very cheap and long-known drugs help save the lungs with coronavirus

Cloving hospital on the basis of the Medical Scientific and Educational Center (ISSC) Moscow State University named after M.V.Lomonosov took the first patients on April 21 and completed his work on June 13. It turned out that it was possible to achieve the best treatment results for COVID-19 in Moscow. Over the entire period, 4 patients died, and among severe patients who got mechanical ventilation, the mortality rate was less than 14% (for comparison, the average for the city and the world was up to 70 – 80%). Eighteen doctors out of 220 employees of the hospital were infected with coronavirus, there were no deaths among the medical staff.

What approaches were used at the University Hospital of Moscow State University to achieve such results? We continue the conversation with the head. Department of Therapy, Faculty of Fundamental Medicine, Moscow State University, Head of the Department of Age-Associated Diseases, Medical Scientific and Educational Center, Doctor of Medical Sciences, Cardiologist Yana Orlova.

MEDICINE FOR COUGH FOR 80 RUBLES

– Most of those who are ill or are afraid to get sick are worried about fibrotic changes in their lungs. They say that you have developed special therapy that can reduce the risk of developing fibrosis. Is it possible?!

– Yes, we launched an appropriate clinical study. There are no final results yet, but we have developed clinical practice.

“What did you do to save the lungs?”

– We used a combination of bromhexine and spironolactone (both are long-known very cheap drugs. – Ed.). Bromhexine is an expectorant that has been prescribed to patients with pneumonia and cough for many years. At the same time, experimental data showed that this drug can block a specific enzyme and impede the penetration of coronavirus into cells. True, it was on this effect that we counted to a lesser extent in inpatients, since such an effect is important mainly in the early stages of the disease. But the expectorant effect of bromhexine really helps patients with COVID. I heard that our colleagues in Peter launched a study of bromhexine for prophylactic purposes. We will wait for the results.

Coronavirus infected 18 doctors from 220 employees of the hospital, there were no deaths among the medical staffPhoto: Ivan MAKEEV

FIBROSIS OBSTACLE

– The second drug – spironolactone – is traditionally widely used in cardiology for the treatment of heart failure, severe hypertension. It has a small diuretic, magnesium and potassium-preserving effect, continues Yana. Orlova. – It has several mechanisms through which it can be useful in coronavirus infection.

Firstly, a mechanism that prevents the development of fibrosis in general in the body. There are works that, in particular, show that spironolactone reduces fibrosis in the heart. At the same time, it is known that the tendency to fibrosis is not local, but systemic – where there is more inflammation, there will certainly be fibrosis. And we see, of course, fibrotic changes in the “covide” in our patients. Therefore, we prescribed spironolactone as a drug for the prevention of this process.

Secondly, this drug blocks sex hormone receptors, in particular testosterone. Some published studies suggest that “high-testosterone” men suffer from “covid” more often and develop more severe fibrotic changes. Therefore, blocking these receptors for several weeks during COVID treatment may be useful in reducing the severity of complications. We are not talking about a longer intake, since male patients are unlikely to agree with a decrease in testosterone levels in the long term.

And perhaps the most important point. In almost all of our patients, we observed hypokalemia (a decrease in potassium levels. – Ed.). With coronavirus infection, potassium is intensely excreted from the body, and scientific articles even suggest that hypokalemia serves as the trigger for a cytokine storm. So spironolactone has a real chance to reduce the risk of this dangerous complication. But the main thing, in my opinion, is that lowering the level of potassium in the body is extremely harmful to the heart and triggers life-threatening rhythm disturbances, increasing the risk of sudden death. We, like all others, replenished potassium with droppers, but it was more effective to retain it in the body with the help of spironolactone.


Men certainly get worse than women;  the elderly are heavier than the young;  overweight people are heavier than patients without excess weight Photo: Ivan MAKEEV

Men certainly get worse than women; the elderly are heavier than the young; overweight people are heavier than overweight patientsPhoto: Ivan MAKEEV

WHEN PRESCRIBED PATIENTS

– Yana Arturovna, how many patients did you have on average?

– About 10 – 14 days. But someone and 50 days.

– Have you noticed signs by which it can be assumed that the disease in the person brought is likely to go the hard way?

– Such studies were carried out in the world, our clinical practice confirmed them. Men certainly get worse than women; the elderly are heavier than the young; overweight people are heavier than overweight patients. Men with a classic male type of baldness, a lot of facial hair, we can say brutal men get sick harder.

– Under what conditions did you discharge patients?

– We acted as close as possible to the recommendations Ministry of Health: so that the temperature for three days was not higher than 37.5 degrees; so that C-reactive protein (an indicator of inflammation) is lower than 10 mg / l, and saturation, that is, the level of oxygen in the blood, is higher than 96%.

“HEAD OF EPIDEMIOLOGY DEPARTMENT OF ITSELF WORKED AT SANPROPUSNIK”

– How often do you get sick doctors and nurses?

– In the first month no one got sick at all. We have a very powerful epidemiological service. The head of the sanitary-epidemiological department, a senior researcher, correctly organized the whole process, and for the first two weeks she personally worked in the sanitary inspection room at the exit from the “red zone” and helped doctors and nurses who were exhausted after the shift safely remove protective clothing.

Then both people’s fatigue and viral load accumulated. By the middle of the second month, sick people began to appear. There were no seriously ill patients. We treated part of the staff in our observation, part of it was treated at home. In total, 18 people were infected from the medical staff (less than 10%).

– Doctors take something for prevention? Vitamins C, D, Zinc?

– I saw the recommendations of American nutritionists, they speak out positively about taking zinc, melatonin and vitamin C. There were somewhat conflicting data on vitamin D. But we did not give any such recommendations to our employees. We have all the prevention was associated with minimizing contacts and other measures of epidemiological safety.

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In Russia, 6852 new cases of coronavirus infection and 188 deaths were detected per day

The incidence of coronavirus in Russia is gradually decreasing: for several days in a row, less than 7 thousand new cases have been detected per day. The total number of infected in the Russian Federation exceeded 627 thousand people. As for the victims of the epidemic, the country has nearly 9 thousand deaths among patients with COVID-19.

Despite the decrease in the number of cases of coronavirus infection, a new surge in incidence may soon occur in Russia. According to the Russian virologist Mikhail ShchelkanovThis will happen in two weeks. The specialist noted that now the increase in incidence is recorded in Europe, and this trend will affect Russia. In his opinion, a major outbreak will affect several large cities – Moscow, St. Petersburg, Nizhny Novgorod and Vladivostok. In order to avoid a new jump in the incidence rate, according to Schelkanov, the borders should remain closed.

We give brief statistics on the distribution of coronavirus in Russia:

  • Over the last day in Russia revealed new cases – 6852 (6800);
  • The total number of cases of infection over the entire period is 627,646 (620,794);
  • The total number of deaths in Russia over the entire period is 8969 (8781);
  • Died in the last day – 188 (176);
  • The incidence in Moscow: 219 354 (218 604) – for the whole time, 750 (813) – for the last day;
  • The total number of patients with coronavirus recovered in Russia is 393 352 (384 152).
  • Russian Deputy Prime Minister Tatyana Golikova took the initiative to establish long-term follow-up for patients who had been ill with coronavirus. She noted that the consequences of the disease have not yet been studied, and it is important to pay attention to the associated risks. Among them, she called the exacerbation of coronary heart disease, hypertension, lung disease, acute diseases of the cardiovascular system of an autoimmune nature, myocarditis and other diseases.

    The Federal Tourism Agency has published a list of restrictive measures that are currently in force for tourists entering foreign countries. Some of them have a two-week quarantine for travelers. There are also countries where a medical certificate is required to cross the border stating that the bearer passed a negative coronavirus test.

    In order for collective immunity to coronavirus to take shape in Russia, about 70 million doses of the vaccine are needed. At the moment, the drugs are in the testing phase.

    World situation

    According to Johns Hopkins University, the number of cases of coronavirus infection in the world has reached 9,801,958 – this is data for all countries since the outbreak. The United States (2.468 million), Brazil (1.275 million), Russia (627.7 thousand), India (508.9 thousand) and the United Kingdom (310.8 thousand) are in the top five in the number of cases of infection.

    Johns Hopkins University has 494,180 deaths. The United States (125.0 thousand), Brazil (55.9 thousand), Great Britain (43.5 thousand), Italy (34.7 thousand) and France (29.8 thousand) are the leaders in the number of deaths from coronavirus.

    Currently, a record daily increase in the incidence of coronavirus is recorded in the United States. Over the past day, more than 40 thousand new cases have been revealed there, and this trend is observed in states where some of the restrictive measures were previously removed.

    According to the President of the United States Donald Trump, the country has low mortality when compared with other states. At the same time, according to Johns Hopkins University, the States are in third place in the number of deaths per 100 thousand people and are second only to Spain and the UK.

    The European Medicines Agency has recommended authorizing the sale of Veklury for the treatment of pneumonia with COVID-19. The drug was used to treat Ebola. In Russia, he is currently undergoing clinical trials.

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    WHO warned of the second wave of the coronavirus epidemic in Europe :: Society :: RBC

    In the coming fall, European countries may face a new wave of the coronavirus epidemic, which needs to be prepared. This was stated by the head of the European Bureau of the World Health Organization Hans Kluge in an interview with the Daily Telegraph.

    According to Kluge, now in some European countries, including France, Great Britain and Italy, the epidemic has subsided, but the abolition of restrictions may be a hasty decision. At the moment, countries have “time for preparation, not celebration,” he said.

    Kluge noted that the second wave of the coronavirus epidemic could be complicated by coinciding in time with an outbreak of other diseases, such as flu or measles. “The pandemic has not ended,” Kluge emphasized, explaining that now countries must strengthen public health systems and build capacity in hospitals and primary and intensive care units.

    European and Asian countries start lifting pandemic restrictions

    Earlier, the Rospotrebnadzor warned about the second wave of the coronavirus epidemic in the fall. The department indicated that the incidence could decline with the onset of hot weather, but in the fall the disease could “return with a new force.” Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases of the United States, also spoke about the “inevitability” of the second wave.

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    The Prime Minister of Ukraine allowed the extension of quarantine for a new term :: Society :: RBC

    Earlier, Shmygal already admitted that quarantine would be extended after May 22, with the subsequent phased lifting of restrictions. The Prime Minister pointed out that in their decisions the Ukrainian authorities rely on WHO data.

    Restrictive measures in Ukraine due to the threat of coronavirus were first announced on March 11. March 25, the country’s Cabinet of Ministers introduced an emergency regime on the territory of the state. In Ukraine, bars, restaurants and cafes stopped working, and mass public events were banned. Rail and bus transport between cities was suspended, the Kiev metro temporarily stopped working. Ukraine also canceled all flights, including domestic flights.

    The World Bank will allocate Ukraine $ 150 million for social assistance and the fight against COVID-19

    On May 7, the country’s authorities extended the quarantine regime until May 22, but at the same time eased a number of restrictions. The government allowed the work of notaries, auditors, psychologists and dentists, opened museums and historical and cultural institutions, as well as a cafe with a summer terrace.

    It was also allowed to operate objects of trade and consumer services provided that staff and visitors comply with the recommended precautions, including restrictions on the number of visitors, social distance and wearing personal protective equipment.

    World Coronavirus Spread Rate

    Cases per day

    Source: JHU

    World Data i

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    Musk in Russian called the former US Secretary of Labor an idiot :: Business :: RBC

    The entrepreneur reacted to the remark of a former official who accused Musk of intent to “deprive people of work”. The head of Tesla previously threatened to move the company’s headquarters and future projects from California to another state

    The founder of the aerospace company SpaceX and the head of Tesla, Ilon Musk, on his Twitter in Russian called idiot of former US Secretary of Labor Robert Reich (he held this position from 1993 to 1997). Later mask apologized and added: “I wanted to say: a boring idiot.”

    So the entrepreneur commented on Reich’s statement that Musk intends to “deprive people of work if he is not allowed to risk their health.” “Capitalism is at its worst,” the ex-minister said.

    We are talking about the promise of Mask to move Tesla’s headquarters and all of the company’s new projects from California to another state. Earlier this week, State Governor Gavin Newsome allowed businesses that were shut down due to the coronavirus pandemic to resume work, but said local authorities could extend restrictive measures if necessary. In Alameda County, where the Tesla plant is located, self-isolation was extended until the end of May.


    Musk threatens to relocate Tesla headquarters from California

    Musk said that this decision is contrary to “constitutional freedoms and, in principle, common sense,” Tesla has already appealed against it in court. Answering questions from Twitter users, the entrepreneur called Alameda’s claims “the last straw” and noted that the company could move to Texas or Nevada.

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    In Moscow, the number of victims with coronavirus exceeded 900 people :: Society :: RBC

    Over the past 24 hours, another 39 patients have died in the capital. All had pneumonia.

    Photo: Alexander Scherbak / TASS

    In Moscow over the past day, 39 patients died due to the coronavirus COVID-19. Thus, the number of victims reached 905. This is reported by the operational headquarters for the fight against infection.

    “In Moscow, 39 patients died with confirmed pneumonia and a positive result for coronavirus,” the report said.

    Sobyanin promised to open cafes and bars in Moscow in the “last resort”

    Photo: Sergey Savostyanov / TASS

    Moscow is in first place in Russia in terms of the number of infected and dead due to coronavirus. Over the past 24 hours, the majority of new infections (5858 out of 10,559) and who died (50 out of 89) in the country were detected in the capital. Since the beginning of the epidemic in Moscow, nearly 86 thousand people have been infected.

    In general, almost 166 thousand cases of infection were registered in Russia, more than 1.5 thousand deaths. 21.3 thousand patients were cured.

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    Trump has adjusted the forecast for mortality from coronavirus in the US :: Society :: RBC

    The President believes that from 75 thousand to 100 thousand people can die from coronavirus in the country. Prior to this, he several times voiced different expectations for mortality

    Photo: Brian Snyder / Reuters

    From 75 thousand to 100 thousand people can become victims of coronavirus in the United States, said President Donald Trump, reports Reuters. Earlier, the head of state changed the expected number of deaths several times.

    “It’s horrible. We must not lose a single person over this amount, ”the president said.

    In early April, the White House presented its first official forecast for the number of expected deaths from coronavirus. Then the experts said that the United States could lose from 100 thousand to 240 thousand people in the event that the restrictions imposed by the authorities are respected. Experts also said that in case of unfavorable development of the situation, the number of victims could reach 2.2 million people. This will happen, they noted, if nothing is done to combat the spread of infection.

    Trump has changed the estimate of the possible number of victims of COVID-19 in the United States

    Photo Credit: Alex Brandon / AP

    Later, in mid-April, Trump announced the new expectations of the US authorities – according to him, the number of people dying from coronavirus will be “significantly” less than 100 thousand. He noted that he managed to reduce the expected number of deaths due to the country’s aggressive policy to save lives and noted positive dynamics in the situation with morbidity.

    .

    Doctors compared mortality of COVID and other infections

    On the page of the doctor and TV presenter Alexander Myasnikov interesting information about the situation with infectious diseases in the world was published on the social network. And in particular that rotavirus infection causes hundreds of thousands of deaths per year in the world. Is the familiar and familiar rotavirus more dangerous than the coronavirus? “KP»Understands together with the immunologist, expert in public health and international health care, candidate of medical sciences Nikolay Kryuchkov.

    – Of course, in addition to COVID-19, there are many other dangerous diseases in the world and these are not necessarily infectious diseases. Let me remind you that mortality from cardiovascular diseases is in the first place, also high mortality is associated with oncological diseases, in particular, lung cancer, and, of course, infectious diseases are also often the cause of death. However, the threat of rotavirus infection today is greatly exaggerated, said Nikolai Kryuchkov.

    How many people die from rotavirus?

    According to pessimistic estimates provided by the World Health Organization, around the world in 2013, 215 thousand children under the age of five died from rotavirus infection. According to other data obtained in international studies, this is 122 thousand deaths in 2013.

    – The situation since 2013 in terms of mortality from rotavirus infection has not changed much. I think here we can talk about 200 thousand deaths per year among children under five years of age. Half of the world’s deaths occur in five countries: India, Pakistan, Nigeria, Angola and Congo– emphasizes the immunologist Nikolai Kryuchkov. – In the media you can often find information that up to a third of deaths of children under five are caused by rotavirus. This is not true! The fact is that among all deaths of children under five years of age in the world, mortality from diarrhea accounts for about 8%, but among these 8% of deaths from diarrhea – from 25% to 30% are attributable to rotavirus. That is, it turns out about 200 thousand deaths of children under five years of age per year in the world, while more than 6 million children under five die in the world per year.

    On the page of the doctor and TV presenter Alexander Myasnikov on the social network, interesting information was published on the situation with infectious diseasesPhoto: Ivan PROKHOROV

    Is rotavirus disease relevant for Russia?

    If you consider Europeyy region to which Russia, then the figures for mortality from diarrhea are lower than in developing countries. Mortality from diarrhea among children under five in Europe is 4% – 5% of all childhood deaths. About a quarter of them are rotavirus.

    In Russia, according to WHO estimates, in 2013, 52 children under the age of five died from rotavirus infection, which is 0.3% of all other deaths of children under five years of age. Rotavirus infection is not the most common cause of death among children, and even more so among adults (the latter rarely die from rotavirus, so all statistics are data on the death of children – approx. Ed.).

    – Rotavirus is a problem primarily in poor countries with a warm climate. For Russia, this is also a problem, but to a much lesser extent, ”said Nikolai Kryuchkov, a doctor. – It is important to emphasize that effective and safe rotavirus vaccines exist.

    The incidence of rotavirus infection after the introduction of vaccination has decreased many times. In Russia, universal vaccination against rotavirus is not carried out, but, despite this, mortality is low, given that it is clear how to help such patients. The main thing here is replenishment of lost fluid and symptomatic therapy. Given these two factors — the availability of a vaccine and the development of affordable treatment — mortality from rotavirus is very low even among children from zero to five years old, not to mention adults. Among adults, these are isolated cases.

    Who is worse: rotavirus or coronavirus?

    According to epidemiologists, mortality (taking into account the number of deaths from the number of episodes of the disease) of rotavirus infection in the world is from 0.05% to 0.09%. This is comparable to mortality from seasonal flu. Yes, in the poorest countries it can reach up to 2%. However, in this case, only moderate to severe episodes are taken into account, and not all cases of rotavirus infection.

    “With coronavirus infection, according to my most optimistic forecasts, the mortality rate in the world will be 2%,” says Nikolay Kryuchkov. – Let me remind you that now the mortality rate from COVID-19 in Russia is about 4%. AT Germany – 3.5%, and this is one of the best examples in Europe. Of course, a lot depends on how the data are kept and analyzed, but even though there are probably unaccounted cases, the mortality from coronavirus infection is much higher than the mortality from rotavirus. And the epidemic of coronavirus infection is still far from over.

    “It is also important to understand that we are having a coronavirus pandemic, and the situation with rotavirus is under control.” The number of deaths from coronavirus is now growing, due to the fact that there is an increase in cases of infection. The daily increase in new cases of coronavirus infection in the world is more than 5%, and in Russia today it is more than 8%. Therefore, it is obvious that the situation with rotavirus is stable, and the coronavirus pandemic for us is not known how it will end. The coronavirus infection pandemic continues to grow, it is important to understand this, ”Nikolay Kryuchkov emphasized in a conversation with“ KP ”. – When we talk about the number of deaths from rotavirus, 200 thousand people a year around the world among children under five years of age are deaths that happened in a year! As we know, the coronavirus epidemic lasts about four months. This is significantly less than a year.


    The daily increase in new cases of coronavirus infection in the world is more than 5%, and in Russia today it is more than 8% Photo: Ivan MAKEEV

    The daily increase in new cases of coronavirus infection in the world is more than 5%, and in Russia today it is more than 8%Photo: Ivan MAKEEV

    How many deaths from coronavirus infection will be in a year (given that, according to the data of May 3, 243,922 people died in the world – approx. Ed.)? Yes, there are other dangerous infections in the world, but many of them can be protected. This is Hepatitis B, and pneumococcal infection, tetanus, and so on. And Dr. Myasnikov rightly points out the need for widespread vaccination against the most dangerous and common infections. Unfortunately, there are no vaccines from COVID-19 yet, they will be ready by the spring of next year at best.

    Also, an important difference between the course of rotavirus infection and coronavirus infection: hospitalization with rotavirus disease in developed countries is very rare. All necessary treatment conditions can be provided at home. With coronavirus, the patient often needs active therapy, which can only be provided in a specialized medical institution.

    SPECIFICALLY

    Dr. Myasnikov gives such statistics on mortality from infections (in the world for a year)

    Measles (there is a vaccine) – 140 thousand deaths per year

    Pneumococcus (there is a vaccine) – 2 -2.5 million deaths per year

    Hepatitis B (there is a vaccine) – 650 thousand deaths per year

    Tetanus (there is a vaccine) – 89 thousand deaths per year

    Cervical cancer (there is a vaccine) – 250 thousand deaths per year

    Tuberculosis (there is a vaccine) – 1.5 million deaths per year

    Influenza (there is a vaccine) – 650 thousand-1 million deaths per year

    Coronavirus (no vaccine) – 244 thousand deaths from the beginning of the spread

    Coronavirus: myths and reality.The farther the coronavirus, the more truth and speculation around it. We tried to deal with the main myths about the Covid-19 pandemic

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    Is it possible to get sick with coronavirus twice, is it transmitted through water, and how do you understand that you are asymptomatic?

    We collected the most common questions of Russians and asked them to leading scientists (details)

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    Sobyanin: such a good feeling that we have reached the peak incidence of coronavirus

    Moscow Mayor Sergei Sobyanin said that perhaps the capital has reached the peak of the incidence of coronavirus. According to him, the situation with COVID-19 has stabilized. However, he believes that Moscow has gone only a quarter of the way.

    “The dynamics of the sick is known, it is published every day. And if you look day to day for the last days of 5, 6, 7, you get the feeling that the situation has stabilized. Every day 2.5-3 thousand sick. There is no such growth that today is 3, tomorrow is 5, then 6. There is such a good feeling that we have reached some threshold of incidence, at the peak, and only a decline awaits us, ”Mr. Sobyanin said on the air of the Russia 24 television channel (quote from RIA Novosti). The mayor believes that Moscow, at best, has gone a quarter of the way, and “there are still big challenges ahead.

    Mr. Sobyanin also said that now more than half of the hospital beds in the capital are occupied by coronavirus infected – about 17 thousand. According to him, these are patients whose condition is assessed as moderate, severe or especially severe. “These are not some invented people who were going to lie down,” the mayor said.

    On the fight against coronavirus in Moscow, in Kommersant’s article, “Quarantine went on holiday.”

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    WHO estimates possible timelines for easing restrictions due to the virus in Russia :: Society :: RBC

    Photo: Sergey Kiselev / AGN “Moscow”

    The mitigation of restrictive measures introduced in the framework of the fight against coronavirus in Russia is possible after two weeks if the growth rate of the number of infected people decreases during this period. This was stated by the representative of the World Health Organization (WHO) in Russia Melita Vujnovic during a round table on the theme “Recognize and defeat COVID-19: diagnostic tactics and ensuring treatment accessibility,” reports TASS.

    “I am very glad that we have seen a decrease in the growth rate over the past ten days, and today in Moscow we have seen a significant decrease in infections,” said Vujnovic. According to her, in the next two weeks it is necessary to “very carefully” monitor the development of the situation and in the case of positive dynamics, we can begin to gradually ease the restrictions.

    Popova announced a decrease in the growth rate of the incidence of COVID-19 in Russia

    Photo: Andrey Nikerichev / AGN “Moscow”

    Earlier on April 29, the head of Rospotrebnadzor Anna Popova announced a decrease in the rate of incidence of coronavirus in Russia. According to her, now the daily increase in infections in the country is 7-8%. The Governor of the Moscow Region, in turn, said that the region reached a plateau in the number of patients with COVID-2019. According to him, the daily increase in new cases of infection in the suburbs is at the level of 5-7%.

    In total, in Russia, according to the operational headquarters, 99.3 thousand cases of coronavirus infection were recorded, more than 10 thousand people recovered, 972 died.

    Coronavirus

    Russia Moscow Peace

    0 (per day)

    Recovered

    0

    0 (per day)

    Infected

    0

    0 (per day)

    Died

    0 (per day)

    Recovered

    0

    0 (per day)

    Infected

    0

    0 (per day)

    Died

    0 (per day)

    Recovered

    0

    0 (per day)

    Infected

    0

    0 (per day)

    Died

    Source: JHU,
    federal and regional
    anti-virus operations

    Source: JHU, federal and regional anti-virus operations

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