No abstract

Цель исследования -изучить закономерности, свойственные эпидемическому процессу COVID-19, в условиях мегаполиса, в фазах подъёма, стабилизации и снижения заболеваемости, а также оценить эффективность противоэпидемических мероприятий. Материал и методы. Проведено комплексное изучение распространения SARS-CoV-2 в Москве с использованием эпидемиологического, молекулярно-генетического и статистического методов исследования в период пандемии COVID-19. Результаты и обсуждение. Показано, что применение максимально жёстких организационно-ограничительных мер в масштабах Москвы, обеспечивающих разрыв механизма передачи SARS-CoV-2, и высокая дисциплина населения по исполнению режима самоизоляции позволили не допустить экспоненциального роста заболеваемости COVID-19. Анализ динамики выявления новых случаев COVID-19 показал, что эффект от применения мер по разобщению и режима самоизоляции в условиях мегаполиса наступает через временной промежуток, равный 3,5 инкубационного периода, при его максимальной длительности 14 дней. Установлено, что показатель частоты определения РНК SARS-CoV-2 среди условно здорового населения и его динамика -важные параметры мониторинга, особенно на фазах роста и стабилизации заболеваемости COVID-19, позволяющие в перспективе 1-2 инкубационных периодов (14-28 дней) прогнозировать развитие эпидемиологической ситуации. Общий коэффициент летальности, рассчитанный за период наблюдения (06.03.2020-23.06.2020) в Москве, составил 1,73%. Заключение. В результате проведённого эпидемиологического анализа ситуации с COVID-19 в Москве определены некоторые закономерности распространения SARS-CoV-2 и оценена эффективность противоэпидемических мероприятий, направленных на разрыв механизма передачи возбудителя.

The ongoing COVID-19 pandemic around the world and in Russia remains a major event of 2020. All over the world, research is being conducted to comprehensively study the patterns and manifestations of the epidemic  process. The main quantitative characteristics of SARS-CoV-2 transmission dynamics among the population, based on the data of official monitoring over the current situation, play an important role in the development of  the epidemiological surveillance system.The aim of this study is to explore the peculiarities of age-gender distribution of COVID-19 patients in Moscow.Material and methods. The data related to the epidemiological characteristics of age-gender structure of COVID-19 patients in Moscow between March 19, 2020 and April 15, 2020, at different stages of the  epidemic were retrospectively analyzed.Results and discussion. The mean age of COVID-19 patients in Moscow was 46,41±20,58 years. The gender ratio (male/female) among the patients was 52.7/47.3 %, wherein the indicators varied depending upon the  age. Male/female ratio in the age group “under 39” stood at 53.7/46.3 %, and “over 40 years of age” – at  39.3/60.7 %. The predominant age range among male cases was 19 to 39 years old – 35.4 %, while among female patients – 40–59 years (36.5 %). The age distribution of patients in Moscow is indicative of the fact that COVID-19 is a disease that primarily affects older age groups. The age structure of all COVID-19 cases during the observation period is characterized by predominance of adult patients over 19 years of age – 92,7 % (92,6–92,8 %), the share of patients aged 40–59 years is 35,7% (35,5–35,9 %). The differences in the age distribution in males and females are as follows: in the male cohort, the age groups 19–39 years old and 40–59 years old prevail – 35.4 % (35.1–35.7 %) and 34.9 % (34.6–35.2 %), respectively. The age group 40–59 years old – 36.5 % (36.3–36.8%) dominates in the female cohort.

Адрес для переписки:Крынский Сергей Андреевич Национальный исследовательский центр «Курчатовский институт» 123182, Россия, Москва, площадь академика Курчатова, 1. Тел.: 8 (499) 196-95-39. Факс: 8 (499) 196-17-04.

The aim of the work was to study the factors of natural and adaptive immunity and systemic inflammation in subacute stage of schizophrenia to clarify the role of these systems in the chronization of the disease. 31 patients with the diagnosis of schizophrenia (SCI) with paranoid after 3-4 weeks of therapy were examined. The control group included 16 healthy volunteers. Markers of systemic inflammation and immunity, including key cytokines and lymphocyte subpopulations, were investigated. Increased levels of IgМ, C-reactive protein and cortisol in the blood were found in patients with SCI. Also in most cases the content of proinflammatory proteins IL-8, IL-6 and IL-10 was increased. The greatest increase in the levels of systemic inflammation and cytokines was found in patients with first psychotic episode. The content of HT was more often normal, but the level of NT-4 and nerve growth factor β (NGFβ) in most patients was positively associated with levels of IL-6. At low levels of BDNF a significant increase in levels of CIC, cortisol, IL-8, IL-6 and IL-10, but not Ig were found. Also, in patients with low BDNF symptoms of delusions prevailed, while in cases of normal or elevated BDNF (19 out of 24 cases), in addition to delusions, hallucinations were pronounced. Conclusion. It is believed that antipsychotic drugs reduce systemic inflammation and activity of the immune system. However, we have found signs of severe systemic inflammation, activation and dysfunction of the immune system in patients with SCI after 3-4 weeks of therapy. Preservation of immune disorders and systemic inflammation in patients with SCI despite clinical improvement can participate in the progression of the disease through neuroimmune interactions. Further studies of the trigger mechanisms of chronic immune activation are needed.