Inflammation and endothelial toxicity: pathogenetic aspects of central nervous system damage due to novel coronavirus disease

Introduction. There are inconsistent data on the incidence of stroke in patients with COVID-19, including acute cerebrovascular accidents in younger people without obligate risk factors, as well as the riskof SARS-CoV-2infection in patients withacute stroke. The aimof the study was to evaluate the features of concomitant stroke andCOVID-19, andthe role of inflammation andendothelial toxicity in cerebral damage. Materials andmethods. The study included1,524patients admittedtovascular clinics across St. Petersburg in2020–2021, including 1,068people withconfirmed COVID-19infection and551deathcases. The patients were dividedinto four groups depending on disease severity, for clinical andlaboratory data analysis. Results. There were markedchanges in the laboratory markers of inflammation, haemostasis, fibrinolysis, cytolysis, iron metabolism, cerebral ischaemia, proteolysis, immunodeficiency (lymphocytopenia, monocytopenia, elevated white blood cell count, elevated levels of C-reactive protein, fibrinogen, D-dimer, creatine kinase, ferritinandneutrophilelastase), withstatistically significant differences whencomparedwithpatients without COVID-19. Changes ininflammatory markers in the first 24–72hours providedthe most information. Amultifoldincrease (escalation)in the marker values was always correlatedwithan imminent adverse outcome andwas usually accompaniedby subsequent laboratory confirmation of COVID-19infection or specific signs of viral pneumonia. Conclusion. COVID-19 should be considered an independent risk factor for acute stroke, while the virus-induced thrombosis, manifesting in an escalation in inflammatory factors and products of endothelial damage, shouldbe considereda pathogenetic linkleading to cerebral tissue damage. © 2022 Authors. All rights reserved.

Gas transport characteristics of hemocorrectors and perfusates based on perfluorocarbon blood-substituting emulsions

This review summarizes the data regarding the gas transport characteristics of hemocorrection and perfusates on the basis of low concentrated drugs nano-sized perfluorocarbonic 20% Per-ftoran (a blood substitute, it is allowed for clinical use in Russia), 20% Ftoremulsion III (an improved blood substitute, registered in Russia), 10-20% Perfusol (a perfusion solution for perfusion of the isolated heart), 20% Ftorem (a cardioplegic emulsion for sur-geries on the stopped heart) used in the biomedical field. The com-pensation of blood loss using traditional plasma substitutes with-out the gas transport function or with low gas transport characteristics leads to a decrease in the oxygen capacity of the resulting mixture and subsequently to deterioration in the oxygen transport characteristics of blood. The synthetic gas-transport blood substitutes can be used in the treatment of various forms of ischemia, such as carbon monoxide poisoning. Furthermore, recent results regarding the mechanism of COVID19 infection indicate a possible use of the synthetic gas-transport blood substitutes in the treatment and therapy of COVID19 infected patients. © 2020, University of Kragujevac, Faculty of Science. All rights reserved.

Fundamental basis of covid-19 pathogenesis

At the end of 2019, a new coronavirus infection occurred in the People's Republic of China with an epicentre in the city of Wu-han. On February 11th, 2020, the World Health Organization as-signed the official name of the infection caused by the new coro-navirus – COVID-19. COVID-19 has affected people from all over the world given that the infection was noted in 200 countries resulting in annunciation of the pandemic situation. Human co-rona viruses cause mild to moderate respiratory infections. At the end of 2002, a new coronavirus appeared (SARS-CoV), the causal agent of atypical pneumonia, which caused acute respiratory distress syndrome (ARDS). The initial stage of COVID-19 infection is the penetration of SARS-CoV-2 into target cells that have angi-otensin converting enzyme type II receptors. The virus enters the body through the respiratory tract and interacts primarily with toll-like receptors (TLRs). The events in SARS-Cov-2 induced infection follow the next scenario: epithelial cells via TLRs recog-nize and identify SARS-Cov-2, and after that the information is transmitted to the transcriptional NF-κB, which causes expression of the corresponding genes. Activated in this way, the epithelial cells begin to synthesize various biologically active molecules. The results obtained on preclinical material indicate that ROS generation increases and the antioxidant protection decreases, which plays a major role in the pathogenesis of SARS-CoV, as well as in the progression and severity of this respiratory disease. © 2020, University of Kragujevac, Faculty of Science. All rights reserved.