Acute respiratory viral infections are the most common human diseases. Symptoms of the infection vary from a slight cold to critical condition requiring artificial lung ventilation and support of cardiovascular system. Main risk factors of severe disease include high viral load, co-infection with other pathogens, age from 0 to 2 years and older than 65 years, and immunodeficiency. Cardiac manifestations of the infection are usually caused by indirect effects due to inflammatory reaction resulting in systemic increase in proinflammatory cytokines, so called cytokine storm. However, there have been reports on the identification of respiratory viruses isolated directly from the myocardial tissue, or testing of viral RNA in the myocardium using real-time polymerase chain reaction. This review discusses the direct and indirect effects of respiratory viral infections on causing cardiovascular complications. The authors discuss the similarities and differences of the immunopathogenic mechanisms associated with COVID-19, influenza infection, as well as diseases caused by enteroviruses, respiratory syncytial viruses, metapneumoviruses, and parainfluenza viruses.

Hyperglycemia has become an urgent problem in new coronavirus infection as it is a predictor of a severe course and poor outcomes in both diabetic and non-diabetic patients. This article describes possible mechanisms of hyperglycemia development in new coronavirus infection COVID-19 taking into account peculiarities of pathogenesis and course of the disease, reproduction of SARS-CoV-2, and the ways for hyperglycemia correction by administering different insulin therapy regimens based on the review of national and foreign literature.

Despite significant progress in understanding the pathogenesis and treatment of viral diseases, the influenza virus alone causes up to three to five million severe cases and 250-500 thousand deaths annually. However, respiratory viruses can affect not only the respiratory system, but also cause complications in the cardiovascular system. For example, acute coronary syndrome, myocarditis, pericarditis, exacerbation of chronic heart failure, acute heart failure, pulmonary embolism, and arrhythmias. This review provides information on the incidence of cardiovascular complications that occurred in association with acute respiratory viral infections (COVID-19, influenza, respiratory syncytial virus infection, adenovirus, and rhinovirus infections), and the mechanisms of respiratory virus impact on the cardiovascular system. Understanding these mechanisms may allow to predict the potential cardiovascular complications in patients with respiratory infections and take prompt measures to prevent them as soon as possible especially in case of life-threatening events.

Due to the rather specific course of COVID-19, the question of what day after the start of hospitalization should be expected to be the maximum risk of death in patients both during hospitalization and after discharge is relevant.

Aim. The aim of the study was to determine the time of maximum risk of death during hospitalization of patients with COVID-19 as well as after their discharge from the hospital.

Methodology and Research Methods. A total of 2,410 patients hospitalized with a diagnosis of COVID-19 were retrospectively studied. Inhospital 28-day mortality rate was 131 patients, and 28-day mortality rate after discharge from the hospital was 9. The accelerated failure time model (AFT) was used to determine the time of maximum risk of death in patients with COVID-19 after hospitalization as well as after discharge from the hospital during the period up to 28 days.

Results. Without taking into account the influence of pathological values of other risk factors, lethal outcomes in patients occurred on days 9-11 after admission to hospital. Age over 60 years and the elevated levels of D-dimer, glucose, urea, creatinine, AST, and C-reactive protein were the risk factors (p < 0.01) that shortened the time to death, except for total protein, which lengthened this period. The maximum risk of death in patients after discharge from the hospital occurred on days 13-25, and an increase in creatinine and a decrease in INR were associated with a shorter time to death.

Conclusion. The periods of maximum risk of death as well as the factors affecting these periods in patients with COVID-19 were determined for both hospital stay (days 9-11) and time after discharge from hospital (days 13-25).

Health status of COVID-19 convalescents poses a serious burden on the healthcare system due to frequent decompensation of existing diseases and high mortality after episode of infection. This requires an analysis of not only the causes of death, but also the time of occurrence of complications in order to implement preventive measures and potentially reduce mortality Aim. The aim of the study was to carry out a clinical and pathoanatomical analysis of fatal outcomes in convalescents of COVID-19 in a multidisciplinary hospital.

Material and Methods. The medical documentation of 67 deceased patients with a documented history of COVID-19 was analyzed. Patients were divided into five groups based on the nosological principle.

Results. The study showed that the absolute majority of fatal outcomes occurred within one to two months (chi2 = 15.53; p = 0.001; df = 1); after that, the mortality rate gradually decreased over time. The rate of patients who died from acute and chronic decompensated cardiac diseases was 63%, which may be attributed to the specifics of the hospital. The number of neglected oncological diseases was 21% in our sample, which also should be considered a negative impact of the pandemic. In our study, the neglected oncological diseases were observed in 45% of patients, which was probably due to the profile of the hospital. The incidence rate of pulmonary embolism and other thrombotic complications was significantly higher in women (chi2 = 30.73; p < 0.001; df = 1). While comparing the time between recovery from COVID-19 and onset of death, we found that thrombotic complications occurred more often either immediately or within one to two months after recovery from COVID-19; sometimes patients already had a formed lung infarction, but in these cases the interval was longer (four to six months), which suggested the beginning of thrombosis during the acute stage of disease.

Conclusion. At the early stage, it is necessary to analyze basic information about the epidemiology of post-COVID-19 syndrome taking into account patient age and comorbidities. Given the high frequency of deaths, most often associated with thrombotic events or disorders of the cardiovascular system, it is necessary to plan clinical and laboratory tests, appropriate registries and clinical trials in order to properly assess thee risks and prepare for the long-term consequences of COVID-19.

Background. Studying the impact of complicated course of new coronavirus infection on the cardiovascular system in the long term after patient discharge from hospital is of high significance.

Purpose. To compare the clinical and echocardiographic parameters of persons with history of verified COVID-19 pneumonia one year after discharge from hospital depending on the value of left ventricular (LV) global longitudinal strain (GLS).

Material and Methods. A total of 116 patients (50.4% men) aged 49.0 ± 14.4 years (from 19 to 84 years) with history of verified COVID-19 pneumonia were examined one year ± three weeks after discharge. The parameters of left ventricular global and segmental longitudinal strain were studied in 80 patients with optimal quality of echocardiographic visualization. Patients were divided into groups depending on the LV GLS value: group 1 included 35 patients with normal LV GLS (<–20%); group 2 comprised 45 patients with impaired LV GLS (≥–20%). The groups did not differ in age (p = 0.145), severity of lung injury during hospitalization (p = 0.691), duration of hospitalization (p = 0.626), and frequency of stay in the intensive care unit (p = 0.420).

Results. Abnormal values of LV GLS one year after discharge were found in 57.5% of patients with optimal visualization quality while the LV ejection fraction (EF) was normal in all patients. The majority of patients in group 2 were men (71.1% vs 28.6%, p < 0.001). A combination of coronary artery disease (CAD) and hypertension (AH) was more often diagnosed in this group (22% vs 6%, p = 0.040). The values of LV EF did not differ between the groups. The values of LV GLS were significantly worse in patients of group 2 (–17.6 ± 1.9% vs –21.8 ± 1.2%, p < 0.001). Moreover, the parameters of diastolic function including the left atrial emptying volume index (1.3 ± 0.3 mL/m2 vs 1.4 ± 0.3 mL/m2, р = 0.052) and velocity of the lateral part of the mitral valve fibrous ring e’ (10.8 ± 4 .4 cm/s vs 12.8 ± 4.0 cm/s, p = 0.045) were also lower in this group.

Conclusions. The LV GLS was impaired in 57.5% patients with normal LV EF one year after COVID-19 pneumonia. In the group with impaired LV GLS, men predominated; coronary artery disease was more often detected in combination with AH; and parameters of LV diastolic function were worse compared with the corresponding parameters in the group of patients with normal LV GLS.

Aim. The aim of the study was to identify the features of a new coronavirus infection in patients with chronic obstructive pulmonary disease (COPD), bronchial asthma (BA), and cardiovascular disease (CVD).

Materials and Methods. The retrospective study included 58 patients with novel coronavirus infection, which were divided into four groups: group 1 comprised 12 patients with COPD and CVD; group 2 comprised 15 patients with BA and CVD; and group 3 comprised 31 patients with CVD only. All patients underwent a clinical examination, complete blood count, biochemical blood examination, coagulation testing, serum ferritin test, and multi-slice computed tomography.

Results. The severity of dyspnea was greater in patients with COPD/CVD compared with BA/CVD, and in patients without bronchopulmonary pathology. The frequency of desaturation was the lowest in BA/CVD group compared with COPD/CVD and COPD/BA/CVD. A lower level of saturation was observed in COPD/CVD group in comparison with BA/CVD. The extent of lung damage also prevailed in group with COPD/CVD compared with patients without bronchopulmonary pathology. Patients with CVD only demonstrated the lowest level of leukocytes in contrast with all other study groups. However, the platelet count prevailed in the CVD group compared with the COPD/CVD group. Serum ferritin in patients with COPD/CVD was higher than in the AD/CVD group.

Conclusion. Patients with COPD had more severe coronavirus infection due to severity of dyspnea, low saturation indicators, high values of ferritin, and greater severity of lung damage according to computed tomography. Patients with asthma were prone to a less severe course of coronavirus infection due to less dyspnea, rare episodes of desaturation, high saturation rates, and low ferritin values.

Aim. To study the condition of the right heart and hepatolienal circulation in patients three months after COVID-19.

Material and Methods. A total of 87 patients aged on average 36.2 years who were treated for COVID-19 three months before underwent echocardiography and the study of hepatolienal blood flow. Patients were divided into groups: group 1 comprised patients with CT 0; group 2 comprised patients with bilateral pneumonia CT 1–2, and group 3 comprised patients with CT 3–4. Control group comprised 22 patients who did not undergo COVID–19.

Results. In patients of group 1, the diastolic velocity of the transtricuspid flow increased by 24% compared to the control p <0.001. The ratio of diastolic velocities E/A and Em/Am decreased in all groups, and the greatest abnormalities were found in group 3. In group 3, systolic pressure in the pulmonary artery increased; the right ventricle, fibrous ring, right branch of the pulmonary artery, and diameters of the inferior vena cava, portal vein, and splenic veins increased. There was a decrease in the flow rate in the splenic vein (14%), and sizes of the liver and spleen increased. Correlations were established between increased pressure in the pulmonary artery and functional parameters of the heart and hepatolienal blood flow as well as between morpho-functional parameters of the heart and indicators of the portal vein, p < 0.001.

Conclusion. Three months after the coronavirus infection, patients with mild and moderate severity of the disease developed subclinical abnormalities in the diastolic function of the right ventricle. In patients with severe viral pneumonia, there was also increased pressure in pulmonary artery; the dilatations of the right ventricle, pulmonary artery, splenic vein, and portal veins developed along with a decrease in the flow rate in the splenic vein and increases in the liver and spleen.

Background. Sleep disorders have a negative impact on many aspects of life. COVID-19 exacerbates this problem in the context of the post-COVID syndrome where sleep disorder is one of the common complaints.

Objective. We aimed to assess the frequency of sleep disorders after COVID-19 and the presence of associations between post-COVID sleep disorders and the severity of COVID-19.

Material and methods. A cross-sectional study was carried out in Novosibirsk. It included 115 people aged 26 to 74 years (an average age of 54.22 ± 12.48 years) after recovery from COVID-19, which occurred two to eleven months before. Patients underwent questionnaire survey (Spiegel sleep score questionnaire, HADS Anxiety and Depression Scale, International Restless Legs Syndrome (RLS) Severity Scale), examination by a somnologist, and screening night computer pulse oximetry. If an index of desaturations was more than five per hour, we performed overnight somnography by WAtch PAT 200 or polysomnography. Patients were divided into groups depending on the presence of sleep disorders, COVID-19 severity, and their age. Statistical analysis included a descriptive analysis. Odds ratio was assessed by determining the risk measure for dichotomous variables in the contingency table.

Results. RLS was the most common post-COVID sleep disorder (n = 63, 75%). However, primary insomnia was diagnosed only in patients with moderate-to-severe course of COVID-19 (n = 3, 9%). There were 40 patients with post-COVID sleep disorder; they had significantly lower sleep time on workdays (7.00 [6.00; 7.50] vs. 7.50 [6.50; 8.00] hours, p = 0.021) and significantly higher mean HADS depression score (5.00 [3.00; 7.00] vs. 3.00 [1.00; 6.00] points, p = 0.006) compared with the corresponding parameters in patients without deterioration of sleep quality. The chance of reduced sleep quality was 11.6 times higher after moderate-to-severe COVID-19 infection than that after mild infection only in patients aged 26-59 years (95% confidence interval 1.42–94.32, p = 0.007).

Conclusion. The chance of worsening sleep quality was significantly higher after a moderate-to-severe COVID-19 infection than after mild infection in 26-59-year-old old patients. At the same time, RLS was the most common post-COVID sleep disorder according to our study. Given the importance of sleep disorders, working-age patients after moderate-to-severe COVID-19 infection require active monitoring by doctors in order to timely correct emerging complaints. 

Introduction. Several viruses including hepatitis C virus (HCV) and human immunodeficiency virus (HIV) can induce vasculitis.

Aim. We aimed to study the incidence, risk factors, and severity of skin vasculitis in patients with HCV and HCV/HIV coinfection.

Patients and Methods. The study group included 331 patients (254 patients with HCV and 77 patients with HCV/HIV coinfection) referred to a specialized hepatology center for antiviral therapy of HCV infection.

Results. Skin vasculitis was found in 21% (95% CI: 17–25%) of cases, n = 69/331. Skin vasculitis was observed in in 20% of patients infected with HCV (95% CI: 15–25%) and in 25% of HIV/HCV co-infected patients (95% CI; 16–35%), χ2 = 0,892, р = 0,345. Most patients with vasculitis infected with HCV had cryoglobulinemia (94%, n = 47/50), meanwhile, in HIV/HCV co-infected patients, cryoglobulinemia was found in 63% cases (n = 12/19), χ2 = 10.568, р = 0.001. Multiple regression analysis showed that skin vasculitis was related with cryoglobulinemia (OR = 6,928, 95% CI: 3.245–14.790, р < 0.001), liver cirrhosis (OR = 2.015, 95% CI: 1.062–3.824, р = 0.032), duration of overt HCV infection (OR = 1.057, 95% CI: 1.021–1.094, р = 0.002), patients age (OR = 1.029, 95% CI: 1.002–1.057, р = 0.033) and inversely related with plasma alanine transaminase (OR 0.433, 95% CI: 0.229–0.820, р = 0.010). The statistical model was normalized for gender, HIV-positivity and bilirubin levels, and regression equation constant was 4.398 (p < 0.001). The intensity of skin rashes was comparable in HCV infected and HCV/HIV co-infected patients (χ2 = 6.741, р = 0.081), and was highly correlated with cryoglobulin levels both in HCV infected (r = 0.788, p < 0.001), and HCV/HIV co-infected patients (r = 0.909, p = 0.001).

Conclusion. Skin vasculitis was found in 20–25% of cases among patients with HCV infection and HCV/HIV co-infection. Cryoglobulinemia was the main factor associated with skin vasculitis, and severity of skin lesions was closely related with cryoglobulin levels.

Aim. To assess the tolerability of vaccination with the first component of Gam-COVID-Vac (Sputnik V), the frequency and nature of adverse events following immunization (AEFI) depending on gender, age, obesity, and chronic diseases.

Material and Methods. The study included male and female patients who received the first component of the Gam-COVIDVac vaccine at MSU Medical Center. Subsequently, after 14 days, a remote survey of respondents was conducted to collect the data regarding the development of adverse events requiring the use of drug treatment or medical care.

Results. The study included 732 participants. Two-thirds of the respondents (65.8%) reported the development of AEFI: pain at the injection site (46.9%), fever (25.5%), muscle pain (29.9%), and headache (27%). At the same time, women noted the occurrence of AEFI more often than men (72.4% vs 57.5%, p < 0.05), and AEFI duration was also longer. Patients over 60 years of age reported less fever than patients under 40 years of age (21.0% vs 31.1%; p < 0.031). Young age and female gender were independent predictors of AEFI after vaccination with the first component of the Sputnik V vaccine. Obesity and a history of reported chronic non-infectious diseases did not correlate with the occurrence of AEFI.

Conclusion. Adverse events after the administration of the first component of Gam-COVID-Vac (Sputnik V) were of short duration and were easily tolerated by both young and old patients.

Purpose. The objective of the study was to elucidate the impact of COVID-19 pandemic on cardiac magnetic resonance imaging (CMR)-derived portrait of a patient in one specialized cardiovascular center.

Material and Methods. The study comprised 987 patients who underwent CMR with paramagnetic contrast enhancement in cardiovascular center from 01.01.2019 to 01.06.2022. Data were obtained from electronic medical records stored in the electronic module keeping track of instrumental studies. Data contained information on type and characteristics of protocol, referring department, clinical and demographic patient characteristics, and diagnosis. Gender, age, type of visit (ambulatory, in-hospital), instrumental data, and unstructured text were analyzed. Contrast-enhanced CMR was performed according to standard method using 1.5-Tesla MRI system Vantage Titan 1.5T (Toshiba Medical Systems) with ECG-synchronization.

Results. Proportion of CMR among all MRI studies increased during the study period. Maximum number of cardiac diseases was detected in 2021. Incidence of fibrosis-dystrophic myocardial changes increased from 67.17% in 2019 to 84.14% in 2022 potentially due to the past cardiac inflammation. Patient numbers in each age group peaked in 2021, and the highest incidence rate was observed in the group of 60-69-year-old patients with high risk for severe COVID-19 course and complications. In 2020, the incidence of acute myocarditis significantly decreased to 10% in men and 13% in women and then gradually increased in 2021. The rate of ambulatory visits significantly increased in 2020, but returned to the pre-pandemic level in 2021.

Conclusion. COVID-19 pandemic increased the need for CMR. Patients with history of COVID-19 had persistent and newly occurring symptoms of myocardial damage suggesting chronic cardiac involvement. Regional myocardial fibrosis was the main COVID-19-associated presentation on contrast-enhanced CMR. Continuous follow-up of patients is required to assess their risk for the left ventricular remodeling.

Introduction. Chest computed tomography (CT) plays a prominent role in determining the extent of pulmonary parenchymal lesions in COVID-19. At the same time, subjectivity of lung lesion volume assessment using 0-4 CT scale in COVID-19 and gradual introduction of low-dose CT (LDCT) requires an investigation of semi-automated lung segmentation accuracy in LDCT compared to CT.

Study Objective. To compare the accuracy of affected lung tissue volume calculation between CT and LDCT in COVID-19 using a semi-automatic segmentation program.

Material and Methods. The retrospective study was performed on data from the earlier prospective multicenter study registered at ClinicalTrials.gov, NCT04379531. CT and LDCT data were processed in 3D Slicer software with Lung CT Segmenter and Lung CT Analyzer extensions, and the volume of affected lung tissue and lung volume were determined by thresholding.

Results. The sample size was 84 patients with signs of COVID-19-associated pneumonia. Mean age was 50.6 ± 13.3 years, and the median body mass index (BMI) was 28.15 [24.85; 31.31] kg/m2. The effective doses were 10.1 ± 3.26 mSv for the standard CT protocol and 2.64 mSv [1.99; 3.67] for the developed LDCT protocol. The analysis of absolute lung lesion volume in cubic centimeters with Wilcoxon Signed Ranks Test revealed a statistically significant difference between CT and LDCT (p-value < 0.001). No statistically significant differences were found in the relative values of lung tissue lesion volume (lesion volume/lung volume) between CT and LDCT using Wilcoxon Signed Ranks Test (p-value = 0.95).

Conclusion. The reliability of developed LDCT protocol in COVID-19 for the semi-automated calculation of affected tissue percentage was comparable to the standard chest CT protocol when using 3D Slicer with Lung CT Segmenter and Lung CT Analyzer extensions.

Aim: To evaluate clinical and morpho-functional predictors of super-response to cardiac resynchronization therapy (CRT) in patients with heart failure and reduced ejection fraction (HFrEF) in the short-term period after implantation.

Material and Methods. The study enrolled 86 patients (88.4% men, 54.0 ± 8.9 years mean age, New York Heart Association (NYHA) class II–IV). Patients were examined at baseline and in dynamics (mean follow-up was 10.6 ± 3.6 months). According to the change in left ventricular (LV) end-systolic volume (ESV) patients were divided into two groups: Group I (n = 19) with a decrease in LV ESV ≥ 30% (super-responders (SR) and Group II (n = 67) – decrease in LV ESV < 30% (non-super-responders (non-SR). Parameters of mechanical dyssynchrony (MD) were assessed in the two groups including LV pre-ejection period, interventricular mechanical delay (IVMD), intraventricular delay (IVD).

Results. At baseline, traditional parameters of MD were higher in SR: LV pre-ejection period (156.8 ± 35.4 ms vs 135.0 ± 35.6 ms; p = 0.021) and IVMD (73.0 [43.0; 108.0] ms vs 47.0 [19.5; 70.0] ms; p = 0.017). Logistic regression results showed that female gender (HR 7.048; 95% CI 1.496–33.206; p = 0.014) and QRS width (HR 1.017; 95% CI 1.000–1.034; p = 0.048) had an independent association with super-response.

Conclusion. In patients with HFrEF, more severe mechanical and electrical dyssynchrony is associated with super-response to CRT in a short-term follow-up period.

Aim. To evaluate the effectiveness of serelaxin with subsequent quadritherapy in the treatment of patients with acute decompensation of heart failure in the long term outcomes.

Material and Methods. A five-year observational, comparative, longitudinal study was conducted with the participation of 34 patients with heart failure. Standard laboratory and instrumental methods of examination were performed, including the determination of the level of Nt-proBNP, electrocardiography, echocardiography. The quality of life was assessed on the basis of the SF-36 questionnaire, the state of health using a visual analog scale (VAS), a survival forecast was made using the MAGGIC scale and the Seattle Heart Failure Model calculator. The assessment of adherence to treatment was carried out using the questionnaire “COP-25”.

Results and Discussion. With serelaxin therapy at the 14th day, there was a significant decrease (p ˂ 0,05) of Nt-proBNP level, pulmonary artery pressure, as well as an increase of left ventricular (LV) ejection fraction (EF) by an average of 5%, which coincided with the leveling of manifestations of heart failure (HF) decompensation and improvement of clinical and instrumental parameters. There was a statistically significant (p ˂ 0,05) improvement in the quality of life based on the patient’s subjective assessment. Stable positive dynamics was recorded on the basis of the SF-36 questionnaire for all health indicators, not only physical, but also social and mental. Subsequent quadrotherapy reduced the mortality rate of patients in the study cohort of patients, as well as increased adherence to treatment.

Conclusion. The use of serelaxin does not lead to a decrease in cardiovascular mortality, however, it reduces the number of hospitalizations due to acute decompensation of heart failure. The subsequent quadrotherapy leads to an increase in the quality of life, physical, social activity and adherence to the treatment. Reverse remodeling of the left heart chambers and an increase in EF LV is characterized by a decrease of the functional class of CHF, which indicates the influence of this therapy on the key pathogenetic mechanisms of the disease.

Introduction. The work presents the results of studying the effects of three new azoloazine derivatives on oxidative glucose metabolism in order to select substances with the most acceptable characteristics for further preclinical study as potential antitumor agents, including for breast cancer chemotherapy.

Aim. The aim of the work is to identify the metabolic properties of new azoloazine derivatives in terms of their effect on glucose metabolism using a culture of MCF-7 tumor cells and Vero non-tumor cells.

Material and Methods. The testing on cell cultures was the main method used in the work, and all tested compounds were applied in final concentrations from 2.5 μmol/L. The comparison drug was epirubicin in the same concentration. The biochemical techniques included the determination of lactate production using commercial Olvex Diagnosticum kits and the determination of oxygen consumption by cells using the Seahorse XFe24 Analyzer for cellular metabolism. The results were processed statistically.

Results. Lactate production in MCF-7 and Vero cell cultures decreased by more than half in the presence of 3-Cyclohexyl4-oxoimidazo[5,1-d]-[1,2,3,5]tetrazine-8-N-piperidinyl-carboxamide, and oxygen consumption decreased by 19-40%, which was the maximum effect among the studied azoloazine derivatives. Diethyl ether of 4-aminoimidazo[5,1-c][1,2,4]triazine-3,8dicarboxylic acid and 4-Amino-8-ethoxycarbonyl-imidazo[5,1-c][1,2,4]triazine-3-N-(p-toluyl)carboxamide were similar in their metabolic effects to the comparison drug epirubicin. They reduced lactate production in MCF-7 and Vero cell culture by a third and by 21–22%, respectively. Oxygen consumption in MCF-7 cell culture decreased by 14–17%, in Vero cell culture it decreased by 18–24%.

Conclusion. The data obtained allow us to consider the (3-Cyclohexyl-4-oxoimidazo[5,1-d]-[1,2,3,5]tetrazine-8-N-piperidinylcarboxamide as the leader among new azoloazine derivatives and recommend it for further preclinical study as a potential antitumor agent.

Introduction. A new coronavirus infection causes a variety of changes in the body of an infected person, which can be monitored using clinical blood analysis. The capabilities of flow cytometry allow to expanding the range of analyzed cell populations, which gives a more complete picture of the patient’s condition and the course of infection process.

Aim. To study the extended 8-diff clinical blood analysis in patients with COVID-19 and to identify the parameters characterizing a severe course and an unfavorable outcome.

Material and Methods. The study group comprised 282 patients with a confirmed diagnosis of a new coronavirus infection. The following parameters of the extended 8-diff clinical blood test were evaluated: the total content of leukocytes and their populations, the number of reactive and antibody-synthesizing lymphocytes (RE-LYMPH, AS-LYMPH), indicators characterizing the reactivity and granularity of neutrophils (NEUT-RI, NEUT-GI), erythrocyte count, hemoglobin level, normoblast count, and platelet count. Statistical data were processed using the Statistica 10.0 software.

Results. The blood picture of patients with a severe course of COVID-19 as well as of those with an unfavorable outcome of disease was characterized by neutrophilia, normoblastemia, and an increase in the number of immature granulocytes. At the same time, there was a significant decrease in the number of lymphocytes and monocytes below the reference interval and a decrease in the number of eosinophils to the extent of complete absence. The performed logistic regression analysis allowed to determine the most significant hematological parameters in predicting the outcome of COVID-19 as follows: the total number of leukocytes (OR 1.3), neutrophils (OR 2.1), reactive neutrophils (OR 1.3), eosinophils (OR 0.05), monocytes (OR 0.2), lymphocytes (OR 0.4), and neutrophil-to-lymphocyte ratio (NLR) (OR 1.4). Also, the threshold values were established for these parameters as follows: the total number of leukocytes > 7.2 × 10⁹/L, neutrophils > 5 × 10⁹/L, reactive neutrophils > 48.6 Fi, eosinophils < 0.05 × 10⁹/L, lymphocytes < 1.3 × 10⁹/L, monocytes < 0.5 × 10⁹/L, and NLR > 2.9 were associated with an unfavorable outcome of the disease.

Conclusion. The obtained data may be used for a comprehensive evaluation of COVID-19 patient condition along with other laboratory markers of the severe course of the infection.

The problem of systemic manifestations of borreliosis is relevant due to the wide distribution of ixodid ticks in the territory of the Russian Federation. The article presents a clinical case illustrating the course of borreliosis in a patient with developed cardiac complications, timely detection of which made it possible to establish a correct diagnosis, identify the pathogen, and prescribe etiotropic treatment. The described case demonstrates the need for increased seasonal attentiveness in the analysis of clinical information and research results, the collection of an extended epidemiological history, a comprehensive assessment of the patient’s condition, and the analysis of all changes in organs and systems.

Isolated left ventricular non-compaction (LVNC) is a rare variant of unclassifiable cardiomyopathy (CMP). The basis of the clinical picture of non-compaction CMP is heart failure, arrhythmias, and thromboembolism. Acute cardiac and extracardiac diseases can act as a trigger for the LVNC manifestation. The paper provides an example of diagnosing LVNC in an adult patient after acute myocarditis against the background of vaccination against a new coronavirus infection COVID-19. The characteristics of the ongoing therapy are given and the dynamics of the course of the disease over a period of five months of observation is reflected.

The article presents a clinical case of SARS-CoV-2 infection complicated by acute respiratory distress syndrome, pulmonary edema, and heart failure in the presence of chronic venous congestion in a patient with chronic rheumatic heart disease. A female patient R., 65 years old, was hospitalized at the Republican Cardiological Dispensary with a diagnosis of novel coronavirus infection COVID-19 (severe course); the virus was identified. Competing diagnosis: (1) acute viral myocarditis;

(2) chronic rheumatic heart disease with combined mitral-aortic disease. Complications of the underlying disease included viral interstitial pneumonia (75%) and pulmonary edema. The patient was admitted at day 8 from the onset of the disease with complaints of increase in body temperature up to 38.5 °C, chest pain, and shortness of breath. She was treated in the outpatient setting without visible improvement. The patient had a history of chronic rheumatic heart disease. Due to persistent fever, patient received computed tomography showing interstitial pneumonia of viral etiology. The diagnosis of COVID-19 was based on a typical clinical presentation and a positive PCR test in nasopharyngeal swabs. Nonspecific changes were observed in the electrocardiogram. Treatment was initiated without positive dynamics, and a fatal outcome occurred. According to the autopsy data, the organs showed signs of chronic venous congestion (brown induration of the lungs, nutmeg fibrosis, cyanotic induration of the spleen and kidneys). The infiltrates consisting of lymphocytes and eosinophils were detected in the myocardium. Also, edema of the intercellular space, plethora of microvasculature vessels, and dystrophic changes in cardiomyocytes were detected. The presence of Aschoff-Talalaev granulomas with fibrinoid necrosis and avulsion of the chorda of the mitral valve leaflet was observed. Morphologically, there were signs of pulmonary infarction with a polysegmental character. Thus, in the presented case, the scientific novelty was the extremely rare development of mitral valve chord avulsion in aortic-mitral disease after infection with SARS-CoV-2, which was the cause of acute heart failure. It is likely that the process was aggravated by concomitant diffuse interstitial serous myocarditis and fibrinoid necrosis in granulomas.

The article describes a clinical case of inhalation therapy with high doses of nitric oxide (NO) in a comorbid patient with a severe course of COVID-19. An air stream containing NO was generated using the PLAZON device. High-dose NO inhalation therapy was administered as a life-saving option due to the lack of effect from treatment delivered in accordance with the current national clinical guidelines for the treatment of COVID-19. The safety and clinical efficacy of the technique was demonstrated.

Introduction. Despite the contribution of medical advances in improving the citizens’ health status, mortality from cardiovascular diseases (CVD) remains at a high level. In most cases patients seek medical assistance after the disease manifestation, which explains the need to develop and implement effective methods to promote a healthy lifestyle as a primary prevention of CVD. The effectiveness of preventive measures for cardiovascular diseases has been known long ago, and their significance is not in doubt, however, the adherence to preventive therapy in society is extremely low.

Aim. To compare the effectiveness of memorization and perception of different ways of presenting the basic principles of primary prevention of CVD among the population of middle age group.

Material and Methods. The study enrolled 102 people (63 women and 39 men) aged 45 to 59 years not suffering from CVD. The initial level of knowledge of the basic principles of CVD prevention was determined by a polling method. Further, all respondents were randomly divided into three groups. Depending on the group all participants were offered to get acquainted with prevention information in the form of a lecture, a booklet or a video. After getting acquainted with the information, the respondents were asked questions regarding the content, as well as the perception of the proposed material. Statistical processing was performed using Statistica 10.0 software package.

Results. It was esteblished that the middle-aged population has a low level of literacy in relation to prevention of CVDs. Thus, 79 respondents (77.5%) gave wrong answers to the most of the questions. After the information was presented, all participants, depending on the group, were offered to review the information in the form of a lecture, a booklet or a video. The most effective form of information delivery among this group of population was booklets, after getting acquainted with which 97% of respondents answered the questions «correctly». Information presented in the format of a video was assimilated a little worse – 90% of correct answers. Only 79% of correct answers were given by respondents who listened to a lecture without visual support, which indicates that this form of presentation of information is not effective enough. When assessing perception of information, the group of respondents who received booklets and watched a video scored 23.5 and 23.2 points, respectively, out of a 25 possible. While the group that listened to the lecture scored only 20 points out of a 25 possible.

Conclusion. The study showed that the middle-aged population has a low level of medical literacy and needs educational information on primary prevention. Booklets were the most effective form of delivering this information to this population group. Information in the form of videos was slightly inferior to booklets, but was also readily perceived by the population and demonstrated a high percentage of knowledge acquisition. The worst results were shown by the lectures without visual support.