Background: More than 750 million cases of COVID-19 have been reported worldwide. The respiratory system, particularly the lungs, is one of the main targets of SARS-CoV-2 infection. Although persistent pulmonary function abnormalities have been described in adults, evidence in pediatric populations remains limited and inconsistent. Children usually experience a milder course of COVID-19; however, the long-term impact of SARS-CoV-2 infection on respiratory function in this group is still unclear. Current studies report conflicting findings regarding persistent spirometric abnormalities and their relationship with disease severity and time since infection. Therefore, further research is needed to better characterize post-infectious respiratory sequelae in children and adolescents. The aim of this study was to evaluate spirometric abnormalities in a pediatric cohort following COVID-19 infection. Methods: This retrospective and prospective observational study included 109 children and adolescents aged 6–18 years with a history of asymptomatic, mildly symptomatic, or symptomatic COVID-19 infection. Spirometry was performed following recovery from infection, and pulmonary function parameters were analyzed according to clinical course and time since infection. Results: Spirometry was conducted at a mean of 4.3 ± 2.8 months after infection. Abnormalities in pulmonary function were identified in 23.85% of the study population, with reduced FVC being the predominant spirometric abnormality. No statistically significant association was observed between the severity of COVID-19 and spirometric impairments (p > 0.5). Abnormal spirometry findings were observed across all post-infection time intervals examined; however, no statistically significant differences were identified between the groups. Conclusions: Spirometric abnormalities, predominantly reduced FVC, were observed in a substantial proportion of pediatric patients following SARS-CoV-2 infection. Although no clinical predictors were identified, the absence of pre-infection measurements and a control group limits interpretation. Longitudinal studies are required to clarify the clinical relevance and persistence of these pulmonary function changes.

The COVID-19 pandemic has left many survivors with persistent respiratory symptoms such as dyspnea, chronic cough, and reduced exercise capacity. Fibrosis-like abnormalities on high-resolution CT are frequently reported in theses patient. This study aimed to describe the morphological pulmonary abnormalities identified on V/Q SPECT/CT after COVID-19 infection and to evaluate their functional consequences on regional ventilation and perfusion. We also sought to identify clinical predictors of abnormal V/Q SPECT/CT findings. This retrospective multicenter study was based on a national registry of patients referred for V/Q SPECT/CT because of persistent respiratory symptoms after COVID-19 infection. CT abnormalities were characterized using standard radiological criteria. Ventilation and perfusion were visually graded using a five-point scale. Clinical, demographic, and acute COVID-19 characteristics were analyzed to identify predictors of abnormal imaging. Among the 217 included patients (mean age 58 ± 15 years), 122 (56%) presented pulmonary abnormalities on V/Q SPECT or CT. The most frequent parenchymal abnormalities were reticulations, consolidations, atelectasis, emphysema, and ground-glass opacities. Emphysema, consolidations, and fibrosis were associated with the most severe impairments of both ventilation and perfusion. Age and pre-existing chronic lung disease were the strongest predictors of abnormal imaging, while a mild acute COVID-19 course without oxygen therapy was protective. V/Q SPECT/CT provides a comprehensive structural and functional assessment of long COVID pulmonary sequelae. It allows the differentiation between reversible inflammatory lesions and persistent structural abnormalities with lasting functional consequences.

BackgroundSince its emergence, the COVID-19 infection has led to significant morbidity and mortality worldwide. Early identification of patients at risk for severe disease is essential for more effective triage, timely therapeutic intervention, and optimal resource allocation. Differences in population characteristics may contribute to variability in disease outcomes, which emphasizes the need for regional-level data, especially from underrepresented regions. The main aim of this study was to identify the demographic, clinical, and laboratory predictors of severe COVID-19, defined as the need for oxygen therapy, in Lithuania.Materials and methodsWe conducted an ambispective observational cohort study at Vilnius University Hospital Santaros Klinikos in Vilnius, Lithuania, from March 2020 to December 2021. Adult patients with a confirmed diagnosis of COVID-19 and hospitalized longer than 24 hours were included in this study. Data were collected from the electronic medical records and patient interviews. To identify predictors of severe COVID-19 course, a multivariable binary logistic regression model was performed.ResultsAmong 495 patients, 52.9% were male, the median age was 55 years, and 61.2% had at least one underlying condition. The most common symptoms on admission were malaise (77.1%), subfebrile fever (65.9%), and cough (69.7%). CRP demonstrated the highest predictive value for severe COVID-19 (AUC = 0.84), followed by LDH (AUC = 0.80). Older age (OR 1.04 per year, 95% CI 1.00–1.08), obesity (OR 3.55, 95% CI 1.35–9.30), lymphopenia (OR 3.70, 95% CI 1.37–9.99), higher LDH (OR 1.008, 95% CI 1.00–1.01) and CRP (OR 1.021, 95% CI 1.01–1.04) levels were identified as the strongest predictors for severe COVID-19 disease course.ConclusionOlder age, obesity, lymphopenia, and higher CRP and LDH were associated with developing severe COVID-19 disease, indicating that combining patient history and laboratory parameters can provide a practical risk stratification approach to help clinicians identify high-risk patients early upon hospitalisation.

Background/Objectives: Secondary bacterial infections in subjects hospitalized with COVID-19 are associated with longer hospital stays and an increased risk of death. Thus, identifying the risk factors associated with bacterial complications in patients with SARS-CoV-2 infection is clinically important. Methods: We analysed the collected records of all adult patients diagnosed with an acute COVID-19 infection who were admitted to the Hospital for Infectious Diseases in Warsaw, Poland, between March 2020 and November 2021. Logistic regression models were used to identify factors associated with bacterial infections complicating the SARS-CoV-2 course. Results: The records of 1963 patients were analysed; 1128 (57.4%) of the patients were male, the median age of the cohort was 63 years (IQR: 50–74 years), and 202 patients (10%) died. A bacterial infection complicating the course of COVID-19 was diagnosed in 351 (18%) patients. In a multivariate logistic regression model the only factors identified as independently associated with an increased odds of bacterial infection were age (OR per decade: 1.21, p = 0.016), length of hospitalization (OR per day: 1.12, p < 0.001), and D-dimer concentration (OR per 500 units: 1.01, p = 0.048). Conclusions: Shortening the length of hospitalization of patients with COVID-19 can reduce the risk of bacterial infection complications, especially in elderly individuals. Coagulation system activation in COVID-19 patients increases the risk of a bacterial infection.

The aim of the study was to compare the key clinical features and course of SARS-CoV-2 infection between the local population of the Ternopil region and internally displaced persons (IDPs), to analyze the quality of life in both participant groups, and to determine the frequency and symptoms of long COVID. A cross-sectional study was conducted involving children with confirmed COVID-19 from September 2022 to May 2024. Clinical symptoms, COVID-19 severity, 25(OH)D and zinc levels, long COVID symptoms, and quality of life were compared between internally displaced and local populations using structured questionnaires and medical records. A total of 299 children with COVID-19 were included, consisting of 29 IDPs and 270 local population. Gastrointestinal symptoms were significantly more common among IDPs (P<.0001), while respiratory symptoms and severe fatigue predominated in the local population (P < .0001 and P=.0229, respectively). The IDPs experienced a more severe course of COVID-19 (P=.0141) and had a longer duration of hospital stay (P < .0001). Serum zinc levels were significantly lower in IDPs compared to local population (P=.0229). Assessment of quality of life demonstrated higher total, physical, psychosocial, and school functioning scores among IDPs, indicating a statistically better perceived health status. The overall frequency of long COVID did not differ between groups; however, its distribution varied by age: it was significantly higher in IDPs under 6 years (P=.0062), whereas among children ≥6 years, it was more common in the local population (P=.0092). Age-specific differences in long COVID symptom patterns were also observed between IDPs and local children. This study highlights the need to consider the impact of war, displacement, and chronic stress on the clinical presentation, timeliness of seeking care, and symptom reporting among children with COVID-19. Future efforts should focus on improving access to healthcare, health education, nutritional, and psychosocial support for displaced children to mitigate the combined negative effects of COVID-19 and war.

COVID-19 among patients with epilepsy: Clinical characteristics and outcomes in a large single-center cohort.

Many studies have shown that SARS-CoV-2 infection requiring hospitalization may result in myocardial damage, heart failure or cardiac arrhythmias, which leads to a severe course of the disease, worsens the prognosis, and is an independent risk factor for death. The study aimed to assess whether the COVID-19 severity affects the occurrence and type of cardiac arrhythmias among non-hospitalized patients without previous CVD in the early period after SARS-CoV-2 infection. The study included patients with no history of prior CVD who suffered from COVID-19 and were treated on an outpatient basis. Study subjects were divided into two groups based on the severity of their COVID-19 course. In the post-COVID period (average 12 ± 6weeks), patients underwent a standard 12-lead resting electrocardiogram (ECG) and a 24-h Holter monitoring. The analysis included 893 patients, among whom 25.2% had a severe course of COVID-19. Age (p = 0.02) and cardiac dysfunction [ejection fraction < 50% and/or contractile dysfunction on echocardiography (p = 0.01)] were associated with a higher risk of cardiac arrhythmias after COVID-19. The most commonly observed ECG abnormalities were prolonged QRS complex duration (p = 0.035) and the occurrence of supraventricular extrasystoles (p = 0.037). Multivariate regression analysis showed that independent risk factors associated with the occurrence of cardiac arrhythmias in non-hospitalized patients after COVID-19 include age, systolic and diastolic LV diameter, LA diameter, and the presence of at least one chronic disease. Based on the analysis of the obtained results, it was observed that the occurrence of cardiac arrhythmias in the early post-COVID-19 period among non-hospitalized patients without prior CVD does not depend on COVID-19 severity. However, identifying significant ventricular arrhythmias should prompt echocardiographic evaluation due to the high risk of left ventricular dysfunction.

BackgroundThe COVID-19 pandemic highlighted the need for novel biomarkers to identify patients at risk of developing severe disease. Circulating cell-free nucleic acids (cfNAs) are released from injured host cells or can be derived from pathogens. As cfNA is suggested to be a useful biomarker in oncologic, autoimmune, and other diseases, the aim of our study was to investigate the role of serum cfNA in predicting the course and outcome of COVID-19 disease.MethodsWe conducted a retrospective cohort study at Vilnius University Hospital Santaros Klinikos, utilizing serum samples collected upon admission and accompanying health information obtained from the Vilnius Santaros Klinikos Biobank. A total of 108 adult COVID-19 patients hospitalized between November 24, 2020, and November 10, 2021, and 24 healthy controls were enrolled. cfDNA concentration was measured using capillary electrophoresis. cfRNA was detected using quantitative real-time PCR.ResultscfDNA concentration was higher in COVID-19 patients compared with controls (4.28 vs. 0.51 ng/µL, p < 0.001) and increased with disease severity: from 1.06 ng/µL in mild to 2.65 ng/µL in severe, and 6.68 ng/µL in critical disease. cfDNA levels were higher in intensive care unit (ICU) patients (6.68 vs. 2.30 ng/µL, p < 0.001), patients requiring advanced respiratory support (ARS) (7.11 vs. 2.74 ng/µL, p < 0.001), and non-survivors (16.68 vs. 3.44 ng/µL, p < 0.001). cfDNA showed high predictive values for ICU admission (AUC 0.79), ARS (AUC 0.77), and lethal outcome (AUC 0.81), outperforming other routine biomarkers. In logistic regression analysis, cfDNA remained an independent predictor for ICU admission (OR 1.21, 95%CI 1.08–1.36), ARS requirement (OR 1.15, 95%CI 1.03–1.28), and in-hospital mortality (OR 1.08, 95%CI 1.02–1.14), while serum SARS-CoV-2 RNAemia remained an independent predictor of ARS requirement (OR 4.18, 95%CI 1.15–15.20).ConclusionsHigher serum cfDNA concentrations were independently associated with greater COVID-19 disease severity, increased likelihood of requiring intensive care, ARS, and in-hospital mortality. cfDNA demonstrated superior prognostic performance, surpassing established biomarkers. Serum SARS-CoV-2 RNAemia was associated with the need for ARS. This indicates that cfNAs may serve as clinically valuable biomarkers for early risk stratification and outcome prediction in COVID-19 patients. Further validation in independent cohorts is required to confirm generalizability.Clinical trial numberNot applicable.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12879-026-13305-7.

Placental Vulnerability to SARS-CoV-2: Viral Entry Pathways and Immune Activation.

Rationale: With the pandemic caused by SARS-CoV-2, accurate identification of patients at high risk for complications has become a key factor in ensuring positive treatment outcomes. A promising technique to facilitate such identification is the use of biomarkers that can predict complications and severity of COVID-19 course. Objective: The purpose is to evaluate the prognostic significance of various biomarkers in individuals with COVID-19 and to determine the value of developing standardized protocols for monitoring these indicators under pandemic conditions. Methods: For the analysis, we reviewed studies on the role of biomarkers such as C-reactive protein, D-dimer, ferritin, lactate dehydrogenase and troponins in predicting complications in patients with COVID-19. Sources used were international peer-reviewed journal publications, clinical trial results, and meta-analyses available in scientific databases. Results: Elevated levels of biomarkers such as C-reactive protein, D-dimer, ferritin, lactate dehydrogenase and troponins correlate with a high risk of acute complications, making them useful tools for monitoring. The common thresholds for assessing severity of illness will reduce data variability and improve comparability of results between healthcare providers. Conclusion : The data highlights the importance of biomarkers for monitoring patients with COVID-19 and the need to develop standardized protocols to improve prognostic accuracy. Prospects for the use of biomarkers in adaptive critical care and resuscitation are important means to optimize patient outcomes and further research.

COVID-19 infection caused by SARS-CoV-2 poses a particular risk to pregnant women and may complicate the course of pregnancy and delivery. To investigate the clinical features of COVID-19 and obstetric outcomes in pregnant women hospitalized in healthcare facilities of Osh region. A retrospective analysis of medical records of 113 pregnant women with laboratory-confirmed SARS-CoV-2 infection who were hospitalized in 2020 was conducted. Clinical course of COVID-19, obstetric complications, delivery methods, and pregnancy and delivery outcomes were evaluated. Descriptive statistics were used. In the majority of patients, the disease was mild to moderate; however, severe COVID-19 was associated with the development of obstetric complications. The most common pregnancy complications included false labor, threatened preterm delivery, anemia, and preeclampsia. Cesarean section was performed in 72 (63.2%) cases. Preterm delivery occurred in 53.1% of patients. Three maternal deaths (2.7%) were recorded in the study group, all associated with severe COVID-19 complicated by bilateral pneumonia and coagulopathy. Pregnant women with COVID-19 should be considered a high-risk group for developing obstetric complications, requiring early risk stratification and active inpatient monitoring.

The COVID-19 pandemic, caused by SARS-CoV-2, has resulted in millions of infections and deaths. Studies describing the pathophysiology and characterizing the outcome of the disease in specific populations, including those living with HIV, are necessary. There is no consensus on whether the disease worsens in immunosuppressed patients, which is considered a risk factor, or if immunosuppression might confer protection against cytokine storms. This retrospective descriptive study reports on the profile of SARS-CoV-2/HIV-1 coinfection in individuals seeking care at the Miguel Riet Correa Jr. University Hospital, located in the southernmost part of Brazil, between January 2020 and December 2022. During this period, 363 HIV-positive individuals sought diagnostic services for COVID-19, with 50 (13.7%) testing positive for the novel coronavirus. Among the 363 patients tested, the average age was 42.7 years, and 50.4% were female. For those with coinfection, several variables were analyzed, revealing a predominantly female population (62%), with 60% of white skin color and an average age of 47.8 years. Among these individuals, 48% exhibited symptoms characteristic of COVID-19, 40% had some comorbidity or coinfection, and 32% required hospitalization. Among the hospitalized patients who were discharged, 55% had discontinued HIV treatment, and among those not adhering to antiretroviral therapy (ART), 66.7% died from COVID-19. The average hospital stay observed was 24 days, and 41.2% of patients required supplementary oxygen. Conversely, among patients who did not require hospitalization, 95% were on ART. These findings are consistent with other studies, suggesting that the course of COVID-19 in people living with HIV is similar to that in the general population, with attention to comorbidities as a risk factor in this group. It may be suggested that maintaining HIV treatment adherence could be protective against COVID-19 hospitalization (p = 0.002). Prevalence testing and Chi-square tests were used for data analysis to observe the correlation between hospitalization and discharge outcomes when considering the use of antiretroviral therapy for HIV treatment.

Background: Patients with congenital heart disease (CHD) were considered to belong to a vulnerable group at risk for COVID-19 infection. Our aim was to investigate the severity of acute COVID-19 infection in this patient group as well as the occurrence of sequelae. Methods: We performed telephone interviews with all accessible COVID positive CHD patients from our online COVID-19 patient survey. Baseline information was extracted from our nationwide data bank, with further details from hospital discharge letters. Results: Ninety-nine patients (or parents) were interviewed (male 50.5%): 28 children, 32 young adults (up to 29 years), and 39 adults (30 years and above). Twenty patients had simple, 38 moderate, and 41 complex CHD (10.1% were cyanotic). In twelve patients the CHD was native, ten underwent univentricular palliation, and the rest had corrective cardiac treatment. Thirty patients had additional non-cardiac risk factors. The acute course of COVID-19 was mild in 50, moderate in 38, and severe in three patients, requiring hospitalization. No deaths occurred. Long COVID symptoms (persisting ≥ 12 weeks) were reported by 31 patients. Conclusions: Despite underlying CHD, the severity of the acute course of COVID-19 in our cohort is comparable to that in the general population. Even patients with cyanotic CHD, complex CHD after univentricular palliation, or those with pulmonary hypertension, usually had a mild to moderate course, so that hospitalization was rarely necessary. The percentage of CHD patients reporting Long COVID symptoms (31%) was higher than in the general population. The long-term impact of COVID-19 and Long COVID in CHD patients is unknown and remains to be investigated.

The high pathogenicity of SARS-CoV-2 and the airborne transmission mechanism are a public health concern. At first, it was believed that a history of allergic reactions aggravated the course of the disease. Later, it turned out that bronchial asthma (BA) in patients or other allergic diseases did not affect the severity of coronavirus infection (CVI). Objective. The aim of the study is to identify the relationship between the course of COVID-19 in patients with asthma and allergies. Material and methods. As a result of the cross-sectional study of the hypothesis, a retrospective analysis of people was conducted for the years 2019–2023. The study group — patients with confirmed COVID-19 and the presence of dispensary registration for bronchial asthma, patients with confirmed COVID-19 and a history of allergies. To assess the severity of the disease, laboratory parameters of patients in dynamics and symptoms were taken. Results. Women with COVID-19 have lower ESR levels than women with concomitant asthma and allergies; men have identical results. The CRP indicators in women with an aggravated anamnesis increase sharply, in contrast to individuals with COVID-19. In men, no significant differences in the CRP results were found. Conclusion. In women and men with bronchial asthma and/or a history of allergies, the course of COVID-19 was milder, both according to laboratory data and the corresponding clinical picture.

Patients with solid organ malignancy (SOM) constitute a high-risk group during the COVID-19 pandemic. Current evidence suggests that this population is more likely to experience severe clinical outcomes, higher hospitalization rates, and increased mortality following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aimed to investigate the clinical course of COVID-19 in patients with SOM and to determine its impact on mortality. This retrospective case-control study included patients aged 18 years and older who tested positive for SARS-CoV-2 by polymerase chain reaction (PCR). As a control group, patients without malignancy but with similar characteristics in terms of age, sex, comorbidities, and vaccination status were selected. Comparisons between the two groups were performed, and risk factors associated with mortality were analyzed. A total of 580 patients with COVID-19 were included in the study, comprising 144 patients with SOM and 436 patients without SOM. Patients with SOM had significantly higher rates of hospital admission (p<0.001), secondary infections (p<0.001), critical illness (p<0.001), intensive care unit requirements (p<0.001), oxygen therapy (p=0.016), and corticosteroid use (p=0.028). In multivariate logistic regression analysis, age (odds ratio [OR]: 1.052), male sex (OR: 2.276), solid organ malignancy (OR: 3.809), C-reactive protein (CRP) >54.7 mg/L (OR: 2.671), procalcitonin >0.110 ng/mL (OR: 2.298), D-dimer >502.5 ng/mL (OR: 2.750), and lactate dehydrogenase (LDH) >412.5 U/L (OR: 2.682) were found to significantly increase the risk of mortality. Notably, the presence of solid organ malignancy was associated with approximately a 3.8-fold higher risk of death. Patients with SOM carry a significantly increased risk of mortality during COVID-19 infection. In this patient group, careful evaluation of age, sex, inflammatory parameters, and biomarker levels is warranted. These findings underscore the importance of early identification of high-risk groups and the implementation of personalized treatment strategies in the management of COVID-19. Graphic Abstract.

Background: Viral-bacterial co-infections may worsen the clinical course of COVID-19; however, the clinical characteristics of pertussis co-infection with SARS-CoV-2 in infants remain poorly described.Methods: We conducted a retrospective study (from January 2024 to September 2025) at Mohammed VI University Hospital in Marrakech. Infants younger than 24 months with clinical suspicion of pertussis underwent multiplex respiratory polymerase chain reaction (PCR) testing using the FilmArray Respiratory Panel 2.1 plus panel (BioMérieux, Marcy-l'Étoile, France). Co-infection was defined as the simultaneous detection of Bordetella pertussis and SARS-CoV-2 from the same nasopharyngeal specimen. Demographic, clinical, laboratory, and radiological data, as well as treatment and outcomes, were collected. Comparisons between groups were performed using Fisher’s exact test for categorical variables.Results: Among 628 tested patients (including 419 children), 69 were diagnosed with pertussis. Nine infants (mean age: 0.08 years) had pertussis-SARS-CoV-2 co-infection. Typical pertussis features were present in all patients. Common findings included respiratory distress (6/9), oxygen desaturation requiring supplemental oxygen (4/9), wheezing (4/9), elevated C-reactive protein (CRP) (5/9), leukocytosis (9/9), lymphocytosis (7/9), including one case of marked lymphocytosis, and thrombocytosis (8/9), with platelet counts ≥ 600 G/L in three cases. Chest imaging revealed interstitial patterns (1/9), focal infiltrate (1/9), or hyperinflation (2/9). The median length of hospital stay was four days.Conclusion: Pertussis-SARS-CoV-2 co-infection in early infancy is uncommon but clinically relevant. Syndromic PCR enabled prompt diagnosis, early initiation of macrolide therapy, and rapid implementation of isolation to limit transmission. Larger studies are needed to better define severity determinants and identify gaps in vaccine-preventable disease coverage.

Objective: Splenectomy is frequently performed in abdominal malignancy surgeries due to direct tumor invasion, vascular injury, or for technical reasons. Although its association with bacterial infections is well documented, the effect of splenectomy on the risk and prognosis of viral infections, particularly COVID-19, remains unclear. To evaluate the incidence of postoperative COVID-19 infection and its prognostic impact in cancer patients undergoing abdominal surgery with and without splenectomy. Methods: This retrospective, single-center study analyzed 337 patients who underwent abdominal surgery for malignancy between March 2020 and March 2022. Forty-four patients underwent splenectomy as part of their oncologic procedure. COVID-19 status, demographic characteristics, comorbidity burden (Charlson Comorbidity Index), and survival outcomes were compared between patients who underwent splenectomy and those who did not. Logistic regression and Kaplan–Meier survival analyses were performed. Results: Postoperative COVID-19 infection occurred in 18.4% of all cancer patients and in 17.7% of those who underwent splenectomy. Splenectomy was not associated with a statistically significant increase in COVID-19 risk (odds ratio (OR): 1.58; 95% CI: 0.75-3.33; P = .22). This finding remained consistent after adjustment for comorbidities (OR: 1.50; 95% CI: 0.70-3.19; P = .29). Similarly, COVID-19 infection was not a significant predictor of mortality in the splenectomy group (adjusted OR: 1.02; 95% CI: 0.22-4.59; P = .97). Kaplan–Meier survival analysis revealed comparable overall survival between patients with and without splenectomy, with no statistically significant difference observed (log-rank test, P = .54). Conclusion: Splenectomy in patients with abdominal malignancies was not found to be a risk factor for acquiring COVID-19 or for poor survival outcomes following infection. While this study suggests no detrimental effect of splenectomy on the clinical course of COVID-19 in patients with cancer, more comprehensive prospective investigations are necessary to support this conclusion. Cite this article as: Deryol R, Avşar G, Hakseven M, Çulcu S, Utkan G, Ünal AE. Splenectomy does not increase COVID-19 risk or mortality in abdominal cancer surgery: A retrospective cohort analysis. Cerrahpaşa Med J. 2026, 50, 0076, doi:10.5152/ cjm.2026.25076.

Endothelial dysfunction is central to COVID-19 pathophysiology, contributing to vascular complications and disease progression. However, the mechanisms driving disease evolution and response to endothelial-targeted therapies remain unclear. This study characterizes endothelial activation throughout the course of acute COVID-19 and evaluates the response to potential therapeutic agents.Serum samples from patients admitted due to moderate to severe COVID-19 pneumonia were prospectively collected on three study time points (+1 day, +4 days and +10 days). Human microvascular endothelial cells were cultured in medium supplemented with pooled serum within the same disease stage, with or without defibrotide, apixaban, or tocilizumab. Endothelial activation was assessed by immunofluorescence and quantitative mRNA expression of adhesion molecules, extracellular matrix (ECM) proteins, and innate immunity receptors. ECM reactivity was evaluated using a platelet adhesion assay. Intracellular signaling pathways were analyzed by immunoblotting.One-hundred and two patients were included. Compared to healthy donor plasma, patient plasma induced upregulation of Vascular cell adhesion molecule-1, Toll-like receptor 4, and von Willebrand factor in endothelial cells. This effect decreased over admission days and in response to drugs. Similarly, ECM reactivity was highest at admission and declined as the disease progressed. Vascular-endothelial cadherin was mildly downregulated, but its expression was unaffected by drug treatment in vitro. Defibrotide mitigated COVID-19 serum induced p38MAPK and Erk activation but enhanced Akt phosphorylation.Serum from severe COVID-19 patients induces a proinflammatory and prothrombotic endothelial phenotype, which can be modulated by endothelial-targeted therapies. These findings support the potential clinical value of endothelial-directed treatments.

Background &amp; Objectives: Mucormycosis is a fungal infection which mainly affects immunocompromised patients and the cases showed an upward trend coinciding with the second wave of COVID-19 pandemic in India. Considering the poor prognosis of established mucormycosis cases, it is worthwhile to identify them at earliest within COVID-19 patients. The objective of this study was to monitor COVID-19 patients prospectively for mucor spp.. and other fungal infections via detailed microbiological analysis of their nasal wash samples. Materials and Methods: COVID-19 patients were called upon at every week interval for one month after their COVID-19 infection and their nasal wash samples were subjected to KOH mount, Gram staining, Calcofluor white staining, SDA culture and LPCB mount. Results: A total of 297 samples were derived from 90 patients. 16(5.3%) were positive for fungal elements in KOH and calcofluor staining. Culture of samples on SDA agar showed that 13(4.3%) samples had Mucor spp. All 13 patients were hyperglycemic during their course of COVID-19. Conclusions: Around 4.3% nasal wash samples of COVID-19 immunocompromised patients taken within two weeks of COVID-19 infection demonstrated definite growth for mucor spp.. These patients could be closely monitored for mucormycosis symptoms/complications and timely interventions could be provided therein. DOI: https://doi.org/10.52783/jchr.v16.i1.11471

Individuals with neuromuscular diseases (NMDs) were considered highly vulnerable during the COVID-19 pandemic due to respiratory and functional impairment. However, local data from Argentina are scarce. The objective was to describe the clinical course and access to the health system in an active cohort of people with NMD treated at two specialized centers in the City of Buenos Aires. Observational, descriptive, cross-sectional study using a self-administered survey (August 2022-April 2023) in adults with confirmed NMDs and respiratory involvement under regular follow-up. Sociodemographic, functional, clinical, vaccination, and COVID-19-related outcomes were collected. Of 120 invitations, 82 patients responded (68%). Half used ventilatory support ≥ 6 h/day. COVID-19 was confirmed in 37%; most had mild symptoms, and no deaths occurred. A total of 97.5% (80/82) had received ≥2 vaccine doses, and 58% had completed four doses. Participants reported 513 healthcare interactions, with a high proportion of remote consultations. In this cohort, high vaccination coverage, specialized follow-up, and sustained healthcare access were associated with a generally favorable clinical course of COVID-19, even in patients with severe respiratory impairment. These findings highlight the importance of ensuring continuity of care and prioritizing vaccination in vulnerable populations.