Recovered Patients Research Articles

Cell-specific housekeeping role of lncRNAs in COVID-19-infected and recovered patients.

A plethora of studies have demonstrated the roles of lncRNAs in modulating disease severity and outcomes during infection. However, the spatio-temporal expression of these lncRNAs is poorly understood. In this study, we used single-cell RNA-seq to understand the spatio-temporal expression dynamics of lncRNAs across healthy, SARS-CoV-2-infected, and recovered individuals and their functional role in modulating the disease and recovery. We identified 203 differentially expressed lncRNAs, including cell type-specific ones like MALAT1, NEAT1, ZFAS1, SNHG7, SNHG8, and SNHG25 modulating immune function in classical monocyte, NK T, proliferating NK, plasmablast, naive,and activated B/T cells. Interestingly, we found invariant lncRNAs (no significant change in expression across conditions) regulating essential housekeeping functions (for example, HOTAIR, NRAV, SNHG27, SNHG28, and UCA1) in infected and recovered individuals. Despite similar repeat element abundance, variant lncRNAs displayed higher Alu content, suggesting increased interactions with proximal and distal genes, crucial for immune response modulation. The comparable repeat abundance but distinct expression levels of variant and invariant lncRNAs highlight the significance of investigating the regulatory mechanisms of invariant lncRNAs. Overall, this study offers new insights into the spatio-temporal expression patterns and functional roles of lncRNAs in SARS-CoV-2-infected and recovered individuals while highlighting the importance of invariant lncRNAs in the disease context.

SARS-CoV-2's brain impact: revealing cortical and cerebellar differences via cluster analysis in COVID-19 recovered patients.

COVID-19 is a disease known for its neurological involvement. SARS-CoV-2 infection triggers neuroinflammation, which could significantly contribute to the development of long-term neurological symptoms and structural alterations in the gray matter. However, the existence of a consistent pattern of cerebral atrophy remains uncertain. Our study aimed to identify patterns of brain involvement in recovered COVID-19 patients and explore potential relationships with clinical variables during hospitalization. In this study, we included 39 recovered patients and 39 controls from a pre-pandemic database to ensure their non-exposure to the virus. We obtained clinical data of the patients during hospitalization, and 3months later; in addition we obtained T1-weighted magnetic resonance images and performed standard screening cognitive tests. We identified two groups of recovered patients based on a cluster analysis of the significant cortical thickness differences between patients and controls. Group 1 displayed significant cortical thickness differences in specific cerebral regions, while Group 2 exhibited significant differences in the cerebellum, though neither group showed cognitive deterioration at the group level. Notably, Group 1 showed a tendency of higher D-dimer values during hospitalization compared to Group 2, prior to p-value correction. This data-driven division into two groups based on the brain structural differences, and the possible link to D-dimer values may provide insights into the underlying mechanisms of SARS-COV-2 neurological disruption and its impact on the brain during and after recovery from the disease.

A stronger antibody response in increased disease severity of SARS-CoV-2

BackgroundAn assessment of the factors that interfere with serum levels and the persistence of anti-SARs-CoV-2 IgG antibodies is essential in order to estimate the risk of reinfection and to plan vaccination. We analyzed the impact of the severity of coronavirus disease 2019 (COVID-19) and the clinical and biological factors regarding the persistence of SARs-CoV-2 anti-spike protein (IgG-S) antibodies at 12 months.MethodsThis was an observational, longitudinal study with individuals who had recovered from COVID-19 between August 2020 and June 2021. Peripheral blood samples were collected from volunteers who were hospitalized (SERIOUS COVID-19) and those who required no hospitalization (COVID-19 LIGHT). Samples were grouped according to days after symptom onset: up to 90, between 91 and 180, ≥ 180 days after symptom onset. A semiquantitative test for IgG anti-spike protein S1(IgG-S1) was used.ResultsWe analyzed 238 individuals who had recovered from COVID-19, of whom 87 had been hospitalized and 151 had not. They provided 148 and 220 samples, respectively. Among those hospitalized, males (65.5%), volunteers aged over 60 years (41.1%), comorbidities such as arterial hypertension (67.8%) and diabetes mellitus (37.9%) were most frequent. We observed higher median serum IgG-S1 titers among those who had recovered from COVID-19 and had been hospitalized, at all collection time intervals (p < 0.001). We observed a weak correlation of increasing age with humoral IgG-S1 response (Spearman correlation = 0.298). There was a greater probability of IgG-S1 antibody persistence over time among samples from hospitalized individuals compared to samples from non-hospitalized participants (p = 0.001).ConclusionThis study has revealed higher titers and a higher probability of the persistence of IgG-S1 in severe cases after SARs-CoV-2 primary infection in unvaccinated recovered patients. Thus, in this study, the severe clinical presentation of COVID-19 was the main factor influencing serum levels and the persistence of IgG-S1 antibodies in COVID-19.

Changes in Cytokine Levels in Patients with Severe Fever with Thrombocytopenia Syndrome Virus.

To characterize the cytokine profile of patients with severe fever with thrombocytopenia syndrome (SFTS) in relation to disease severity. 60 laboratory-confirmed SFTS patients and 12 healthy individuals from multi-centers in Shandong Province of China were included, and all patients were divided into fatal patients (9) and recovered patients (51) due to their final outcomes. Multiplex-microbead immunoassays were conducted to estimate levels of 27 cytokines in the sera of patients and controls. The results showed that levels of IL-2, IL-4, IL-6, IL-7, IL-8, IL-15, IL-1RA, G-CSF, GM-CSF, IFN-γ, TNF-α, basic FGF, PDGF-BB, RANTES, IP-10, MIP-1α, MIP-1β, MCP-1, and Eotaxin differed significantly among the SFTS fatal patients, recovered patients, and the healthy controls (all p<0.05). Compared to the healthy controls, the fatal patients and recovered patients had reduced levels of IL-2, IL-4, IL-7, PDGF-BB, RANTES, and Eotaxin, while the levels of PDGF-BB and RANTES were significantly lower in fatal patients compared to recovered patients. The increasing levels of IL-6, IL-8, IL-15, IL-1RA, G-CSF, GM-CSF, IFN-γ, TNF-α, basic FGF, IP-10, MIP-1α, MIP-1β, and MCP-1 were observed in fatal patients (all p<0.05), and the levels of IL-6, IP-10, MIP-1α, and MCP-1 were significantly higher than other two groups. The Spearman correlation analysis indicated a positive correlation between platelet count and PDGF-BB levels (p<0.05), while the white blood cell count had a negative correlation with MIP-1 level (p<0.05). The research exhibited that the SFTS virus (SFTSV) caused an atypical manifestation of cytokines. The levels of IL-6, IP-10, MIP-1α, and MCP-1 had been observed a positive association with the severity of the illness.

Biochemical and Hematological Profile of Covid-19 Patients on Mechanical Ventilation.

The study is a retrospective study of patients with RT-PCR confirmed presence of the Sars-CoV-2 virus who were hospitalized at the Zenica Cantonal Hospital. The study lasted from February to April 2021. The results of the study, which included a sample of 302 participants, indicate that men were more represented in both the mechanical ventilation group and the recovered group, with 59.6% compared to women with 40.4%. Among the investigated biochemical and hematological parameters, there was a significantly higher number of leukocytes, urea, creatinine, LDH, and troponin in patients on mechanical ventilation, while the number of platelets was significantly higher in recovered patients. The most common comorbidity was hypertension in both groups of patients, with 24.5%. In patients on mechanical ventilation with cardiovascular disease, there was a significantly higher number of leukocytes, urea, creatinine, LDH, and troponin. In the same patients with three comorbidities, there was a significantly higher number of leukocytes, troponin, and LDH, while recovered patients without comorbidities had a significantly higher number of platelets. The male gender and comorbidities remain a vicious circle in COVID-19 infection, while biochemical and hematological markers can help in forecasting and improve the clinical treatment of these high-risk patients.

Six and twelve-month respiratory outcomes in a cohort of severe and critical COVID-19 survivors: A prospective monocentric study in Latin America.

Severe COVID-19 can result in long-term sequelae known as "chronic COVID," characterized by a wide range of persistent physical and mental symptoms. Chest imaging and pulmonary function test alterations have been observed in recovered patients. Most studies focus on up to a 3-month follow-up after symptom onset or hospital discharge, with few reports on long-term follow-up and limited evidence regarding disease progression in Latin America. This study aims to describe the clinical characteristics and changes in pulmonary function, imaging, and quality of life in severe and critical COVID-19 patients requiring ICU admission in a high-complexity hospital in Latin America. A prospective cohort of survivors underwent clinical, radiological, pulmonary function, and quality of life assessments 6 and 12 months post-discharge. One hundred twelve patients were included, all of whom attended the 6-month follow-up, and 99 returned for the 12-month follow-up. Most subjects had no previous respiratory symptoms or significant medical history. At the end of the follow-up period, 74% of the patients showed interstitial infiltrates in chest tomography and a higher frequency of fibroatelectatic tracts and parenchymal bands. Pulmonary function tests returned to normal ranges, except for carbon monoxide diffusion, but no altered scores were reported in the questionnaires. Despite residual radiological findings, most parameters studied in severe and critical COVID-19 survivors improved over the 12-month follow-up period. Regardless of the imaging abnormalities, the improvement in variables such as symptomatic relief and normal pulmonary function suggests that these alterations are transient. Carbon monoxide diffusion did not normalize by the end of the follow-up, which is consistent with the abnormalities reported in multiple studies, indicating a potential disease-related pattern.

Memory Impairment and its Impact on Post-COVID-19 Patients among Saudi Population: An Exploratory Study

Introduction: Coronavirus Disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged as a global pandemic in late 2019, quickly affecting millions worldwide. It presents with a range of symptoms, from mild respiratory issues to severe cases requiring hospitalisation. The disease’s long-term effects, especially cognitive impairments post-recovery, remain an area of active research and concern. Aim: To assess the prevalence and severity of cognitive impairments, including memory loss, attention deficits, and executive function disorders, in individuals who have recovered from COVID-19 in Riyadh, Saudi Arabia. Materials and Methods: This cross-sectional study was conducted from May to August 2023 in Riyadh, Saudi Arabia, involving 539 participants confirmed to have recovered from COVID-19 via Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) tests. Cognitive impairments, including memory loss, attention deficits, and executive function disorders were assessed. Data were analysed using IBM Statistical Package for Social Sciences (SPSS) version 22.0 Chi-square tests and T-tests were utilised to examine the statistical significance of differences between recovered individuals and controls. Results: The study identified significant memory changes in 211 (39.15%) of post-COVID-19 patients, with specific challenges including difficulty recalling names/faces in 146 (27.09%), reduced attention span in 45 (8.35%), and verbal communication issues in 145 (26.9%) study subjects. Demographically, females (n=134, 24.86%) and individuals aged 21-30 reported higher rates of memory impairments compared to males (n=77, 14.29%) or other age groups, challenging prior assumptions about cognitive recovery and age. Further, patients with brain injuries and mental health conditions experienced exacerbated memory issues, underscoring the need for thorough patient assessments. Despite the considerable impact on daily activities reported by 111 (20.59%) of participants, only 17 (3.15%) sought medical help for these memory concerns. The findings highlight the prevalence of memory impairments among Saudi post-COVID-19 patients and call for increased healthcare interventions to manage these long-term cognitive effects. Conclusion: The study conclusively demonstrated that postCOVID-19 memory impairment was prevalent among recovered patients in Saudi Arabia, with significant variations by age, gender, and medical history. This underscored the critical need for healthcare providers to have enhanced awareness and to have developed targeted support services to effectively address and manage the long-term cognitive consequences of COVID-19.

An initial assessment of status of post-COVID-19 symptoms in Vietnamese students

A cross-sectional descriptive study through the online survey was conducted within a month to describe the status of post-COVID-19 symptoms, quality of life, and related factors among Vietnamese students. The questionnaire consists of three main parts: Part 1: Personal information; Part 2: The post-COVID-19 symptoms; and Part 3: EQ-5D. 402 Vietnamese students over 18 years old had complete responses. Surprisingly, up to 78% of the total reported experiencing at least one post-COVID-19 symptom. Of these, the most reported symptoms were neurological (66.17%). Digestive symptoms were relatively uncommon with only 14.18%. Regarding the quality of life, some reported problems with pain and discomfort (25.62%), and anxiety (37.56%). Self-rated health was a related factor to both the status of post-COVID-19 symptoms and quality of life. These findings suggested that more studies are needed to explore potential treatments for alleviating symptoms and improving the quality of life in recovered patients in the future.

The Impact of Psychological, Social, Societal, and Economic Factors Leading to Relapse in Patients Recovered from Addiction

Abstract Background: The problem of using psychotropic substances and addiction has become one of the major problems in the world. Despite the significant increase in treatment programs of addiction, many studies indicate that the rate of relapse globally is very high, especially when treatment is limited to the medical side only. Aims: The study aims to determine the percentage of influence of psychological, societal, social, economic, and other factors that lead to relapse when recovering from addiction. Methods: This study conducted in two main hospitals for the treatment of substance use disorders in Baghdad (Ibn Rushud Teaching Hospital for Psychiatry and Al-Ataa Center for Addiction Treatment) through the period from January 10, 2023, to June 10, 2023. All (300 inpatient) who are suffering from relapse to addiction after recovery were included in the study. The scale was prepared for the psychological, social, therapeutic, environmental, and economic factors, which was used by a group of senior doctors working in the field of treatment of addiction and rehabilitation centers, who unanimously agreed with their expertise on these factors. Results: This study revealed that the most important factor for relapse is the availability of addictive substances (91%); other factors include psychological, social pressures that the addict is exposed to in his social environment, in addition to the loss of social support (76%). The pressure of friends or peers with a rate of (78%) and the weakness of family control (44%) in addition to the influence of other factors that were examined in this study. Conclusion: There are many factors affecting the return of those recovering from addiction to addiction again, and the most prominent of these factors is the abundance or ease of access to psychoactive substances in addition to other factors, which include (psychological, social, societal, and economic factors). Society must realize that the responsibility for preventing addiction should not be borne by the medical treatment alone, because it is a problem that must be dealt with collectively by all parties to enable recovered patients from addiction to build their lives with confidence.

Assessment of the quality of life of COVID-19 recovered patients at the Ghana Infectious Disease Centre.

The Coronavirus Disease (COVID-19), initially thought to be a respiratory disease, is now known to affect multiple organ systems with variable presentation and devastating or fatal complications. Despite the large numbers of people who have suffered this disease globally, the mid- to long-term impact of COVID-19 on a person's general well-being and physical function has not been fully investigated in Ghana. This study sought to determine the Quality of Life (QoL) and associated factors among Ghanaian patients following clinical recovery from COVID-19 infection. This was a cross-sectional quantitative study involving 150 COVID-19 recovered patients attending the review clinic of the Ghana Infectious Disease Centre. Quality of life was estimated using the EuroQol Group Association five-domain, five-level questionnaire (EQ-5D-5L) while participants' overall health status was measured on a visual analogue scale (EQ-VAS): a scale ranging from 0 (worst health) to 100 (best health). Kruskal-Wallis tests were used to assess differences in domain and overall QoL scores while quantile regression was used to determine demographic and clinical factors associated with QoL scores. The mean QoL from the EQ-5D-5L assessment tool was (81.5 ± 12.0) %, while the self-reported QoL from the EQ-VAS tool (75.6 ± 22.0) %. Persistence of symptoms after 30 days was significantly associated with EQ-5D-5L QoL (Adjusted median difference [95% CI] = -9.40 [-14.19, -4.61], p<0.001) while access to rehabilitative centres was significantly associated with EQ-VAS QoL (Adjusted median difference [95% CI] = -29.60 [-48.92, -10.29], p = 0.003). Quality of life was relatively good among the COVID-19 recovered patients. Persistence of symptoms and access to rehabilitative centres significantly predicted one's QoL.

Nasal cavity microbiota features among people who have had COVID-19

The new coronavirus infection of 2019 is accompanied by damage to a number of organs, tissues, systems of the human body, including the microbiome. However, some aspects of the influence of this infection on the state of the microbiota of individual biotopes in individuals vaccinated with the Gam-COVIDVac vaccine require further research.Purpose: to study the characteristics of the nasal microbiota in vaccinated Gam-COVID-Vac and non-vaccinated individuals who have had COVID-19.Materials and methods: 60 people aged 18 to 23 years old were examined, divided into 3 equal groups: group 1 – vaccinated, sick after vaccination, group 2 – not vaccinated, recovered, group 3 (control) – not sick and not vaccinated. In all examined persons, muconasal secretions from the nasal cavity were examined using conventional bacteriological methods.Results. In the group of unvaccinated and recovered patients, the coronavirus infection caused a significant change in the composition of the nasal cavity microbiota in the form of a significant increase in the number of opportunistic microorganisms (S. aureus, E. coli, Streptococcus spp;) relative to similar indicators in the control group (who had not recovered from the disease and were not vaccinated). In vaccinated and recovering individuals compared with the control group, the changes are unreliable.Conclusion: Transmission of COVID-19 in individuals vaccinated with the Gam-COVID-Vac vaccine does not lead to changes in the nasal microbiota. Significant changes in the microbiota with an increase in the number of opportunistic microorganisms were found in unvaccinated individuals who underwent COVID-19.

Antibody response and risk of reinfection over 2 years among the patients with first wave of COVID-19

ObjectivesTo describe the dynamics and factors related to natural and hybrid humoral response against the SARS-CoV-2 and risk of reinfection among first-wave patients. MethodsA prospective longitudinal study with periodic serological follow-up after acute onset of all recovered patients with SARS-CoV-2 infection cared in Udine Hospital (March–May 2020). Nucleocapsid (N) protein and spike receptor-binding domain (S-RBD) antibody tests were used to distinguish natural and vaccine-induced response. ResultsOverall, 153 patients (66 men, mean age 56 years) were followed for a median of 27.3 (interquartile range 26.9–27.8) months. Seroreversion was 98.5% (95% CI: 96.8–99.4) for SARS-CoV-2-N IgM at 1 year and 57.4% (95% CI: 51.5–63.5) for SARS-CoV-2-N IgG at 2 years. Initial serological response (hazard ratio [HR]: 0.99, 95% CI: 0.99–0.99, p 0.002 for IgM and HR: 0.97, 95% CI: 0.97–0.98, p < 0.001 for IgG) and severity of acute infection (HR: 0.62, 95% CI: 0.39–0.96, p 0.033 for IgM and HR: 0.60, 95% CI: 0.37–0.99, p < 0.001 for IgG) were independently associated with persistent SARS-CoV-2-N IgM/IgG response. Older age and smoker status were associated with long-term SARS-CoV-2-N IgM and SARS-CoV-2-N IgG, respectively (HR: 0.75, 95% CI: 0.57–0.98, p 0.038; HR: 1.77, 95% CI: 1.19–2.61, p 0.004 respectively). All patients maintained SARS-CoV-2-S-RBD IgG response at 24-month follow-up. Reinfections occurred in 25 of 153 (16.3%) patients, mostly during the omicron circulation. Reinfection rates did not differ significantly between SARS-CoV-2-N IgG seronegative and seropositive patients (14/89, 15.7% vs. 10/62, 16.1%, p 0.947). Unvaccinated patients had higher risk of reinfection (4/7, 57.1% vs. vaccinated 21/146, 14.4%, p 0.014). DiscussionFirst-wave patients had durable natural humoral immunity in 40% and anti-S-RBD response in 100% up to 2 years after infection. Natural humoral response alone was not protective against reinfections with omicron SARS-CoV-2 variants, whereas vaccination was effective to reduce the risk of a new infection.

Evidence of a Sjögren's disease-like phenotype following COVID-19 in mice and humans.

Sjögren's Disease (SjD) is a systemic autoimmune disease characterized by lymphocytic inflammation of the lacrimal and salivary glands (SG), dry eyes and mouth, and systemic symptoms. SARS-CoV-2 may trigger the development or progression of autoimmune diseases. To test this, we used a mouse model of SARS-CoV-2 infection and convalescent patients' blood and SG in order to understand the development of SjD-like autoimmunity after infection. First, SARS-CoV-2-infected human angiotensin-converting enzyme 2 (ACE2) transgenic mice exhibited decreased salivation, elevated antinuclear antibodies (ANA), and lymphocytic infiltration in the lacrimal and SG. The sera from patients with COVID-19 sera showed increased ANA (i.e., anti-SSA [Sjögren's-syndrome-related antigen A]/anti-Ro52 and anti-SSB [SS-antigen B]/anti-La). Male patients showed elevated anti-SSA compared with female patients, and female patients exhibited diverse ANA patterns. SG biopsies from convalescent COVID-19 patients were microscopically similar to SjD SG with focal lymphocytic infiltrates in 4 of 6 patients and 2 of 6 patients exhibiting focus scores of at least 2. Lastly, monoclonal antibodies produced in recovered patients blocked ACE2/spike interaction and cross-reacted with nuclear antigens. Our study shows a direct association between SARS-CoV-2 and SjD. Hallmark features of SjD-affected SGs were histologically indistinguishable from convalescent COVID-19 patients. The results implicate that SARS-CoV-2 could be an environmental trigger for SjD.

Altered thalamic volumes and functional connectivity in the recovered patients with psychosis

BackgroundInvestigating neural correlates in recovered patients with psychosis is important in terms of identifying biological markers associated with recovery status or predicting a possible future relapse. We sought to examine thalamic nuclei volumes and thalamus-centered functional connectivity (FC) in recovered patients with psychosis who discontinued their medication. MethodsThirty patients with psychosis who satisfied the criteria for full recovery and 50 healthy controls (HC) matched for age, sex, and education underwent magnetic resonance imaging and clinical evaluation. The recovered patients were divided into the maintained and relapsed subjects according to their clinical status on the follow-ups. Thalamic nuclei volumes and thalamus-centered FC were measured between the recovered patients and HC. Correlations between the thalamic nuclei or altered FC, and clinical symptoms and cognitive functioning were explored. ResultsModest cognitive impairments and reduced thalamic nuclei volumes were evident in the recovered patients. Moreover, we found altered thalamo-cortical connectivity and its associations with negative symptoms and cognitive functioning in the recovered patients compared with HC. ConclusionThese findings suggest that there are still cognitive impairments, and aberrant neuronal changes in the recovered patients. The implication of differential FC patterns between the maintained and the relapsed patients remain to be further explored.

Restoring Order to Adolescent Eating Disorders: Unveiling Causes, Solutions, and Societal Impacts

This article delves into the complexities of eating disorders, positioning them as substantial mental health concerns rather than mere manifestations of unhealthy dietary preferences. The research contributes valuable insights into the pivotal role played by media in exerting social pressure and shaping body ideals, shedding light on the phenomena of social comparison and the associated social stigma prevalent among adolescents. The profound isolation resulting from nominalization synergistically impacts adolescent body image and susceptibility to appetite disorders. The article also underscores the escalating global prevalence of eating disorders, with a specific focus on their occurrence among adolescents in Singapore. Employing a methodology encompassing interview groups, individual interviews, and expert guidance from psychologists, the research suggests the exploration of media literacy enhancement and the elimination of societal stigma as potential avenues for recovery among individuals grappling with eating disorders. Drawing upon the narratives of recovered patients, the article advocates for heightened awareness within society, emphasizing the imperative to address and actively ameliorate this frequently overlooked social issue.

Glymphatic system dysfunction in recovered patients with mild COVID-19: A DTI-ALPS study

Central nervous sequelae are often reported in recovered patients with COVID-19. It is not clear whether recovered COVID-19 patients have glymphatic impairment and clinical correlation. In this study, we demonstrated that mild COVID-19 patients experienced asymmetric bilateral glymphatic function decline after four months of recovery, and the decrease in glymphatic function was more obvious in older recovered patients. Our results further showed that recovered patients with right-sided glymphatic dysfunction experienced a greater proportion of cognitive decline (MoCA score <26) than patients with left-sided glymphatic dysfunction. With COVID-19 infection over 90% of the general population currently, future studies of cognitive disorders in the older population should consider the impact of COVID-19 infection.

Effect of Vaccination on COVID-19 Severity and Outcome: A Comparative Study in a Tertiary Care Hospital.

Vaccination is an important aspect of preventing/decreasing the severity of any viral disease including severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). This disease being very new in the experience of mankind has very little data on the effect of vaccination on the severity of this disease. We conducted this study with the primary objective to assess the severity and clinical outcome of COVID-19 infections among nonvaccinated and vaccinated individuals. This was a hospital-based retrospective cohort study including all individuals developing microbiologically confirmed COVID-19 over 5 months from February to 31st July 2021. A questionnaire was used to acquire demographic details, history of vaccination with dates, severity of COVID-19 infection, comorbidities, and outcome. Patients found positive microbiologically for SARS-CoV-2 before any dose of its vaccine were considered nonvaccinated, while patients developing SARS-CoV-2 infection even after a single dose or both doses of vaccine were considered "vaccinated." The outcome and mortality among the vaccinated and nonvaccinated patients were evaluated and compared. The study included 2,879 patients, but complete data were obtained only from 1,500 patients. A total of 1,500 patients were analyzed, out of which 880 are male and 620 are female. The severity of the disease was categorized into mild, moderate, and severe in the age-group of <60 years and >60 years with urban (1051, 70.07%) and rural (449, 29.93%) populations. A total number of recovered patients (n = 245), died patients (n = 215) in the age-group of >60 years while the total recovered patients (n = 823) and dead patients (n = 217) in the age-group <60 years with p = 0.001. Total vaccinated patients in the age-group >60 years (n = 204) and not vaccinated (n = 256) while in the age-group of <60 years total vaccinated n = 229 and not vaccinated n = 811. The outcome of disease in the age-group of >60 years in nonvaccinated 50% recovered and 50% died during the course of illness while in the vaccinated 57.3% recoverd and 42% died p-value 0.14, while in the age-group of <60 years recovery in nonvaccinated 77.6% and death in nonvaccinated was 27.32% while in vaccinated patients 82.28% were recovered and 15% died with significant p-value 0.04. Disease outcome was not found significantly associated with a number of doses with p-values of 0.84 and 0.507 in the age-group of >60 years and <60 years, respectively. A total number of 56 patients received Covaxin and 377 patients received Covishield and disease outcome was not found significantly associated with the type of vaccine. Vaccination against COVID-19 was significantly effective in terms of hospitalization and disease severity. Vaccinated persons were less among patients with COVID-19 hospitalization and with severe disease progressing to death. These findings indicate vaccination is helpful in reducing the development of severe COVID-19 infection as compared to nonvaccinated status.

Longitudinal Analysis of Antibody Response Following SARS-CoV-2 Infection Depending on Disease Severity: A Prospective Cohort Study.

Severe coronavirus disease 19 (COVID-19) is characterized by a dysregulated inflammatory response, with humoral immunity playing a central role in the disease course. The objective of this study was to assess the immune response and the effects of vaccination in recovered individuals with variable disease severity up to one year following natural infection. A prospective cohort study was conducted including patients with laboratory-confirmed COVID-19. Disease severity was classified as mild, moderate, and severe based on clinical presentation and outcomes. Anti-RBD (receptor binding domain) and neutralizing antibodies were evaluated at multiple timepoints during the first year after COVID-19 diagnosis. A total of 106 patients were included; of them, 28 were diagnosed with mild, 38 with moderate, and 40 with severe disease. At least one vaccine dose was administered in 58 individuals during the follow-up. Participants with mild disease presented significantly lower anti-RBD and neutralizing antibodies compared to those with moderate and severe disease up to the 3rd and 6th months after the infection, respectively. After adjusting for covariates, in the third month, severe COVID-19 was associated with significantly higher anti-RBD (β: 563.09; 95% confidence intervals (CI): 257.02 to 869.17) and neutralizing (β: 21.47; 95% CI: 12.04 to 30.90) antibodies. Among vaccinated individuals, at the 12th month, a history of moderate disease was associated with significantly higher anti-RBD levels (β: 5615.19; 95% CI: 657.92 to 10,572.46). Severe COVID-19 is associated with higher anti-RBD and neutralizing antibodies up to 6 months after the infection. Vaccination of recovered patients is associated with a remarkable augmentation of antibody titers up to one year after COVID-19 diagnosis, regardless of disease severity.

Late gadolinium enhancement following Covid-19 infection does not predict outcome: a single-centre study

Abstract Background Some patients are found to have myocardial scarring after infection with coronavirus-2019 disease (COVID-19) as evidenced by the presence of late gadolinium enhancement on cardiac MRI (CMR). In many types of heart disease, the presence of late gadolinium enhancement (even without symptoms) is associated with a poorer prognosis. However, it is not known whether the presence of scar after COVID-19 is associated with outcome. Purpose This study explores the association between late gadolinium enhancement (LGE) in recovered patients with COVID-19 and of longer-term clinical outcomes. Methods In this single-centre, retrospective, observational cohort study, troponin levels, CMR data, and follow-up outcomes of 169 patients with COVID-19 were collected. The primary outcome was all-cause mortality. The secondary outcome was a composite of myocardial infarction, stroke, and admission for heart failure. The log-rank test was used to compare survival of those with and without late gadolinium enhancement. Results A total of 169 patients (mean age 61 ± 16 years, 54% male) were included. Scans were typically performed in patients with a raised troponin or ongoing cardiac symptoms post COVID-19 infection. The median (IQR) time between COVID-19 diagnosis and CMR was 14 (7-23) weeks. Median follow-up was 28 (IQR 23 to 37) months. Troponin was performed in 92% (n=155) of patients. Of those, 78% (n=121) had a positive result. Late gadolinium enhancement was present in 54 patients (32%). There were no observed differences in comorbidities such as hypertension, known ischaemic heart disease or heart failure, diabetes, obesity, or frailty between in patients with LGE compared to those without LGE. Kaplan-Meier survival analysis showed no significant difference in all cause mortality for patients with COVID-19 with LGE compared to those without LGE (Log-rank P = 0.36). Similarly, the composite secondary endpoint was not significantly different (Log-rank P = 0.48). Conclusion In this single centre study, patients found to have myocardial LGE after COVID-19 did not have an increased risk of mortality or cardiovascular events compared to those without. The overall event rates remain low even after 2-3 years of follow-up. The cause of this is unclear but underlines the importance of larger multicentre studies to follow-up COVID-19 survivors.

Psychocognitive dysfunction in comorbid patients in the post-COVID period

Introduction. Currently, psychopathological symptoms are noted in a third of patients with COVID-19, according to published systematic reviews. Aim. To study psychocognitive function in comorbid patients depending on the coronavirus infection caused by SARS-CoV-2.Material and methods. The observational analytical cohort study included 223 patients with AF and comorbidity (ischemic heart disease, arterial hypertension, obesity, type 2 diabetes mellitus) aged 60–74 years, who were divided into 2 groups: 1st – 123 patients without COVID –19 and 2nd – 110 patients with a history of COVID-19 and the presence of PCS. The group of patients with a history of COVID-19 was retrospectively divided into 2 groups depending on the intake of sulodexide; patients in the subgroups were comparable. The work assessed psychological disorders (anxiety and depression) and cognitive status using specialized scales «HADS» and «SPMSQ».Results. In patients with COVID-19, compared with patients from group 1, there is a more pronounced depressive syndrome (p&lt;0.001); subclinical depression in 26% of patients (p&lt;0.001) and the absence of the latter in group 1; clinically pronounced depression was found in 15% (p=0.007). At the same time, the severity of subclinical symptoms of anxiety syndrome was noted in patients without COVID-19, and clinically significant anxiety was more often observed in recovered patients, although statistical significance was not achieved. When assessing cognitive function, it was found that moderate dysfunction was observed in patients with COVID-19 significantly more often (p=0.001). In the sulodexide group, only mild cognitive dysfunction was detected (14%), and the majority of patients taking sulodexide had no cognitive dysfunction.Conclusion. Thus, in comorbid elderly patients in the post-COVID period, an increase in the number of people with psychocognitive disorders was noted. In this regard, long-term follow-up of patients who have undergone COVID-19 is necessary, both for the dynamic assessment of underlying diseases and the analysis of psychocognitive status. In addition, it should be noted that the drug sulodexide, consisting of a heparin-like fraction and dermatan sulfate, has many pharmacodynamic (anti-inflammatory, angioprotective, anticoagulant, antifibrotic) and pharmacokinetic advantages (safety, the possibility of oral administration) can effectively prevent the development of cognitive dysfunction, which requires even further in-depth research.