Estimation of incidence of COVID-19 in Armenia based on self-reported data

Introduction. The COVID-19 pandemic has become a major global health, political, and economic issue. Despite efforts to establish strong national registration and reporting systems in many countries, including international sources of information such as https://www.worldometers.info/coronavirus/ there are serious doubts about the completeness of the registration of cases of disease due to different reasons including the availability of health care, diagnostic criteria, seeking medical help depending on severity of cases, “family cases”, patient’s behavior, etc. In Armenia COVID-19 diagnosis based solely on the positive PCR test. The official number of COVID-19 cases in Armenia is about 450,000, with a rate of 151,000 per million population. Aim. The aim of this study is to estimate the “true” incidence of COVID-19 based on self-reported data obtained during interviews of a random sample of population in randomly selected villages and towns in the regions of the Republic of Armenia. Material and methods. This cross-sectional non-experimental quantitative research was conducted using a 15-item questionnaire as the primary tool. The study was conducted from January 1, 2021, to December 31, 2022, with a total of 1393 participants from 100 villages and 48 towns across the Republic of Armenia. To ensure the sensitivity of the topic was taken into account, the questionnaire was completed anonymously, and efforts were made to obtain honest responses from all participants. The statistical analysis was performed using SPSS 16.0. Results. Of the total 1393 participants only 782 (56.1%) were tested for COVID19, among those 38.5% tested positive, while 61.5% tested negative. Out of 518 respondents reported history of COVID-19 only 294 (57%) were PCR tested and had a positive result, while 224 (43%) were never tested and were not formally recognized as COVID-19 patients. The overwhelming majority of those who did not seek medical assistance had a mild (46.9%) to moderate (32.4%) course of the disease. The positive test rate was higher in the cities (40.7%) compared to villages (36.8%), but the difference was not statistically significant (p>0.05). Among test takers, 51% were from villages and 63.3% were from towns, with a statistically significant difference between the two settlements (χ2=18, p<0.0001). There were no significant gender differences neither in taking the PCR test for men (55.8%) and women (56.7%), nor in the prevalence of a positive test result: 38.1% of men and 38.8% of women tested positive, (p>0.01). Conclusions. A significant proportion of cases of COVID-19 are underreported due to the low level of patients’ medical help seeking behavior. Mild condition of disease course, “family” cases, when one of the family members has already been diagnosed and got medical assistance, allows other members to “share” the treatment, prescribed medications, get treated while avoiding diagnosis related isolation and other restrictions. We did not find statistically significant differences between the prevalence of positive COVID-19 test results among participants residing in villages and towns in the RA. Participants living in the towns of Armenian regions reported taking more tests than those living in villages of the regions, indicating reliable statistical differences

Peculiarities of situational and personal anxiety degree in the schoolchildren with ENT chronic diseases

Abstract Background A number of the QL researches in case of different pathologies are being increased during the last decade. The existing traditional research methods provide mostly arbitrary data on the disease and its treatment, which are not sufficient for the schoolchildren overall psychological and social adaptation and wellness evaluation. Methods The research object became schoolchildren of 3 randomly selected schools in Yerevan. 443 monitoring units formed the selection population. The degree of situational and personal anxiety was evaluated with the help of Spielberger’s and Gerbachevski’s tests. Results According to our research data the anxiety degree was 29,2 ± 2,3 points among the girls and 12,5 ± 1,6 points among the boys, respectively. The individual anxiety level was especially high: it made up 44,5 ± 0,8 points, and that of the situational anxiety made up 37,2 ± 0,5 points (p < 0,05). According to Gerbachovski’s test in the group of schoolchildren with ENT pathology those with a high level of demands made up 53,5 ± 3,2%, with a medium level of demands - 32,4 ± 3,0% and with a low level of demands −14,1 ± 2,2%. A number of the practically healthy schoolchildren with a low level of demands made up 50,3%, and with a high level – 30,7%. Conclusion According to the investigation data those children who suffer from the ENT chronic diseases usually avoided communication, were sluggish and shy. According to the results of the research, the socio-psychological and adaptation abilities of children with the ENT chronic diseases were lower than those of the practically healthy (without ENT pathologies) coevals. This fact urges to improve the prophylactic measures provision in the mentioned pathologies aspect

Reduction of Hospitalization and Mortality by Echocardiography-Guided Treatment in Advanced Heart Failure

In advanced heart failure (AHF) clinical evaluation fails to detect subclinical HF deterioration in outpatient settings. The aim of the study was to determine whether the strategy of intensive outpatient echocardiographic monitoring, followed by treatment modification, reduces mortality and re-hospitalizations at 12 months. Methods: 214 patients with ejection fraction 1 hospitalization during the last year underwent clinical evaluation and echocardiography at discharge and were divided into intensive (IMG; N = 143) or standard monitoring group (SMG; N = 71). In IMG, volemic status and left ventricular filling pressure were assessed 14, 30, 90, 180 and 365 days after discharge. HF treatment, particularly diuretic therapy, was temporarily intensified when HF deterioration signs and E/e’ > 15 were detected. In SMG, standard outpatient monitoring without obligatory echocardiography at outpatient visits was performed. Results: We observed lower hospitalization (absolute risk reduction [ARR]-0.343, CI-95%: 0.287–0.434, p p p < 0.05). Conclusion: In AHF, outpatient monitoring of volemic status and intracardiac filling pressures to individualize treatment may potentially reduce hospitalizations and mortality at 12 months follow-up. Echocardiography-guided outpatient therapy is feasible and clinically beneficial, providing evidence for the larger application of this approach

Kinetics of Anti-Nucleocapsid IgG Response in COVID-19 Immunocompetent Convalescent Patients

International audienceAbstract The comprehension of a long-term humoral immune response against SARS-CoV-2 can shed light on the treatment and vaccination strategies of COVID-19 disease, improving the knowledge about this virus infection and/or re-infection. We assessed the IgG antibodies against SARS-CoV-2 nucleocapsid (N) protein (anti-SARS-CoV-2 (N) IgG) in 1441 COVID-19 convalescent patients within 15~months longitudinal study from middle-developed country. The main inclusion criteria was positive RT\textendash PCR result on nasopharyngeal swab samples at least one month before antibody testing and absence of any induced or inherited immunodeficiency. 92.7% of convalescent patients' serum contained anti-SARS-CoV-2 (N) IgG and only 1.3% of patients had a delayed antibody response. In the majority of convalescent patients' the durability of antibodies lasted more than one year. The kinetics of anti-SARS-CoV-2 (N) IgG took a bell-shaped character\textemdash increased first 25\textendash 30~weeks, then started to decrease, but were still detectable for more than 15~months. We found that on the one hand anti-SARS-CoV-2 humoral response level correlates with disease severity, on the other, in particular, the level of peak antibodies correlates with age\textemdash older patients develop more robust humoral response regardless of sex, disease severity and BMI

Incidence patterns and review of Hodgkin lymphoma in the Republic of Armenia

Hodgkin lymphoma (HL) accounts for roughly 10% of all lymphomas and 0.6% of all malignant tumours analysed worldwide yearly. Data regarding HL in developing world are exceptionally constrained. The main objective of this research is to investigate the incidence patterns of HL within the Republic of Armenia and to portray disease distribution according to age and sex. There is a very strict evidence on the frequency of HL in Armenia. The results of our research find out that the frequency of HL in Armenia has not changed altogether over the past 15 years and is comparable to that detailed from the USA and Europe