Skin manifestations of COVID-19

Dvoryankova E.V., Korsunskaya I.M., Slavyanskaya T.A.


The infection caused by the recently identified SARS-CoV-2, dubbed coronavirus disease-19 (COVID-19), has become a pandemic. With exponential growth of morbidity among the people around the world, the clinical characteristics of COVID-19 are becoming clearer and description of new disease symptoms descriptions is emerging. The sufficient amount of descriptions of various skin manifestations in patients with COVID-19 has appeared, however they are characterized by great heterogeneity. The pathogenetic mechanisms of the development of skin rashes in patients with COVID-19 are currently unknown, however, hypotheses have been put forward that they have an overactive immune response, activation of the complement system and microvascular damage. Based on the published literature data and our own experience, the following characteristic types of skin rashes can be distinguished among the skin manifestations of this viral disease: urticaria, confluent, papulovesicular exanthema, acral rashes similar to frostbite, livedo reticularis and purpura. Possible development of skin lesions against the background of the development of COVID-19 provides the need to inform dermatologists about the features of the skin manifestations of this disease, as well as to study further these symptoms of COVID-19 to determine their diagnostic and prognostic value.

RUDN Journal of Medicine. 2021;25(1):9-15
pages 9-15 views

Cutaneous manifestations in children with the new coronavirus infection COVID-19

Tamrazova O.B., Stadnikova A.S., Rudikova E.V.


In late 2019, a new viral infection appeared in China, which spread around the world, causing a pandemic. The causative agent of the new coronavirus infection COVID-19 is the SARS-CoV-2 coronavirus. The review presents modern data on the epidemiology, pathogenesis and course of the novel coronavirus infection COVID-19 in children. Chinese, American and European scientists have described a variety of cutaneous manifestations in children with COVID-19. The article provides a literature review of the cutaneous manifestations of COVID-19 coronavirus infection in children. During our own observation of 301 patients with coronavirus infection COVID-19 caused by SARS-CoV-2 at the Bashlyaev’s Children Hospital in Moscow from May 17 to November 16, 2020, it was revealed that 39 (13 %) patients had skin manifestations. The article presents a classification of skin manifestations characteristic of COVID-19. A brief description of each group is given.

RUDN Journal of Medicine. 2021;25(1):16-24
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Indomethacin & SARS-CoV-2: Prospects for clinical management of the inflammatory state

Kodidala S.R., Sorout J., Jayachandra S., Narapogu V.


Severe acute respiratory syndrome - (SARS) is a pandemic (called as SARS-CoV-2 or COVID-19), severely affected by transmission and fatal disease caused by unknown coronavirus family of RNA virus (SARS-COV). Humans are under great threat among other species were non-identified. Phenotype can range from asymptomatic to fulminate cytokine storm which leads multiorgan failure resulting death. Still the world is eagerly waiting for antiviral drug to stop the corona virus infection. Previous studies found that indomethacin had ability to inhibit the RNA and DNA virus replication. Objectives . Interleukins (IL), Interferons (IFN) and metabolites like «cyclopentane cyclooxygenase» (COX 1/COX 2) are active against several RNA viruses. Experts have divided the SARS infection in three phases (Phase-1, 2, 3) based on severity of infection. In phase-3 there was «cytokine storm» due to exuberant inflammation observed which can damage organs and even fatal. We investigated that effect of indomethacin on COX inhibitor on coronavirus replication and cytokine storm in reducing the hyper inflammatory state. In this article we tried to assess the clinical management of inflammation due to SARS-COV-2 by Indomethacin. Results . Indomethacin can cause relief from the pain on taking deep breath in corona virus infected patients. Indomethacin can be considered safe and effective for prevention and treatment of coronavirus infection also antiviral activity. Conclusion : Indomethacin is a potent inhibitor of SARS CoV-2.

RUDN Journal of Medicine. 2021;25(1):25-30
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Problems of creating predictive models of the COVID19 coronavirus pandemic

Levkova E.A., Sepiashvili R.I., Savin S.Z.


Relevance. The article is devoted to creating prognostic models based on epidemiological and immunological data. Objective: to study the comparative dynamic epidemiological and immunological characteristics of patients with COVID-19. Materials and methods. Methodological approaches to the use of system analysis of epidemiological and immunological characteristics of patients with COVID-19 using multivariate analysis are described. The used technologies of computer-aided analysis systems, algorithms for recognizing, measuring and identifying the condition of patients, and methods of statistical data processing made it possible to create a universal information predictive model for calculating the dynamics of infectious diseases prone to generalization (pandemics), as well as to understand in which groups these new infectious diseases are most dangerous. Results and discussion. Using the methods of system analysis, the epidemiological and immunological aspects of predictive models of the coronavirus pandemic were evaluated using the most objective international data, which increased the information content of the analysis. Conclusions . Creating predictive epidemiological and immunological models of the pandemic is an urgent and promising task to combat the medical and social consequences of the spread of coronavirus infection in Russia.

RUDN Journal of Medicine. 2021;25(1):31-38
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Costs of treating community-acquired bacterial bronchopneumonia in pediatric patients

Ochoa Y.P., Abreu Y.J., Mateo G.P.


Relevance. Health management has not escaped the pressure of the current epidemiological situation. In a complex scenario, characterized by the COVID-19 pandemic, the daily dynamics become more complex and greater agility is required for decision-making. Much of the success of those decisions is determined by access to timely information, especially in crisis conditions and limited resources. For this reason, health organizations are interested in knowing the costs of pathologies that frequently constitute causes of hospitalization. In this sense, community - acquired bacterial bronchopneumonia stands out, which is a disease that frequently causes hospitalization of pediatric patients. Objective. This article aims to carry out a partial retrospective financial evaluation in order to determine the costs associated with the treatment of community-acquired bacterial bronchopneumonia in pediatric patients. Materials and methods. The study was developed from the perspective of the health institution General Hospital Guillermo Luis Fernández Hernández - Baquero in the city of Moa. For this, the analysis - synthesis and comparative methods were used, as well as the methodology to calculate and analyze disease costs. Results. The research focused on the January-March quarters of the years 2017 and 2018 and provided valuable accounting information regarding the direct and indirect costs of the treatment of the pathology in question, which serves as a tool for the correct management of the hospital institution. Conclusion . The direct costs exceeded the indirect costs and the items that most affected the total cost were the salaries of the workers, food, and medicines used to treat the disease. The need to develop digital health was evidenced, with special emphasis on digital medical records to facilitate access to them and thus avoid the loss of information due to its deterioration. The study provides useful information to the management of the health institution, which serves as support for budget analysis and future projections.

RUDN Journal of Medicine. 2021;25(1):39-47
pages 39-47 views


Assessment of the role of IL6 and IL10 gene polymorphisms as a risk factor for the development of restenosis in patients after implantation of drug-eluting stents

Timizheva K.B., Aghajanyan A.V., Tskhovrebova L.V., Shugushev Z.K., Azova M.M.


Relevance. Currently, the number of percutaneous coronary interventions continues to increase, which leads to an increase in the absolute number of restenosis cases, which is the main complication of the long-term postoperative period. The search for risk factors responsible for restenosis and artery re-narrowing mechanisms in order to prevent this complication is an important goal in interventional cardiology. Risk factors for the restenosis development include clinical, angiographic and genetic factors. An active search for biomolecular markers associated with the coronary artery restenosis is currently underway. Objective: to study the role of polymorphic variants C-174G of the IL6 gene and C-819T of the IL10 gene as a risk factor for the development of restenosis in patients after stent implantation. Materials and Methods : The study included 113 patients with stable coronary artery disease, who had previously undergone balloon angioplasty and implantation of drug-eluting stents, and 62 patients with intact arteries that were included to the control group. Statistical data processing was carried out using the R-language program and the SPSS Statistics 20 software package. Results: GG genotype for IL6 gene was associated with the development of coronary artery disease. In the subgroup of patients over 65 years of age and instent restenosis, the GG genotype was significantly less frequent. The homozygous CC genotype for IL10 gene was associated with rapid angiographic in-stent restenosis progression.

RUDN Journal of Medicine. 2021;25(1):48-54
pages 48-54 views

Oxidative stress correlates well with markers of metabolic syndrome in clinically hypothyroid cases: a hospital based study in a remote tribal district

Panda S., Dash M.K., Thatoi P.K., Dandapat J., Rath B.


Relevance. Dislipidemia is one of the major manifestation of thyroid disease process due to alteration of metabolic parameters which are also seen in metabolic syndrome. Though oxidative stress has been implicated in both processes, controversial results have been obtained. Objective. To determine the status of lipid peroxidation product (Lpx) in the study group and identify the association of different components of metabolic syndrome. Material and Methods: 102 patients comprising of 60 healthy euthyroid controls and 42 hypothyroid patients served as the study group. Blood samples were collected for fasting blood sugar, renal parameters, lipid profile, tri-iodothyronin (T3), thyroxine (T4) and thyroid stimulating hormone (TSH). Level of lipid peroxidation in the samples was determined by monitoring the level of thiobarbituric acid like substances (TBARS) like substances. Results. The demographic parameters were significantly altered in hypothyroid patients. Systolic and diastolic blood pressure amongst both the groups was observed to have higher mean value in hypothyroid patients. The fasting blood sugar (FBS), total cholesterol, triacylglycerol, low density lipoprotein (LDL) and high density lipoprotein (HDL) in the hypothyroid was significantly higher than euthyroid control groups. The most frequent alteration in the hypothyroid patients was rise in SBP (95 %), Hypertriglyceridemia (50 %) and raised waist circumference (48 %) and DBP (42 %). A fourfold rise in Lpx was observed in hypothyroid subjects (p<0.001). Robust positive association was observed between TSH and Lpx. Multiple linear regressions revealed strongest and statistically significant association between serum serum thyroid stimulating hormone and waist circumference. Conclusion. The hypothyroid patients have significant higher degree of oxidative stress and the components of metabolic syndrome. They are the candidates for preventive health intervention.

RUDN Journal of Medicine. 2021;25(1):55-65
pages 55-65 views

Giant Inguinoscrotal Hernia

Protasov A.V., Kulakova A.L., Dzhabiev A.A., Mekhaeel M.S.


The following article devoted to the case of surgical treatment of giant inguinoscrotal hernia of a patient which signed the informed consent to the processing of personal data with dimensions of hernial sac 400x330x306 mm, size of hernial gates 9x8x7cm, loops of the small intestine, mesentery, a large number of heterogeneous liquid up to 14.7 L were determined in the hernial sac. Left herniotomy was performed. Back wall plastic of the inguinal canal was performed according to Liechtenstein. Mesh implant was used for the plastic.

RUDN Journal of Medicine. 2021;25(1):66-72
pages 66-72 views

Analysis of the effects of caffeine and dioxidine on biochemical indicators of blood in mouse

Durnova N.A., Sheremetyeva A.S., Karetnikova A.Y.


Relevance . In connection with the widespread use of caffeine, an important issue is the study of its interaction with substances that can exhibit toxic effects. Objective. The aim of the study is to assess the degree of influence of caffeine and dioxidine on the biochemical parameters of blood in mice in the forced swimming test. Materials and methods. The studies were carried out on 6 groups of male mice: control and five experimental. During 15 days of the experiment, the animals of the control group were injected with physiological saline, and the experimental animals were injected with caffeine at a dose of 40 mg/kg or 100 mg/kg (1 and 2), dioxidine in an amount of 200 mg/kg (3), and caffeine was combined and dioxidine (4 and 5). Biochemical parameters were used to determine the content of glucose, cholesterol, urea, creatinine, the activity of aspartic and alanine aminotransferases. Results . The introduction of caffeine at a dose of 40 mg/kg led to a decrease in glucose levels below normal and an increase in cholesterol and urea concentrations. The use of caffeine at a dose of 100 mg/ kg caused a decrease in glucose levels below normal and an increase in urea concentration. With the introduction of dioxidine at a dose of 200 mg/kg, an increase in the level of glucose, cholesterol, urea, as well as the activity of AST and ALT was taken. The combined use of caffeine and dioxidine by the 15th day led to 100 % mortality in experimental animals. Conclusions . The results of the experiment indicate that the introduction of caffeine at a dose of 40 mg/kg and 100 mg/kg leads to an increase in most of the measured parameters relative to the control values, but they do not go beyond normal values, however, a decrease in glucose levels is noted. These changes in indicators are due to the predominance of catabolic processes over anabolic ones. In animals treated with dioxidine, a significant increase in the concentration of metabolites and the activity of blood enzymes was found, especially an increase in AST and ALT was noted, which indicates a predominant lesion of cardiomyocytes. The mortality rate of the experimental groups receiving caffeine and dioxidine together by the last day of the experiment is due to the action of an excessive stress factor leading to the depletion of the adaptive capabilities of the organism and the death of experimental animals.

RUDN Journal of Medicine. 2021;25(1):73-79
pages 73-79 views

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