Aim: To analyze prevalence and type of symptomatic gastrointestinal involvement during symptomatic COVID-19 (up to 412 weeks after the disease) and post-COVID-19 syndrome (more than 12 weeks from the disease onset). Materials and methods: We retrospectively analyzed the data from 785 in-patients with the diagnosis of COVID-19, who were treated in the infectious disease hospital from May to December 2020. At the first phase of the study we analyzed how frequently they were referred for out-patient care by a gastroenterology specialist after they were discharged from the hospital (all 785 patient medical files). At the 2nd study phase we performed phone calls to 247 patients, that were discharged from the infectious disease hospital, during which a specially designed questionnaire was filled with items on their comorbidities, general and specific complaints, as well as the standardized Gastrointestinal Symptom Rating Scale (GSRS). Results: Within 2 years after their discharge from the infectious disease hospital, 88 patients asked for specialized gastroenterological care on an out-patient basis. The most common diagnoses were pancreatic diseases (33%), gastric disorders (31%), intestinal disorders (25%), liver and biliary disorders (11%). At referral, the most common complaints were dyspeptic: nausea, bitter taste in the mouth, heartburn, bloating (25%), abdominal pains of various location (17%) and stool abnormalities, such as diarrhea and constipation (11%). Among patients who participated in the phone survey (N = 247), symptomatic COVID-19 was observed in 90 (11.46%) cases, with predominant complaints being loss of taste, loss of smell, and fever. Post-COVID-19 syndrome was identified in 157 (20%) cases, with their main complaints being weakness, shortness of breath and joint pain. Stool abnormalities and abdominal pain occurred during symptomatic COVID-19 and in the post-COVID-19 period with the same frequency (9% and 10%, respectively). According to the GSRS results, the post-COVID-19 dyspeptic syndrome was characterized by prevailing complaints of heartburn (24%), upper abdominal pain and discomfort (20%), and bloating (15%). Conclusion: In the patients with a history of COVID-19, along with respiratory syndromes, gastrointestinal symptoms are seen, with their types being variable at various period of the coronavirus infection. In the early COVID-19, these are stool abnormalities and abdominal pain, and during the post-COVID-19 syndrome, nausea, bitter taste in the mouth, heartburn and bloating are more common.

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Drug-induced headache (DIH) is one of the most common forms of chronic headache (CH). Management of patients with DIH remains a pressing problem of modern medicine. This condition is characterized by headache over 15 days a month for more than 3 months. On the basis of the BSMU Clinic, we assessed the health status of young people with DIH and nicotine addiction. Patients with nicotine addiction were evaluated for the degree of negative effect of smoking on respiratory function. It was found that the majority of patients took monocomponent analgesics, and the minority of patients took combined analgesics and triptans; compared with young men, young women were less likely to seek medical advice if the episodes of headache became more frequent; however, uncontrolled use of painkillers was observed more often in males. In the absence of an analgesic effect 30 h after medication intake, young men repeated the medication in 60% of cases. Educational programs about DIH and the development of CHs with associated nicotine addiction may play an important in preventing the development of the condition.

The objective of our study was the analysis of using immunosuppressive therapy in patients with COVID-19 at the Clinic of the Bashkir State Medical University. Material and methods — We conducted the analysis of clinical and laboratory parameters of inflammatory response in 322 patients with COVID-19 who received tocilizumab, baricitinib, high doses of dexamethasone, or standard therapy. Results — There was an increase in the levels of leukocytes (p=0.04) and neutrophils (p=0.002) in patients receiving tocilizumab, compared with standard therapy, on days 5 and 10 of a hospital stay. The level of C-reactive protein was initially elevated in all patients, but by day 5 of hospitalization it was significantly higher in patients treated with tocilizumab and baricitinib (p=0.0019 and p=0.013, respectively), compared with high-dose glucocorticoid therapy and standard treatment, against which the normalization of parameter values was noted. The neutrophil-to-lymphocyte ratio increased in the group of patients receiving tocilizumab and high-dose glucocorticoid therapy on day 5 of hospitalization (p=0.017 and p=0.004). When assessing the dynamics of pneumonia, based on computed tomography data, the median of changes exhibited an increase in the volume of lung damage in all groups, compared with the baseline level. Conclusion — Tocilizumab in the form of monotherapy effectively reduced inflammation, while the efficacy of baricitinib for stopping the cytokine storm in monotherapy was insufficient. Based on CT data, both target drugs did not stop the progression of lung lesions on day 5.