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Macrophage-derived cytokines in pneumonia: Linking cellular immunology and genetics
No full textMacrophages represent the first line of anti-pathogen defense - they encounter invading pathogens to perform the phagocytic activity, to deliver the plethora of pro- and anti-inflammatory cytokines, and to shape the tissue microenvironment. Throughout pneumonia course, alveolar macrophages and infiltrated blood monocytes produce increasing cytokine amounts, which activates the antiviral/antibacterial immunity but can also provoke the risk of the so-called cytokine “storm” and normal tissue damage. Subsequently, the question of how the cytokine spectrum is shaped and balanced in the pneumonia context remains a hot topic in medical immunology, particularly in the COVID19 pandemic era. The diversity in cytokine profiles, involved in pneumonia pathogenesis, is determined by the variations in cytokine-receptor interactions, which may lead to severe cytokine storm and functional decline of particular tissues and organs, for example, cardiovascular and respiratory systems. Cytokines and their receptors form unique profiles in individual patients, depending on the (a) microenvironmental context (comorbidities and associated treatment), (b) lung monocyte heterogeneity, and (c) genetic variations. These multidisciplinary strategies can be proactively considered beforehand and during the pneumonia course and potentially allow the new age of personalized immunotherapy
The overview of software and information support services for distance learning
No full textThe article provides the overview of software and services for information support of distance learning-e-learning systems, knowledge test control and video conferencing. The advantages of openness of software code and modularity of their structure are shown. The pros and cons of the installed software and cloud services by subscription are discussed. The systems are compared on a number of criteria. Examples of their practical application are also described
Effect of anticoagulant therapy on the course of covid-19 in comorbid patients
No full textIntroduction. Analysis of the pathogenesis of coronavirus infection caused SARS-CoV-2 indicates a significant impact of hemorheological disorders on its course and outcomes. It is known that chronic cardiovascular diseases are associated with the risk of severe course and lethal outcomes both in COVID-19 and other infectious diseases. Therefore, in each case it is necessary to study the interaction and mutual influence of different components of the treatment program prescribed to such patients. The purpose of this work was to evaluate the effect of coagulation activity on the course of a novel coronavirus infection (COVID-19) and to justify the management of comorbid patients having been received novel oral anticoagulants (NOACs) in previously selected doses according to indications in concomitant somatic diseases. Material and methods. Total 76 cases of confirmed coronavirus infection in patients who had been received initial therapy on an outpatient basis were analyzed. 26 patients who received NOACs (rivaroxaban, apixaban, dabigatran) made up the main group and 50-the comparison (control) group in which patients had not been administered any drugs that affect blood clotting until the episode of COVID-19. All patients have been prescribed therapy following the Provisional guidelines «Prevention, diagnosis and treatment of coronavirus infection (COVID-19)» (https://static-0.minzdrav.gov.ru/system/attachments/attaches/). Results and discussion. The number of hospitalizations was significantly fewer in the group of patients who had been received NOACs (19 vs. 66% in the control group). No deaths or cases of severe respiratory and/or renal failure were observed in the main group, while adverse outcomes were noted in 14% of patients who had not been administered these drugs. Conclusion. Taking NOACs reduces the probability of severe course and adverse outcomes in the development of coronavirus infection caused by SARS-CoV-2, which indicates a significant contribution of coagulation mechanisms to the pathogenesis in COVID-19. There were no indications for drug replacement and correction of anticoagulant therapy regimens in patients who received adequate therapy with oral anticoagulants for treating a non-severe form of coronavirus infection in ambulatory patient settings
Clinical and morphological manifestations of immune system dysfunction in new coronavirus infection (Covid-19)
No full textRapid development in 2020 of the COVID-19 pandemic caused by SARS-CoV-2 initially indicated signifi-cant involvement of the immune system. However, information on specific changes in organs of the immune system is still limited. A wide range of alterations was revealed in our study: from pronounced devastation of B-dependent and T-dependent zones of lymphoid tissue, reminiscent of changes in HIV infection at the AIDS stage, to hyperplasia of the tissue of lymph nodes and spleen of varying degrees. Analyzing the literature data, we focused on the fact that pathomorphological changes revealed in the autopsy studies of patients with a severe COVID-19 were accompanied by premortal lymphopenia in most cases. However, the cause of lymphopenia in COVID-19 has not yet been disclosed, authors of the review hypothesized that unregulated apoptosis of circulating lymphocytes is one of the potential lymphopenia inductors. Cytokine activation (“cytokine storm”) may be associated with lymphoid organs’ atrophy, which also contributes to a decrease in the circulating lymphocyte count. There is no doubt about the relevance of further identification of the immune cell apoptosis as one of the causes of lymphopenia and immune dysfunction in COVID-19 patients, which has prospects for pharmacological developments to manage lymphocytic apoptosis
Organizing experience in an epidemiological service in the context of urgent conversion of a general hospital to manage patients with SARS-CoV-2 infection
No full textFebruary 11, 2020, World Health Organization (WHO) declared a pandemic of the new coronavirus and assigned the official name of the infection caused by the new coronavirus-COVID-19 («Coronavirus disease 2019»). On February 11, 2020, the International Committee on Virus Taxonomy gave the official name to the infectious agent as SARS-CoV-2. À new coronavirus infection caused by SARS-CoV-2 has become a challenge for the healthcare system as in Russia as over the world. The medical community has focused its efforts on fighting the pandemic. On March 20, 2020, there the O. M. Filatov Municipal clinical hospital was decided to be redesigned, and this general hospital, including maternity wards, became an infection hospital. One of the main reasons for redesigning was multidisciplinary medical care, including working with patients with a new coronavirus infection, the presence of a maternity home with boxes and own reanimation, the presence of a transition connecting for all three buildings, a large area, with ability to organize routes and placements additional temporary buildings. In the first place there were solved problems as a device of sanitary systems with the gateway, division to the «red» and «green» zones in all buildings of the clinics, development of detailed routing the patients including infectious requirements, navigation inside buildings and on hospital territories for the separation of medical personal, transport, the realization of a plan with the requirements, submitted by Federal Service for Oversight of Consumer Protection and Welfare to medical institutions, working with a new coronavirus infection, in terms of sanitary standards: Disinfection of areas and surfaces and transport, creation inventory curative diagnostic (including reanimation) equipment, sufficient number of oxygen points, medicines, disinfection products and personal protective equipment. One of the scale tasks were about care for the health safety of medical personal. Changes to the work concerned various aspects: Legal regulation, ethical problems, features practical work and education, interaction with all of them structural departments of the hospital. Within a week task, which put the Department of health of the city of Moscow, was resolved by management of hospital, and on March 27, 2020, the hospital accepted the first patients as an infectious disease hospital
Features of developing SARS-CoV-2 nucleocapsid protein population-based seroprevalence during the first wave of the COVID-19 epidemic in the Russian Federation
No full textThe novel coronavirus (SARS-CoV-2) pandemic, dubbed COVID-19, has become one of the most serious challenges for human populations in the vast majority of countries worldwide. Rapid spreading and increased mortality related to it required new approaches to manage epidemic processes on a global scale. One of such approaches was based on analyzing SARS-CoV-2 seroprevalence associated with COVID-19. Our aim was to summarize the results on assessing seroprevalence to the SARS-CoV-2 nucleocapsid antigen (Nc) in residents from 26 regions of the Russian Federation, carried out during the first wave of the COVID-19 epidemic. Materials and methods. Seroprevalence distribution was examined in 26 model regions of the Russian Federation according to the unified method developed by the Rospotrebnadzor with the participation of the Federal State Institution Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology. Such approach implied formation of a group of volunteer subjects in model geographic region who were tested by ELISA for anti-Nc serum antibody level in peripheral blood. Analyzed primary data obtained in separate regions were either accepted for publication or released. Results. The current paper finalizes the data obtained in all 26 regions of the Russian Federation. The total SARS-CoV-2 seroprevalence was 19.5 (10.0–25.6)% with the maximum and minimum value found in the Kaliningrad Region and the Republic of Crimea, respectively (50.2% vs. 4.3%). A pattern of age-related seroprevalence distribution indicates insignificant predominance of seroprevalence among subjects of 1–17 years old: 22.1 (13.1–31.8)%. Among COVID-19 convalescents positive for SARS-CoV Nc antibodies it reached 60.0 (40.0–73.3)%. The number of contact persons comprised 6285 subjects or 8.5% of total volunteer cohort, with the level of seroprevalence reaching up to 25.3 (17.95–35.8)%. A direct correlation was revealed between levels of seroprevalence in convalescent and contact volunteers. In addition, the reproductive number for SARS-CoV was calculated comprising 5.8 (4.3–8.5) suggesting that one convalescent subject can infect at least 4 healthy individuals. A high level of asymptomatic forms of COVID-19 among seropositive subjects was confirmed empirically comprising up to 93.6 (87.1–94.9)%. Conclusion. A single cross-sectional study performed during 2020 June–August timeframe allowed to assess pattern of sex- and age-related COVID-19 seroprevalence for general population in 26 Russian Federation regions. The data obtained may serve as a basis for the longitudinal cohort investigation with serial subject sampling. The timing and duration of study will be determined by dynamics of ongoing COVID-19 epidemic
Perinatal outcomes in pregnant women with COVID-19 in Siberia and the Russian Far East
No full textObjective: To assess the incidence and perinatal outcomes of COVID-19 in pregnant women in the Far Eastern and Siberian Federal Districts of Russian Federation over 10 months of a pandemic. Materials and methods: This was secondary analysis of Public Data basis on 25 Dec 2020. Statistics included descriptive statistics, analysis of contingency tables, which assessed the value of χ , the achieved significance level (p). Results: During the first year of the SARS-CoV-2 pandemic, 8485 cases of COVID-19 were registered in pregnant women in the Far Eastern Federal District and the Siberian Federal District, accounting for 5.9% of registered pregnant women and 1.71% of the total affected population. The morbidity rate in pregnant women was 3.02 times higher than in the general population: 5933.2 vs 1960.8 per 100 thousand population. 27.4% of mothers had asymptomatic disease; 52.7%–mild; 16.6%–moderate, 2.5%–severe, 0.5%–critical disease. The incidence of hospitalization in ICU of pregnant women was higher relative to the general population (3.57% vs 2.24%,
Comparative efficiency of green and conventional bonds pre- and during COVID-19: An asymmetric multifractal detrended fluctuation analysis
No full textMotivated by the lack of research on price efficiency dynamics of green bonds and the impact of the COVID-19 on the pricing of fixed-income securities, this study investigates the comparative efficiency of green and conventional bond markets pre- and during the COVID-19 pandemic applying asymmetric multifractal analysis. Specifically, the multifractal scaling behaviour is examined separately during upward and downward trends in bond markets using the asymmetric multifractal detrended fluctuation analysis (A-MF-DFA) approach. The empirical findings confirm the presence of asymmetric multifractality in the green and traditional bond markets. Not surprisingly, inefficiency in both bond markets significantly escalated during the COVID-19 outbreak. Furthermore, our results indicate a higher level of efficiency of the conventional bond market over the full sample period. However, the green bond market is more efficient during a black swan event, such as the COVID-19 global pandemic, showing the potential of green bonds to become an effective diversifier for investors in traditional assets in times of extreme market turmoil. The results of the study can have important implications for investors and policymakers
Multiple COVID-19 Risk Factors Increase the Likelihood of Experiencing Anxiety Symptoms in Canada
No full textCoronavirus disease 2019 (Covid-19) and autoimmunity
No full textThe coronavirus 2019 pandemic (coronavirus disease, COVID-19), etiologically related to the SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus-2), has once again reawakened healthcare professionals' interest towards new clinical and conceptual issues of human immunology and immunopathology. An unprecedented number of clinical trials and fundamental studies of epidemiology, virology, immunology and molecular biology, of the COVID-19 clinical course polymorphism and pharmacotherapy have been conducted within one year since the outbreak of 2019 pandemic, bringing together scientists of almost all biological and physicians of almost all medical specialties. Their joint efforts have resulted in elaboration of several types of vaccines against SARS-CoV-2 infection and, in general, fashioning of more rational approaches to patient management. Also important for COVID-19 management were all clinical trials of biologics and “targeted” anti-inflammatory drugs modulating intracellular cytokine signaling, which have been specifically developed for treatment immune-mediated inflammatory rheumatic disease (IMIRDs) over the past 20 years. It became obvious after a comprehensive analysis of the entire spectrum of clinical manifestations and immunopathological disorders in COVID-19 is accompanied by a wide range of extrapulmonary clinical and laboratory disorders, some of which are characteristic of IMIRDs and other autoimmune and auto-inflammatory human diseases. All these phenomena substantiated the practice of anti-inflammatory drugs repurposing with off-label use of specific antirheumatic agents for treatment of COVID-19. This paper discusses potential use of glucocorticoids, biologics, JAK inhibitors, etc., blocking the effects of pro-inflammatory cytokines for treatment of COVID-19