Background: Human granulocytic anaplasmosis (HGA) is a vector-borne natural focal disease that is not officially registered in Ukraine. The first 13 cases of HGA in adults in Ukraine were identified in 2007. The purpose of our study was to develop a predictive model of HGA based on clinical and laboratory characteristics to develop a three-level standard case definition of HGA.
Materials and Methods: Researchers examined 498 patients with suspected tick-borne infections and carried out a retrospective clinical and epidemiological analysis of 60 cases recruited from Lviv regional infectious disease hospitals. Logistic regression was used to create a model of the probability of the diagnosis of HGA depending on the presence of certain clinical and laboratory factors that, when examined, together may help to confirm a case of HGA. For logistic regression, eight clinical and laboratory factors were selected: history of tick bite, hyperthermia, signs of pharyngitis, changes in chest X-ray picture (enhancement of the pulmonary pattern and enlargement of the lung root boundaries), increased bilirubin (>21 lmol/L), increased alanine aminotransferase (ALT >36 U/L), erythema migrans, and detected Lyme disease.
Results: In the presence of all eight factors, the probability of HGA is 95.7%. When the five main signs are absentsigns of pharyngitis, changes in chest X-ray picture, increased bilirubin and ALT, and a history of tick bite the probability of HGA in the patient dramatically decreases to 6.8%, meaning that HGA might be excluded.
Conclusions: Based on the analysis of epidemiological, clinical, and laboratory signs, criteria for establishing a suspected, probable, and confirmed diagnosis of HGA have been developed to improve diagnosis

With the onset of the Covid-19 pandemic, the dominant pathogen of acute respiratory infections (ARI) became the coronavirus. Cases of coronavirus disease are registered throughout the year, with increase in the incidence in the autumn-winter period. Since the fall of 2022, the appearance of the type A influenza virus has been noted, which caused a severe course of the flu in patients. The aim of our study was to compare the distribution of laboratory-confirmed cases of Covid-19 and influenza. From January 2022 to April 2023, 4,205 nasopharyngeal swab specimens from Lviv Regional Infectious Disease Hospital inpatients with suspected ARI were examined by PCR. Also, from November 2022 to April 2023, 392 samples from the above-described patients were also examined for influenza. Covid-19 was laboratory confirmed in 1238 cases (29.5%). The age of the patients ranged from 2 to 94 years. One of the highest levels of laboratory-confirmed cases was recorded in January 2022 where 309 positive out of 578 collected cases (53.5%), with a decrease to 10% in June. An increase of morbidity was observed in August (46.8%) and September (56.5%). Since October, a decrease in the indicator (32.2%) was registered, followed by a drop in the level of laboratory-confirmed cases of the coronavirus disease to 5.2% in November and 1.9% in December. Since January 2023, there has been an increase in incidence rates with a peak (39.5%) in February and a subsequent gradual decline to 17.6% in April 2023. However, since November, the number of confirmed cases of influenza has increased sharply to 53.4% and 35.3% in December. Hospitalized patients with influenza had a severe course of the disease. Three patients had positive tests for Coronavirus and influenza A at the same time. From January to April 2023, no laboratory-confirmed cases of influenza A were reported, which corresponds to the increase in the incidence of Covid-19. Thus, in the structure of ARI, along with the coronavirus, the type A influenza virus plays an active role, both in terms of the number of cases and the severity of the course. That is, it can be possible that these pathogens compete with each other

У структурі захворюваності на гострі респіраторні інфекційні хвороби поряд з COVID-19, захворюваність на який в 2022 році наближалась до показників сезонних респіраторних хвороб, активну роль в епідемічному процесі восени 2022 року відігравав вірус грипу типу А, як за кількістю випадків, так і за важкістю перебігу. Ймовірно, ці два збудники конкурують між собою за популяцію. В осінній період 2022 року вірус грипу повернувся в екологічну нішу, у якій протягом 2020-2022 років стійко утримувався SARS-CoV-2

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.