ABSTRACT
The purpose: to study the association of hyperuricemia and renal dysfunction in convalescents of new coronavirus infection. Materials and methods: The study included 234 people who had a new coronavirus infection COVID-19 and were observed two months after convalescence. The mean age was 54.10±12.88 years. Three groups of patients were formed according to the anamnesis according to the severity of the new coronavirus infection: mild (n=108), moderate (n=112), and severe (n=14). In patients, BMI, creatinine, and uric acid levels were determined. Statistical processing of the obtained results was performed using the SPSS software package. Results: the average level of GFR was 80.34±16.66 ml/min/1.73 m2. In patients with a mild course of coronavirus infection, the average GFR was 82.52±15.78 ml/min/1.73 m2, with a moderate course – 78.33±17.69 ml/min/1.73 m2, with a severe course – 79.71±13.38 ml/min/1.73 m2. А decrease in GFR below 90 ml/min/1.73 m2 occurred in 69.3% of cases. Significant differences were obtained between the 1st and 2nd groups (p=0.046). Hyperuricemia was registered in 33.8% of cases. Moreover, in patients with a severe course of coronavirus infection, hyperuricemia was more common than in those with a mild course (64.3% vs 26.4%, p=0.0001) and those with a moderate course (64.3% vs 31.8%, p=0.002). Decreased GFR in patients with a mild form of COVID-19 is associated with the presence of hyperglycemia. In addition, an increase in BMI by 1 kg/m2 leads to a 10% reduction in the risk of developing renal dysfunction. In patients who had moderate COVID-19, a decrease in GFR was associated only with hyperuricemia. Conclusion: hyperuricemia is observed in 33.8% of patients 2 months after a new coronavirus infection. A decrease in GFR of less than 60 ml/min/1.73 m2 was observed in 10% of patients. Hyperuricemia is directly related to the severity of COVID-19 infection. The causal relationship between hyperuricemia in patients after COVID-19 and impaired renal function requires further research. © 2022 Authors. All rights reserved.
ABSTRACT
Background. Sleep disorders have a negative impact on many aspects of life. COVID-19 exacerbates this problem in the context of the post-COVID syndrome where sleep disorder is one of the common complaints. Objective. We aimed to assess the frequency of sleep disorders after COVID-19 and the presence of associations between post-COVID sleep disorders and the severity of COVID-19. Material and methods. A cross-sectional study was carried out in Novosibirsk. It included 115 people aged 26 to 74 years (an average age of 54.22 ± 12.48 years) after recovery from COVID-19, which occurred two to eleven months before. Patients underwent questionnaire survey (Spiegel sleep score questionnaire, HADS Anxiety and Depression Scale, International Restless Legs Syndrome (RLS) Severity Scale), examination by a somnologist, and screening night computer pulse oximetry. If an index of desaturations was more than five per hour, we performed overnight somnography by WAtch PAT 200 or polysomnography. Patients were divided into groups depending on the presence of sleep disorders, COVID-19 severity, and their age. Statistical analysis included a descriptive analysis. Odds ratio was assessed by determining the risk measure for dichotomous variables in the contingency table. Results. RLS was the most common post-COVID sleep disorder (n = 63, 75%). However, primary insomnia was diagnosed only in patients with moderate-to-severe course of COVID-19 (n = 3, 9%). There were 40 patients with post-COVID sleep disorder;they had significantly lower sleep time on workdays (7.00 [6.00;7.50] vs. 7.50 [6.50;8.00] hours, p = 0.021) and significantly higher mean HADS depression score (5.00 [3.00;7.00] vs. 3.00 [1.00;6.00] points, p = 0.006) compared with the corresponding parameters in patients without deterioration of sleep quality. The chance of reduced sleep quality was 11.6 times higher after moderate-to-severe COVID-19 infection than that after mild infection only in patients aged 26-59 years (95% confidence interval 1.42-94.32, p = 0.007). Conclusion. The chance of worsening sleep quality was significantly higher after a moderate-to-severe COVID-19 infection than after mild infection in 26-59-year-old old patients. At the same time, RLS was the most common post-COVID sleep disorder according to our study. Given the importance of sleep disorders, working-age patients after moderate-to-severe COVID-19 infection require active monitoring by doctors in order to timely correct emerging complaints. © 2022 Tomsk State University. All rights reserved.
ABSTRACT
Purpose of the work: to study liver elasticity indicators, hydrogen and methane levels in exhaled air, and their associations with clinical and biochemical parameters for patients who underwent COVID-19. Materials and methods. We examined 30 patients (mean age 51.8±2.91) who underwent COVID-19 (confirmed by SARSCoV-2 RNA test or SARS-CoV-2 antigen) 12-16 weeks after the onset of the first symptoms, of which 11 were diagnosed with pneumonia. 19 people (mean age 47.1±3.09) who did not have COVID-19 made up the comparison group. The patients underwent a clinical and biochemical study, the degree of liver fibrosis was determined (FibroScan® 502 Echosens, France), the levels of hydrogen (H2) and methane (CH4) in the exhaled air were measured (baseline and after taking lactulose solution) (GastroCheck Gastrolyzer, Bedfont Scientific Ltd., England). Results. Past COVID-19 infection was directly correlated with age (r=0.331, p=0.022), male gender (r=0.324, p=0.025), and presence of liver fibrosis (r=0.291, p=0.044). COVID-19 survivors were more likely to have liver fibrosis (p<0.001) and higher liver elasticity in kPa (p=0.018) with overweight and obesity (63.3%) and elevated body mass index (p= 0.03) compared with the control group. The presence of liver fibrosis was associated with moderate pneumonia (p<0.001). Among those who had COVID-19, there were significantly more non-producers of methane (p=0.02), fewer people with an average level of methane in exhaled air (p=0.016). In COVID-19 convalescents, bacterial overgrowth syndrome (BOS) was detected less frequently than in controls (p=0.04), but signs of delayed intestinal transit were more often recorded (p<0.05). The presence of liver fibrosis in survivors of COVID-19 is associated with BOS detection (23.3% vs. 5.2%, p<0.001), which probably contributes to the pathogenesis of liver damage. Hydrogen levels at 120 min and methane at 60 min after ingestion of lactulose solution distinguished between COVID-19 convalescents and COVID-19 survivors with an AUC of 0.683 and 0.660, respectively. The associations of the levels of gases in the exhaled air with clinical and biochemical parameters were revealed: the presence of overweight and obesity showed inverse associations with the level of methane production (r= -0.342, p<0.05), its concentration after taking lactulose at various time intervals, and also the basic level of hydrogen (r= -0.313, p<0.05);the degree of obesity was also inversely correlated with the level of methane emission (r= -0.368, p=0.038). Direct links were established between indicators of liver elasticity in kPa and the level of hydrogen production (r=0.275, p<0.05). Conclusions. Obtained indirect signs of pronounced changes in the intestinal microbiome, which obviously contribute to a more severe course of COVID-19, the development of liver fibrosis, so the impact on the intestinal microflora can be considered as a potential target in the treatment of patients with COVID-19. © 2022 Kola Science Centre of the Russian Academy of Sciences. All rights reserved.
ABSTRACT
Aim. To study the associations of changes in lipid metabolism parameters and the severity of a coronavirus disease 2019 (COVID-19). Material and methods. This cross-sectional study included 270 patients aged 26-84 years (mean age, 53,09+/-13,22 years) who had COVID-19 within prior two months, which were divided into 3 groups: mild (1, n=128), moderate (2, n=128) and severe (3, n=14) COVID-19. Patients were assessed for body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C). In addition, atherogenic index of plasma (AIP) was calculated. Statistical processing was performed using the SPSS software package (version 13.0). Results. Patients with severe COVID-19 had significantly higher levels of TG and AIP compared with patients with moderate and mild course. BMI and WC were significantly higher in patients in groups 2 and 3 compared with patients in group 1. In women, BMI and AIP levels were significantly higher in the severe COVID-19 group compared to groups 1 and 2. HDL-C levels were lower in patients with severe COVID-19 compared to those with moderate disease. WHR was higher among men in group 3 compared with group 1. Conclusion. Patients with severe COVID-19 have higher BMI, WC, AIP, TG levels, and lower HD-C levels. The relative odds for severe COVID-19 are associated with increased WC, AIP, TG, and lower HDL-C. Copyright © 2022, Silicea-Poligraf. All rights reserved.
ABSTRACT
The 2020 coronavirus infection pandemic has potentiated a large number of studies in the world on the etiopathogenesis, clinical and morphological manifestations of COVID-2019 infection. This review presents biochemical, molecular genetic and clinical aspects of COVID-2019. © 2021 Siberian State Medical University. All rights reserved.