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У 80% військовослужбовців, які перенесли бойову психічну травму, зумовлену тривалим стресом та спровоковану індивідуально-психологічними особливостями, виявлено симптоми травматизації психіки. Згідно з отриманими даними, переживання бойової психічної травми визначається насамперед індивідуально-психологічними особливостями військовослужбовця, які провокують можливий подальший розвиток ПТСР, хвороб адаптації (психосоматичних захворювань, неврозів і невротичних станів) та ін.

80% of military who suffered combat mental trauma, caused by long-term stress and provoked by individual psychological characteristics, showed symptoms of mental trauma. According to the obtained data, the experience of combat mental trauma is determined, first of all, by the individual and psychological characteristics of the military, which provoke the possible further development of post-traumatic stress disorder (PTSD), adaptation diseases (psychosomatic diseases, neuroses and neurotic states), etc.

Background: The high rate of infection with COVID-19 in patients worldwide and Europe, and mutation of viruses have led to the emergence of variants of SARS-CoV-2. On November 26, 2021, the SARS-CoV-2 B.1.1.529, or Omicron variant, was recognized as a new Variant of Concern (VOC). We hypothesized that the emergence of SARS-CoV-2 variants in Ukraine followed the prevalence of Delta and Omicron in Europe. To test this hypothesis, we performed a retrospective study to determine the prevalence of SARS-CoV-2 variants circulating among patients hospitalized at Lviv Regional Infectious Diseases Hospital (LRIDH) in 2022.

Methods: From January 2022 to October 2022, 994 LRIDH inpatients were PCR positive for COVID-19. From these positive samples, 225 were selected for further analysis by the randomization method. Samples represented three stages. Stage 1 positive samples included the months of January and February. Stage 2 samples included the months of July and August, and stage 3 samples were from October of 2022. The presence SARS-CoV-2 spike S371L/ S373P mutations (Omicron, B.1.1.529) and the presence of Spike T478K mutations (Delta, B.1.617.2) were determined using VirSNiP SARS-CoV-2 Spike S371L S373P and "VirSNiP SARS-CoV-2 Spike T478K (TIB MOLBIOL LightMix, Germany). Testing was performed at the virological reference laboratory of the Public Health Center in Kyiv city, Ukraine. Statistical analysis was conducted using Chi-square tests.

Results: For stage 1, (January and February 2022) 75 samples (33.3%) were examined. Of these, 54 (72%) were Omicron and 16 (21.3%) were Delta. No mutation was detected in 5 samples (6.7%) (Ct˃30). Omicron (without sub-lineage) was found in 17 samples (31.5%), BA.1 sub-lineage in 21 samples (38.9%), BA.2 sub -lineage 10 samples (18.5%), and in 6 samples (11.1%) BA.2/BA.3 sub-lineage. In stage 2, 142 samples (63.1%) were examined. Of these, 134 (94.4%) were Omicron, and for 8 (5.6%), no mutation was detected. Omicron BA.2 was identified in 128 (95.5%) of these samples. In stage 3, (October 2022) 8 samples (3.6%) were examined. All were Omicron and BA.5.1 was found in 3 samples (37.5%), BA.5.2 in 1 sample (12.5%), BA.5.2.1 in 2 samples (25%) and in 2 samples (25%) BA.5.2.6.

Conclusions:Studying the evolution of the SARS-CoV-2 virus and detecting its mutation makes it possible to predict the severity of the disease and the effectiveness of vaccination. The results are consistent with our hypothesis that in Ukraine, the prevalence of SARS-CoV-2 variants were consistent with Europe. The obtained results showed that the viruses circulating in Ukraine belong to the global genetic line B originating from China with a slight shift in time. In Ukraine, these tests can be performed routinely to assess the epidemiological situation and prevent the increase of the SARS-CoV-2 morbidity.

The spread of the incidence of COVID-19 and measures related to the pandemic have a significant impact on the mental health of the population, namely on the cognitive, emotional and volitional spheres, and social communication. Among the high-risk groups are persons suffering from chronic infectious diseases, including HIV-infected patients. The aim of our work was to assess the impact of anxiety and depression in patients with secondary immunodeficiency caused by HIV on consent to vaccination against the corona virus disease during the COVID-19 pandemic in Ukraine. From December 2021 to April 2022, a survey of 67 patients with a diagnosis of HIV/AIDS in "Lviv Regional Information and Analytical Center of Medical Statistics" was conducted. The average age of the respondents was 35.67±1.25 years and ranged from 18 to 68 years. All patients were on antiretroviral therapy at the time of the survey. The GAD - 7 (General Anxiety Disorder - 7) questionnaire was used to assess the level of anxiety, and the PHQ - 9 (Patient Health Questionnaire - 9) was used to diagnose the level of depression. The HIV Registry software was used for statistical processing of the results. During the survey, 52.2% of patients noted mild anxiety, 25.4% - moderate anxiety, 14.9% - severe anxiety, and 7.5% had panic level anxiety. As for the manifestations of depression, 53.7% of respondents denied signs of depression, 28.4% of patients complained of mild depression, 13.4% - moderate depression, and 4.5% of patients noted moderate-severe depression. In 3.0% of respondents, a combination of moderate-severe depression with panic level anxiety was found. Among patients with severe and panic level anxiety, 73.3% were aware of their HIV status within 3 years. And among patients with moderately severe and severe depression, this figure was 75%. Regarding the data on the incidence of SARS-COVID-19, in the group of patients with severe and panic level anxiety, the rate of laboratory-confirmed cases was 26.7%, and among patients with moderate-severe and severe depression - 25.0%. At the time of the survey, 34.3% of people refused to be vaccinated against SARS-CoV-2. Among patients with severe and panic level anxiety, 40% of respondents refused vaccination, and among patients with moderate-severe and severe depression - 50% of surveyed patients refused to be vaccinated. The mental state of the patient, namely, anxiety and depressive symptoms, can significantly affect the perception and awareness of information by patients regarding the need for preventive and therapeutic measures due to the SARS-COVID-19 pandemic, in particular, the provision of consent for vaccination, which should be taken into account by specialists in the field of health care health. Thus, when organizing the provision of medical care to HIV-infected patients, it is necessary to take into account changes in mental health as a result of the SARS-COVID-19 pandemic.

Вступ. Пандемія COVID-19 почалась у березні 2020 року та триває дотепер. Наявність ВІЛ-інфекції у пацієнта залишається важливим фактором ризику інфікування SARS-CoV-2 і пов’язана з підвищеним ризиком смертності від COVID-19. Тому ВІЛ-інфіковані пацієнти потребують першочергово отримати щеплення від COVID-19.

Метою нашої роботи була оцінка питання вакцинації від коронавірусної хвороби серед пацієнтів з вторинним імунодефіцитом, спричиненим ВІЛ.

Методи. Розроблено опитувальник щодо охопленості вакцинацією від COVID-19 серед пацієнтів з ВІЛ-статусом. Для статистичної обробки результатів використано програмне забезпечення HIV Registry.

Результати. Всього опитувальник заповнили 60 осіб. Це пацієнти, які перебувають на диспансерному обліку в КНП ЛОР «Львівський обласний інформаційно-аналітичний центр медичної статистики» з діагнозом ВІЛ/СНІД. Серед опитаних пацієнтів частка жінок становила 33,3 % і чоловіків 66,7 %. Середній вік становив 35,2±1,36 років та коливався в межах18 і 68 років. Всі пацієнти на момент опитування знаходились на антиретровірусній терапії.

Серед опитаних рівень вакцинації від COVID-19 становив 63,3 %. Більшість опитаних - 39,5 % були щеплені вакциною Comirnaty/Pfizer та 28,9 % – Coronavac/Sinovac, майже порівну 15,8 % - AstraZeneca-SKBio і 13,2 % - Moderna (mRNA-1273, Spikevax). І лише один пацієнт (2,6 %) отримав вакцину Janssen (Johnson & Johnson) закордоном.

Щодо причин, які спонукали респондентів вакцинуватись, 34,2 % опитаних вибрали одну відповідь – «щоб отримати захист від COVID-19 і не захворіти». На другому місці по 18,4 % порівну розділились респонденти, які вибрали дві причини для вакцинації: перша група поєднала пункти «щоб отримати захист від COVID-19 і не захворіти» та «щоб не звільнили з роботи» і друга група - «щоб отримати захист від COVID-19 і не захворіти» та «щоб їздити закордон». На третьому місці – 15,8 % опитаних відповіли «щоб не звільнили з роботи».

37,7 % опитаних ВІЛ-інфікованих пацієнтів вакцинуватись відмовились. Серед них 50 % вибрали відповідь «маю сумніви щодо вакцини» та 22, 7% не вказали причину відмови від щеплення. Решта респондентів обрали відповіді «працюю неофіційно і не маю потреби щепитись», «у мене низький рівень СД4 клітин (менше 200)» та «маю сумніви щодо вакцини», «маю сертифікат» (отриманий без вакцинації).

Висновки. До проблем вакцинації від COVID-19у ВІЛ-інфікованих відносимо недостатній рівень охоплення щеплення (63,3 %), що зумовлено активною антивакцинальною кампанією в суспільстві, поширенням неправдивої інформації щодо вакцин у мас медіа та невиправданою безпечністю щодо свого здоров’я частини населення.

COVID-19 vaccines are considered the most promising approach for curbing the COVID-19 pandemic worldwide. However, COVID-19 vaccine hesitancy is increasing worldwide and remains a main concern among vulnerable population including those who are immunocompromised. Studies indicate that people living with HIV, presents poorer COVID-related outcomes compared to those without HIV. This study focuses on understanding reason and beliefs for Covid-19 hesitancies in Ukrainian people living with HIV. We examined COVID-19 vaccination coverage among 70 HIV-positive patients treated at the HIV Unit in “Lviv Oblast Information and Analytical Center for Medical Statistics” (Ukraine) between December 2021 to April 2022. HIV Registry software was used for statistical processing of results. Among the surveyed patients, majority were men (68.6%) and age of the respondents was ranged from 18 to 68 years. 32.9% respondents refused to get SARS-CoV-2 vaccination. Among the patients refusing to get vaccinated, 30.4% knew about their HIV status for more than five years, and 43.5% were diagnosed with clinical Stage 4 HIV/AIDS. At the time of the survey, 62.5% of patients had a CD-4 count below 200 cells/ml. More than half of the participants expressed having doubts about the vaccine (52.2%), chose the answer “I have doubts about the vaccine” from the proposed, and 21.7% did not indicate the reason for refusal of vaccination. The rest of the respondents chose the answers “recently had coronavirus infection” – 13.1%, few (8.7%) felt that since they were unemplyed they did not need to be vaccinated and few (4.3%) other had a low count of CD4 cells (less than 100) therefore were hesitant to get vaccinated. About 32.9% of HIV/AIDS patients surveyed, for whom vaccination was indicated and could protect against the severe course and risk of death from COVID-19, did not receive specific prophylaxis. The most common reason for refusing vaccination was doubts about the quality of the vaccine (52.2%). This population may benefit from educational and informational activities on the reasoned safety of vaccination to address vaccine hecitantcy among this high-risk groups.