Clinical Manifestations Of COVID-19 Research Articles

Impact of IL-6 rs1800795 and IL-17A rs2275913 gene polymorphisms on the COVID-19 prognosis and susceptibility in a sample of Iranian patients

BackgroundFrom asymptomatic to acute and life-threatening pulmonary infection, the clinical manifestations of COVID-19 are highly variable. Interleukin (IL)-6 and IL-17A are key drivers of hyper inflammation status in COVID-19, and their elevated levels are hallmarks of the infection progression. To explore whether prognosis and susceptibility to COVID-19 are linked to IL-6 rs1800795 and IL-17A rs2275913, these single-nucleotide polymorphisms (SNPs) were assessed in a sample of Iranian COVID-19 patients. MethodsThis study enrolled two hundred and eighty COVID-19 patients (140 non-severe and 140 severe). Genotyping for IL-6 rs1800795 and IL-17A rs2275913 was performed using tetra primer-amplification refractory mutation system-polymerase chain reaction (tetra-ARMS-PCR). IL-6 and IL-17A circulating levels were measured using enzyme-linked immunosorbent assay (ELISA). Also, mortality predictors of COVID-19 were investigated. ResultsThe rs1800795 GG genotype (78/140 (55.7 %)) and G allele (205/280 (73.2 %)) were significantly associated with a positive risk of COVID-19 severe infection (OR = 2.19, 95 %CI: 1.35–3.54, P =.006 and OR = 1.79, 95 %CI: 1.25–2.56, P <.001, respectively). Also, rs1800795 GG genotype was significantly linked to disease mortality (OR = 1.95, 95 %CI: 1.06–3.61, P =.04). The rs2275913 GA genotype was protective against severe COVID-19 (OR = 0.5, 95 %CI: 0.31––0.80, P =.012). However, the present study did not reveal any significant link between rs2275913 genotypes with disease mortality. INR ≥ 1.2 (OR = 2.19, 95 %CI: 1.61–3.78, P =.007), D-dimer ≥ 565.5 ng/mL (OR = 3.12, 95 %CI: 1.27–5.68, P =.019), respiratory rate ≥ 29 (OR = 1.19, 95 %CI: 1.12–1.28, P =.001), IL-6 serum concentration ≥ 28.5 pg/mL (OR = 1.97, 95 %CI: 1.942–2.06, P =.013), and IL-6 rs1800795 GG genotype (OR = 1.95, 95 %CI: 1.06–3.61, P =.04) were predictive of COVID-19 mortality. ConclusionThe rs1800795 GG genotype and G allele were associated with disease severity, and INR, D-dimer, respiratory rate, IL-6 serum concentration, and IL-6 rs1800795 GG genotype were predictive of COVID-19 mortality.

Фізична реабілітація при коронавірусній інфекції та постковідному синдромі у санаторно-курортних установах України

This article is devoted to the problem of physical rehabilitation of patients who have suffered coronavirus infection and suffer from post-Covid syndrome. The authors consider the possibilities and advantages of physical rehabilitation in sanatorium and resort institutions of Ukraine in the context of updating physical and psychological health. The article highlights effective methods of physical therapy, physical education and rehabilitation procedures that help improve the condition of patients and improve the quality of life after infection with coronavirus. The results of the article may be useful for specialists in the field of medicine and rehabilitation, as well as for patients who are looking for optimal methods of recovery after COVID-19. Taking into account the restrictions providing for a quarantine regime and other measures to slow down the spread of viral infection, we examined exactly how they affected the sanatorium and resort institutions of Ukraine, because in a pandemic, any mass gatherings are dangerous to health due to the risks of spreading the infection. The actions and influence of viruses from the family were studied Coronaviridae and their mode of transmission. The clinical manifestations of COVID-19, its spread, forms and possible complications are analyzed. Statistics are provided on the number of patients and deaths among them. To date, it has not yet been clarified why patients continue to experience symptoms after treatment, so this condition has been called post-Covid syndrome. The symptoms of post-Covid syndrome, its prerequisites, course and impact are described. Rehabilitation methods that can be used for COVID-19 and post-Covid syndrome are presented. The direction of therapeutic physical culture is characterized as a means that can be started in the first stage of rehabilitation. The feasibility of using massage, physiotherapy and hydrotherapy in combination with exercise has been proven. It has been established that Ukraine has good climatic and natural resource potential, which stimulates the development of the sanatorium and resort industry. The problems of recreation that lead to damage in the health resort industry and threaten its existence are examined. It is proposed to pay attention to the need for resorts, sanatoriums, boarding houses and other health institutions, where rehabilitation for coronavirus infection and post-Covid syndrome will help patients speed up recovery and shorten the period of incapacity.

Pediatric Multisystem Inflammatory Syndrome (MIS-C) associated with Covid-19 culminating in multiple complications: A case report

On January 30, 2020, the World Health Organization (WHO) declared a Public Health Emergency of International Concern, due to the novel coronavirus 2019 (definitively named on February 12, 2020 as COVID-19). Initially, Covid-19 infection did not appear to affect the paediatric population, with few reported cases, negligible morbidity, and mortality, and generally asymptomatic. However, subsequently, the English National Health System (NHS) issued an alert about new clinical manifestations of COVID-19 in children, which may be temporarily linked to a previous SARS-CoV-2 infection and determined by history of exposure, serology, or viral detection by RT-PCR, described as a paediatric multisystem inflammatory syndrome temporally associated with SARS-COV-2 (MIS-C). This paper reports the case of a 3-year-old and 6-month-old male patient, neuropathic, microcephalic, epileptic who sought medical attention with persistent fever and abdominal pain. Laboratory tests showed myositis, hepatitis, pancreatitis, positive PCR, elevated D-dimer and serology for covid-19 with non-reactive IgM and reactive IgG, thus meeting the diagnostic criteria for MIS-C. As for its prognosis, MIS-C is a dangerous and potentially fatal disease. The estimated mortality rate for MIS-C is between 0% and 5.3%, which is considered low but much higher than the overall mortality rate for children with COVID-19 (0.09%). Treatment depends on the severity of the disease, the risk of complications, and the possibility of follow-up, with most patients requiring hospitalization.

Cardiovascular imaging in COVID-19: insights into features and complications

The clinical manifestations of COVID-19 which mainly involve the respiratory system may however affect also cardiovascular system. There are a lot and still increasing numbers of reports revealing cardiovascular complications of COVID-19, which may occur in the acute phase as well as during longer follow-up period. The most clinically important diseases include: pulmonary embolism (PE), myocarditis, and acute coronary syndromes (ACS) as well as arrhythmias with the very common atrial fibrillation (AF) and pericarditis. In this review, we present cardiac imaging options in patients with and after coronavirus infection, showing potential utility for expanding and improving the full and accurate diagnosis of potential complications. We considered echocardiography, magnetic resonance imaging, and computed tomography (CT) in turn, highlighting their best advantages in patients affected by COVID-19.

CO-INFECTION WITH COVID-19 AND GENETIC DIVERSITY OF SARS-COV-2 IN CHILDREN

In the pediatric population, coronavirus infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is more commonly observed in asymptomatic and moderately symptomatic cases. However, when COVID-19 coexists with other infections, it can result in a more severe disease progression. Various subtypes of the SARS-CoV-2 virus are associated with different clinical presentations, with certain subtypes exhibiting a predominance of specific symptoms or manifestations. Clinical manifestations of COVID-19 in children, both during the acute phase of the disease and in the post-COVID-19 period, are not fully understood and different compared to adults. This article presents four clinical cases in which PCR-confirmed COVID-19 was observed in combination with infections caused by viruses such as Ebstein-Barr, varicella, and rotavirus. The severity of the disease in these cases was attributed to symptoms related to intoxication, as well as skin and intestinal syndromes. To understand important genomic signatures of SARS-CoV-2 virus circulating in the area, the genome-wide sequencing was performed for the SARS-CoV-2 samples isolated from nasopharyngeal swabs collected from four patients. Based on the genotyping results, all four samples were found belonging to the SARS-CoV-2 virus Omicron lineage. Three months after the initial testing, follow-up evaluations of the children indicated a higher likelihood of complete recovery. However, some underlying disease manifestations, including anemia and atopic dermatitis, persisted despite the resolution of COVID-19 symptoms.

HLA class I associations with the severity of COVID-19 disease in the United Arab Emirates.

SARS-CoV-2 appears to induce diverse innate and adaptive immune responses, resulting in different clinical manifestations of COVID-19. Due to their function in presenting viral peptides and initiating the adaptive immune response, certain Human Leucocyte Antigen (HLA) alleles may influence the susceptibility to severe SARS-CoV-2 infection. In this study, 92 COVID-19 patients from 15 different nationalities, with mild (n = 30), moderate (n = 35), and severe (n = 27) SARS-CoV-2 infection, living in the United Arab Emirates (UAE) were genotyped for the Class I HLA -A, -C, and -B alleles using next-generation sequencing (NGS) between the period of May 2020 to June 2020. Alleles and inferred haplotype frequencies in the hospitalized patient group (those with moderate to severe disease, n = 62) were compared to non-hospitalized patients (mild or asymptomatic, n = 30). An interesting trend was noted between the severity of COVID-19 and the HLA-C*04 (P = 0.0077) as well as HLA-B*35 (P = 0.0051) alleles. The class I haplotype HLA-C*04-B*35 was also significantly associated (P = 0.0049). The involvement of inflammation, HLA-C*04, and HLA-B*35 in COVID-19 severity highlights the potential roles of both the adaptive and innate immune responses against SARS-CoV-2. Both alleles have been linked to several respiratory diseases, including pulmonary arterial hypertension along with infections caused by the coronavirus and influenza. This study, therefore, supports the potential use of HLA testing in prioritizing public healthcare interventions for patients at risk of COVID-19 infection and disease progression, in addition to providing personalized immunotherapeutic targets.

Role of Interleukin 6 as Predictive Factor for the Severity of COVID 19

Abstract Background Covid-19 is a disease with high morbidity and mortality among elderly residents of long-term care facilities (LTCF). During an outbreak of SARS-CoV-2 infection in the LTCF an effective screening tool is essential to identify the patients at risk for severe disease. Excessive interleukin-6 signaling is a key factor contributing to the cytokine release syndrome implicated in clinical manifestations of COVID-19. Aim of the Work To determine the Role of interleukin 6 as predictive factor for the severity of Covid-19. Patients and Methods This was Case Control study, conducted at Abassia Fever hospital and El Demerdash University Hospital on 75 participants (50 patients with Covid-19 disease manifestation and 25 controls) during a period of 6 months. Results There was no statistically significant difference between cases with less than 50% and more than 50% lung affection among mild cases groups as regard serum IL-6. Conclusion The concentration of IL-6 &amp;gt; 24 pg/mL at initial assessment predicted the development of hypoxemia requiring hospitalization with excellent sensitivity and good specificity. IL-6 appears as a potential predictor for the development of the severe Covid-19 and might serve for early identification of patients in need of hospitalization. Further studies are needed to evaluate the robustness of the use of IL-6 as an effective screening tool for the severe course of Covid-19.

COVID-19 and post-covid syndrome in patients with rheumatoid arthritis

Objective: to study the course of COVID -19 and post-covid syndrome (PCS) in patients with rheumatoid arthritis (RA).Material and methods. The study included 32 adult patients with a confirmed diagnosis of RA, who met ACR/EULAR criteria. All patients had COVID-19. Material for analysis was obtained by means of a questionnaire developed at the V.A. Nasonova Research Institute of Rheumatology, which patients completed during their interview with the researcher.Results and discussion. The study group consisted mainly of women (n=29, 90%). The mean age of the patients was 50.75±16.48 years. Among the clinical manifestations of COVID-19, weakness/fatigue (90.6%; p&lt;0.0001), fever (71.9%; p=0.0005) and anosmia (62.5%; p=0.045) were significantly more common. Almost half of the patients had dysgeusia (59.4%), increased arthralgia (53.1%), dyspnea on exertion (50%), and cough (46.9%). A significant positive association was found between increased arthralgia during COVID-19 and RA activity (r=0.72; p&lt;0.05). Hospitalisation was required in 37.5% of patients with COVID-19. In 12.5% of cases, COVID-19 progressed with complications. Patients with higher RA activity were more likely to have an increase in arthralgia as a symptom of infection. PCS was registered in 47.8% of patients who underwent COVID-19. Retrospective evaluation of patients with PCS revealed a higher rate of hospitalisation in infectious disease departments and a more severe course of COVID-19. Subsequently, repeated cases of COVID-19 were more common in this group.Conclusion. Risk assessment of PCS development is necessary to appropriately distribute the burden on the health care system and to develop a strategy for prevention, timely diagnosis, and treatment of this syndrome in patients with rheumatic diseases. To achieve this goal, new studies in a larger cohort of patients with RA and rheumatic diseases in general are needed.

Characteristic of upper respiratory tract microbiota in severe covid-19 adult patients in Indonesia

Introduction: Nowadays, new cases of COVID-19 have been found with severe cases and deaths. The upper respiratory microbiota has been associated with susceptibility to viral infection and disease severities. However, the association of respiratory tract microbiota with the modulation of COVID-19 outcomes still raises a question. Therefore, we examined the association between the diversity of upper respiratory microbiota and clinical manifestations of COVID-19. Methods: This research is an observational cross-sectional study. We characterized the microbiota in the upper airway using the 16S ribosomal RNA sequencing method in 74 COVID-19 patients aged 18-64 years. We also examined the association between COVID-19 severities with alpha and beta diversity of upper respiratory microbiota. The alpha and beta diversity was analyzed by QIIME and shown by R software, AMOVA and MRPP testing was done with R software. The t test and diagrams were performed using R software. Bivariate analysis was carried out by t-test and Chi-square test. Results: The top five phyla in the upper respiratory tract of Indonesian COVID-19 patients with age 18-64 years old were Firmicutes (32,3%), Bacteroidota (27,1%), Fusobacteriota (15,2%), Proteobacteria (15,1%) and Actinobacteria (7,1%). Shannon and ACE index analysis showed no decline of microbiota diversity in the upper airway with increased disease severity. However, there were significant beta diversity differences in the upper airway microbiota between mild and severe COVID-19. The Firmicutes phylum and Oribacterium genus abundance were significantly higher in severe COVID-19 than in mild. The quantity of the Fusobacteriota phylum, Neisseria, and Fusobacterium genera was significantly higher in mild COVID-19 than in severe. Conclusion: Our research supports the relationship between the severity of COVID-19 and the diversity of the microbiota in the upper airway in adults. Further studies are needed to examine how microbiota prevents COVID-19 severities.

How do orphan disease patients live during the pandemic of Omicron variant? A nationwide survey of spinal muscular atrophy patients in China

ObjectivesTo investigate the challenges of patients with spinal muscular atrophy (SMA) during the Omicron variant COVID-19 pandemic. DesignA cross-sectional survey was conducted in China from January 02, 2023, to January 12, 2023, using a questionnaire that covered three aspects: (1) Demographic information; (2) SMA-related information; and (3) COVID-19-related information. We recruited patients with SMA from 33 provinces. The prevalence, course, and clinical manifestations of COVID-19 were calculated. The relationships between independent and outcome variables were investigated. ResultsIn total, 677 patients (male: 349; female: 328) were included in this study (average age = 11.40 years); 534 (78.88%) suffered from COVID-19. The most common symptoms were fever (95.51%), cough (57.87%), and sputum (49.44%). Of the infected patients, 91.57% recovered with at-home care, and 8.43% were hospitalized; 1.31% were admitted to the intensive care unit (ICU). A positive correlation was observed between the SMA severity and hospitalization rate. The ICU stay rate in patients with SMA type I was significantly higher than that in other SMA types. ConclusionThis is the first large sample survey to timely reveal the living situation of patients with SMA during the COVID-19 pandemic's Omicron variant. Patients with SMA type I should be paid more attention in terms of hospitalization and ICU stay.

Prevalence of symptoms, comorbidities, and reinfections in individuals infected with Wild-Type SARS-CoV-2, Delta, or Omicron variants: a comparative study in western Mexico.

The variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been classified into variants of interest (VOIs) or concern (VOCs) to prioritize global monitoring and research on variants with potential risks to public health. The SARS-CoV-2 high-rate mutation can directly impact the clinical disease progression, epidemiological behavior, immune evasion, vaccine efficacy, and transmission rates. Therefore, epidemiological surveillance is crucial for controlling the COVID-19 pandemic. In the present study, we aimed to describe the prevalence of wild-type (WT) SARS-CoV-2 and Delta and Omicron variants in Jalisco State, Mexico, from 2021 to 2022, and evaluate the possible association of these variants with clinical manifestations of COVID-19. Four thousand and ninety-eight patients diagnosed with COVID-19 by real-time PCR (COVIFLU, Genes2Life, Mexico) from nasopharyngeal samples from January 2021 to January 2022 were included. Variant identification was performed by the RT-qPCR Master Mut Kit (Genes2Life, Mexico). A study population follow-up was performed to identify patients who had experienced reinfection after being vaccinated. Samples were grouped into variants according to the identified mutations: 46.3% were Omicron, 27.9% were Delta, and 25.8% were WT. The proportions of dry cough, fatigue, headache, muscle pain, conjunctivitis, fast breathing, diarrhea, anosmia, and dysgeusia were significantly different among the abovementioned groups (p < 0.001). Anosmia and dysgeusia were mainly found in WT-infected patients, while rhinorrhea and sore throat were more prevalent in patients infected with the Omicron variant. For the reinfection follow-up, 836 patients answered, from which 85 cases of reinfection were identified (9.6%); Omicron was the VOC that caused all reported reinfection cases. In this study, we demonstrate that the Omicron variant caused the biggest outbreak in Jalisco during the pandemic from late December 2021 to mid-February 2022 but with a less severe form than the one demonstrated by Delta and WT. The co-analysis of mutations and clinical outcomes is a public health strategy with the potential to infer mutations or variants that could increase disease severity and even be an indicator of long-term sequelae of COVID-19.

Features of the Immune Response in COVID-19

BACKGROUND This review is devoted to the analysis of the features of the immune response in COVID-19. The review indicates the clinical manifestations of COVID-19, modern data on the immunopathogenesis of the disease and its complications are considered.Aim of STUDY To clarify some pathogenetic mechanisms of the immune response in COVID-19, which can help in creating an algorithm for examining patients for early prognosis and prevention of severe course and complications of the disease.MATERIAL AND METHODS To achieve this goal, the results of domestic and foreign scientific studies on the pathogenesis, diagnosis and treatment of COVID-19 were analyzed. The literature search was carried out in electronic search engines Scopus and PubMed. For the analysis, scientific articles published in the period from 2019 to 2021 were selected; 88% of analyzed works are not older than 5 years.CONCLUSION The late production of type I IFN, an increase in the level of pro-inflammatory monocytes, a decrease in the expression of HLA-DR on monocytes, violation of the presentation of the virus and the formation of specific lymphocytes, the death of T-lymphocytes and profound immunosuppression are of greatest importance for the development of a severe form of COVID-19.

Risk factors and clinical manifestations of COVID-19 in pregnant women in Indonesia

Background/Aims Pregnant women are at higher risk for severe illness from COVID-19 than non-pregnant women. Research investigating risk factors and clinical manifestations of COVID-19 in pregnant women is limited in Indonesia. Therefore, this study's aim was to investigate these clinical issues. Methods For this observational cross-sectional study, data were collected from Merah Putih Government Hospital. A total of 106 medical records were analysed using descriptive statistics and Pearson's Chi-squared test, to examine differences in risk factors or clinical manifestations in pregnant women with or without COVID-19. Results There were no significant differences between the two groups in terms of risk factors such as diabetes, bronchial asthma and cardiovascular disease. There were significant differences between the groups for clinical manifestations of fever, cough, dyspnea, ageusia, rapid antigen test and lymphocytopenia. Conclusions Coordinated care strategies should be initiated, particularly in the assessment of vulnerable pregnant women. Future pandemic preparedness studies should be considered to improve and protect maternal and child health in Indonesia.

Infection Control Measures for SARS CoV-2 in Pediatric Wards During the COVID-19 Pandemic

&lt;p&gt;新冠病毒(SARS CoV-2) Omicron變異株於兒童族群感染具有高病毒量及高傳染性，且臨床症狀與其他秋冬常見之呼吸道病毒感染類似，加上兒童非藥物介入措施(non-pharmacological interventions, NPI)順從性及疫苗接種率低，若無適當之感管措施，容易於兒童病房中造成群聚感染。兒科病房COVID-19群突發事件常發生於社區流行高峰時期，可能造成住院之高風險兒童出現重症，亦可能引起醫護人員感染，並導致醫療照護人力不足。預防兒童病房COVID-19群聚感染，除包括全院規範之感染措施外，另須特別加強住院時病人全面篩檢、醫療人員個人防護裝備選擇（尤其是眼睛黏膜保護）、減少不必要的氣溶膠產生之醫療處置及加強環境清消。而一旦於病房發現確診個案，亦需在第一時間進行隔離措施、流行病學調查及健康管理。具風險因子之兒童若有必要應盡速給予抗病毒藥物治療，並注意重症之危險徵兆。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Compared with prior variants, the SARS-CoV-2 Omicron variant causes high viral loads and high infectivity in the pediatric population. However, the clinical manifestations of COVID-19 in children are similar to those caused by other respiratory viruses. Besides, poor non-pharmacological interventions (NPI) compliance and low vaccination coverage in the pediatric population also contributed to the magnitude of the COVID-19 outbreak in Taiwan. Outbreaks of COVID-19 in pediatric wards might spread to the rest of the community, contribute to severe symptoms in children with underlying comorbidities, and infect healthcare workers leading to inadequate healthcare staffing. In addition to universal infection control measures, the infection control bundle for COVID-19 in pediatric wards should include measures such as universal screening for SARS CoV-2 before admission, provision of proper personal protection equipment (especially eye protection) of healthcare workers, minimization of the unnecessary aerosol generation procedures, and enforcement of environmental sanitization. If a new COVID-19 case is detected in the ward, it should be epidemiologically investigated, and the patient should be immediately quarantined and monitored. Children with comorbidities should be prescribed antiviral treatment and receive close monitoring for severe manifestations of COVID-19.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Kelainan Neurologi akibat Kondisi Hiperkoagulasi pada Pasien Coronavirus Disease-19

Coagulopathy is one of the clinical manifestations of severe Coronavirus Disease of 2019 (Covid-19), and causes a poor prognosis of the disease. The clinical manifestations of Covid-19 have a broad spectrum, namely asymptomatic, non-specific mild symptoms (fever, dry cough, diarrhea), mild pneumonia, severe pneumonia (dyspnea, tachypnea, and impaired gas exchange), acute respiratory distress syndrome (Acute Respiratory Syndrome). Distress Syndrome/ARDS), Disseminated Intravascular Coagulation (DIC), sepsis, and multiple multiorgan dysfunction syndrome. Covid-19 patients experience a severe inflammatory state that causes an increase in the activation of the coagulation cascade, an increase in thrombin, and a hypercoagulable state, thereby increasing the risk of thrombosis in the blood vessels of the brain and spinal cord. Conditions such as old age, smoking, hypertension, diabetes, cardiovascular disease, chronic obstructive pulmonary disease, and malignancy can increase a patient's risk of experiencing a more severe degree of COVID-19 and higher mortality. The presence of Covid-19 complications such as thrombosis can affect the patient's prognosis and mortality

New coronavirus infection in patients with chronic non-communicable diseases in primary care

BACKGROUND: The pandemic of a new coronavirus infection, which began in the Chinese city of Wuhan in December 2019, has spread to more than 200 countries and territories. There are a number of studies, the results of which indicate that deaths are mainly registered among the middle-aged and elderly population with chronic non-communicable diseases. Most of these studies are based on the study of cases of COVID-19 with severe course or in hospitalized patients. At the same time, a greater number of patients, including those with chronic non-communicable diseases, carry COVID-19 to a mild degree and remain under the supervision of primary care physicians.&#x0D; AIM: To identify risk factors for the development of severe COVID-19 in patients with chronic non-communicable diseases who sought outpatient care during various periods of increased incidence of new coronavirus infection from March 2020 to February 2022.&#x0D; MATERIALS AND METHODS: The study was carried out on the basis of the Family Medicine Center of North-Western State Medical University named after I.I. Mechnikov, which provides primary health care to the population attached under compulsory health insurance. The design of the study was published earlier. A retrospective cohort study was conducted based on the analysis of outpatient records of patients who sought medical care at the Family Medicine Center during various periods of increased incidence of COVID-19: from 19.03.2020 to 30.06.2020 (group 1), from 1.10.2021 to 30.11.2021 (group 2) and from 18.01.2022 to 28.02.2022 (group 3).&#x0D; RESULTS: 343 patients were included in the study: 137 men (39.9%) and 206 women (60.1%). The number of patients with at least one chronic non-communicable disease was 232 (67.9%). It was found that the severity of COVID-19 is not affected by the presence of one or more chronic non-communicable diseases of mild severity in the patient. At the same time, grade II obesity and grade III hypertension are independent factors that significantly increase the risk of developing severe COVID-19 by 13.4 and 5.4 times, respectively (p 0.05). It should be noted that the combination of these diseases significantly increased the likelihood of developing severe COVID-19 by 11.9 times (p 0.05).&#x0D; CONCLUSIONS: Regardless of the period of morbidity, the clinical manifestations of COVID-19 in patients with chronic non-communicable diseases have their own characteristics: weakness, sweating, dry and wet cough are significantly more common (p 0.05). With each subsequent wave of increase in the incidence of COVID-19 in patients with chronic non-communicable diseases, there is a significant tendency to decrease the frequency of severe and very severe course of the disease, pneumonia and hospitalization, as in patients without chronic non-communicable diseases. It was found that the severity of the COVID-19 course is not affected by the presence of mild chronic non-communicable diseases in the patient. At the same time, grade II and higher obesity or grade III hypertension are independent factors that significantly increase the risk of developing severe COVID-19 by 11.9 and 5.4 times, respectively (p 0.05). The combination of these diseases significantly increased the probability of developing severe COVID-19 by 13.4 times (p 0.05).

ПАТОГЕНЕТИЧНІ АСПЕКТИ ПОСТ КОВІДНИХ УСКЛАДНЕНЬ У СИСТЕМІ ЗГОРТАННЯ КРОВІ

Disorders in the blood coagulation system play an important role in the pathogenesis and clinical manifestations of COVID-19 both during the acute phase of the disease and in the post-infectious period. The coronavirus disease is associated with a high risk of thrombotic and thromboembolic complications due to a prolonged state of hypercoagulation, which can occur even after recovery. Despite the extremely large amount of scientific data, the pathophysiological aspects of SARS-CoV-2 infection remain uncertain. The presented review summarizes the results of modern scientific research on pathological changes in the hemostasis system that can occur against the background of the transferred coronavirus disease, and considers the main mechanisms of the development of COVID-19-associated coagulopathies. From scientometric databases PubMed, Scopus, Web of science, ScienceDirect, Google Scholar, etc. the latest publications devoted to this issue were selected and analyzed. Hemostasis is a dynamic, tightly regulated process which is provided by three closely interrelated links: coagulation, anticoagulation, and fibrinolytic. Activation of the coagulation cascade and the platelet link of hemostasis, which causes a prothrombotic state in convalescent patients with COVID-19, is primarily associated with dysregulation of the renin-angiotensin system, a long-term local and systemic inflammatory reaction, an increase in the immune response due to the release of pro-inflammatory mediators that interact with platelets, stimulate the expression of tissue factor, suppress the fibrinolytic system and lead to dysfunction of the endothelial cells of blood vessels, triggering thrombogenesis. Understanding the pathogenetic mechanisms of post-COVID-19 complications and monitoring the main markers of hemostasis (level of D-dimer, fibrinogen, prothrombin time, platelet count, etc.) are important for the timely detection of disorders in the blood coagulation system, and make it possible, depending on the clinical situation, to take timely measures for their correction at various stages of pathology development.

Self-perception of cognitive sequels in post-COVID-19 individuals.

The aim of this study was to assess the self-perception of cognitive sequelae in post-COVID-19 individuals and identify whether there is a possible relationship between the outcome of the participants' self-perception and sociodemographic and clinical data. This is a cross-sectional study, carried out through an online questionnaire on the Google Forms platform, in which sociodemographic data, general health data, clinical manifestations of COVID-19, and post-COVID-19 self-perception of the cognitive domains of memory, attention, language, and executive functions were collected. The final sample consisted of 137 participants, and it was possible to identify that memory and attention were the domains with the highest impression of worsening post-COVID-19, followed by executive functions and language. In addition, it was identified that being female may be related to a worse self-perception of all cognitive functions and that having depression or other psychiatric diseases and obesity can significantly affect at least half of the cognitive domains evaluated. This study pointed to a post-COVID-19 cognitive worsening of the participants.

COVID-19's next top model

To date, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reportedly infected over 630 million people, leading to the deaths of more than 6.5 million people. Despite expansive investigation of its pathogenesis and the development of vaccines and therapeutics, research in preclinical models must continue to ensure that we can combat the continuing COVID-19 and future pandemics. Two exemplary animal models – Syrian golden hamsters and K18-promoter-driven human ACE2-expressing (K18-hACE2) mice – recapitulate the human pathology, immune response and clinical manifestations of COVID-19, and are also accessible with low cost. However, there are vast differences in the severity of disease in these models, with mild clinical manifestations in the hamsters and high lethality in the mice.Jeong and colleagues intranasally infected Syrian golden hamsters and K18-hACE2 mice with the same dose of SARS-CoV-2, resulting in mild clinical signs in hamsters, such as minor decreases in body weight, and severe manifestations in mice, leading to death by 7 days post-infection (dpi). The authors thoroughly interrogated the infection in these animals to elucidate the mechanisms behind the differing clinical outcomes. They used in situ hybridization imaging to show that SARS-CoV-2 infection was mainly confined to microvillar club (∼88%) and ciliated (∼12%) cell subsets in the bronchus region of hamsters. These infected cells were rapidly eliminated, with high levels of cell death apparent at 2 dpi. By 5 dpi, in the hamsters, the infected area was highly infiltrated with B and CD8+ T cells, which are important for clearing infected cells. Surprisingly, lung pathology was more severe in hamsters than in mice at 5 and 7 dpi, with imaging revealing markers of bronchioalveolar adenoma and bronchopneumonia in hamsters. However, after 7 dpi, pulmonary lesions and adaptive immune cell accumulation were ameliorated, with only regenerative hyperplasia apparent in the bronchus at 14 dpi. Overall, the initial robust immune response was key in limiting and resolving SARS-CoV-2 infection in hamsters.By contrast, SARS-CoV-2 primarily infected the alveolar area of mouse lungs, with type 1 alveolar cells comprising roughly 97% of total infected cells, and very few infected cells were eliminated. The infection also spread to distal organs, such as the spleen at 2 dpi and the brain at 7 dpi, which resulted in inflammatory cell death and histopathological damage in several organs. B and T cells progressively accumulated in the mouse lungs up until death at 7 dpi, but the extent of infiltration was much lower than that in hamsters at early time points. The deficient clearance of infected cells in the mice was potentially due to the lower levels of CD8+ T cells, which are associated with COVID-19 mortality in humans. Taken together, these results indicate that the pathology of SARS-CoV-2 infection in K18-hACE2 mice mimics severe COVID-19 in humans.COVID-19 pathology is highly variable in humans, and the mechanism behind this variability needs to be thoroughly explored to optimise prognosis and treatment. Direct comparison of these two integral disease models not only informs future research using animal models of COVID-19, but also provides comprehensive insights into variation in COVID-19 pathology.

Pan-neutralizing, germline-encoded antibodies against SARS-CoV-2: Addressing the long-term problem of escape variants.

Despite the initially reported high efficacy of vaccines directed against ancestral SARS-CoV-2, repeated infections in both unvaccinated and vaccinated populations remain a major global health challenge. Because of mutation-mediated immune escape by variants-of-concern (VOC), approved neutralizing antibodies (neutAbs) effective against the original strains have been rendered non-protective. Identification and characterization of mutation-independent pan-neutralizing antibody responses are therefore essential for controlling the pandemic. Here, we characterize and discuss the origins of SARS-CoV-2 neutAbs, arising from either natural infection or following vaccination. In our study, neutAbs in COVID-19 patients were detected using the combination of two lateral flow immunoassay (LFIA) tests, corroborated by plaque reduction neutralization testing (PRNT). A point-of-care neutAb LFIA, NeutraXpress™, was validated using serum samples from historical pre-COVID-19 negative controls, patients infected with other respiratory pathogens, and PCR-confirmed COVID-19 patients. Surprisingly, potent neutAb activity was mainly noted in patients generating both IgM and IgG against the Spike receptor-binding domain (RBD), in contrast to samples possessing anti-RBD IgG alone. We propose that low-affinity, high-avidity, germline-encoded natural IgM and subsequent generation of class-switched IgG may have an underappreciated role in cross-protection, potentially offsetting immune escape by SARS-CoV-2 variants. We suggest Reverse Vaccinology 3.0 to further exploit this innate-like defense mechanism. Our proposition has potential implications for immunogen design, and provides strategies to elicit pan-neutAbs from natural B1-like cells. Refinements in future immunization protocols might further boost long-term cross-protection, even at the mucosal level, against clinical manifestations of COVID-19.