[Guillain-Barre syndrome associated with COVID-19]. / Sindrom Giiena­Barre, assotsiirovannyi s COVID-19.

This paper reports two cases of Guillain-Barre syndrome associated with coronavirus infection COVID-19. The clinical symptoms and neurological status of patients, the data of the additional examination and the features of the prescribed therapy are described in detail. The issue of the tropicity of the SARS-CoV-2 virus to human nervous tissue and its possible ways of affecting the peripheral nervous system is discussed.

Eighteen Months Follow-up In Patients With Tachycardia-induced Cardiomyopathy

One of the causes of chronic heart failure (HF) may be tachycardia-induced cardiomyopathy (TIC) - a heart disease that occurs with persistent supraventricular tachyarrhythmia, characterized by partially or completely reversible dysfunction and dilatation of the ventricles. The long-term prognosis in these patients is poorly understood. Objective: To evaluate the rate of rehospitalisation and the dynamics of the left ventricular ejection fraction in patients with TIC in 6 to 18 months after discharge from the hospital. Materials and methods: A retrospective analysis of patients diagnosed with TIC was carried out from January 2019 to February 2021. The diagnosis of TIC corresponded to the following signs: a stable tachycardia with more 100 beats per min;left ventricular ejection fraction (LVEF) <45%;exclusion of other causes of heart failure;partial or complete restoration of LVEF after restoration and maintenance of sinus rhythm or heart rate control. Patients were monitored by phone calls and called for follow-up of a transthoracic echocardiography. A total of 52 patients were examined, including 40 men (76.9%) 64.4 ± 10.3 (33;88) years old. The most common cause of TIC was atrial fibrillation, recorded in 48 (92.3%) patients, in 4 (7.69%) patients - atrial flutter. In 46 (88.5%) patients, arterial hypertension was previously diagnosed, and in 12 (23.1%) cases - type 2 diabetes mellitus. Initial LVEF at hospitalization was 40.3 ± 8.2%, while LVEF <35% was recorded in 15 (28.85%) patients. Patient management was in accordance with clinical guidelines. Patients were treated during an episode of tachyarrhythmia and after restoration of sinus rhythm. Dynamic monitoring of echocardiography was possible in 26 patients. Differences were considered statistically significant at p <0.05. Results: The average follow-up period was 18,4 ± 6 [4;27] months. With control echocardiography in 17 (32.69%) people the LVEF was more than 45%. During the observation period, 7 patients (13.46%) died, non-cardiovascular causes predominated in the mortality structure: in 4 patients (7.69%), death was due to oncopathology and in 1 patient (1.92%) due to coronavirus infection. The mean value of LVEF with control echocardiography was 47.8 ± 9.3% [31;66] (p <0.0001) (Pic.1). In 3 (3.85%) patient, LVEF remained <35%. In 5 (9.62%) patients, LVEF after treatment increased, but remained <45%. Conclusion: The data of the presented long-term follow-up of patients with TIC indicate a favorable course in most cases, regardless of (or in despite of) the initial LVEF.

Myocardial infarction versus COVID-19 blood secretome

Background: Both myocardial infarction (MI) and COVID-19 are characterized by cytokine storm in blood. Purpose: The objective of this study was to compare the concentration of 39 cytokines, chemokines, and growth factors in blood sera of patients with MI, COVID-19 (COV), and healthy donors. Methods: Patients' blood was collected within 1-2 days after hospitalization in the cardiovascular or COVID intensive care units. All COV patients were in a severe condition;all had increased C reactive protein, 86 and 95% had increased ferritin and D-dimers levels accordingly, 8-10 times decreased lymphocyte numbers. The analysis of the humoral factors in blood serum of MI (n=22), COV (n=23) and donors (n=27) was performed using a 39-plex cytometric analysis. Results: Among all factors analyzed TGFa, IL-1b, 2, 3, 5, 9, 13, 17A were almost not detectable both in patient and donor sera. The concentrations of the other 31 humoral factors in normal sera differed significantly from 0 to 22000 pg/mL. We divided them into house-keeping factors HKF ranged from 1000 to 22000 pg/mL;sentinel innate immunity factors SIF (30-200 pg/mL), and acute phase factors APF (0-30 pg/mL). HKF were detected in all samples. Among SIF and APF IL-1a, G-CSF, IFNa2, IL-7, MIP-1a, IL- 12, and IFNg were detected in 56-80% donor blood while IL-1RA, MCP-3, IL-2, 6, 10, 12, 15, FLT-3F, GM-CSF, TNF-b - only in 10-55%. At the same time all MI patients were 100% positive in all these factors showing extensive activation of blood secretome. Among low incidence APF cytokines in COV patients, percentage of IL-1RA, MCP-3, IFNa2, IL-6, 10, 15, FLT-3L negative sera decreased 3-5 times;and all sera were positive for MIP-1a and IL-12. At the same time TNF-a level decreased significantly from 0 in control to 85% of negative sera in COV patients. Summarized results are shown as the ratios of factor concentrations in MI or COV sera to normal control (Fig). Blood secretome of MI changed more significantly than of COV patients. The major factors (shown in red) in MI were IL-6, IL-12, IFNg, FLT-3L, GM-CSF, and IL-15, which increased 12, 9, 6, 6, 6, and 5 times accordingly. In COV sera IL-6, IL-10, IP-10, and MCP-3 increased by 28, 12, 10, and 9 times accordingly. Less expressed however significant increases are marked with asterisks. Conclusions: Acute MI is characterized by severe disturbances in blood secretome with an increased level of 25 out of 39 factors studied. Contrary to it, in COV patients the levels of IL-6, 10, IP-10, and MCP-3 were more enhanced while only 15 out of 31 exceeded normal levels.