Introduction. The study of the manifestations of symptoms of COVID-19 and hemorrhagic fever with renal syndrome (HFRS) is an important aspect of the diagnosis, especially for regions endemic for HFRS.Aim. To conduct сomparative study of the clinical symptoms and parametres of a complete blood test at the onset of the disease with lung involvement in patients with HFRS and COVID-19 with moderate severity.Materials and methods. A retrospective comparative analysis and identification of laboratory data of patients with moderate form of HFRS with respiratory syndrome (n = 52) and patients with moderate severity form of COVID-19 (n = 52) upon admission to the hospital was carried out.Results. Fever is one of the main symptoms for both diseases, characterizing the degree of severity. At the same time, the temperature in patients with HFRS on admission was higher than in patients with COVID-19 (p < 0.05). Shortness of breath is much more often recorded in the group of patients with viral pneumonia COVID-19 (p = 0.0001). The oxygen saturation index (SpO2) in patients with HFRS was below 95%, but the average value of 96.4% was normal, while in patients with COVID-19 the average value was 92.8% (p < 0.05). When comparing the indicators of the general blood test, there was a statistically significant excess of the level of red blood cells and hematocrit in the group of patients with COVID-19, with a comparable level of hemoglobin in both groups. The average value of the absolute content of platelets was significantly lower, and the number of patients with thrombocytopenia is much higher in the group of patients with HFRS.Conclusion. Kidney damage in HFRS is the main clinical and laboratory syndrome, but it is important to remember that lung damage by the type of viral pneumonia in HFRS is also possible. In all suspicious cases, an examination for SARS-CoV-2 and serological diagnosis of hantavirus infection are indicated.

Aim: to assess clinical efficacy of azoximer bromide in the complex inpatient treatment for COVID-19. Patients and Methods: the study included 20 patients aged 16–65 years with verified moderate novel coronavirus infection who received inpatient care. All patients were divided into two groups. Study group patients (n=10) received complex treatment that included azoximer bromide. Control group patients (n=10) received standard therapy only. The criterion of treatment efficacy was the improvement of major disease symptoms, radiographic manifestations, and pro-inflammatory laboratory tests. Results: azoximer bromide as a component of the treatment for novel coronavirus infection provides more rapid symptom relief (i.e., cough, sputum, fever, respiratory rate) compared to the standard therapy (p<0.05). azoximer bromide also provides more rapid radiographic improvement as demonstrated by helical computed tomography, i.e., by day 14, the percentage of lung parenchyma involved was 5% in the study group and 10–12% in the control group (p<0.05). In addition, the improvement of pro-inflammatory laboratory tests (i.e., normal WBC count, decrease in ESR) was revealed as well (p<0.05). Conclusion: azoximer bromide as a component of the complex treatment for novel coronavirus infection is associated with the clinical improvement that manifests with more rapid relief of inflammation and lung parenchyma involvement as compared with the standard therapy. No adverse reactions were reported. KEYWORDS: coronavirus infection, SARS-CoV2, COVID-19, pneumonia, immune correction, pathogenetically-oriented therapy, azoximer bromide. FOR CITATION: Mukhamadieva L.R., Mavzyutova G.A., Tyurina E.B., Kuzovkina O.Z. Pathogenetically-oriented therapy for novel coronavirus infection. Russian Medical Inquiry. 2020;4(4):192–198. DOI: 10.32364/2587-6821-2020-4-4-192-198.

The review systematizes data on the structure of lipopolysaccharides (LPS) and their role in physiological and systemic pathological processes. The analysis of literature and our own data is of scientific and practical interest for specialists in the field of clinical laboratory diagnostics, anesthesiologists, resuscitators, therapists, immunologists and obstetrician-gynecologists, including studies on the role of LPS in unique three-component systems - «mother-placenta-fetus». The prospects of using LPS as immunomodulatory, including for the treatment of infectious diseases, are justified. It is shown that along with their use for the correction of immunodeficiency or the development of new adjuvants and vaccines, it is possible to use their high regulatory activity even at the epigenetic level. The possibility of the prophylactic and therapeutic use of LPS in the context of an alternative solution to the problem of antibiotic resistance of bacteria is discussed.

Aim: to evaluate the clinical efficacy of azoximer bromide inclusion in the complex therapy of patients with a confirmed diagnosis of COVID-19 (moderate degree) who were receiving treatment on an outpatient basis. Patients and Methods: data from medical records of 100 patients who were treated in outpatient clinics for COVID-19 in Ufa (June–November 2020) were retrospectively evaluated. There were 2 groups of 50 patients: the main group receiving azoximer bromide and the comparison group receiving only standard therapy. The criteria for evaluating the therapy efficacy were the dynamics of the disease clinical picture, laboratory parameters characterizing inflammation. Results: in the main group, the relief of complaints and a significant condition improvement according to physical examination were recorded significantly earlier — after 9.68±5.23 days versus 13.00±4.95 days in the comparison group (p=0.0012). The period of body temperature normalization in patients receiving immunomodulatory therapy was 7.20±1.41 days, which is significantly less than in patients receiving standard therapy — 16.20±2.74 days (p=0.0001). When contacting the outpatient clinic, all patients had an increase in the level of C-reactive protein: in the main group — up to 13.91±17.28 mg/L, in the comparison group — up to 12.22±8.32 mg/L (p=0.71). The result of therapy was a decrease in this indicator to 6.28±5.06 mg/L and 4.44±3.73 mg/L, respectively (p=0.0314). On the 17th day after the treatment initiation, all patients had antibodies (IgM and IgG) to SARS-CoV-2. Conclusions: azoximer bromide inclusion in the complex therapy of patients with COVID-19 allows for faster normalization of the patients’ condition, is not accompanied by adverse events and can be considered as a pathogenetic therapy variant of patients with COVID-19 with a predominantly severe course in the setting of concomitant diseases. KEYWORDS: coronavirus infection, SARS-CoV-2, COVID-19, pneumonia, immunocorrection, pathogenetic therapy, azoximer bromide. FOR CITATION: Mukhamadieva L.R., Mavzyutova G.A., Mirsayeva G.Kh. et al. Possibilities of immunocorrection in COVID-19 therapy of patients on an outpatient basis. Russian Medical Inquiry. 2021;5(7):468–472 (in Russ.). DOI: 10.32364/2587-6821-2021-5-7-468-472.