Under the COVID-19 pandemic, healthcare workers were at the highest risk of getting infected with the disease; this necessitates specialized studies in this occupational group. The aim of the study was to identify non-occupational risk factors and laboratory markers indicating that severe clinical forms of new coronavirus infection would probably develop in healthcare workers in the initial period of the pandemic. The study included 366 workers who suffered COVID-19 in 2020–2021. The disease was confirmed by examining smears from the pharynx and nose with PCR. Some of the samples were examined using the SARS-CoV-2 whole genome sequencing technology. To determine laboratory prognostic indicators evidencing the development of more severe forms of the disease (pneumonia), a number of healthcare workers underwent laboratory examination during the acute period of the disease, namely: general clinical and biochemical blood tests, immunophenotyping of lymphocytes, analysis of the hemostasis system and cytokine levels. To study non-occupational risk factors of pneumonia, all healthcare workers after recovery were asked to fill in a Google form developed by the authors. The most severe clinical forms of COVID-19 were registered in healthcare workers who were older than 40 years, with low physical activity and a body mass index higher than 25.0, had diabetes mellitus and chronic diseases of the genitourinary system. When analyzing the results of laboratory tests, markers indicating development of pneumonia were identified and their critical values (cut-off points) were determined: the level of lymphocytes (below 1.955•109/l), T-cytotoxic lymphocytes (below 0.455•109/l), T-helpers (below 0.855•109/L), natural killers (below 0.205•109/l), platelets (below 239•109/L), erythrocyte sedimentation rate (above 11.5 mm/h), D-dimer (above 0.325 mcg/ml), total protein (below 71.55 g/L), lactate dehydrogenase (above 196 U/L), C-reactive protein (above 4.17 mg/l), and interleukin-6 (above 3.63 pg/l). The study identified non-occupational risk factors causing development of severe COVID-19 and established laboratory prognostic indicators.

Результаты и обсуждение. Наиболее частыми клиническими проявлениями COVID-19 были слабость, повышение температуры тела, миалгия, артралгия, затруднение носового дыхания, серозно-слизистое отделяемое из носа, боль в горле, кашель, чувство сдавленности в грудной клетке, одышка, головная боль, боль в области глазных яблок, головокружение, аносмия, агевзия и диспептические проявления в виде диареи, тошноты или рвоты.Выявлены маркеры, связанные с развитием тяжелого течения пневмонии, ассоциированной с COVID-19. Определены пороговые значения лабораторных показателей для прогнозирования тяжелого течения COVID-19: количество тромбоцитов (<239×10 9 /л), лимфоцитов (<1,955×10 9 /л), цитотоксических Т-лимфоцитов (<0,455×10 9 /л), Т-хелперов (<0,855×10 9 /л), NK-клеток (<0,205×10 9 /л), скорости оседания эритроцитов (>11,5 мм/ч), лактатдегидрогеназы (>196 ед/л), общего белка (<71,55 г/л), D-димера (>0,325 мкг/мл), С-реактивного белка (>4,17 мг/л), интерлейкина-6 (>3,63 пг/л).Заключение. Полученные данные позволяют прогнозировать возможность развития тяжелого варианта течения COVID-19.Финансирование. Исследование не имело спонсорской поддержки. Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Introduction: The epidemic process of the novel coronavirus disease (COVID-19) can be managed only through vaccination. Yet, despite the availability of effective immunobiological preparations, health administrators often face a negative attitude of the population, including healthcare professionals, to vaccination. Objective: To establish commitment of workers of health facilities to vaccination against COVID–19 during different periods of the pandemic using modern online resources and to justify the need to develop effective practices of dealing with communicative risks in the course of vaccination. Materials and methods: The study was conducted in several successive stages corresponding to five waves of the COVID-19 pandemic in the Russian Federation by means of an online survey of 5,304 health workers using Google Forms. We applied sociological and statistical methods of research. Results: We observed that the attitude to vaccination against COVID-19 among the employees of health institutions was ambiguous and changed over time demonstrating a gradual increase in adherence to inoculations. The potential risk group with a negative attitude towards vaccination included female nurses and workers of non-medical specialties with less than five years of work experience. An insufficient level of commitment to coronavirus vaccination among the personnel of health facilities has been also noted in other countries, which is a serious problem on a global scale hindering the victory over this novel infection. Conclusion: We assessed commitment to inoculations against COVID-19 among medical workers using modern online resources and found its inadequate level necessitating effective interventions aimed at awareness raising and training in modern practices of effective communications.

BACKGROUND: Medical workers are one of the groups at high risk of contracting a new coronavirus infection (COVID-19), which requires in-depth study of this professional group. AIM: To determine the main directions for the rehabilitation of medical workers with past COVID–19 based on the study of residual clinical manifestations in the early and late recovery periods. MATERIALS AND METHODS: The study was conducted based on the materials of an online survey of employees of medical organizations in three consecutive stages. At the first and second stages, residual clinical manifestations data of the coronavirus infection in the early (up to 6 months) and late recovery periods (6-15 months) were analyzed. At the third stage of the study, the characteristics of affective disorders of COVID-19 convalescents in comparison with employees intact for COVID-19, were given. RESULT: During the first 6 months after the disease, asthenovegetative manifestations persisted in the form of general weakness and increased fatigue, unproductive cough, shortness of breath, anosmia, disorders of a number of cognitive functions. In the late recovery period (from 6 to 15 months), the majority of respondents noted increased fatigue, impaired memory and concentration. Some of the study participants had a change in the structure of their hair and its loss (alopecia). Some of the employees were first diagnosed with arterial hypertension in the long-term after the disease. It was found that the frequency and severity of affective disorders and asthenic manifestations in COVID-19 convalescents were significantly higher than in the group of employees intact for the disease, which is a direct indication for inclusion of the diagnosis of affective disorders and the provision of specialized psychological assistance in the rehabilitation programs of COVID-19 patients. CONCLUSIONS: During the study, data were obtained on the negative consequences of a coronavirus infection for the health of medical workers, which should be used in the development of rehabilitation programs for employees in the early and late recovery periods.

Under the COVID-19 pandemic, healthcare workers were at the highest risk of getting infected with the disease; this necessitates specialized studies in this occupational group. The aim of the study was to identify non-occupational risk factors and laboratory markers indicating that severe clinical forms of new coronavirus infection would probably develop in healthcare workers in the initial period of the pandemic. The study included 366 workers who suffered COVID-19 in 2020–2021. The disease was confirmed by examining smears from the pharynx and nose with PCR. Some of the samples were examined using the SARS-CoV-2 whole genome sequencing technology. To determine laboratory prognostic indicators evidencing the development of more severe forms of the disease (pneumonia), a number of healthcare workers underwent laboratory examination during the acute period of the disease, namely: general clinical and biochemical blood tests, immunophenotyping of lymphocytes, analysis of the hemostasis system and cytokine levels. To study non-occupational risk factors of pneumonia, all healthcare workers after recovery were asked to fill in a Google form developed by the authors. The most severe clinical forms of COVID-19 were registered in healthcare workers who were older than 40 years, with low physical activity and a body mass index higher than 25.0, had diabetes mellitus and chronic diseases of the genitourinary system. When analyzing the results of laboratory tests, markers indicating development of pneumonia were identified and their critical values (cut-off points) were determined: the level of lymphocytes (below 1.955•109/l), T-cytotoxic lymphocytes (below 0.455•109/l), T-helpers (below 0.855•109/L), natural killers (below 0.205•109/l), platelets (below 239•109/L), erythrocyte sedimentation rate (above 11.5 mm/h), D-dimer (above 0.325 mcg/ml), total protein (below 71.55 g/L), lactate dehydrogenase (above 196 U/L), C-reactive protein (above 4.17 mg/l), and interleukin-6 (above 3.63 pg/l). The study identified non-occupational risk factors causing development of severe COVID-19 and established laboratory prognostic indicators.