Recovered Patients Research Articles

Serum High-Mobility Group Box 1 and Heme Oxygenase-1 as Biomarkers in COVID-19 Patients at Hospital Admission.

The careful monitoring of patients with mild/moderate COVID-19 is of particular importance because of the rapid progression of complications associated with COVID-19. For prognostic reasons and for the economic management of health care resources, additional biomarkers need to be identified, and their monitoring can conceivably be performed in the early stages of the disease. In this retrospective cross-sectional study, we found that serum concentrations of high-mobility group box 1 (HMGB1) and heme oxygenase-1 (HO-1), at the time of hospital admission, could be useful biomarkers for COVID-19 management. The study included 160 randomly selected recovered patients with mild to moderate COVID-19 on admission. Compared with healthy controls, serum HMGB1 and HO-1 levels increased by 487.6 pg/mL versus 43.1 pg/mL and 1497.7 pg/mL versus 756.1 pg/mL, respectively. Serum HO-1 correlated significantly with serum HMGB1, oxidative stress parameters (malondialdehyde (MDA), the phosphatidylcholine/lysophosphatidylcholine ratio (PC/LPC), the ratio of reduced and oxidative glutathione (GSH/GSSG)), and anti-inflammatory acute phase proteins (ferritin, haptoglobin). Increased heme catabolism/hemolysis were not detected. We hypothesize that the increase in HO-1 in the early phase of COVID-19 disease is likely to have a survival benefit by providing protection against oxidative stress and inflammation, whereas the level of HMGB1 increase reflects the activity of the innate immune system and represents levels within which the disease can be kept under control.

The study of some biochemical parameters in the serum of infected and recovered patients with COVID-19

Few biochemical and immunological studies have been conducted on Iraqis infected with novel coronaviruses, and also Patients' post-recovery condition is unknown. Therefore, we aimed to study the impact of COVID-19 on some biochemical compounds in the serum of the infected subjects and to follow up the impact after 6-7 months. The research was conducted in Baghdad-Iraq from October to December 2021, and the study included four groups (each group consisted of 20 subjects): Group (A) Infected subjects without vaccination; group (B) Recovered subjects without vaccination; group (C) Recovered subjects after vaccination; and group (D) Non-infected subjects after vaccination. Subjects with COVID-19 infection confirmed by PCR and vaccinated individuals received the same type of vaccine. The authors measured some positive acute phase reactants (ferritin, C-reactive protein, and D-dimer), antibodies (IgM and IgG), and enzymes (LDH, AST, and ALT) in the subjects' serum. The study result showed an Increase in ferritin, CRP, D-dimer and LDH levels in the serum of infected subjects (group A). The antibody levels in the four groups were elevated, while the liver enzymes (ALT and AST) were in the normal values. Elevation of LDH level also in the serum of recovered subjects (groups B and C). Elevated ferritin, CRP, and D-dimer levels may not remain in infected patients after recovery from COVID-19 except for LDH, which is still elevated in some Iraqi subjects in Baghdad. Keywords: Iraq, COVID-19, Vaccine, Acute Phase Reactants, Antibodies, Liver enzymes

Virtual reality for assessing stereopsis performance and eye characteristics in Post-COVID

In 2019, we faced a pandemic due to the coronavirus disease (COVID-19), with millions of confirmed cases and reported deaths. Even in recovered patients, symptoms can be persistent over weeks, termed Post-COVID. In addition to common symptoms of fatigue, muscle weakness, and cognitive impairments, visual impairments have been reported. Automatic classification of COVID and Post-COVID is researched based on blood samples and radiation-based procedures, among others. However, a symptom-oriented assessment for visual impairments is still missing. Thus, we propose a Virtual Reality environment in which stereoscopic stimuli are displayed to test the patient’s stereopsis performance. While performing the visual tasks, the eyes’ gaze and pupil diameter are recorded. We collected data from 15 controls and 20 Post-COVID patients in a study. Therefrom, we extracted features of three main data groups, stereopsis performance, pupil diameter, and gaze behavior, and trained various classifiers. The Random Forest classifier achieved the best result with 71% accuracy. The recorded data support the classification result showing worse stereopsis performance and eye movement alterations in Post-COVID. There are limitations in the study design, comprising a small sample size and the use of an eye tracking system.

Health-related Quality of Life of Cured Patients of the Covid-19 after Discharge from Hospital

Background: Examining the results of the treatment of patients after discharge from the hospital is an essential question in measuring the effectiveness of the treatment of COVID-19 for health systems. Therefore, this study aims to investigate the Quality of Life of cured patients with covid-19 using the wellknown EQ-5D scale.
 Methods: A systematic search was conducted in available databases including PubMed, Scopus, Web of Science, and EMBASE from the beginning of January 2019 to the beginning of July 2022. After three screening stages, studies related to the quality of life of COVID-19 survivors were included.
 Results: Data were categorized and extracted based on the five dimensions of the EQ5D questionnaire. Finally, the analysis of the results of the studies indicated that the utility score was above 70% so, in more than half of them, the most complaint among the questionnaire dimensions was related to disruption in usual activities and self-care. Next, mobility and pain had the most significant impact on reducing the quality of life of recovered patients. The most minor complaints of the discharged patients were related to anxiety/depression.
 Conclusion: Considering that the symptoms of the disease are present in the cured patients, it is necessary to follow up on these symptoms to prevent them from getting worse by simple and essential actions. So, an organized follow-up structure in health centers is fundamental to improving the quality of life for the survivors of COVID-19.

The effect of long-haul COVID-19 toward domains of the health-related quality of life among recovered hospitalized patients.

People with long-haul COVID-19 could experience various health problems, from mild to severe. This research aimed to identify the effect of long-haul COVID-19, specifically on the Quality-of-Life domains experienced by COVID-19 patients who have been discharged. Data collection was done online, using data from DKI Jakarta hospitalized patients confirmed with and recovered from SARS-CoV-2 infections. We selected patients who have a minimum of 28 days after being hospitalized for COVID-19 positive. The Logistic regression technique was used to analyze the data. The questionnaire used in this research contained questions regarding long-haul COVID-19 symptoms and domains of Quality of Life, which WHOQOL-BREF measured. Before collecting data, we tested the questionnaire with 30 recovered patients hospitalized outside DKI Jakarta. 172 recovered inpatients who filled out the questionnaire correctly and were aged 18 years and above were randomly selected. Almost one-third (30.2%) of the recovered inpatients had long-haul COVID-19, with 23.8% experiencing one long-haul symptom and 6.4% experiencing more than one symptom. This research also showed that the long-haul effects of COVID-19 affected almost all domains of Quality of Life except the environmental one. Age, gender, and marital status were covariates for the association between long-haul COVID-19 and The Quality of Life. Continuing health services after the patient is discharged from the hospital is an important program for COVID-19 survivors because it can prevent a decline in the Quality of Life among patients due to the long-haul COVID-19.

Evaluation of Frequency and Risk Factors of Barotrauma among Patients with Severe Covid-19 Pneumonia Underwent Non-Invasive Ventilation in Afzalipour Hospital Kerman

Background: Acute respiratory distress syndrome (ARDS) following Covid-19 pneumo-nia is an important complication; using non-invasive ventilation (NIV) is one of the best supportive options available. In the recent Covid-19 pandemic, we have seen a significant increase in baro-trauma incidence following the use of NIV in patients with severe Covid-19 pneumonia. We aimed to identify the risk factors of barotrauma in patients with Covid-19 pneumonia under-going NIV. Methods: In this retrospective study, all adult patients with severe Covid-19 pneumonia who under-gone NIV and suffered from any form of barotrauma from July to September 2021 in Afzalipour Hospital, Kerman, Iran were evaluated. Laboratory tests and NIV machine settings were collected from patients' files. A chi-square test and an independent t-test were used for analytical statistics. Results: Twenty patients with barotrauma secondary to severe Covid-19 pneumonia were enrolled. The most common manifestation of barotrauma was pneumomediastinum in 19 patients (95%). No significant relationship was seen between the occurrence of barotrauma and Laboratory tests. The mean ± SD Inspiratory Positive Airway Pressure (IPAP) level in passed-away patients (17.8 ± 1.1) was significantly higher than in recovered patients (13.5 ± 0.5) (p = 0.04). Conclusion: According to the results of the study, using a low level of IPAP in the ventilator ma-chine settings of patients with barotrauma secondary to severe Covid-19 pneumonia will reduce the mortality rate.

CLINICAL AND PATHOANATOMICAL PARALLELS OF THE HEART DAMAGE DUE TO COVID-19

The aim – to investigate the clinical and pathomorphological features of the heart damagein patients who died due to COVID-19 pneumonia.Materials and methods. A retrospective analysis of the medical records of 556 patients,hospitalized to Lviv Clinical Emergency Care Hospital in January- February 2021, witha diagnosis of COVID-19 pneumonia and 90 reports of pathological examination ofthe causes of death of patients with COVID-19 pneumonia was carried out. Clinicalparameters (demographic data, comorbidities, presence of COVID-19 pneumoniacomplications, complaints, medical history, results of physical examination andadditional laboratory and instrumental investigations, performed during hospitalization,including levels of NT-proBNP and troponin, determined by immunofluorescence method)and results of pathological examination were evaluated.The results. During life, most patients who died due to COVID-19 pneumonia werediagnosed with acute respiratory distress syndrome (ARDS), the development of multipleorgan failure, rarely PE. They showed significantly lower capillary blood oxygensaturation indicators compared to similar indicators of recovered patients, as well asan increase in markers of systemic inflammation (level of leukocytes and interleukin-6),fibrin degradation products (D-dimers) and markers of multiorgan failure (creatinine,NT-proBNP, troponin I). The most frequent pathomorphological signs of heartdamage in patients with COVID-19 were interstitial edema with hyperemia (63.5 %) and fragmentation of cardiomyocytes (34.1 %). Every fourth patient had mononuclear cell infiltration, which was associated with increased level of NTproBNP, oxygen saturationdecrease in capillary blood, and increase in aspartate aminotransferase. Myocardialinfarction, pericarditis, and myocarditis occurred more rarely in patients with COVID-19.Conclusions. The variety of clinical scenarios of heart damage requires a high level ofsuspicion in the early stages of the disease and the use of appropriate investigations toidentify its cause.

Features of the course of liver cirrhosis in the background of infection with COVID-19

Purpose of research. The study of the statistical and clinical features of liver cirrhosis (LC) against the background of a coronavirus infection caused by the SARS-CoV-2 virus. Materials and methods. 98 patients (51 men and 47 women) aged 23 to 69 years (mean age 53.8±1.9 years) with a verified diagnosis of cirrhosis were examined. The patients were divided into 2 groups. Group 1 consisted of 49 patients who underwent surgery in 2020-2021. coronavirus infection. The 2nd group also included 49 patients with cirrhosis who underwent treatment and examination in 2017-2018, which made it possible to exclude infection caused by the SARS-CoV-2 virus in them. Both groups were divided into 2 subgroups: recovered and deceased. A comprehensive statistical processing was carried out. Results. In the subgroups of recovered patients, the results in the dynamics of treatment were positive. The dynamics of liver function indicators in deceased patients of the 1st and 2nd groups also turned out to be similar, but negative. The analysis of cytolysis indicators established their significant progression and more significant in the 1st group. Alkaline phosphatase and gammaglutamyltransferase had the same dynamics, which indicated the progression of cholestasis syndrome. Violations of bilirubin metabolism worsened and also significantly significantly in the 1st group. Worsened protein metabolism. Hemostasis indicators worsened in patients of the 1st group. As expected, the level of C-reactive protein was higher in patients of the 1st group, which was due to a specific inflammatory process of the respiratory organs. Conclusion. Our observations allow us to state that patients with cirrhosis have certain features of the course of the disease against the background of COVID-19 infection, namely, higher rates of liver function decompensation and death when infected with the SORS-CoV-2 virus.

Divergent adaptive immune responses define two types of long COVID.

The role of adaptive immune responses in long COVID remains poorly understood, with contrasting hypotheses suggesting either an insufficient antiviral response or an excessive immune response associated with inflammatory damage. To address this issue, we set to characterize humoral and CD4+ T cell responses in long COVID patients prior to SARS-CoV-2 vaccination. Long COVID patients who were seropositive (LC+, n=28) or seronegative (LC-, n=23) by spike ELISA assay were recruited based on (i) an initial SARS-CoV-2 infection documented by PCR or the conjunction of three major signs of COVID-19 and (ii) the persistence or resurgence of at least 3 symptoms for over 3 months. They were compared to COVID patients with resolved symptoms (RE, n=29) and uninfected control individuals (HD, n=29). The spectrum of persistent symptoms proved similar in both long COVID groups, with a trend for a higher number of symptoms in the seronegative group (median=6 vs 4.5; P=0.01). The use a highly sensitive S-flow assay enabled the detection of low levels of SARS-CoV-2 spike-specific IgG in 22.7% of ELISA-seronegative long COVID (LC-) patients. In contrast, spike-specific IgG levels were uniformly high in the LC+ and RE groups. Multiplexed antibody analyses to 30 different viral antigens showed that LC- patients had defective antibody responses to all SARS-CoV-2 proteins tested but had in most cases preserved responses to other viruses. A sensitive primary T cell line assay revealed low but detectable SARS-CoV-2-specific CD4 responses in 39.1% of LC- patients, while response frequencies were high in the LC+ and RE groups. Correlation analyses showed overall strong associations between humoral and cellular responses, with exceptions in the LC- group. These findings provide evidence for two major types of antiviral immune responses in long COVID. Seropositive patients showed coordinated cellular and humoral responses at least as high as those of recovered patients. In contrast, ELISA-seronegative long COVID patients showed overall low antiviral responses, with detectable specific CD4+ T cells and/or antibodies in close to half of patients (52.2%). These divergent findings in patients sharing a comparable spectrum of persistent symptoms raise the possibility of multiple etiologies in long COVID.

COVID-19 Vaccine Antibody Response in a Single-Center Urban Hemodialysis Unit.

The longitudinal response to the COVID-19 vaccines among patients on hemodialysis with and without prior SARS-CoV-2 infection has not been well characterized. To guide vaccination strategies in patients on hemodialysis, it is critical to characterize the longevity and efficacy of the vaccine; therefore, we conducted a prospective single-center monthly antibody surveillance study between March 2021 and March 2022 to investigate the dynamic humoral response to a series of COVID-19 mRNA vaccines in patients on hemodialysis with and without prior SARS-CoV-2 infection. Monthly quantitative antibody testing was performed using the Beckman Coulter Access SARS-CoV-2 IgG Antibody Test©, which detects IgG antibodies targeting the receptor binding domain (RBD) of the SARS-CoV-2 spike protein. This cohort of 30 participants (mean age: 61 ± 3 years) predominantly self-identified as African American (97%) and male (53%). Eight participants (27%) had recovered from COVID-19 (recovered) before the vaccine initiation. All participants received two vaccine doses, and 86.6% received a 6-month booster dose. Among patients naïve to COVID-19, the antibody positivity rate (APR) was 55% post-first-dose, 91% post-second-dose, 50% pre-booster at 6 months, 100% post-booster, and 89% at 6 months post-booster. Recovered patients sustained a consistent 100% APR throughout the year. The naïve patients demonstrated lower peak antibody levels post-second-dose than the recovered patients (17.9 ± 3.2 vs. 44.7 ± 5.6, p < 0.001). The peak antibody levels post-booster showed no significant difference between both groups (27.1 ± 3.9 vs. 37.9 ± 8.2, p = 0.20). Two naïve patients contracted COVID-19 during the follow-up period. The patients naïve to COVID-19 exhibited an attenuated and foreshortened antibody response following two doses of the mRNA vaccines compared with the recovered patients, who maintained 100% APR before the booster dose. The 6-month booster dose counteracted declining immunity and stimulated antibody responses in the naïve patients, even in previously non-responsive patients. This observation implies that different booster vaccination strategies might be required for COVID-19-naïve and -recovered patients. Post-vaccination antibody testing may serve as a valuable tool for guiding vaccination strategies.

Long-term evaluation of the seroprevalence of SARS-CoV-2 IgG and IgM antibodies in recovered patients: a meta-analysis

Estimating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) -specific immunoglobulin G (IgG) immunoglobulin M (IgM) antibodies are increasingly important for tracking the spread of infection and defining herd immunity barrier and individual immunization levels in the ongoing coronavirus disease 2019 (COVID-19) pandemic. Therefore, we conducted the present systematic review and meta-analysis to evaluate the seroprevalence of SARS-CoV-2 IgM and IgG antibodies of recovered COVID-19 patients in long-term follow-up studies. A systematic search of the MEDLINE, Embase, COVID-19 Primer, PubMed, CNKI, and the Public Health England library databases was conducted. Twenty-fourth eligible studies were included. Meta-analysis showed that 27% (95%CI: 0.04–0.49) and 66% (95%CI:0.47–0.85) were seropositive for SARS-CoV-2 IgM and IgG, respectively, while in long-term 12 months following up studies, the seroprevalences of IgM antibody (17%) decreased and IgG antibody (75%) was higher than 6 months follow-up patients. However, due to the limited number of relevant studies, the high level of heterogeneity, and the large gap in studies conducted, the findings of our study may not accurately reflect the true seroprevalence status of SARS-CoV-2 infection. Nevertheless, sequential vaccination or booster immunization is considered to be a necessary long-term strategy to sustain the fight against the pandemic.

Clinical features and short-term clinical outcomes in Covid-19 infected Adult Population during fourth wave

Objective: To evaluate the clinical characteristics and comorbidities in COVID 19 patients and analyze its impact on outcome of COVID 19 during fourth wave. Study Design: Prospective observational study. Place and Duration: Department of Medicine of Fazaia Ruth Pfau Medical College for six months i.e. from 1st June 2021 to 1st December 2021 during fourth wave of Covid 19. Methodology: The patients with confirmed nasal swab test in SARI specialized acute respiratory illness unit of hospital (report available within 12 hours) were included in the study who required admission in medical COVID ward or intensive care unit. For data collection two residents were trained and assigned to collect the data by recording history of clinical features, comorbidities. Their physical examination along with vitals, oxygen saturation, and relevant laboratory workup was carried out. They recorded all the investigations carried out in admitted patients and observed them till they got better and discharged or could not survive. Results: A total of 113 patients were enrolled, mean age of recovered patients in our study was 45.99 ± 17.80 years whereas for expired it was 71.38 ± 11.62 years (p value &lt;0.05). In the recovered group 70.10% (68) were males and 29.90 %( 29) were females whereas expired group included 62.50% (10) males and 37.5% (6) females. Fever, cough and body aches were observed in 72.57%, 49.56% and 46.02% respectively in recovered patients and 11.50%, 9.73% and 8.85% respectively in expired patients. Diabetes mellitus, hypertension and ischemic heart disease were found as comorbidities in 5.31%, 8.85% and 2.65% of recovered patients’ whereas18.75 %, 6.25% and18.75 % in expired group respectively. Conclusion: Our findings suggest that patients with COVID-19 who have presented with shortness of breath and have diabetes mellitus or ischemic heart disease are at increased risk of mortality. These patients should be closely monitored and provided with appropriate supportive care. Keywords: Clinical Features, Comorbidities, COVID 19, Outcome. How to Cite This: Zahra f, kidwai SS, Ahmed A, Umar M, Waseem F, et al. Clinical features and short-term clinical outcomes in Covid-19 infected adult Population during fourth wave. Isra Med J. 2023; 15(1): 20-24. DOI: https://doi.org/10.55282/imj.oa1359. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Clinical features and short-term clinical outcomes in Covid-19 infected Adult Population during fourth wave

Objective: To evaluate the clinical characteristics and comorbidities in COVID 19 patients and analyze its impact on outcome of COVID 19 during fourth wave. Study Design: Prospective observational study. Place and Duration: Department of Medicine of Fazaia Ruth Pfau Medical College for six months i.e. from 1st June 2021 to 1st December 2021 during fourth wave of Covid 19. Methodology: The patients with confirmed nasal swab test in SARI specialized acute respiratory illness unit of hospital (report available within 12 hours) were included in the study who required admission in medical COVID ward or intensive care unit. For data collection two residents were trained and assigned to collect the data by recording history of clinical features, comorbidities. Their physical examination along with vitals, oxygen saturation, and relevant laboratory workup was carried out. They recorded all the investigations carried out in admitted patients and observed them till they got better and discharged or could not survive. Results: A total of 113 patients were enrolled, mean age of recovered patients in our study was 45.99 ± 17.80 years whereas for expired it was 71.38 ± 11.62 years (p value &lt;0.05). In the recovered group 70.10% (68) were males and 29.90 %( 29) were females whereas expired group included 62.50% (10) males and 37.5% (6) females. Fever, cough and body aches were observed in 72.57%, 49.56% and 46.02% respectively in recovered patients and 11.50%, 9.73% and 8.85% respectively in expired patients. Diabetes mellitus, hypertension and ischemic heart disease were found as comorbidities in 5.31%, 8.85% and 2.65% of recovered patients’ whereas18.75 %, 6.25% and18.75 % in expired group respectively. Conclusion: Our findings suggest that patients with COVID-19 who have presented with shortness of breath and have diabetes mellitus or ischemic heart disease are at increased risk of mortality. These patients should be closely monitored and provided with appropriate supportive care. Keywords: Clinical Features, Comorbidities, COVID 19, Outcome. How to Cite This: Zahra f, kidwai SS, Ahmed A, Umar M, Waseem F, et al. Clinical features and short-term clinical outcomes in Covid-19 infected adult Population during fourth wave. Isra Med J. 2023; 15(1): 20-24. DOI: https://doi.org/10.55282/imj.oa1359. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Fatigue Potentially Reduces the Effect of Transcranial Magnetic Stimulation on Depression Following COVID-19 and Its Vaccination.

COVID-19's long-term effects, known as Long-COVID, present psychiatric and physical challenges in recovered patients. Similarly, rare long-term post-vaccination side effects, resembling Long-COVID, are emerging (called Post-Vaccine). However, effective treatments for both conditions are scarce. Our clinical experience suggests that transcranial magnetic stimulation (TMS) often aids recovery in Long-COVID and Post-Vaccine patients. However, its effectiveness is reduced in patients with severe fatigue. Therefore, we retrospectively analysed Tokyo TMS Clinic's outpatient records (60 in total; mean age, 38 years) to compare Long-COVID and post-vaccine patients' characteristics and symptoms, assess the impact of TMS on their symptoms, and investigate the role of fatigue in depression recovery with TMS. The primary outcome was the regression coefficient of the initial fatigue score on depression score improvement using TMS. Secondary outcomes included psychiatric/physical scores before and after TMS and their improvement rates. We found no differences in the initial symptoms and background factors between Long-COVID and Post-Vaccine patients. After ten TMS sessions, all psychiatric and physical symptom scores improved significantly. TMS improves depression, insomnia, anxiety, and related neuropsychiatric symptoms, which were the primary complaints in this study. Thus, we conclude that TMS improves depression and anxiety. The effectiveness of TMS in treating depression in Long-COVID and Post-Vaccine patients decreased as fatigue severity increased. In conclusion, TMS relieved depressive symptoms following COVID-19 and vaccination; however, fatigue may hinder its effectiveness.

P-466 The effect of SARS-CoV-2 infection or vaccination on controlled ovarian stimulation and in vitro fertilization: A multicenter retrospective cohort study

Abstract Study question Are the ovarian response to controlled ovarian stimulation (COS) and embryo development after in vitro fertilization (IVF) affected by SARS-CoV-2 infection and immunization? Summary answer Both SARS-CoV-2 infection and SARS-CoV-2 mRNA or inactivated vaccinations do not affect ovarian responsiveness to COS or embryo development following IVF. What is known already SARS-CoV-2 infects the target cell by binding to angiotensin-converting enzyme 2 (ACE2) via its surface spike protein. ACE2 receptors are present in the vagina, uterus, fallopian tubes, and ovaries of the female reproductive system. They regulate ovarian steroidogenesis, follicular development, oocyte maturation, and follicle atresia. The virus downregulates ACE2 levels, resulting in decreased conversion of Angiotensin II (ANGII) to Ang (1-7) and increased accumulation of (ANGII). This may impair reproductive fertility. However, initial studies conclude that both SARS-CoV-2 infection and vaccination would not affect reproductive outcomes, but it is necessary to develop new studies that confirm their applicability. Study design, size, duration A retrospective multicentric cohort study of 428 patients who underwent COS for oocyte donation between January 1st, 2018 and July 31th, 2022 were screened for eligibility and followed up to September 18th, 2022. Oocyte donation cycles were utilized because this model is an excellent choice for controlling known female characteristics Participants/materials, setting, methods Eligibility criteria were donors between 18 to 32 years. Patients were categorized into the vaccinated group if they had received SARS-CoV-2 vaccines (BNT162b2 mRNA Pfizer-Biontech, mRNA-1273 Moderna or inactivated SARS-CoV-2 vaccine Sinovac). The control group was chosen from medical records before March 2020 ensure they were neither infected or vaccinated. Demographic, cycle characteristics, and laboratory outcomes were compared. Normally, distributed data were compared across groups by univariate ANOVA. All P-values were considered significant at &amp;lt; 0.05. Main results and the role of chance In total, 428 patients were included in the study, with 12 recovering from SARS–CoV-2 infection (Group 1), 92 reporting vaccination (Group 2), and 324 patients who underwent COS before March 2020 assigned to the non-exposed group (Group 3). The mean time from recovery to oocyte aspiration was 122 days (range 39-315 days) and 213 days from the first vaccine dose to oocyte aspiration (range 17–249 days). The study's participants had an average age of 24.8 years. Age was found to be normally distributed and did not differ significantly between the three groups (P-value 0,953). Similarly, ovarian reserve markers, as measured by AFC and AMH, did not differ between groups (P-values of 0,787 and 0,423 respectively). No significant differences were observed regarding stimulation duration and total gonadotropin dose. The number of retrieved oocytes, MII oocytes, fertilized oocytes, and good-quality day 5 embryos were also similar between the three groups. Comparing oocyte retrieval rate, mature oocyte rate, normal fertilization rate, and blastocyst formation rate consistently revealed no statistically significant differences. Limitations, reasons for caution The main limitation is its retrospective design. Other limitations include the small sample size of recovered patients, the absence of sperm analyses, and data of live birth rates and neonatal outcomes. Wider implications of the findings SARS-CoV-2 infection and vaccination seem unrelated to detrimental effects on ovarian response or embryo development. These findings contribute to the growing body evidence that supports vaccination in women trying to conceive. Further prospective studies with larger cohort sizes and longer follow-ups are warranted to validate our conclusion. Trial registration number NCT05562479

Physical Activity Modifies the Severity of COVID-19 in Hospitalized Patients-Observational Study.

Physical activity (PA) can modulate the immune response, but its impact on infectious disease severity is unknown. We assess if the PA level impacts the severity of COVID-19. Prospective, cohort study for adults hospitalized due to COVID-19, who filled out the International Physical Activity Questionnaire (IPAQ). Disease severity was expressed as death, transfer to intensive care unit (ICU), oxygen therapy (OxTh), hospitalization length, complications, C-reactive protein, and procalcitonin level. Out of 326 individuals, 131 (57; 43.51% women) were analyzed: age: median-70; range: 20-95; BMI: mean-27.18 kg/m²; and SD: ±4.77. During hospitalization: 117 (83.31%) individuals recovered, nine (6.87%) were transferred to ICU, five (3.82%) died, and 83 (63.36%) needed OxTh. The median for the hospital stay was 11 (range: 3-49) for discharged patients, and mean hospitalization length was 14 (SD: ±5.8312) for deaths and 14.22 days (SD: ±6.92) for ICU-transferred patients. The median for MET-min/week was 660 (range: 0-19,200). Sufficient or high PA was found in recovered patients but insufficient PA was observed in dead or ICU-transferred patients (p = 0.03). The individuals with poor PA had a higher risk of death (HR = 2.63; ±95%CI 0.58-11.93; p = 0.037). OxTh was used more often in the less active individuals (p = 0.03). The principal component analysis confirmed a relationship between insufficient PA and an unfavorable course of the disease. A higher level of PA is associated with a milder course of COVID-19.

Functional Characteristics of Serum Anti-SARS-CoV-2 Antibodies against Delta and Omicron Variants after Vaccination with Sputnik V.

Anti-SARS-CoV-2 vaccination leads to the production of neutralizing as well as non-neutralizing antibodies. In the current study, we investigated the temporal dynamics of both sides of immunity after vaccination with two doses of Sputnik V against SARS-CoV-2 variants Wuhan-Hu-1 SARS-CoV-2 G614-variant (D614G), B.1.617.2 (Delta), and BA.1 (Omicron). First, we constructed a SARS-CoV-2 pseudovirus assay to assess the neutralization activity of vaccine sera. We show that serum neutralization activity against BA.1 compared to D614G is decreased by 8.16-, 11.05-, and 11.16- fold in 1, 4, and 6 months after vaccination, respectively. Moreover, previous vaccination did not increase serum neutralization activity against BA.1 in recovered patients. Next, we used the ADMP assay to evaluate the Fc-mediated function of vaccine-induced serum antibodies. Our results show that the antibody-dependent phagocytosis triggered by S-proteins of the D614G, B.1.617.2 and BA.1 variants did not differ significantly in vaccinated individuals. Moreover, the ADMP efficacy was retained over up to 6 months in vaccine sera. Our results demonstrate differences in the temporal dynamics of neutralizing and non-neutralizing antibody functions after vaccination with Sputnik V.

Interferon-Induced Transmembrane Protein 3 rs34481144 C/T Genotype and Clinical Parameters Related to Progression of COVID-19.

Recent research has associated the interferon-induced transmembrane protein 3 gene (IFITM3) with the outcomes of coronavirus disease 2019 (COVID-19), although the findings are contradictory. This study aimed to determine the relationship between IFITM3 gene rs34481144 polymorphism and clinical parameters with COVID-19 mortality. The tetra-primer amplification refractory mutation system-polymerase chain reaction assay was used to analyze IFITM3 rs34481144 polymorphism in 1,149 deceased and 1,342 recovered patients. The clinical parameters were extracted from the patients' medical records. In this study, the frequency of IFITM3 rs34481144 CT genotypes (OR 1.47, 95% CI 1.23-1.76, P < 0.0001) in both sexes was significantly higher in deceased patients than in recovered patients. Moreover, IFITM3 rs34481144 TT genotypes (OR 3.38, 95% CI 1.05-10.87, P < 0.0001) in women were significantly associated with COVID-19 mortality. The multivariable logistic regression model results indicated that mean age (P < 0.001), alkaline phosphatase (P = 0.005), alanine aminotransferase (P < 0.001), low-density lipoprotein (P < 0.001), high-density lipoprotein (P < 0.001), fasting blood glucose (P = 0.010), creatinine (P < 0.001), uric acid (P < 0.001), C-reactive protein (P = 0.004), 25-hydroxyvitamin D (P < 0.001), erythrocyte sedimentation rate (P < 0.001), and real-time PCR Ct values (P < 0.001) were linked with increased COVID-19 death rates. In conclusion, IFITM3 rs34481144 gene polymorphism was linked to the mortality of COVID-19, with the rs34481144-T allele being especially important for mortality. Further studies are needed to confirm the results of this study.

Post-COVID immunopatology syndrome: characteristics of phenotypical changes in the immune system in post-COVID patients

This study examines the long-term effects of SARS-CoV-2 infection on immune status. Given the prolonged and profound immune dysregulation observed during acute SARS-CoV-2 infection, it remains to be determined whether these changes translate into subsequent immune system dysfunction in recovering individuals. In this sense, the aim of the study was to study the parameters of the immune system in patients who had undergone SARS-CoV-2 infection. 150 patients who underwent SARS-CoV-2 infection were examined according to 96 parameters using flow cytometry. A complete blood count was performed using a Medonic device (Sweden); ELISA method determined the levels of general and specific IgM, IgG, IgA, compliment fragments (JSC Vector-Best, Russia). The activity of the phagocytes was studied according to the generally accepted method. The study found that at least four phenotypes of immune system disorders are detected in patients. The first two phenotypes are related to the impairment of innate immune system factors and are associated with a decrease in the number of CD46+ and NK cells. It has been observed that a decrease in CD46+ persists for a long time in a significant number of recovered patients, highlighted by the impaired expression of this marker in various subpopulations of lymphocytes. The decrease in the level of natural killers was accompanied by a compensatory increase in the number of T lymphocytes, mainly due to T helpers and TNK lymphocytes, and the growth of total memory B cells. Two other identified phenotypes are characterized by damage to acquired immune response factors and are associated with damage to B cells and T cytotoxic cells. The relationship of such disorders with damage to hematopoiesis erythrocyte and platelet sprouts, which contribute to the appearance of hypoxia and possible violation of the blood coagulation system, has been shown. Therefore, the results obtained indicate a long-term pronounced damage to the immune system in postCOVID patients that requires immunocorrection of these disorders.

Patterns in the development of collective immunity to SARS-CoV-2 during the COVID-19 pandemic

The ongoing coronavirus disease (COVID-19) pandemic over the past three years has caused close attention to the problem of herd immunity, which is understood as: "resistance to the spread of a contagious disease within a population or herd". Collective immunity is formed both as a result of infection (natural spread of the pathogen in a population of susceptible individuals) and as a result of the use of specific vaccines. During the COVID-19 pandemic, both mechanisms for the formation of collective immunity were realized. In the first wave, there was a natural formation of collective immunity to the virus following recoveries from COVID-19 caused by pandemic spread of SARS-CoV-2. Starting from December 2020, the widespread use of specific vaccines against SARS-CoV-2 began in the USA, Great Britain, China, Russia, and a number of other countries. This launched the process of post-vaccination collective immunity formation; its features have depended on the vaccine types implemented. Currently, in those countries where vaccination and revaccination of recovered patients is widely carried out, immunity is "hybrid" in nature. Several commonalities should be noted in the pandemic experience: a somewhat regular, periodic (wavelike) nature of the COVID-19 epidemic process; changes in pathogen genetics in variants in all countries; and expansive mass vaccination programs in many populations. From these, we can draw some conclusions about the general trend for all countries in the formation of collective immunity during the pandemic: At the beginning of the pandemic in 2020, overall population seroprevalence did not exceed 20%. Other findings were: the highest seroprevalence rates were noted in the children's age group; pronounced regional differences were revealed; and the highest indicators were noted among medical workers. Collective immunity developed as a result of infection or illness, and in the majority of seropositive volunteers, it was represented by antibodies to both antigens. At the height of the pandemic in the summer of 2021, population seroprevalence reached 50%. This was due to both a significant number of convalescents and the start of mass vaccination campaigns. In all countries, specific differences in seroprevalence (by age, region, profession) leveled out, leading to more uniformity. During this period, the formation of "hybrid" immunity is clearly prominent, and the proportion of individuals with antibodies to RBD alone increased (due to vaccination with vector vaccines). Later, mass vaccination, as well as involvement of most of the population in the epidemic process due to the emergence of the highly contagious Omicron strain, raised the level of collective immunity to 80-90%. This led to a sharp decrease in COVID-19 incidence in the second half of 2022 in all countries participating in the study. In the later stages of the pandemic (2022-2023), almost 90% of seropositive volunteers had hybrid immunity, reflected as antibodies to both antigens (Nc, RBD).