Psychosomatic state and laboratory parameters of COVID-19 convalescent patients.

Objective. To evaluate some parameters of the psychosomatic state, cytokine levels (IL-6, IL-8, IL-17A), and free radical status (levels of nitrates and nitrites, antioxidant plasma activity) in convalescent patients after severe COVID-19. Patients and methods. We examined 64 patients who had severe COVID-19 and underwent either a 30-35-day course of inpatient rehabilitation after their discharge from a hospital for infectious diseases or a 60-65-day course of outpatient rehabilitation at the Ambulatory Center of Nalchik, Clinical Hospital No 1. Results. We surveyed patients after severe COVID-19 and found that they required a long rehabilitation. Many of them reported asthenic syndrome, psycho-emotional disorders, and other complaints upon discharge from the hospital. Serum levels of proinflammatory cytokines remained high in patients after severe COVID-19 even 30-35 days following their discharge (p < 0.05). Serum levels of IL-6, IL-8, nitrites, and nitrates remained elevated on days 60-65 following discharge (p < 0.05), despite comprehensive therapy in a rehabilitation department. Plasma antioxidant activity was reduced, whereas IL-17A level normalized by this time. Conclusion. Our findings suggest that currently used rehabilitation measures for COVID-19 are insufficient. Adequate rehabilitation of convalescent COVID-19 patients requires proper monitoring of their immune system condition, as well as new effective methods for immune correction and restoration of their psychoemotional status after the acute phase of the disease.Copyright © 2022, Dynasty Publishing House. All rights reserved.

[Clinical cases of complicated diverticulitis against the background of severe course COVID-19. Case report].

Two clinical cases of perforation of a previously undiagnosed colon diverticulum in patients with coronavirus infection caused by the SARS-CoV-2 virus treated at the Hospital №1 of Nalchik. Both patients were elderly, overweight, had a lot of chronic concomitant diseases. Patients received hormone therapy and were targeted: the first patient twice (tocilizumab on the first day of hospitalization and olokizumab on the 7th day of inpatient treatment). The second patient received levilimab on the 3rd day of his stay in the hospital. A short time after targeting, both patients developed acute diffuse abdominal pain, the patients were transferred to the surgical department and operated on. During the operation, both patients were found to have previously undiagnosed diverticular disease, complicated by diverticular perforation and peritonitis on the background of immunosuppression. Both patients died. Thus, when using targeted therapy for patients with COVID-19, it is necessary to take into account that they may have previously undiagnosed chronic diseases that can cause fatal complications against the background of immunosuppression.

Psychosomatic state and laboratory parameters of COVID-19 convalescent patients.

Objective. To evaluate some parameters of the psychosomatic state, cytokine levels (IL-6, IL-8, IL-17A), and free radical status (levels of nitrates and nitrites, antioxidant plasma activity) in convalescent patients after severe COVID-19. Patients and methods. We examined 64 patients who had severe COVID-19 and underwent either a 30-35-day course of inpatient rehabilitation after their discharge from a hospital for infectious diseases or a 60-65-day course of outpatient rehabilitation at the Ambulatory Center of Nalchik, Clinical Hospital No 1. Results. We surveyed patients after severe COVID-19 and found that they required a long rehabilitation. Many of them reported asthenic syndrome, psycho-emotional disorders, and other complaints upon discharge from the hospital. Serum levels of proinflammatory cytokines remained high in patients after severe COVID-19 even 30-35 days following their discharge (p < 0.05). Serum levels of IL-6, IL-8, nitrites, and nitrates remained elevated on days 60-65 following discharge (p < 0.05), despite comprehensive therapy in a rehabilitation department. Plasma antioxidant activity was reduced, whereas IL-17A level normalized by this time. Conclusion. Our findings suggest that currently used rehabilitation measures for COVID-19 are insufficient. Adequate rehabilitation of convalescent COVID-19 patients requires proper monitoring of their immune system condition, as well as new effective methods for immune correction and restoration of their psychoemotional status after the acute phase of the disease.Copyright © 2022, Dynasty Publishing House. All rights reserved.

Characteristics of patients with severe and extremely severe sars-cov-2 infection treated in the intensive care unit of nalchik hospital no 1

The first patients with SARS-CoV-2 infection were registered in Kabardino-Balkar Republic (KBR) in the end of March 2020, when Hospital No 1 at the Center for AIDS and Infectious Diseases was completely equipped for the admission of COVID-19 patients. Objective. To assess clinical and laboratory characteristics of patients with severe and extremely severe COVID-19 treated in the intensive care unit of Hospital No 1 in Nalchik in 2020-2021. Patients and methods. A total of 283 patients were treated in the intensive care unit (ICU) during this year. More that one-third of patients (41.3%) died;most of them were male. The majority of patients in the ICU were between 61 and 70 years of age;the majority of deaths were registered among patients aged 71 to 80 years. One hundred and seventy-three individuals in the ICU required non-invasive or invasive ventilation;105 of them (60.7%) died. Two hundred and fifty-two patients (89%) had severe concomitant diseases. The disease severity was also determined by advanced lung damage (more than 50%) in 143 patients (50.5%). Patients were examined and treated in accordance with temporary guidelines (effective at that time). Results. The most common causes of death among patients treated for COVID-9 in the ICU were pulmonary embolism (n=50;42.75%), sepsis (n=19;16.2%), and acute respiratory failure (n=17;14.5%). © 2021, Dynasty Publishing House. All rights reserved.