Aim. The study evaluates clinical effectiveness and safety of etiotropic antiviral medications with a direct mechanism of action (Riamilovir, Ribavirin, Umifenovir) for the treatment of moderate SARS-CoV-2 infection in adults. Materials and methods. The study used the data from 59 health records of patients with moderate PCR-confirmed SARS-CoV-2 infection. Control group included 29 patients treated with 1250 mg Riamilovir off-label per day for 5 days (250 mg 5 times a day), comparison group consisted of 30 patients, who received 800 mg Ribavirin and Umifenovir per day for 5 days. The effectiveness of the medications was assessed by the duration and severity of general infectious and respiratory syndromes, anosmia and ageusia, as well as the oxygen content in the blood, the timing of SARS-COV-2 virus elimination from the body according to the results of control studies of nasopharyngeal swabs using the PCR method and dynamics of blood tests results. Results. A statistically significant decrease in the duration of fever, cough, and anosmia and a more rapid elimination of the virus from the body were noted in the group of patients receiving Riamilovir. Decreased levels of non-specific inflammatory markers in blood serum, as well as normal values of liver enzymes were observed in control group during therapy, as opposed to the comparison group. No serious adverse events were noted when using the medication. Conclusion. Nucleoside analogue medication Riamilovir showed good effectiveness and safety profile in adult patients with moderate SARS-CoV-2 infection.

The main pathogenetic aspects of non-alcoholic fatty liver disease as a comorbid factor of chronic hepatitis C are considered. Non-alcoholic fatty liver disease is currently the most common liver disease worldwide, both among adults and children. It is usually accompanied by obesity, insulin resistance and diabetes mellitus. Non-alcoholic fatty liver disease includes a spectrum of pathologies from simple fatty liver infiltration to non-alcoholic steatohepatitis, which is characterized by inflammation with potential progression to fibrosis and cirrhosis over time. On average, non-alcoholic fatty liver disease occurs in 55% of patients with chronic hepatitis C, which is significantly higher than the prevalence of each disease individually. This condition leads to a greater rate of progression of fibrosis, as well as a continuing high risk of developing cirrhosis and hepatocellular carcinoma even after achieving a sustained virological response. In this regard, complex therapy aimed at normalization of the nutritional status, optimization of body weight, correction of impaired intestinal microflora, reduction of severity of liver steatosis and achieving a sustained virological response is a priority task in the treatment of patients with chronic hepatitis C.

Chronic hepatitis C remains one of the most important socially significant infections for world health. The use of modern highly effective drugs with direct antiviral action allowsto achieve a sustained virological response in patients. At the same time, in a significant number of cases after elimination of HCV infection, the progression of fibrosis continues with the development of its terminal stages and an unfavorable outcome for patients. The article focuses on comorbid pathology, which is a leading factor in this process in patients with chronic hepatitis C who have achieved a sustained virological response and presenting a serious challenge to modern hepatology.

Aim. In this study we evaluated clinical effectiveness and safety of nebulized prostacyclin in patients with Novel Coronavirus Disease (SARS-CoV-2). Materials and methods: We have included 44 male patients with moderate PCR confirmed SARS-CoV-2 infection in this study. Control group consisted of 23 patients treated with nebulized prostacyclin (PGI2). besides standard therapy. We compared intensiveness and duration of infectious intoxication syndrome, duration of fever, cough as well as SpO2 level, complete blood count and chemokine status values. Results: Statistically significant difference in duration of fever, cough, intensiveness and duration of infectious intoxication syndrome were observed. Lymphocyte and platelet counts were significantly higher in control group We have also noticed significantly lower level of proinflammatory mediators and C4-complement component in control group. Only 1 adverse effect associated with inhaled prostacyclin was reported. Conclusion. Nebulized prostacyclin showed therapeutic efficacy and good safety profile in adults with moderate COVID-19.

Аbstract. We consider the possibility of optimizing the diagnosis of infection caused by SARS-CoV-2 using polymerase chain reaction in a multi-specialty hospital, repurposed for the treatment of COVID-19 patients, using the example Of the military medical Academy named after S.M. Kirov. The analysis of scientific publications selected in accordance with the purpose of the study, analyzed data from 218 samples of polymerase chain reaction in patients with COVID-19, who were in the clinics Of the military medical Academy named after Sm. Time intervals were established depending on the clinical forms and severity of the infectious process, in which the probability of a positive and negative result of a polymerase chain reaction to SARS-CoV-2 RNA was maximum and minimum. It was shown that during the examination and treatment, molecular biological diagnostics were performed excessively (4 times in more than 50% of patients) and in 97,3% of patients unreasonably early (8,50,4 days). At the same time, the highest frequency of negative results of polymerase chain reaction to SARS-CoV-2 RNA was observed in the period from 9 to 10 and from 12 to 14 days, while it depended on the clinical form and severity of the infectious process. In this regard, the volume diagnosis using polymerase chain reaction should be reduced and to conduct research when entering the hospital, on the 9th-10th day (in patients inapparently forms and acute respiratory diseases, lung flow) and 12-14 days before discharge in patients with moderate and severe course of the infectious process.