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. Aims: to develop a predictive model to determine the effectiveness/failure of glucocorticosteroid (GCS) monotherapy in patients with moderate COVID-19. Methods. Retrospective analysis of electronic medical record data of all patients admitted consecutively from October 1, 2020 to January 31, 2021. The study included 71 patients with a probable (clinically confirmed) and confirmed (laboratory) case of 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 patients in this sample 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, 53 (74.7%) of them did not require an escalation of anti-inflammatory therapy, which was regarded as an effective use of corticosteroids in the form of monotherapy (group 1). In the remaining 18 patients, the use of corticosteroids for an average of 5.5 (from 3 to 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 ROC 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 were selected that had significant differences in the studied groups before the appointment of GCS: the number of lymphocytes, platelets and body temperature.The quality of the constructed model is assessed as very good, the optimal cutoff point is 0.697. The sensitivity index of the model is 81.1%, 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, has a high sensitivity and specificity.

Kurzrezension Shibanov А. А.: Подражательные слова в удмуртском языке [Onomatopoeic Words in the Udmurt Language]. УИИЯЛ УрО РАН. Ижевск: Издательство «Шелест», 2017. 201 S.