Aim: to evaluate the efficacy and safety of Anaferon and Anaferon for children for the prevention and treatment of of acute respiratory viral infections (ARVI)/influenza using meta-analysis. Patients and Methods: the meta-analysis included data from 11 randomized clinical trials (RCTs) involving 3079 patients aged 1 month to 69 years, of which: 1729 people were included in the meta-analysis of the preventive drugs efficacy, 1550 patients — in the meta-analysis of the therapeutic efficacy of Anaferon for children. The evaluation of the therapeutic efficacy was conducted according to the criteria "disease duration" and/or "fever duration", the evaluation of the preventive efficacy was conducted according to the criterion "the proportion of patients not falling ill with ARVI/influenza". The safety was evaluated taking into account the number of adverse events (AEs). Statistical methods included the exact Fisher criterion, the Student criterion, fixed and random effects models, the Z-test, the Cochrane-Mantel-Hensel criterion, Cochrane Q-statistics and the I2 coefficient, the Breslow-Day test, the calculation of relative risk (RR), odds ratios (OR) and their 95% confidence intervals (CI). Results: according to the criterion "the proportion of patients not falling ill with ARVI/influenza", the RR of Anaferon for children was 1.2 [95% CI 1.2; 1.3] with an OR of 2.2 [95% CI 1.7; 2.9], while for Anaferon, the RR was 6.7 [95% CI 3.8; 11.8] with an OR of 20.1 [95% CI 9.2; 44.0]. At the same time, the proportion of patients without ARVI/influenza during Anaferon intake exceeded that in the absence of preventive intervention by almost 8 times, and during Anaferon for children intake — 1.3 times vs. placebo. When evaluating the therapeutic effect of Anaferon for children, it was found that the average disease duration was 1.4 times shorter than during placebo intake, and was 4.71±2.53 days (p<0,001). The average fever duration was 2.19±1.21 days vs. 3.22±1.81 days during placebo intake (p<0,001). According to the criterion "disease duration", the weighted average effect value was 1.05 [95% CI 0.44; 1.67], according to the criterion "fever duration" — 0.97 [95% CI 0.61; 1.33] (p<0.001, p-value of the two-tailed Z-test; random effects model). The therapeutic efficacy of Anaferon for children did not depend on the etiology of ARVI, the symptoms, and the presence of comorbidity (asthma). The total number of AEs is similar to those in the comparison group. Conclusion: the conducted review and meta-analysis concerning the efficacy and safety of Anaferon and Anaferon for children for the treatment and prevention of ARVI/influenza allow us to conclude the following: 1) Anaferon for children is effective and safe for the treatment of influenza and other acute respiratory infections, regardless of the pathogen and the presence of comorbidity (asthma); 2) Anaferon and Anaferon for children are effective and safe for the prevention of acute respiratory infections/influenza, including patients with concomitant bronchopulmonary pathology and frequently ill children. KEYWORDS: ARVI, influenza, prevention, treatment, meta-analysis, Anaferon, Anaferon for children. FOR CITATION: Geppe N.A., Zaplatnikov A.L., Kondyurina E.G. et al. Efficacy and safety of Anaferon for children and Anaferon for the prevention and treatment of influenza and other acute respiratory viral infections: systematic review and meta-analysis. Russian Medical Inquiry. 2021;5(5):335–347 (in Russ.). DOI: 10.32364/2587-6821-2021-5-5-335-347.

This literature review aims to provide an update on the problem of coronavirus infection in children. It covers specific features of the pathogens and ways of their transmission in children and focuses on the nuances of the clinical course. It also describes the approaches to diagnosis, treatment, and prevention of seasonal coronavirus infections and COVID-19. Particular attention is paid to treatment and prevention of acute respiratory viral infections (ARVIs), including seasonal coronavirus infections, during the ongoing COVID-19 pandemic using Anaferon for children, a drug with an immune-mediated antiviral effect. The article provides the data on experimental and clinical evaluation of Anaferon efficacy in children with coronavirus infections. Experimental in vitro studies of Anaferon for children demonstrated its antiviral efficacy against highly pathogenic MERS-CoV. Clinical trials, including double-blind placebo-controlled RCTs, showed that the inclusion of Anaferon for children in the comprehensive therapy of seasonal coronavirus infections reduced the disease duration, mitigated symptoms, and decreased the incidence of nosocomial infections. These effects were associated with the modulating activity of Anaferon for children affecting both cellular and humoral immunity. The analysis of studies evaluating Anaferon for children allows us to recommend this drug for widespread use in the treatment and prevention of seasonal ARVIs, including those caused by coronaviruses during the ongoing COVID-19 pandemic. Key words: Anaferon for children, treatment, coronavirus infection, prevention, COVID-19

Background Depression and suicide rates are relatively high in the colder regions of Russia. Older individuals in these regions are especially susceptible to these issues and are understudied in this regard. This study aims to better understand the current depression prevalence, and the factors related to depression, among the older individuals in these colder regions of Russia by studying a population in Novosibirsk oblast. Methods A questionnaire survey was administered to 422 older individuals, assessing basic attributes and health status, and employing the following standardized scales: 8-item Short-Form Health Survey, Pittsburgh Sleep Quality Index, and 15-item Geriatric Depression Scale (GDS). Participants were divided in two groups (GDS ≤ 6, GDS > 6) and compared, using Student’s t test, χ2 test, and logistic regression analysis. Results Young old (YO) adults showed significant correlation of depression with asthma (P = 0.005, OR = 6.40, 95%CI: 1.74–23.5), having a spouse (P = 0.016, OR = 1.99, 95%CI: 1.14–3.48), and daily communication with others (P < 0.001, OR = 0.336, 95%CI: 0.197–0.572). Among old old (OO) adults, significant correlation with depression was found for the variables work status (P = 0.047, OR = 0.115, 95%CI: 0.014–0.974), and weekly walking (P = 0.014, OR = 0.288, 95%CI: 0.106–0.778). Conclusions Twenty eight percent of the participants have depression. In YO adults, frequent communication and social ties with individuals outside of the family can mitigate depression prevalence. As for OO adults, the factors that have the highest impact on mitigating depression are related to daily activity, including both frequent walking and working or self-employment. Asthma patients are one of the more sensitive groups towards depression, but further research on this topic is needed.

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Цель обзора: рассмотреть вопросы этиологии, патогенеза, клинических проявлений и диагностики, а также терапии ингаляционными глюкокортикостероидами (ИГКС) бронхиальной обструкции (БО), возникающей у детей дошкольного возраста на фоне острой респираторной инфекции (ОРИ). Основные положения. Изучение БО, возникающей у детей дошкольного возраста на фоне ОРИ, осложнено гетерогенностью ее генеза, трудностями дифференциальной диагностики, распространенностью и частотой рецидивирования. Проблемы ведения детей с рецидивирующей БО приводят к поздней диагностике бронхиальной астмы и некоторых других пульмонологических заболеваний. Заключение. Современные подходы к терапии БО у детей не зависят от этиологии и включают использование бронхолитической терапии в сочетании с ИГКС. Необходимы мультидисциплинарное взаимодействие и ступенчатый подход к ведению детей с выраженной и повторяющейся БО. Ключевые слова: бронхиальная обструкция, бронхиальная астма, дошкольники, ингаляционные глюкокортикостероиды, будесонид, суспензия.