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.

Pregnancy represents a distinct immunological and physiological state that modifies maternal susceptibility to SARS-CoV-2 and influences the clinical and biological course of COVID-19. Accumulating evidence indicates that the interaction between viral entry determinants, gestation-specific immune modulation, placental endocrine-angiogenic pathways, and systemic inflammatory responses underlies the characteristic manifestations of SARS-CoV-2 infection during pregnancy. This review consolidates current understanding of SARS-CoV-2 viral structure, receptor biology, and the gestational regulation of key entry cofactors, including ACE2, TMPRSS2, NRP1, CTSL and FURIN, within reproductive and placental tissues. The review further integrates documented mechanisms of cytokine-mediated immune dysregulation, endothelial injury, thrombo-inflammation, and steroidogenic alteration observed in affected pregnancies, and examines their contribution to placental malperfusion, preeclampsia-like presentations, fetal growth abnormalities and preterm birth. Published molecular and computational studies characterising trophoblast antiviral defenses, receptor expression patterns, and structural determinants of Spike-ACE2 affinity are synthesised to contextualise the biological basis of placental susceptibility and the rarity of confirmed transplacental transmission. Current evidence on maternal clinical outcomes, fetal and neonatal consequences, vaccination efficacy, therapeutic considerations and contemporary management guidelines is also critically reviewed. By integrating molecular, immunological, pathological and clinical insights, this article provides a comprehensive framework for understanding the interaction between SARS-CoV-2 infection and pregnancy-specific physiology, with implications for risk assessment, preventive strategies and maternal-fetal care.

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.

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.

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.

Multiple factors have been reported to influence both the acute clinical course of SARS-CoV-2 infection (COVID-19) and the risk of developing multisystem inflammatory syndrome in children (MIS-C), including age, sex, ethnicity, comorbidities, and genetic susceptibility. However, additional immunomodulatory influences, including the somatotropic axis - comprising growth hormone (GH) and insulin-like growth factor-1 (IGF-1) - may also contribute to variations in disease susceptibility and severity. This study aimed to explore the potential role of GH and IGF-1 in the clinical course of COVID-19 and MIS-C. A cohort study was conducted in Ukraine from 2021 to 2023. This study analyzed GH and IGF-1 levels in 90 children aged 1 month to 17 years: 63 with COVID-19, 15 with MIS-C, and 12healthy non-infected by SARS-CoV-2 peers. Hormone levels were measured using an enzyme-linked immunosorbent assay (ELISA). GH levels were within the age- and sex-specific reference ranges in all children. However, children in the MIS-C group had significantly lower GH levels than those in the healthy control group. Overall, 27 (30%) patients exhibited reduced IGF-1 levels. The frequency of low IGF-1 increased with disease severity: 12.5% (mild), 25% (moderate), 53.3% (severe COVID-19), and 66.7% (MIS-C). Reduced GH levels correlated with elevated CRP and ferritin levels, neutrophilia, lymphopenia, and increased neutrophil-to-lymphocyte ratio. Low IGF-1 levels were associated with higher levels of CRP, procalcitonin, ferritin, ESR, and IL-6. A GH level <0.54 ng/mL increased the risk of severe COVID-19 by 2.05-fold (AUC=0.656, 95% CI [0.49-0.83], p = 0.058), while a level <0.465 ng/mL was associated with MIS-C (AUC = 0.742, 95% CI [0.64-0.85], p = 0.003). An IGF-1 level <52.5ng/mL showed a trend toward severe COVID-19 (AUC = 0.591, 95% CI [0.44-0.74], p = 0.270), whereas <44.1 ng/mL predicted MIS-C (AUC = 0.838, 95% CI [0.72-0.95], p < 0.001). Understanding how GH and IGF-1 influence the pediatric immune system is crucial for anticipating the progression of infectious diseases such as COVID-19 and MIS-C. Their immunomodulatory roles should be considered not only in children with GH deficiency but also in previously healthy patients during clinical monitoring.

According to the literature, patients with hypochromic anemia are considered a "risk group" for an unfavorable course of COVID-19. It has been established that hypochromic iron deficiency anemia has a negative impact on virtually all aspects of the immune system, which play a key role in protecting the body from the SARS-CoV-2 virus. The development of COVID-19 leads to changes in iron homeostasis—the so-called inflammatory anemia—which negatively impacts the course of this infection.Objective: to determine the features of the clinical course, laboratory and instrumental examination data, and to analyze the effectiveness of COVID-19 treatment in children with hypochromic anemia.Materials and methods: in 2022–2024, 60 children with COVID-19 suffering from hypochromic anemia (observation group) and 60 children with this infection without anemia (comparison group) were examined in accordance with regulatory documents.Results: The severity of the condition in observation group was determined by the degree of damage to the respiratory tract, fever and intoxication, as well as diarrhea. From laboratory data, patients with COVID-19 and hypochromic anemia are characterized by a decrease in the level of red blood cells and hemoglobin, and a tendency to hypercoagulation. The severity of the inflammatory process in them was more reflected by CRP than ferritin. In order to achieve a favorable outcome, patients in this group needed longer treatment for all types of therapy they receive in children without anemia.Conclusion: COVID-19 in children with hypochromic anemia is more severe than in patients suffering from this infection without anemia.

The histologic study of placental tissues in women with subcompensated chronic placental insufficiency associated with moderate COVID-19 was conducted. Histologic study of placenta from women of the main group revealed the following uncharacteristic specific signs of viral tissue damage: decidual vasculopathy, lymphoplasmacytic infiltration, thrombi in the venous vessels of the stem villi, villitis and intervillusitis, deposition of intervillous fibrinoid, hyperplasia of syncytiotrophoblast and chorangiosis. Morphometric analysis showed an increase in the proportion of perivorsinchal fibrin and capillaries in terminal villi, and a decrease in the density of syncytiotrophoblast membranes. In addition, an increase in the number of syncytial nodules and intermediate immature villi, as well as capillary bleeding in intermediate and terminal villi were found. The moderately severe course of COVID-19 in the second and third trimesters of pregnancy is associated with structural changes in the placenta, which, with insufficient efficiency of compensatory and adaptive mechanisms, is one of the causes of the development of subcompensated chronic placental insufficiency.

Sex hormones not only influence the severity of SARS-CoV-2 infection, but can also be direct targets of viral damage. However, in the pediatric population, hormone level assessment was not included in COVID-19 management protocols, resulting in insufficient understanding of hormonal profile alterations during SARS-CoV-2 infection and multisystem inflammatory syndrome in children (MIS-C). This study aimed to investigate the features of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, and estradiol levels in prepubertal and pubertal children infected with SARS-CoV-2. Materials and methods. A total of 123 children with COVID-19, 32 patients with MIS-C, and 25 healthy SARS-CoV-2–negative children aged 1–17 years were examined. Hormone levels were determined using the AccuBind ELISA Kit (Monobind Inc., Lake Forest, CA, USA). The study was conducted in compliance with the ethical principles outlined in the Declaration of Helsinki and was approved by the Bioethics Committee of I. Horbachevsky Ternopil National Medical University, Ministry of Health of Ukraine (Protocol No. 71, dated 25 October 2022).Statistical analysis was performed using IBM SPSS Statistics 21.0 and GraphPad Prism 8.4.3. Research project: “Optimization of the diagnosis of clinical and pathogenetic characteristics of coronavirus infection COVID-19 in children with comorbid pathology and treatment features”, UDC: 616.98:578.834.1-06-071-08-053.2, State Registration No.: 0123U100064, implementation period: 2023–2025. Results. In boys with COVID-19, a significant decrease in LH and testosterone levels was observed during puberty, as well as lower testosterone levels in the prepubertal period compared to healthy peers. In boys with MIS-C, LH, FSH, and testosterone levels were reduced in both prepubertal and pubertal groups. Despite a statistically significant decrease relative to controls, testosterone levels remained within reference ranges. In girls with COVID-19, FSH levels were reduced during the prepubertal period, and both LH and FSH were decreased during puberty. In contrast, MIS-C was associated with a progressive decline in gonadotropin concentrations. Compared to reference values, a significantly higher frequency of reduced FSH levels was observed in COVID-19 (13.43%) and MIS-C (25.00%), as well as elevated FSH levels in MIS-C (18.75%), compared with the control group (p&lt;0.05) in prepubertal age. One-third of adolescents with MIS-C (31.25%) had reduced FSH levels, which was not seen in the control group (p &lt; 0.05) Conclusions. The course of COVID-19 and MIS-C in children is associated with dysfunction of the hypothalamic–pituitary–gonadal axis, which should be considered during clinical follow-up and management of patients after recovery.

The aim of the study was to evaluate the relationship between the concentration of interleukin-15 (IL-15) in the blood and coagulation and biochemical parameters in women with COVID-19 at different times of pregnancy and depending on the clinical course of COVID-19. Materials and methods. The study included 60 pregnant women with COVID-19: 14 women in the first trimester, 17 in the second trimester and 29 in the third trimester. The comparison group consisted of 20 pregnant women without clinical and laboratory signs of acute respiratory viral infections. The concentration of IL-15 in the blood serum was determined by enzyme immunoassay. Statistica 10.0 (StatSoft, USA) was used for statistical data processing. The statistically significant error level was considered to be p &lt; 0.05. Results. The main clinical manifestations of COVID-19 in pregnant women are catarrhal respiratory syndrome (93.3 ± 3.23 % of cases), intoxication syndrome (86.7 ± 4.38 % of cases) and neurological manifestations (66.7 ± 6.08 % of cases). Pregnant women with COVID-19 had higher blood levels of IL-15 (p = 0.003). COVID-19 is characterized by a decrease in the level of IL-15 in the blood in the third trimester of gestation compared to the first and second trimesters (p = 0.001; p = 0.013). IL-15 in the blood of SARS-CoV-2-infected pregnant women had a direct correlation with prothrombin time (p = 0.017), thrombin time (p = 0.027) and international normalized ratio (p = 0.039), and an inverse correlation with the level of lymphocytes in the blood (p = 0.009), fibrinogen (p = 0.005), serum iron (p = 0.012) and direct bilirubin (p = 0.008 in mild COVID-19). Factors associated with IL-15 in the blood of pregnant women with COVID-19 are impaired sense of smell and taste (p = 0.043), cough (p = 0.014) and vomiting (p = 0.005). Conclusion. The relationship of IL-15 concentration in the blood with coagulation and biochemical parameters in women with COVID-19 at different stages of pregnancy and depending on the clinical course of COVID-19 was evaluated.