Aim. In this study we evaluated the effects of Riamilovir on SARS-CoV-2 viral shedding and on admission duration in patients with moderate COVID-19. Materials and methods. We have used data from 69 health records of patients with moderate severe PCR confirmed SARS-CoV-2 infection. Control group included 34 patients treated with off-label riamilovir 1250 mg per day for 5 days (250 mg 5 times a day), comparison groups 35 patients, who received ribavirin and umifenovir 800 mg a day for 5 days. The antiviral therapy was administered within 72 hours from the onset of the disease. The primary endpoints were elimination of virus in oropharyngeal and nasopharyngeal swabs on 7 day of admission and discharge from the hospital by 14 day. Results. Patients assigned to riamilovir had significantly shorter time to clinical improvement as well as increased PCR negative rate by day 7. Conclusion. Yearly administration of riamilovir as opposed to the umifenovir and ribavirin in therapy of moderate SARS-CoV-2 infection was associated with significant shorter time to clinical improvement by 14 day of hospitalization. PCR negative rate by 7 days of hospitalization is significantly more likely in riamilovir group.

BACKGROUND: COVID-19 is an international emergency. The Military Medical Academy, including the Department and Clinic of Infectious Diseases (with a course in medical parasitology and tropical diseases) are actively involved in the fight against the COVID-19 pandemic, and are also studying the pathogenesis, diagnosis and treatment of this disease. AIM: to systematize the work done at the Military Medical Academy in relation to the fight against a new coronavirus infection. MATERIALS AND METHODS: This article provides a brief description of the studies conducted in relation to COVID-19. RESULTS: The departments view of the infection caused by SARS-CoV-2 is presented, the main indicators of the work of the clinic of infectious diseases in the fight against COVID-19 are briefly reflected, and their own research in the field of this infectious disease is demonstrated. CONCLUSION: Based on our scientific work, our experience in treating patients with a new coronavirus infection, the main conclusions and recommendations are formulated: It is necessary to take into account the clinical feature of COVID-19 a long initial period (up to 8 days), which creates the illusion of imaginary well-being and contributes to late hospitalization. PCR is not an ideal diagnostic method, which creates the possibility of obtaining a false negative result. In this regard, clinical, epidemiological and radiological diagnostics are decisive. The organization of early active detection of patients with all clinical forms of infection caused by SARS-CoV-2, and their timely hospitalization helps to reduce the risk of developing a severe course, complications and epidemiological danger of patients. Complex antiviral and anticoagulant therapy should be early (up to 5 days from the clinical manifestation), proactive, aimed at reducing the likelihood of developing pneumonia with respiratory failure and thrombosis of the LA branches. Anti-inflammatory therapy increases the survival of patients with severe COVID-19 and should be administered as early as possible with a preventive goal at the first minimal clinical and laboratory signs of a hyperinflammatory response.

Background. Influenza and acute respiratory viral infection account for about 90% of all infectious morbidity in the population. Every year in Russia alone, from 27 to 41 million cases of these diseases are registered, and according to WHO, every adult on average gets sick with acute respiratory viral infection 2 to 4 times a year. Acute respiratory viral infection s are an etiologically heterogeneous group of infectious diseases affecting the respiratory tract, characterized by a relatively mild and short course. Today, specific antiviral drugs, including those against influenza, are widely represented on the pharmaceutical market. However, to date, no universal broad-spectrum antiviral agent has been created that can prevent the spread of acute respiratory viral infection. In this regard, the development of new antiviral drugs comes to the fore. Objective. To evaluate the effectiveness and safety of antiviral drugs (enisamia iodide and umifenovir) in real clinical practice in patients with acute respiratory viral infection, with the exception of SARS-CoV-2. Materials and methods. As part of the research work, 265 medical records of patients with infections caused by various pathogens of respiratory viral infections, with the exception of SARS-CoV-2. All medical records of patients were divided into 3 groups in accordance with the prescribed etiotropic therapy. The comparison group included patients who were not prescribed antiviral drugs. To study the effectiveness of the compared treatment regimens, we assessed the duration of hospitalization and the duration of the main clinical manifestations of acute respiratory viral infection, as well as the severity of the general infectious intoxication syndrome according to the anamnesis and the dynamics of the disease extracted from medical records. Results. The duration of hospitalization of patients receiving antiviral therapy enisamia iodide was significantly less than that of patients receiving umifenovir (p < 0.05) and not receiving antiviral therapy. A significantly longer duration of fever was detected in the group of patients who did not receive antiviral therapy (p < 0.05). The duration of the main syndromes affecting the respiratory tract in patients from the group that did not receive etiotropic treatment was significantly longer (p < 0.05). Conclusion. The drug enisamia iodide has been shown to have high therapeutic efficacy and a good safety profile. This allows us to consider it as a promising universal antiviral agent for the treatment of patients with influenza and acute respiratory viral infection (with the exception of SARS-CoV-2).

   Aim. Evaluation of the effectiveness of the preventive use of the directacting antiviral drug riamilovir in reducing the incidence of COVID-19, as well as its impact on the dynamics of infection spread using mathematical simulation on the example of the Kurgan region population to optimize preventive strategies for epidemiologically significant diseases.   Material and methods. To simulate the spread of COVID-19 in the Kurgan region, the extended SEIR model was used, taking into account the effect of riamilovir on the likelihood of contracting a new coronavirus infection. The numerical solution of the system of differential equations was carried out using the 4^th order Runge-Kutta method. The input parameters of the modelwere based on demographic data from the region and the results of a clinical study of riamilovir preventive efficacy against COVID-19 and acute respiratory viral infections. The scenarios under consideration involve 30 % and 50 % of the population taking the drug, which reduced the likelihood of infection by 25.7 % and 40 %, respectively.   Results. Based on mathematical simulation, it has been established that the preventive use of riamilovir by 30% or 50% of the population shifts the peak of the epidemic to a later date, and the maximum number of active cases is significantly reduced compared to the scenario without the drug. The total number of cases is decreasing, which reduces the burden on the healthcare system and improves control over the spread of infection.   Conclusion. Mathematical simulation has shown that the scenario of preventive use of riamilovir on the example of the Kurgan region can significantly reduce the incidence of infections with epidemic potential, reduce the burden on the healthcare system, and slow down the peak of the epidemic.