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    Novichok nerve agent poisoning : the Alexej Nawalny Medical History

    On Aug 20, 2020, a 44-year-old man who was previously healthy suddenly became confused and began to sweat heavily on a domestic flight in Russia approximately 10 min after departure; he vomited, collapsed, and lost consciousness. After an emergency landing, the man was admitted to the toxicology unit of a local hospital in Omsk, Russia, approximately 2 h after symptom onset. According to the discharge report, the patient presented comatose with hypersalivation and increased diaphoresis and was diagnosed to have respiratory failure, myoclonic status, disturbed carbohydrate metabolism, electrolyte disorders, and metabolic encephalopathy.

    Novichok nerve agent poisoning

    Therapeutic measures included intubation, mechanical ventilation, and unspecified drugs for symptom control and neuroprotection. On Aug 22, 2020, the patient was transferred by a German air ambulance to the Charité-Universitätsmedizin Berlin at the request of his family. Severe poisoning with a cholinesterase inhibitor was subsequently diagnosed. 2 weeks later, the German Government announced that a laboratory of the German armed forces designated by the Organization for the Prohibition of Chemical Weapons (OPCW) had identified an organophosphorus nerve agent from the novichok group in blood samples collected immediately after the patient's admission to Charité, a finding that was subsequently confirmed by the OPCW. Here, we report clinical details of this case.

    Read the full artice on "The Lancet" (; free registration needed):