Mortality of the population due to diseases of the cardiovascular system is the most acute problem in Russia. According to the World Health Organization, the standardized death rate from cardiovascular diseases in the Russian Federation remains one of the highest in Europe. This review presents statistical data on morbidity and mortality from cardiovascular diseases in the Russian Federation and analyzes the delivery of medical care to patients with these diseases in 2017. Information about activity of primary vascular departments and regional vascular centers is given. The article suggests a set of measures aimed at improvement of the provision of medical care to patients with cardiovascular diseases.

Background Several factors that could affect survival and clinical outcomes of COVID-19 patients require larger studies and closer attention. Objective To investigate the impact of factors including whether COVID-19 was clinically or laboratory-diagnosed, influenza vaccination, former or current tuberculosis, HIV, and other comorbidities on the hospitalized patients' outcomes. Design Observational nationwide cohort study. Patients All subjects, regardless of age, admitted to 4,251 Russian hospitals indexed in the Federal Register of COVID-19 patients between March 26, 2020, and June 3, 2020. All included patients for which complete clinical data were available were divided into two cohorts, with laboratory- and clinically verified COVID-19. Measurements We analyzed patients' age and sex, COVID-19 ICD-10 code, the length of the hospital stay, and whether they required ICU treatment or invasive mechanical ventilation. The other variables for analysis were: verified diagnosis of pulmonary disease, cardiovascular disease, diseases of the endocrine system, cancer/malignancy, HIV, tuberculosis, and the data on influenza vaccination in the previous six months. Results This study enrolled 705,572 COVID-19 patients aged from 0 to 121 years, 50.4% females. 164,195 patients were excluded due to no confirmed COVID-19 (n=143,357) or insufficient and invalid clinical data (n=20,831). 541,377 participants were included in the study, 413,950 (76.5%) of them had laboratory-verified COVID-19, and 127,427 patients (23.5%) with the clinical verification. Influenza vaccination reduced the risk of transfer to the ICU (OR 0.76), mechanical ventilation requirement (OR 0.74), and the risk of death (HR 0.77). TB increased the mortality risk (HR 1.74) but reduced the likelihood of transfer to the ICU (OR 0.27). HIV comorbidity significantly increased the risks of transfer to the ICU (OR 2.46) and death (HR 1.60). Patients with the clinically verified COVID-19 had a shorter duration of hospital stay (HR 1.45) but a higher risk of mortality (HR 1.08) and the likelihood of being ventilated (OR 1.36). According to the previously published data, age, male sex, endocrine disorders, and cardiovascular diseases increased the length of hospital stay, the risk of death, and transfer to the ICU. Limitations The study did not include a control group of subjects with no COVID-19. Because of that, some of the identified factors could not be specific for COVID-19. Conclusions Influenza vaccination could reduce the severity of the hospitalized patients' clinical outcomes, including mortality, regardless of age, social, and economic group. The other factors considered in the study did not reduce the assessed risks, but we observed several non-trivial associations that may optimize the management of COVID-19 patients.

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Aim. To study the possibilities and limitations of the social network as a digital medical tool, which is aimed at improving programs for primary and secondary stroke prevention in young people.Material and methods. The study was carried out in the format of online training for volunteers. At the first stage of the work, the online school “Stroke in Young People” was announced in 8 medical blogs. As part of the school, a special account was created for readers (n=1354). At the second stage, 49 respondents (4% of men, whose average age was 24.4±5.2 years) were selected from 1354 listeners, who were surveyed on “Awareness of risk factors and stroke symptoms among users of social networks” before and after the online school.Results. The online school audience is predominantly female (91%), and 43% of readers were in the 25-34 age group. The total number of people who listened to and read the online school material is 8712 people. 17% worked in the healthcare system, and 22% of respondents had a history of stroke. 38 (78%) people of the 2nd stage among the respondents independently searched for information about stroke earlier, and 30 (61%) received this information passively from medical workers in 2020. Before the online school start, the majority of respondents (over 60%) were aware of 2 out of 7 stroke risk factors (dyslipidemia and arterial hypertension) and 3 out of 6 stroke signs (drooping of the face half, weakness in the limbs and difficulty speaking). Less than 40% of the participants considered the stroke risk factors for diabetes mellitus, other cardiovascular diseases (CVD), obesity, and alcohol use; less than 20% were aware of stroke symptoms such as impaired vision and coordination and very severe headache. After completing online learning, the greatest increase in knowledge was found among the following risk factors – smoking and other CVDs (p<0.05); stroke symptoms - headache and drooping of the face half (p<0.05).Conclusion. The online school aroused interest among healthcare workers and people without medical education, including those with stroke. Most of the respondents believed that they knew how to prevent a stroke (over 80%) and would be able to provide first aid to a person with a stroke (over 90%). At the same time, the awareness of risk factors and stroke symptoms was low prior to the start of learning, even though the study included healthcare workers and stroke survivors. Online learning has led to increased awareness of some risk factors and stroke symptoms. Social media can be one of the tools for medical prevention of stroke in young people, but program planning should take into account the way the material is presented and its readability.

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Background: Along with the primary damage to the respiratory system, coronavirus disease (COVID-19) affects the cardiovascular system, which is thus involved in the pathological process. However, in the available literature, analyses of electrocardiographic (ECG) findings are based only on small-sample studies and case reports, which determines the relevance of larger-scale studies to clarify the nature and prevalence of ECG abnormalities in subjects with confirmed coronavirus infection. Aim: To determine the distribution of ECG changes in 42,799COVID-19 patients representing a non-selective population of Moscow residents. Materials and methods: From March10, 2020 to March10, 2021, a retrospective analysis of ECGs from 42,799patients with a verified diagnosis of COVID-19 was performed. The study included patients admitted to Moscow clinical hospitals connected to the ECG IT Center. A standard 12-lead ECG was obtained and then transmitted via an Internet connection to the server of the ECG IT Center where the ECG interpretation was performed. Results: ECG changes were detected in 54% of patients. The most common cardiac arrhythmias were supraventricular extrasystole and atrial fibrillation reported in 12.6% and 12.0% of patients, respectively. Signs of overloaded right heart were detected in 12.5% of cases, of which the ECG pattern of pulmonary embolism was confirmed in 485patients (1,13%). Infarction ECG pattern was observed in 4.5% of subjects, among which 3cases of Brugada ECG pattern were reported. The incidence of ST-T changes was 2.2% of all study patients. Prolonged QT and QTc intervals were recorded in 540patients (1.26%). Individual cases of ventricular fibrillation, Frederick syndrome, and atrioventricular block of various degrees were reported. Conclusion: Based on the data obtained, the distribution of incidence of ECG changes in COVID-19 was shown. The high incidence of atrial fibrillation, which is a risk factor for thromboembolic complications, was confirmed. At the same time, a significant prevalence of ECG patterns of overloaded right heart was shown, some of which are associated with pulmonary embolism. Other reported ECG changes were characterized by a significantly lower prevalence, which does not reduce their clinical significance. The data obtained may be used to improve COVID-19 patient management strategy in the future.