scholarly journals Current, effectiveness of therapy and outcomes of new coronavirus infection: preliminary analysis

Author(s):  
Sergey A. Sayganov ◽  
Vadim I. Mazurov ◽  
Igor G. Bakulin ◽  
Elguja L. Lataria ◽  
S A Artyushkin ◽  
...  

Relevance. Verification of a new coronavirus infection (COVID-19) requires clear algorithms for the diagnosis and treatment of patients, depending on clinical, laboratory and instrumental dates. Timely and informed decisions on optimizing management tactics and prescribing proactive anti-inflammatory therapy before development of a complete symptom complex life threatening conditions are needed in some cases. Aim of the study. To analyze the course and outcomes of a new coronavirus infection, depending on the initial characteristics of the patients and treatment options. Materials and methods. A preliminary analysis of the case histories of 129 people hospitalized in the center for treating patients with a new coronavirus infection at North-Western State Medical University n.a. I.I. Mechnikov was made by random sampling. Among the hospitalized patients there were 67 men (51.9%), the average age was 57.9 16.4 years, 62 women (48.1%), and the average age was 60.2 13.6 years. During hospitalization, all patients underwent standard clinical laboratory and instrumental examination, as well as determination of saturation (SpO2), markers of the cytokine storm (CRP, ferritin, AST, D-dimer, fibrinogen, lymphocytes), compute tomography (CT) of the lungs. The effectiveness and safety of therapy was evaluated by the outcome (recovery, death), as well as by the presence of adverse events in the background of the therapy. Statistical processing of the research results was carried out using the Statistica 12 for Windows application software package, the significance of differences between the two relative values was evaluated using the Student t-test (t 2, p 0.05). Results. Fatal outcomes were significantly more frequently recorded among patients of older age groups and males. The presence of concomitant diseases such as obesity, diabetes mellitus, pathology of the cardiovascular system was accompanied by more frequent fatal outcomes. That allows considering comorbidity as a risk factor for severe course and poor prognosis of COVID-19. However, in general, in the presence of the indicated forms of concomitant diseases, it was not possible to establish significant differences with the outcomes of COVID-19, which may be due to an insufficient amount of patients. Predictors of fatal outcome was low values of saturation, the presence of respiratory failure, a significant amount of lung tissue damage (CT-3-4), as well as high values of CRP, ferritin, AST, D-dimer, neutrophilia, lymphopenia, thrombocytopenia. The use of anticytokine drugs (ACD) in complex therapy can be considered a favorable predictor of outcome, which indicates the advisability of wider use. The materials of the study allow not only a preliminary assessment of the course and effectiveness of complex therapy using anticytokine drugs with COVID-19 in patients with comorbid diseases, but also to develop therapeutic and diagnostic algorithms in patients of this category.

2021 ◽  
Vol 12 (2) ◽  
pp. 43-47
Author(s):  
A. A. Lebedenko ◽  
O. E. Semernik ◽  
E. B. Tyurina ◽  
A. A. Appoeva ◽  
N. S. Musiychuk ◽  
...  

Objective: to study the role of macroelements in the pathogenesis of bronchial asthma in children. Materials and methods: A total of 131 patients with different degrees of bronchial asthma severity were examined instantaneously. The reference group consisted of 31 children of the respective gender and age groups 1 and 2A. The average age of children was 11.83 ± 3.38 years old. All children in the cohort were given a comprehensive clinical-laboratory examination, peakflowmetry, pulsoxymetry, and spirometry. The study of mineral homeostasis in blood serum was carried out by X-ray fluorescence analysis. Statistical processing of the results was performed using the Statistica 10 and Microsoft Office Excel 2010, calculations were carried out in the program R. Results: It was found that the levels of potassium, phosphorus, and sulfur in children with bronchial asthma were elevated, while the levels of calcium, magnesium, and chlorine were reduced compared to the control group patients. The content of these macronutrients in patients with varying degrees of disease severity did not have significant differences. Conclusions: The data obtained on the changes in macro-element homeostasis indicate the important role of diselementosis in the pathogenesis of BA. It is a significant factor that contributes to the progression of chronic inflammation in bronchial organs that requires correction of therapy in children.


2020 ◽  
Author(s):  
NG Bomshteyn ◽  
YuV Bolotov ◽  
IA Kim ◽  
DV Trukhin

Taking into account the gut–lung microbiota axis, the new probiotic treatment methods for COVID-19 are currently being discussed. There are effective medicinal preparations of domestic manufacture in the Russian Federation, the immobilized probiotics. The study was aimed to determine the effectiveness of the mixed immobilized probiotic containing the immobilized B. bifidum and lactobacilli L. plantarum (100 million CFU per dose) or the simple immobilized probiotic containing the immobilized B. bifidum (500 million CFU per dose) in the complex therapy of patients with COVID-19. During the open-label, prospective, observational study 70 patients with confirmed diagnosis of COVID-19 received complex treatment which included the immobilized probiotics. All patients were discharged from the hospital with imporoved health status, as well as with improved instrumental and laboratory indicators: body temperature returned to normal in all patients; shortness of breath, cough, feeling of chest tightening, myalgia and headache disappeared; the patients regained sense of smell and taste; the weakness decreased or disappeared (pathognomic symptom for COVID-19). The dynamics of clinical, laboratory and instrumental indicators reflecting the course of the novel coronavirus infection demonstrates the effectiveness of the used complex therapy. The immobilized probiotics may be recommended for the complex treatment of patients with COVID-19.


2020 ◽  
Vol 99 (6) ◽  
pp. 73-83
Author(s):  
Yu.Yu. Novikova ◽  
◽  
D.Yu. Ovsyannikov ◽  
A.A. Glazyrina ◽  
O.I. Zhdanova ◽  
...  

The most severe manifestation of the new coronavirus infection COVID-19 in children is the multisystem inflammatory syndrome in children (MIS-C). A systematic review of foreign publications as of July 25, 2020 contains an analysis of the disease course in 662 children with this syndrome and is used for comparison with the data obtained. Objective of the research: to characterize clinical manifestation, results of laboratory and instrumental studies, therapy, outcomes and consequences of the COVID-19- associated MIS-C, based on the observation of patients hospitalized to Morozov Children's City Clinical Hospital and Children’s clinical hospital of infectious diseases № 6 from May 1 to September 15, 2020. Materials and methods: the pilot study included 32 children aged 9 months – 15 years with COVID-19-associated MIS-C, verified based on WHO criteria (2020), including symptoms of Kawasaki disease (KD), arterial hypotension/shock, laboratory and instrumental signs of heart damage, signs of coagulopathy, gastrointestinal symptoms, increased inflammation markers, COVID-19 markers. Results: the median age of patients was 6 years, boys predominated among the patients (66%), all patients had antibodies to SARS-CoV-2 (31 children of the IgG class); MIS-C manifested itself as a combination of KD symptom complex (75% of patients) with arterial hypotension/shock (28%), neurological (50%), respiratory (41%), gastrointestinal (59%) symptoms; macrophage activation syndrome (MAS) was verified in 16% of patients. Therapy included intravenous immunoglobulin (75%), systemic glucocorticosteroids (88%), anticoagulants (91%), vasoactive/vasopressor support (31%). In 38% of cases treatment was performed in intensive care unit; one child died. According to echocardiography, 16% of patients had coronariitis, ectasia, and coronary arteries aneurysms. Conclusion: COVID-19-associated MIS-C is characterized by a severe course, cross-features with KD, shock syndrome with KD, MAS which requires intensive therapy and can cause acquired pathology of the cardiovascular system in children.


2020 ◽  
Vol 2 (3) ◽  
pp. 8-13
Author(s):  
Sergey V. Petlenko ◽  
Vyacheslav S. Smirnov ◽  
Victor V. Rudenko

Due to the lack of COVID-19 specific preventive measures with a prophylactic and therapeutic (as part of complex therapy) purpose, various drugs were used as humanitarian aid from manufacturing companies to prevent influenza and SARS in St. Petersburg hospitals. The study of Russian Scientific Research Institute of Traumatology and Orthopedics named after R.R. Vreden patient treatment shows the possibility of using drugs containing a synthetic regulatory thymus peptide (L-glutamine-L-tryptophan-thymogen) as an active ingredient in a patient with an in-hospital coronavirus infection. This compound has a number of extra- and intracellular immunotropic effects of key importance in the pathogenesis of respiratory viral infections, including coronavirus etiology. The components have an indirect antiviral effect against acute respiratory viral infections, comprising COVID-19. This led to the use of drugs containing thymogen for the prevention and treatment of COVID-19. The use of immunotropic agents promoted the rapid involution in the patient of clinical, laboratory and instrumental (radiological) signs of the disease and its uncomplicated course both in the primary infection and the development of superinfection cases. The study has shown that the use for the prevention and treatment (as part of complex therapy) of drugs with immunomodulatory activity, as well as those capable of affecting various links in the pathogenesis of pulmonary lesions in coronavirus infection, seems to be highly relevant and justified.


Author(s):  
М.В. ДОВЫДЕНКОВА

Проведена статистическая обработка сформированной базы данных показателей неспецифической резистентности MS «Excel» с целью изучения динамики иммунитета по параметрам бактерицидной, лизоцимной и фагоцитарной активности у крупного рогатого скота черно-пестрой породы разных возрастов. Было установлено, что средние значения показателей лизоцимной и бактерицидной активности у телят в 6 мес были ниже (47,89% и 49,09%, соответственно), чем у животных в 3—4 года (53,75% и 52,81%). Выведено уравнение регрессии, описывающее взаимосвязь между средними показателями фагоцитарной активности и возрастом при высокой степени достоверности (R2=0,90). Изменения лизоцимной и бактерицидной активности в зависимости от возраста были недостоверными (R2=0,58 и R2=0,49, соответственно). Установлена высокая корреляция между бактерицидной и лизоцимной активностью. Отмечена динамика изменения неспецифического иммунитета у коров различных возрастных групп. Создание баз данных и постоянный мониторинг основных показателей естественной резистентности в зависимости от различных факторов (породы, возраста, стадий лактации, кормления, способов содержания), которые влияют на данные показатели, необходимо для оценки физиологического состояния организма животных и их устойчивости к болезням. Statistical processing of the generated MS "Excel" on indicators of non-specific resistance database was carried out with the aim of studying the dynamics of the development of immunity in terms of bactericidal, lysozyme and phagocytic activity in black-and-white cattle of different ages. It was found that the average values of indicators of lysozyme and bactericidal activity in calves at 6 months were lower (47.89% and 49.09%, respectively) than in animals at the age of 3—4 years (53.75% and 52.81%). The equation of regression was derived, it describes the relationship between the average indicators of phagocytic activity and the age with a high degree of reliability (R2=0.90). The changes in lysozyme and bactericidal activity depending on age were dubious (R2=0.58 and R2=0.49, respectively). The high correlation between bactericidal and lysozyme activity was established. It was noticed that the cows of different age groups experienced the dynamics of changes in nonspecific immunity. The creation of databases and constant monitoring of the main indicators of natural resistance, depending on various factors (breed, age, stages of lactation, feeding, methods of keeping) that affect these indicators, is necessary for assessing the physiological state of the animals’ body of and their resistance to diseases.


2020 ◽  
Vol 20 (5) ◽  
pp. 382-389 ◽  
Author(s):  
Shimaa EL-Sharawy ◽  
Osama El- Sayed Negm ◽  
Sherief Abd-Elsalam ◽  
Hesham Ahmed EL-Sorogy ◽  
Mona Ahmed Helmy Shehata

Background & Aims: Hepatocellular carcinoma (HCC) is a highly aggressive cancer with few treatment options. Toll-like receptor 3 (TLR3) plays a key role in innate immunity and may affect the development of cancers. This study aimed to investigate the association between TLR3 gene polymorphism and HCV-related hepatocellular carcinoma in Egypt. Methods: This work was conducted on 70 individuals; fifty HCV cirrhotic patients were included in two groups; with HCC (30 patients) and without HCC (20 patients) compared with a group of 20 apparently healthy controls. All of the studied individuals underwent clinical-laboratory evaluation. TLR3 gene single-nucleotide polymorphism (SNP) (+1234C/T) was tested by polymerase chain reaction- restriction fragment length polymorphism. Results: This study reported that the prevalence of TLR3 +1234TT genotype was significantly increased in cirrhotic patients with HCC than without HCC, while it was not detected at all among the controls. When analyzing the TLR3 SNP +1234C/T with different clinical parameters in HCC patients, there was a significant association between+1234C/T SNP; namely TT genotype and each of the hepatic focal lesions᾽ number, size and the patients᾽ higher Okuda and BCLC stages. No association could be detected between TLR3 SNP and the age, sex, Child-Pugh grades, MELD score or AFP of the studied HCC cases. Conclusion: TLR3 gene SN P +1234C/T could be a novel risk factor for the HCV-related HCC among the Egyptian population.


Author(s):  
Hamid Owaysee Osquee ◽  
Sepehr Taghizadeh ◽  
Mehdi Haghdoost ◽  
Hadi Pourjafar ◽  
Fereshteh Ansari

Introduction: In this article, we report data on confirmed CCHF cases from Iran and describe the association between studying factors and outcomes of the disease. Objective: Crimean Congo Hemorrhagic Fever (CCHF) is an acute and fatal disease with various clinical and paraclinical characteristics. Methods: In the Study design, we evaluated demographic characteristics, clinical, laboratory and sonographic findings of 160 CCHF confirmed cases during 2003 and 2012 in Zabol (A city in Sistan and Baluchestan province of Iran). The association between these factors and the fatal outcome was evaluated by regression analysis. Results: The disease had a fatal outcome in 7 (4.4%) of patients. Females had more severe symptoms and higher odds for death (odds ratio11.57, p=0.005). Leukocytosis (p<0.001), PT (p<0.001) and PTT (p=0.008) elongation, AST (p=0.010) and ALT (p<0.001) elevation were significantly associated with fatal outcome. CNS related symptoms (odds ratio 5.9, p=0.027) in clinical examination and ascites (odds ratio 38.4, p=0.012) and liquid in the pelvic cavity (odds ratio 24.2, p=0.004) were also identified as risk factors of death in this study. Conclusions: Our data suggest that in addition to clinical and laboratory findings practitioners consider sonography for CCHF prognosis.


Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Saima Habeeb ◽  
Manju Chugani

: The novel coronavirus infection (COVID‐19) is a global public health emergency.Since its outbreak in Wuhan, China in December 2019, the infection has spread at an alarming rate across the globe and humans have been locked down to their countries, cities and homes. As of now, the virus has affected over 20million people globally and has inflicted over 7 lac deaths. Nevertheless, the recovery rate is improving with each passing day and over 14 million people have recuperated so far. The statistics indicate that nobody is immune to the disease as the virus continues to spread among all age groups; newborns to the elders, and all compartmentsincluding pregnant women. However, pregnant women may be more susceptible to this infection as they are, in general, highly vulnerable to respiratory infections. There is no evidence for vertical transmission of the COVID-19 virus among pregnant women, but an increased prevalence of preterm deliveries. Besides this, the COVID-19 may alter immune response at the maternal-fetal interface and affect the well-being of mothers as well as infants. Unfortunately, there is limited evidence available in the open literature regarding coronavirus infection during pregnancy and it now appears that certain pregnant women have infected during the present 2019-nCoV pandemic. In this short communication, we study the impact of the COVID-19 infection on vertical transmission and fetal outcome among pregnant women.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 930-930
Author(s):  
Tara Rose ◽  
Elyse Manzo ◽  
Katherine Erickson ◽  
Joshua Valenzuela

Abstract Music interventions and music therapy have become more common globally as nonpharmacological treatment options for memory loss, pain management, reduction of behavioral and psychological symptoms, and increased quality of life. Knowledge of multiethnic interventions is important when creating evidence-based programs within culturally diverse countries, such as the U.S. The purpose of this systematic review is to analyze music interventions for older adults across the globe to better understand emerging best practices. A review of all trials registered at clinicaltrials.gov and registries in the WHO Registry Network containing the key words “music therapy” were included, regardless of intervention type. Of the 627 studies generated, 449 met the eligibility criteria, with 11% enrolling only older adults and 89% enrolling older adults along with other age groups. Studies were conducted in 6 continents, 48 countries (23% in the U.S.), and in 23 languages. Music interventions for specific medical conditions (64%) or medical procedures (24%) were the primary foci in studies. While studies crossed multiple continents, less than 2% referenced ethnicity or culture in the study details. Detailed data on intervention types, demographics, measures, settings, and methodology will be presented. Results suggest that best practices in music therapy are being developed world-wide for the multitude of health challenges faced by older adults and demonstrate the diversity of music interventions in both medical and community settings. Information from this review can be used to improve the implementation of music intervention programs and may be particularly beneficial in countries with diverse multicultural populations.


Author(s):  
Eman Ragab ◽  
Asrar Helal Mahrous ◽  
Ghadeer Maher El Sheikh

Abstract Background High-resolution computed tomography (HRCT) has proved to be an important diagnostic tool throughout the COVID-19 pandemic outbreaks. Increasing number of the infected personnel and shortage of real-time transcriptase polymerase chain reaction (RT-PCR) as well as its lower sensitivity made the CT a backbone in diagnosis, assessment of severity, and follow-up of the cases. Results Two hundred forty patients were evaluated retrospectively for clinical, laboratory, and radiological expression in COVID-19 infection. One hundred eighty-six non-severe cases with home isolation and outpatient treatment and 54 severe cases needed hospitalization and oxygen support. Significant difference between both groups was encountered regarding the age, male gender, > 38° fever, dyspnea, chest pain, hypertension, ≤ 93 oxygen saturation, intensive care unit (ICU) admission, elevated D-dimer, high serum ferritin and troponin levels, and high CT-severity score (CT-SS) of the severe group. CT-SS showed a negative correlation with O2 saturation and patients’ outcome (r − 0.73/p 0.001 and r − 0.56/p 0.001, respectively). Bilateral peripherally distributed ground glass opacities (GGOs) were the commonest imaging feature similar to the literature. Conclusion Older age, male gender, smoking, hypertension, low O2 saturation, increased CT score, high serum ferritin, and high D-dimer level are the most significant risk factors for severe COVID-19 pneumonia. Follow-up of the recovered severe cases is recommended to depict possible post COVID-19 lung fibrosis.


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