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.

Association of HLA Class I Genotype with Mortality in Patients with Diabetes Mellitus and COVID-19.

Numerous studies showed that diabetes mellitus (DM) increases the risk of death from COVID-19 by five times. It is generally accepted that the high lethality of COVID-19 against the background of DM is due to the main complications of this disease: micro- and macroangiopathies, as well as heart and kidney failure. In addition, it was shown that acute respiratory viral infection increases the production of interferon gamma, increases muscle resistance to insulin, and modulates the activity of effector CD8+ T cells. The ability of CD8+ T cells to recognize SARS-CoV-2-infected cells depends not only on humoral factors but also on individual genetic characteristics, including the individual set of major histocompatibility complex class I (MHC-I) molecules. In this study, the relationship of the MHC-I genotype of patients with DM aged less than 60 years with the outcome of COVID-19 was studied using a sample of 222 patients. It was shown that lethal outcomes of COVID-19 in patients with DM are associated with the low affinity of the interaction of an individual set of MHC-I molecules with SARS-CoV-2 peptides.

Relationship of Covid-19 Severity with SARS-CoV-2 NS8 Protein Mutations Depending on Virus Strain.

In mid-2021, the Delta strain of SARS-CoV-2 caused the third wave of the COVID-19 pandemic. Huge efforts have been devoted to studying the effect of its mutations on the effectiveness of neutralizing antibodies. Much less attention was paid to the individual features of the presentation of its peptides by molecules of the major histocompatibility complex class I (MCHC-I). In this study, the correlation of the HLA-I genotype of patients under the age of 60 years with the severity of COVID-19 caused by the two most common variants of the SARS-CoV-2 Delta strain in the summer of 2021: AY.122 and B.1.617.2 was studied. Analysis of the severity of the course of COVID-19 revealed a more severe course of the disease caused by the AY.122 variant. Comparison of the mutation profile of the two most common variants of the Delta strain showed that that the G8R mutation in the NS8 protein makes the greatest contribution to the ability of MHC-I to present viral peptides. Given that the NS8 protein is able to suppress the maturation of MHC-I molecules, the appearance of a mutation in one of its immunogenic epitopes could make a significant contribution to the prevalence of the AY.122 variant in the Russian population.

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.

DYNAMICS OF CT-PICTURE CHANGES IN PATIENTS WITH A CRITICAL DEGREE OF LUNG TISSUE DAMAGE CAUSED BY THE SARS-COV-2 VIRUS

It was found that death from coronavirus infection is the more likely, the higher the degree of damage to the lung on the visual scale "CT 0-4". Thus, patients with pulmonary involvement of 75% or more are predictively poor in terms of outcome. Assessment of the influence of the rate of disease progression to CT-4 on mortality and the search for factors affecting this indicator may be of practical importance. The purpose of this study is comparison of the duration of progression of the CT picture to a critical degree in various "waves" of the pandemic, the search for factors influencing the interval of "debut diseases - CT 4", as well as the assessment of the state of the lung tissue after a total process in a long period of time. Materials and methods: a retrospective analysis of 708 patients (226 in the first wave, 482 in the second wave), hospitalized at City Clinical Hospital No. 15 and having a critical degree of lung. 25 discharged patients underwent a control CT scan 6 and 12 months after discharge from the hospital. Results: The study groups were comparable in terms of demographic characteristics and the degree of CT at admission in hospital. When comparing the interval "onset of the disease - detection of CT-4", no significant differences between the "waves" were found (p = 0.372). When assessing the CT-picture in the delayed period, there were no significant differences in the frequency of changes between the groups;an almost complete regression of inflammatory changes was observed. In the study of the entire sample, an increase in the interval "onset of the disease - detection of CT-4" (p = 0.033) was found in men (11 days (7-16)) compared with women for 10 days (6-15), and in discharged patients (12 days (8-18) compared with deaths (10 days (6-15)) (p <0.001). There was a significant reduction in the progression time with increasing age of patients (p = 0.003) Conclusions: Considering the data obtained on the possible influence of the timing of the progression of the CT picture on the mortality of patients, as well as the results of long-term observation, it is advisable to search for modifiable risk factors for the rapid progression of the disease.

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.

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.

DiagNostic findings in patients with chest pain, cough, and shortness of breath during the COVID-19 pandemic: What else besides pneumonia?

Purpose. Description and illustration of the most common alternative causes of shortness of breath, cough, and acute chest pain in pandemic COVID-19 conditions. Material and methods. Authors evaluated results of the retrospective single-center study and instrumental data of 67 patients with complaints of sudden chest pain, cough and shortness of breath. For patients admitted to the hospital between March, 27 and June, 30, 2020, the first stage of diagNosis was made with the performed multispiral computed tomography (MSCT) of the chest, confirming the presence of pulmonary manifestations of COVID-19. The study did Not include patients with pneumothorax identified at the pre-And hospital stages. We describe early radiographic changes in the chest organs, main vessels, and coronary bed in patients with CT-confirmed COVID-19 admitted to O.M. Filatov Municipal Clinical Hospital No. 15, Moscow for sudden chest pain, cough, and shortness of breath. Results. In CT of the chest organs, combinations of COVID-19 and pulmonary artery thromboembolism, central/peripheral lung cancer, and acute aortic syndrome manifestations were most common. Combinations of radiation techniques in pandemic settings are COVID-19 required by patients with the acute coronary syndrome. However, it will be possible to analyze all cases of a combination of acute chest pain and sudden shortness of breath in patients with COVID-19 only after processing an extensive array of data. Conclusion. In pandemic conditions, COVID-19 performing standard imaging methods should be Not lost about the most frequent causes of chest pain and sudden shortness of breath, complementing native MSCT with contrasting enhancement in suspected pathology of the main arteries, and small circulation in high-risk patients. © 2021 Izdatel'stvo Meditsina. 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.

Visualizing techniques for new coronavirus infection: Focus on computed tomography. experience of the city clinical hospital no. 15 named after O.M. Filatov

The first case of Coronavirus pneumonia (COVID-19) was detected in Wuhan, China, but the disease became a pandemic and health-care institutions in the Russian Federation faced confirmed cases of COVID-19. Objective. To describe the possibilities of imaging techniques with a focus on multispiral computed tomography (MSCT), as well as a dynamic analysis of pathology manifestations in patients hospitalized in Clinical Hospital No. 15 named after O.M. Filatov with a confirmed coronavirus infection. Material and methods. The retrospective study collected data from 300 patients with confirmed coronavirus infection from one of the largest multidisciplinary hospitals in the Russian Federation. General clinical manifestations were analyzed, as well as characteristics and features of the development of changes, revealed mainly by MSCT of the chest. Results. Examined 300 patients with PCR-confirmed COVID-19. Among the clinical manifestations, coughing, fever, shortness of breath prevailed. Most of the changes identified in pulmonary MSCT were polysegmental and bilateral in nature of the lesion, were more likely to be localized in the peripheral departments, 235 (78%) patients had more than two lobes involved in the pathological process, 263 (87.7%) patients had focal points of pulmonary tissue compaction by «frosted glass» type, and the combination of the above manifestations with the presence of consolidation foci and reticular changes was noted in 129 (43%) among the complications, there were more frequent: thickening of the pleura, hydrothorax, less often pneumothorax, and in rare cases, the empyema of pleura. When monitoring lung MSCT in 300 patients, rapid development of positive dynamics (on average, 5—7 days) was noted in 95 (31.6%) patients, 40 (13.2%) patients showed multidirectional dynamics, progression (CT stage in-creases) was observed in 111 (37%) cases, in 54 (18.2%) cases there were no significant changes in the dynamics of the X-ray pat-tern. Conclusions. Lung MSCT plays a key role in the diagnosis of COVID-19. The appearance of specific zones of pulmonary tissue compaction in the form of a «frosted glass», as a manifestation of a one-sided or two-sided, mono-or polyphocal lung lesion, can with a high probability indicate a manifestation of COVID-19 with a possible rapid progression of the X-ray pattern in a short period of time.

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.