Post-COVID-19 and reproductive health (data from the survey and analysis of the results)

The article presents the data of a survey and analysis of the results of the studies «Post-covid syndrome in obstetrics and reproductive medicine» and «COVID-19 and reproductive health outside and during pregnancy» of 1000 patients of the obstetric department of the Filatov City Clinical Hospital No.15 of the Moscow Departament of Health for the period of the COVID-19 pandemic from March 27, 2020 to March 26, 2022. The state of the cardiovascular system of a group of patients after COVID-19 was separately assessed, a number of important parameters of myocardial function were identified to identify groups at high risk of cardiac complications and their long-term individual rehabilitation after infection. The importance of vaccination at the preconception stage in women and men, during pregnancy and lactation was noted. © 2023, Media Sphera Publishing Group. All rights reserved.

Post-COVID-19 consequences in Obstetrics and Reproductive Medicine

Post-COVID-19 syndrome is an urgent and acute problem with a diverse clinical picture, including reproductive disorders. The key to minimizing Post-COVID-19 complications is timely vaccination, active treatment of covid-associated inflammation and hypercoagulation syndrome, an individual rehabilitation program to maintain gynecological health and reproductive potential of each woman. The article presents the results of the work of the of the obstetric department of the Filatov City Clinical Hospital No.15 for the period of the COVID-19 pandemic from 03/27/2020 to 03/26/2022 (inclusive). The results of the study «Post-COVID-19 syndrome in Obstetrics and Reproductive Medicine» are presented. Issues of the impact of COVID-19 on the reproductive and sexual health of women and men were brought up for discussion. A clinical case with an effective multidisciplinary treatment and diagnostic tactics of management and a personalized rehabilitation program is demonstrated. © 2022, Media Sphera Publishing Group. All rights reserved.

Post-COVID-19 syndrome in Obstetrics and Reproductive Medicine

The article provides information on the Post-COVID-19 syndrome that is relevant today. Post-COVID-19 syndrome is systemic in nature and is manifested, as a rule, by persistent asthenia and neurocognitive impairment in patients. Possible mechanisms of prolonged pro-longation or the occurrence of various multiple organ complications in patients undergoing COVID-19 are considered. The ways of supporting patients with Post-COVID-19 syndrome is proposed, including for reducing significant socio-economic consequences. The analysis of the world literature was carried out, the lack of studies with a comprehensive and objective assessment of the quality of life of pregnant women and those who gave birth with COVID-19 was revealed. In order to understand the immediate and long-term consequences of the transferred new coronavirus infection in 1510 patients of the obstetric department of the Filatov City Clinical Hospital No.15 a questionnaire has been drawn up, the collection and analysis of the data obtained is being carried out. © 2021, Media Sphera Publishing Group. All rights reserved.

Left ventricular global longitudinal strain by speckle tracking echocardiography in pregnant COVID-19 patients

Background. The new coronavirus disease (COVID-19), which has arisen as a result of infection SARS-CoV-2, which causes severe respiratory syndrome, is characterized by high morbidity, mortality and is a big problem in the health sector. The aim - to use 2-dimensional speckle-tracking echocardiography (STE) in combination with transthoracic echocardiography (TTE) in the assessment of left ventricular longitudinal strain (LVGLS) in pregnant women with confirmed coronavirus infection, hospitalized in the O.M. Filatov Municipal Clinical Hospital No. 15, Moscow, Russian Federation. Methods. The results of STE were analyzed in 102 pregnant women with confirmed coronavirus infection at the hospital stage of treatment. Results. There was no decrease in LVGLS values in pregnant women with COVID-19 without a history of cardiovascular pathology. There was also no additional decrease in the LVGLS value in pregnant women with COVID-19 and initially reduced LVGLS in the presence of a cardiovascular history (the results were consistent with those in pregnant women with concomitant cardiovascular pathology, but without a new coronavirus infection). Conclusions. In pregnant women with COVID-19 without a history of concomitant pathology, STE did not provide additional information regarding possible subclinical left ventricular dysfunction.

Labor outcomes and inpatient medical rehabilitation of patients with the novel coronavirus infection covid-19 (Data of the of the obstetric department of the filatov city clinical hospital no.15)

Presented are two clinical cases of pregnancy, childbirth and the postpartum period in patients with a new coronavirus infection COVID-19 of the obstetric department of the Filatov City Clinical Hospital No.15. Despite the severe course of the disease, an extremely high risk of fatal complications, thanks to clear routing, a multidisciplinary approach and effective treatment tactics, it was possible to successfully solve the most difficult medical and diagnostic problems, save the lives and preserve the health of patients and newborns. © 2021, Media Sphera Publishing Group. All rights reserved.

Vaccination against COVID-19 in pregnancy is safe and effective (Literature review)

This review provides current information on safety and effectiveness of COVID-19 vaccines for pregnant and lactating patients. Various vaccine types, information regarding reproductive toxicology studies and vaccines efficacy against variants of concern are described in the article. The review also reflects practice guidelines of international professional communities on the use of COVID-19 vaccines in pregnancy, including the World Health Organization, RCOG (Royal College of Obstetricians and Gynecologists), ACOG (American College of Obstetricians and Gynecologists), RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists), etc. Currently, there is no evidence of a negative impact of COVID-19 vaccines on male and women’s reproductive health. On the other hand, the negative consequences of COVID-19 infection are well known both on the reproductive health of men and on the course and outcomes of pregnancy. Results of analysis of data on the course of pregnancy, childbirth, the postpartum period and the condition of newborns in 891 patients with coronavirus infection and in 1694 patients without coronavirus infection of the obstetric department of the Filatov City Clinical Hospital No. 15 for the period from January 1, 2020 to April 25, 2021. It was revealed that patients with coronavirus infection have a higher risk of preterm birth, a higher probability of having premature babies, and a higher percentage of operative delivery, than in patients without coronavirus infection. Newborn children in patients with coronavirus infection were more often admitted to the intensive care unit, than children of patients without coronavirus infection. Patients with coronavirus infection have a higher perinatal mortality rate than patients without coronavirus infection. No data has been received to support vertical transmission of the virus from a mother infected with COVID-19 to her fetus. There were no specific changes in placental tissue in patients with coronavirus infection. Based on the available results of clinical studies on the safety and efficacy of COVID-19 vaccines, all mentioned professional communities (WHO, CDC, ACOG, RCOG, RANZCOG, etc.) strongly recommend getting COVID-19 vaccine for women who are pregnant or breastfeeding. © 2021, Media Sphera Publishing Group. All rights reserved.

COVID-19 vaccine does not affect male reproductive health (Based on RNA sequencing data)

Objective. To evaluate the effect of COVID-19 vaccine on molecular features of semen samples based on the gene expression analysis. Materials and methods. 10 men of reproductive age with no history of laboratory-confirmed COVID-19 were inlcuded in this study. Six men were planning to get vector-based COVID-19 vaccine «Gam-COVID-Vac» («Sputnik-V») of the National Research Center for Epidemiology and Microbiology named after N.F. Gamaleya, four men were included in the control group. Gene expression level in semen samples of men who received COVID-19 vaccine was analyzed using RNA-sequencing (semen samples were collected prior to the vaccination and 75 days after the administration of the second dose of the «Gam-COVID-Vac» vaccine). The semen samples, collected of men of the control group at the same time interval, were also analyzed using RNA-sequencing. Results. Comparative analysis of the gene expression level in the semen samples collected prior to and after getting COVID-19 vaccine did not reveal statistically significant changes in the intracellular molecular pathways functioning. Conclusion. Study results indicate the absence of an adverse effects of the «Gam-COVID-Vac» («Sputnik-V») vaccine on molecular features of semen samples. © 2021, Media Sphera Publishing Group. All rights reserved.

Impact of COVID-19 and other viral infections of male fertility (preliminary data)

Objective. To study the parameters of the hormonal status, hemostasis parameters, biochemical blood test and semen analysis in men of reproductive age who have undergone a new coronavirus infection (COVID-19). Material and methods. The study included 50 men who had a new coronavirus infection (COVID-19) and received treatment in hospital setting. The study was conducted 3 months later in the presence of positive IgG antibodies to COVID-19. All patients underwent a comprehensive examination, including the study of the hormonal profile, hemostasis parameters, biochemical blood test, identification of concomitant urological diseases, as well as semen analysis (concentration, mobility, morphology, MAR-test), according to WHO 2010 criteria. Results. The examination revealed a decrease in the level of total testosterone in 19 (38%) patients. The values ranged from 6.41 to 10 nmol/l (reference values 10.50-35.40 nmol/l). The biochemical blood analysis revealed the following changes: an increase in creatinine levels to 117-180 muM / L (reference values 80-115 muM/L) in 15 (30%) patients, total bilirubin (22-42.7 muM/L (reference values 1.7-21.0 muMol/L) in 9 (18%) patients, alanine aminotransferase 43-109 U/L (reference values 0.0-41 U/L) in 19 (38%) patients, the level of aspartate aminotransferase was 45-82 U/L (with a norm of 0.0-40 U/L) in 10 (20%) patients Analysis of the hemostasis revealed hypercoagulation in 11 (22%) patients, and hypocoagulation in 6 (12%) patients. Abnormalities in the semen analysis were found in 10 (20%) patients with teratozoospermia in all the samples. In 8 (16%) patients, leukospermia was determined. There was a statistically significant decrease in the serum total testosterone level in 38% of patients (p<0.025). At the same time, the levels of follicle-stimulating hormones, luteinizing hormones, estradiol and prolactin remained within the reference values. Conclusions. The results of this study demonstrated the changes in sperm morphology, an increase in the number of leukocytes in the ejaculate and a decrease in testosterone levels in patients who have undergone a new coronavirus infection (COVID-19). There were deviations in the biochemical blood test and hemostasis parameters. The given data are preliminary. In order to perform a comprehensive statistical analysis further studies are needed on a larger sample of patients who have had a new coronavirus infection Цель исследования. Изучить параметры гормонального статуса, определить особенности параклинических данных (коагулограмма, биохимический анализ крови), показатели спермограммы у мужчин репродуктивного возраста, перенесших новую коронавирную инфекцию (COVID-19). Материал и методы. В исследование включены 50 мужчин, перенесших новую коронавирусную инфекцию (COVID-19) и получавших лечение в условиях стационара. Исследование проводилось через 3 мес при наличии положительных антител IgG к COVID-19. Все пациенты проходили комплексное обследование, включающее изучение гормонального профиля, параметров коагулограммы, биохимического анализа крови, выявление сопутствующих урологических заболеваний, а также оценку параметров спермограммы (концентрация, подвижность, морфология, MAR-тест), согласно критериям ВОЗ 2010. Результаты. В результате обследования у 19 (38%) пациентов выявлено снижение уровня общего тестостерона. Значения колебались в пределах от 6,41 до 10 нмоль/л (референсные значения 10,50-35,40 нмоль/л). В биохимическом анализе крови выявлены следующие изменения: повышение уровня креатинина - 117-180 мкМоль/л (референсные значения 80-115 мкМоль/л) у 15 (30%) пациентов, общего билирубина - 22-42,7 мкМоль/л (референсные значения 1,7-21,0 мкМоль/л) у 9 (18%) пациентов, аланинаминотрансферазы - 43-109 Ед/л (референсные значения 0,0-41 Ед/л) у 19 (38%) пациентов, уровня аспартатаминотрансферазы - 45-82 Ед/л (при норме 0,0-40 Ед/л) у 10 (20%) пациентов. При анализе коагулограммы у 11 (22%) пациентов выявлены признаки гиперкоагуляции, у 6 (12%) - гипокоагуляции. По результатам исследования, обнаружены отклонения в спермограмме у 10 (20%) пациентов, при этом тератозооспермия отмечена во всех исследуемых образцах (снижение количества морфологически нормальных сперматозоидов в 2 раза и более). У 8 (16%) пациентов определена лейкоспермия (повышение количества лейкоцитов в нативном эякуляте в 2 раза и более). Отмечено статистически значимое снижение сывороточного уровня общего тестостерона у 38% пациентов (p<0,025). Вместе с тем уровень фолликулостимулирующего, лютеинизирующего гормонов, эстрадиола и пролактина оставался в пределах референсных значений. Выводы. Результаты данного исследования показывают изменения морфологии сперматозоидов, повышение количества лейкоцитов в эякуляте и снижение уровня тестостерона у пациентов, перенесших новую коронавирусную инфекцию (COVID-19). Наблюдаются отклонения в показателях биохимического анализа крови и гемостазиограммы. Приведенные данные являются предварительными. Необходимо проведение дальнейших исследований на большей выборке пациентов, перенесших новую коронавирусную инфекцию, для выполнения полноценного статистического анализа.

Impact of covid-19 and other viral infections of male fertility (Literature review)

An infectious factor is the cause of male infertility in 15% of cases. Male infertility can be associated with several viral infections, including human papillomavirus (HPV), herpes simplex viruses (HSV) and human immunodeficiency viruses (HIV), mumps virus and SARS-CoV virus. The emergence of a new infection, COVID-19, contributes to a thorough study of the possible consequences of this disease on male fertility. This literature review provides up-to-date information on the impact of COVID-19 and other viral infections on male reproductive health. © 2020, Media Sphera Publishing Group. All rights reserved.

Covid-19 and men’s reproductive health (Literature review)

According to the world statistics, men are much more susceptible to infection with the new coronavirus than women. Nowadays, investigation of potential impact of COVID-19 on men’s reproductive health is a particularly relevant topic. Previous research has shown that more than 25 viruses, including herpes simplex virus and human immunodeficiency virus, can infect human sperm. It is currently not fully understood whether the novel coronavirus SARS-CoV-2 has a negative impact on sperm quality and whether the virus is sexually trans-mitted. Published data indicate decreased sperm quality and possible development of orchitis in patients with COVID-19. Moreover, severe stress and corticosteroid therapy may be risk factors for patients’ sexual dysfunction. Thus, further studies are needed to determine the effects of COVID-19 on men’s reproductive health, which will help to optimize the management and rehabilitation of these patients. © 2020, Media Sphera Publishing Group. All rights reserved.

Maternity care during coronavirus epidemic

The paper describes the healthcare service at the maternity hospital in the setting of an infectious hospital;describes the reception and sorting of pregnant women, women in labor, obstetric patients and newborns;analyzes indications for early and operative delivery, and provides the main results of maternity obstetric service in the presence of the pandemic. © 2020, Media Sphera Publishing Group. All rights reserved.

Restoration of reproductive health in women who recover from COVID-19. Several aspects

This review provides current information on the different aspects of restoration of reproductive health in women who recover from COVID-19. The article addresses various issues such as pregnancy management in women who recover from COVID-19, prevention of complications, recommendations for pregnancy planning, contraception and the use of assisted reproductive technologies in women who recover from COVID-19. The review reflects practice guidelines of international professional communities, including the RCOG (Royal College of Obstetricians and Gynecologists) and ESHRE (European Society of Human Reproduction and Embryology). The relationship between the psychological state of women who recover from COVID-19 and reproductive health is also considered. © 2020, Media Sphera Publishing Group. All rights reserved.

Covid-19 and women’s health (Literature review)

This review provides current information on the impact of the new coronavirus infection COVID-19 on the management of patients in obstetrics and gynecology. The article addresses various issues such as pregnancy and neonatal management, different aspects of gynecological surgery and the use of assisted reproductive technologies during the COVID-19 pandemic. The review reflects practice guidelines of international professional communities, including the World Health Organization, RCOG (Royal College of Obstetricians and Gynecologists), ACOG (American College of Obstetricians and Gynecologists), RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists), as well as Temporary guidelines of the Ministry of Health of the Russian Federation on the prevention, diagnosis, and treatment of new coronavirus infection.