Severe Fatigue and Memory Impairment Are Associated with Lower Serum Level of Anti-SARS-CoV-2 Antibodies in Patients with Post-COVID Symptoms

Background: Post-COVID manifestation is defined as persistent symptoms or long-term complications beyond 4 weeks from disease onset. Fatigue and memory impairment are common post-COVID symptoms. We aimed to explore associations between the timeline and severity of post-COVID fatigue and anti-SARS-CoV-2 antibodies. Methods: Fatigue and memory impairment were assessed in a total of 101 post-COVID subjects using the Chalder fatigue scale (CFQ-11) and a visual analogue scale. Using the bimodal scoring system generated from CFQ-11, a score ≥4 was defined as severe fatigue. Serum anti-SARS-CoV-2 spike (anti-S-Ig) and nucleocapsid (anti-NC-Ig) antibodies were examined at two time points: 4–12 weeks after onset of symptoms, and beyond 12 weeks. Results: The serum level of anti-S-Ig was significantly higher in patients with non-severe fatigue compared to those with severe fatigue at 4–12 weeks (p = 0.006) and beyond 12 weeks (p = 0.016). The serum level of anti-NC-Ig remained high in patients with non-severe fatigue at both time points. In contrast, anti-NC-Ig decreased significantly in severe fatigue cases regardless of the elapsed time (4–12 weeks: p = 0.024; beyond 12 weeks: p = 0.005). The incidence of memory impairment was significantly correlated with lower anti-S-Ig levels (−0.359, p < 0.001). Conclusion: The systemic immune response reflected by antibodies to SARS-CoV-2 is strongly correlated with the severity of post-COVID fatigue.

The role of vitamin D in subjective tinnitus—A case-control study

Regarding the high prevalence of vitamin D (25(OH)D) deficiency in the population and its possible association with ear diseases, we aimed to investigate the 25(OH)Dserum level in patients with subjective, nonpulsating tinnitus and its effect on tinnitus severity. The study included 201 tinnitus patients and 99 controls. Patient clinical information, including tinnitus characteristics and severity according to Tinnitus Handicap Inventory (THI), loudness assessed by Visual Analogue Scale (VAS), audiometry, and the blood level of vitamin D, was recorded. The level of 25(OH)D in tinnitus patients was significantly decreased compared with the controls (19.86 ± 7.53 and 27.43 ± 8.85 ng/ml, respectively; P value < 0.0001). More patients in the tinnitus group were deficient in vitamin D, compared with the controls (50.7% vs. 22.2% respectively, p < 0.0001). Tinnitus patients with a lower serum level of 25(OH)D (≤15 ng/dl) were significantly younger, had a higher degree of tinnitus severity measured with THI and VAS scales, had higher triglyceride and TSH levels, and a lower HDL level compared with individuals who had higher 25(OH)D level (>15 ng/dl). There was a strong correlation between the 25(OH)D level and THI. Our findings suggest that a large proportion of tinnitus patients suffers from vitamin D deficiency and that the vitamin D level correlates with tinnitus impact. We recommend a vitamin D assessment for all tinnitus patients.

Spexin is associated with Painful Diabetic Peripheral Neuropathy

Background: Spexin exerts multiple functions in the regulation of energy metabolism and glucose homeostasis. Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes and almost one-third of patients with DPN suffer from neuropathic pain. Recent studies have shown that Spexin has antinociceptive effect. This study aims to evaluate the correlation between circulating Spexin level with the painful DPN. Methods: This is a cross-sectional study including 20 patients with diabetes but without DPN (non-DPN) as the control group, 24 patients with painless DPN and 16 patients with painful DPN. A questionnaire and laboratory investigation were carried out to obtain information on demographic and clinical data. The existence and severity of DPN was assessed by electromyography (EMG) examination. Serum Spexin level was measured by ELISA. Results: The serum Spexin level of patients with painful DPN was significantly lower than that of non-DPN patients (p<0.001) and painless DPN patients (p=0.035). The binary logistic regression analysis showed that lower serum level of Spexin was independently associated with the presence of painful DPN after adjusting for age, sex, BMI, duration of diabetes, HbA1c, 2hPBG, hypertension and status of smoking or drinking. Compared to individuals with higher level of Spexin, the prevalence rate of painful DPN in those with lower level of Spexin was significantly higher. Conclusion: Circulating Spexin level decreased in painful DPN, suggesting a possible role of this peptide in pain-related pathogenesis.

Phosphate clearance in peritoneal dialysis

In renal failure, hyperphosphatemia is common and correlates with increased mortality making phosphate removal a key priority for dialysis therapy. We investigated phosphate clearance, removal and serum level, and factors associated with phosphate control in patients undergoing continuous ambulatory (CAPD), continuous cyclic (CCPD) and automated (APD) peritoneal dialysis (PD). In 154 prevalent PD patients (mean age 53.2 ± 17.6 year, 59% men, 47% anuric), 196 daily collections of urine and 368 collections of dialysate were evaluated in terms of renal, peritoneal and total (renal plus peritoneal) phosphorus removal (g/week), phosphate and creatinine clearances (L/week) and urea KT/V. Dialytic removal of phosphorus was lower in APD (1.34 ± 0.62 g/week) than in CAPD (1.89 ± 0.73 g/week) and CCPD (1.91 ± 0.63 g/week) patients; concomitantly, serum phosphorus was higher in APD than in CAPD (5.55 ± 1.61 vs. 4.84 ± 1.23 mg/dL; p < 0.05). Peritoneal and total phosphate clearances correlated with peritoneal (rho = 0.93) and total (rho = 0.85) creatinine clearances (p < 0.001) but less with peritoneal and total urea KT/V (rho = 0.60 and rho = 0.65, respectively, p < 0.001). Phosphate removal, clearance and serum levels differed between PD modalities. CAPD was associated with higher peritoneal removal and lower serum level of phosphate than APD.

Association of potato and other starchy vegetable consumption with cardiovascular diseases risk factors in Iranian elderly men

Objectives. Given the limited research on potato and other starchy vegetable consumption with cardiovascular diseases (CVD), we examined the association of potato and other starchy vegetable intakes in association with cardiovascular risk factors and inflammatory biomarkers among elderly men. Study Design. A cross-sectional study. Methods. In this study, 357 elderly men were participated. Dietary intake was assessed using food a valid and reliable frequency questionnaires. Two separated groups were considered. 1. Potato, 2. Other Starchy vegetables including corn, squash, green pea, and green lima beans. CVD risk factors including HDL, LDL, FBS, TG, TC, Alkaline phosphatase, Fibrinogen, Insulin, IL-6, TNF-α, SGOT and SGPT were measured. Results. Participants in the highest tertile of potato consumption had a 45% lower serum level of fasting blood sugar (OR: 0.55; 95%CI: 0.31, 1.97; P trend: 0.041). However, this significant association disappeared after controlling for confounders. The participants in the highest tertile of potato consumption had higher serum level of triglyceride (OR: 4.52 95%CI: 1.10, 18.56; P trend: 0.030). Moreover, participants in the highest tertiles of other starchy vegetable consumption had an 84% lower serum level of alanine aminotransferase (OR: 0.16 95%CI: 0.03, 0.90; P trend: 0.040). Conclusion. Overall, more consumption of potato may be related to developing CVD risk factors. Future research is needed to elucidate the association between potato and other starchy vegetable consumption with cardiovascular diseases risk factors in both genders.

ASSOCIATION OF HLA AND CYTOKINES OF BLOOD WITH ANTIINFLAMMATORY EFFECTS IN PATIENTS WITH CHRONIC GLOMERULONEPHRITIS

Cytokines and HLA take important part in immunogenesis of many diseases, therefore the analysis of these indices and this associations in dependence of glomerulonephritis (GN) can define their value as the additional prognostic markers. Aim of the work is to determine the of associations the high serum levels of cytokines (IL-4, IL-17) and peculiarities of some HLA in phenotype to substantiate of chronic glomerulonephritis with nephrotic syndrome (CGN, NS) immunogen- esis and to ascertain the additional prognostic markers. Materials and methods. There was studied the HLA-antigens distribution in the 264 adult patients CGN, NS (the diagnosis was confirmed morphologically using the thin needle nephrobiopsy) and 350 healthy donors by typing the lymphocytes with the aid of standard microlymphocytotoxic test (Terasaki’s test). HLA antigens were defined using a standard microlymphocytotoxic test on the Terasaki's planchette with special panels ofanti-HLA serums (20 antigens of locus A, 31 - B and 9 - DR). The etiologic fraction (attributive risks ) was counted using the formula: ct = x - y/I - y, where x - frequency of antigen in patients and y - frequency in healthy. The ct reading was considered significant when it exceeded 0,1. Using ELISA, the level of the cytokines was studied in the blood serum - IL-4 in 76 and IL-17 – 79 patients. Results. HLA-A23, -24, -28, -B8, -38, -41, -44, DR1, -4, -w52 in adults patients have associations (RR>2) CGN, NS; the attributive risk (AR) (<j>0,1) to develop GN detected in patients have A24, A28, B8, DR 1, 4, w52. The CGN, NS patients has statistically higher serum level of the IL-4 and IL-17, with more high indices of this cytokines in patients with attributive risk antigens HLA-A24 and A-28. The highest levels of IL-17 detected also in adults case have B14 and B38, which associated with steroid sensitive NS. HLA-B8, which associated with steroid resistant NS, have more patients with CGN, NS with lower serum level of antiinflammatory IL-4. Conclusion. The patients with CGN, NS have associations of HLA and serum levels of pro- and antiinflammatory cytokines IL-4 and IL-17, which play role of additional prognostic predictors.