Critical Materials' Supply Chains and Us National Security

The COVID-19 crisis and the Special Military Operation in Ukraine have showed how quickly and deeply global supply chains can be disrupted. This is especially true for critical and strategic materials. Many of these raw materials are critical to the European and US economies. They form a strong industrial base, participating in the production of a wide range of goods used in everyday life and modern technologies. Reliable and unfettered access to certain raw materials is a growing concern in the United States and around the world. Success in transforming and modernizing economies depends on the sustainable supply of primary and secondary raw materials needed to scale up clean and digital technologies in all industrial ecosystems. One of the lessons of the COVID-19 crisis is the need to reduce dependency and strengthen the diversity and security of supply of critical raw materials. The expansion of strategic self-sufficiency is a priority of the long-term policy of the US and the EU. This article highlights the challenges and priorities for the United States to strengthen its strategic approach to building more sustainable commodity value chains. Strategic self-sufficiency, therefore, should, in the opinion of American and European experts, be based on diversified access to world commodity markets. At the same time, in order to reduce external dependence, the problem of rapidly growing global demand for resources is proposed to be solved by reducing and reusing materials. Achieving resource security requires action to diversify supply from primary and secondary sources, reduce dependency, and improve resource efficiency. This applies to all types of raw materials, including base metals, industrial minerals, and biotic materials.

Viktor Mikhailovich Zhdanov and the eradication of smallpox

Considering current epidemiological and social phenomena such as CoVid-19 pandemic, re-occurrence of monkeypox and vaccine hesitancy, the authors chose to delineate an historical, human, and scientific profile of Dr. Viktor Mikhailovich Zhdanov, as a key figure related not only to smallpox eradication, but also to the building up of worldwide vaccination strategies. The authors present some of Zhdanov main life and scientific experiences and awards in virology, epidemiology, and public health. The authors highlight the need for international commitment to cooperate in the fields of vaccine research and vaccine hesitancy. © Mattioli 1885

Levilimab clinical efficacy for interleukin-6 receptor inhibition in COVID-19 and its potential for treating cytokine release syndrome of other aetiologies.

The COVID-19 mortality is associated with an increase in interleukin-6 (IL-6) levels. Levilimab is an anti-IL-6 receptor antibody with proven clinical efficacy in patients with severe COVID-19. The aim of the study was to assess the association of COVID-19 severity and levilimab effectiveness with IL-6 levels and to explore the potential for using levilimab in other conditions accompanied by cytokine release syndrome. Material(s) and Method(s): the subgroup analysis was based on the data of COVID patients with known baseline IL-6 levels from the CORONA clinical study. Subgroups were formed according to baseline IL-6 levels: <=5 pg/mL (normal) and >5 pg/mL (elevated). The subgroup analysis included descriptive statistics of the patients and time courses of their clinical and laboratory findings (at screening, on the day of investigational product administration, and further until day 14). In order to compare the percentages of patients who had required rescue therapy, the authors used Fisher's exact test. Result(s): the subgroup analysis included 91 patients (47 from the levilimab group and 44 from the placebo group). At baseline, the authors observed elevated levels of IL-6 in 31/47 (66%) subjects in the levilimab group and 29/44 (48.4%) subjects in the placebo group. The subjects with elevated IL-6 demonstrated more pronounced clinical signs of pneumonia and abnormalities in inflammatory markers. Elevated baseline IL-6 levels were associated with the need for rescue therapy (OR=3.714;95% CI: 1.317-9.747;p=0.0183);this association was stronger in the placebo group (OR=8.889;95% CI: 2.098-33.31;p=0.0036). Also, the placebo group showed long-term abnormalities in the clinical and laboratory findings. Conclusion(s): IL-6 is one of the key elements in the pathogenesis of cytokine release syndrome related to COVID-19 and other conditions. Elevated IL-6 levels are associated with the severity of COVID-19. Inhibition of IL-6 receptors by levilimab leads to clinical improvement in patients with severe COVID-19, suggesting the effectiveness of levilimab in pathogenesis-oriented therapy for cytokine release syndrome of other aetiologies.Copyright © 2023 Safety and Risk of Pharmacotherapy. All rights reserved.

Levilimab clinical efficacy for interleukin-6 receptor inhibition in COVID-19 and its potential for treating cytokine release syndrome of other aetiologies

The COVID-19 mortality is associated with an increase in interleukin-6 (IL-6) levels. Levilimab is an anti–IL-6 receptor antibody with proven clinical efficacy in patients with severe COVID-19. The aim of the study was to assess the association of COVID-19 severity and levilimab effectiveness with IL-6 levels and to explore the potential for using levilimab in other conditions accompanied by cytokine release syndrome. Materials and methods: the subgroup analysis was based on the data of COVID patients with known baseline IL-6 levels from the CORONA clinical study. Subgroups were formed according to baseline IL-6 levels: ≤5 pg/mL (normal) and >5 pg/mL (elevated). The subgroup analysis included descriptive statistics of the patients and time courses of their clinical and laboratory findings (at screening, on the day of investigational product administration, and further until day 14). In order to compare the percentages of patients who had required rescue therapy, the authors used Fisher's exact test. Results: the subgroup analysis included 91 patients (47 from the levilimab group and 44 from the placebo group). At baseline, the authors observed elevated levels of IL-6 in 31/47 (66%) subjects in the levilimab group and 29/44 (48.4%) subjects in the placebo group. The subjects with elevated IL-6 demonstrated more pronounced clinical signs of pneumonia and abnormalities in inflammatory markers. Elevated baseline IL-6 levels were associated with the need for rescue therapy (OR=3.714;95% CI: 1.317–9.747;p=0.0183);this association was stronger in the placebo group (OR=8.889;95% CI: 2.098–33.31;p=0.0036). Also, the placebo group showed long-term abnormalities in the clinical and laboratory findings. Conclusions: IL-6 is one of the key elements in the pathogenesis of cytokine release syndrome related to COVID-19 and other conditions. Elevated IL-6 levels are associated with the severity of COVID-19. Inhibition of IL-6 receptors by levilimab leads to clinical improvement in patients with severe COVID-19, suggesting the effectiveness of levilimab in pathogenesis-oriented therapy for cytokine release syndrome of other aetiologies.

The assessment of ROTEM test in patients with critical form of COVID-19

Background: Patients with comorbidities could have severe COVID-19 outcomes. Thrombosis or hemorrhages were frequently reported during COVID-19 evolution Aims: The study evaluated the role of ROTEM in the identification of patients with a high risk of vascular complications Methods: We analyzed clinical, ROTEM, and laboratory data of 80 patients admitted to the intensive care unit (ICU) Department of our hospital, during 2020-2021. Result(s): Thrombosis was diagnosed in 26 cases (27.96%) and was more frequent in patients with severe pneumonia and ARDS, Chi-squared 3.55, p = 0.05. Hemorrhages were identified in 21 cases (22.58%) and were less frequent in patients with severe ARDS, Chi-squared = 4.67, p = 0.03. ROTEM analyses were focused on ExTEM, InTEM, and FibTEM clotting time (CT), clot amplitudes after five and ten minutes (A5/A10), maximum clot firmness (MCF), and maximum lysis (ML). In the ExTEM median CT (eCT) value was 90.5 (50-207) s in patients with severe ARDS vs 75(58-571) s in patients with mild/ medium ARDS, p = 0.02;A5 44 (16-68) in patient with thrombosis vs. 53 (12-69) in patient without thrombosis;ML 6 (0-104) in patients with sepsis vs 8 (0-15) in patient without sepsis, p = 0.04.The median FibTEM CT (fCT) was 91 (53-7913) s in patients with severe ARDS vs 76 (52-8203) s in patients with mild/medium ARDS, p = 0.009;there were a significant correlation with ferritin level, rho = 0.22, p = 0.05. An increasing value of fCT during COVID-19 evolution was observed especially in the critical form of COVID-19. Lymphopenia was significant in patient with severe ARDS 0.48 x 1000/uL (0.02-8.03) vs 0.67 x 1000/uL (0.14-9.09) identified in patients with mild/medium ARDS, p = 0.05;it was not obtained significant correlations between lab test and ROTEM results. Conclusion(s): The ROTEM test suggests showing hypercoagulability probably due to severe inflammation. Patients with a critical form of COVID-19 developed thrombotic complications more frequently than hemorrhages. We have to check these results in large cohorts of patients.

Development of а remote learning system in higher educational institutions of the Russian Federation: from local practice to integration into the digital university model

The experience of remote learning during the pandemic COVID-19 significantly accelerated the process of digitalisation of the higher education in Russia and intensified preparations for the transition to a model of the Digital University. However, even those educational institutions that successfully applied remote technologies in the educational process faced the problem of effectively managing the entire remote learning system. The aim of the study is to identify the management potential of remote learning at universities in Russia from the point of view of the methodology of active management systems. Models of the remote learning system in institutions of higher education relevant for different stages of development have been created;recommendations are made to integrate the proposed models into the Digital University model. Research results contribute to the development of the theory and practice of active management systems in terms of modelling remote learning in institutions of higher education. Copyright © 2022 Inderscience Enterprises Ltd.

Development of remote learning system in higher educational institutions of the Russian Federation: from local practice to integration into the digital university model

The experience of remote learning during the pandemic COVID-19 significantly accelerated the process of digitalisation of the higher education in Russia and intensified preparations for the transition to a model of the Digital University. However, even those educational institutions that successfully applied remote technologies in the educational process faced the problem of effectively managing the entire remote learning system. The aim of the study is to identify the management potential of remote learning at universities in Russia from the point of view of the methodology of active management systems. Models of the remote learning system in institutions of higher education relevant for different stages of development have been created;recommendations are made to integrate the proposed models into the Digital University model. Research results contribute to the development of the theory and practice of active management systems in terms of modelling remote learning in institutions of higher education.

The importance of the long Covid-19 in the evolution of patients with neoplasms

Background: Patients with comorbidities especially those with oncological diseases could have severe COVID-19 outcomes. OBJECTIVE: The aim of this study was to evaluate the role of prolonged positivity of SARS-Cov2 in evolution of patients with various neoplasia. Methods: We analysed clinical and laboratory (hematological parameters and inflammatory markers: interleukin-6 and ferritin) data of COVID-19 patients admitted in intensive care unit (ICU) Department of our hospital, during 2020-2021 and presented in medical history solid tumors or haematological neoplasia . The cohort of patients included 78 patients with severe and critical form of COVID-19, 31 patients with solid tumors and 47 patients with hematologic malignancies. We consider long COVID-19 all cases with SARS Cov2 positivity more than 14 days. Results: The frequency of long COVID-19 was quite equal between patients groups with solid tumors and hematologic malignancies, incidence rate 1:2, the incidence rate differences was 1:18, p = 0.75. Long COVID-19 was observed in 60% cases with favourable evolution, Chi-squared 5.35%, p = 0.02, these patients had moderate form and was admitted in hospital in 1 or more days after the onset, median value 3 (min 1, max 55) compared with patients with normal duration of positivity of SARS-Cov2 test-median value 2 (min 1, max 8), p = 0.01. The Kaplan Meyer survival analyses indicated long COVID-19 as predictive factor for unfavourable evolution, Chi-squared 17.97, p < 0.0001. Although we have not obtain significant differences, we observed more severe lymphopenia in patient without long COVID-19, probably because a part of these patients group died in the first 14 days of COVID-19 (0.765 (min 0.04, max 297.64) vs. 1.01 (min 0.09, max 254.35), p = 0.09). The rest of hematological and biochemistry parameters was not significant different between groups. Infectious and thrombotic complication was most frequent in patients with long COVID-19, Chi squared 8.6, p = 0.003. Conclusions: Long Covid-19 is predictable for unfavourable evolution and is associated with sepsis and thrombotic complication. This diagnosis is frequent in patients who was admitted in hospital after the onset of COVID-19 symptoms, early treatment of COVID-19 in oncological patients being very important for favourable evolution.

PDSTP Is the First Drug in Class to Treat Coronavirus Infection.

The results of a comprehensive study are presented on the development and creation of an original small PDSTP molecule, able to prevent the SARS-CoV-2 coronavirus infection from binding to the host cell. The PDSTP molecule was designed to electrostatically interact with heparan sulfate proteoglycans on the cell surface, and coronaviruses, particularly SARS-CoV-2, use this mechanism as the first stage of interaction with the cell. By blocking this process, it is possible to stop the life cycle of the virus, thus leading to its death. The drug candidate PDSTP, with its unique mechanism of action, is characterized by a very low toxicity and a high safety profile and demonstrates good efficacy in animal experiments.

FELLOW EXPERIENCES WITH ENDOSCOPY SIMULATION BEFORE AND DURING THE COVID-19 PANDEMIC: AN INTERNATIONAL SURVEY

Background With the COVID-19 pandemic there was an acute drop in procedural volume for trainees, highlighting the need and potential of simulation-based training (SBT). Prior to the pandemic, the uptake of simulation was poorly categorized and inconsistent across programs despite the variety of endoscopic simulators available. We aimed to evaluate the current state of endoscopy training internationally in the wake of the pandemic as perceived by trainees. Methods This cross-sectional study utilized a survey composed of 21 questions eliciting demographic data, COVID-19-related training experiences, and experience with SBT. This survey was distributed internationally (USA, Canada, EU, Philippines, Singapore) to gastroenterology trainees between August 2021 to October 2021. Results The questionnaire was completed by 182 fellows, with 55 (30.2%) from the USA and 127 (69.8%) from other countries. Of the respondents, 79.1% were fellows during the first year of the pandemic. A majority (69.2%) found endoscopy training in general to be negatively impacted. Of those who reported a negative impact from the pandemic, 75.0% attributed it to a decline in endoscopic volume, 40.0% to institutional/regional guidelines, 25.0% to a shortage of personal protective equipment. Overall, 47.2% of respondents believed COVID-19 will negatively affect their endoscopic proficiency upon fellowship completion. A total of 71 respondents (39.0%) had experienced SBT before or during fellowship, with 27 from the USA (49.1% of respondents from USA) and 44 from other countries (34.6% of respondents from other countries). In the USA, 63.0% had used virtual reality (VR), 37.0% mechanical models, and 37.0% animal models compared to 47.7% VR, 68.2% mechanical models, and 27.3% animal models in other countries. Respondents agreed that SBT was most helpful with developing technical skills such as ergonomic handling, torque steering, and fine tip control. A majority (52.1%) found SBT appropriate to their level of training. Respondents believed increased access to SBT (43.7%) and mentored training (54.9%) would improve the experience. Conclusion While current data supports the use of SBT early in training, the cumulative uptake of SBT across programs before and during the COVID-19 pandemic remained low. In the USA and abroad, fellows perceive a negative impact of COVID-19 on their training and proficiency upon graduation. Compared to other countries, the USA had higher utilization of VR and lower utilization of mechanical models. Decrease in endoscopic volume was reported as the main factor negatively impacting endoscopic training. This survey highlights the potential benefit of SBT with low case volumes and further prospective evaluation of SBT in achieving endoscopic competence. (Table Presented)

Accounting the factor of randomity of social processes in prediction of demand for electric energy

Мета. Урахування фактору випадковосл сощальних процесш при прогнозуванш попиту на електричну енерпю для зменшення похибки. Методика. Апарат математично! статистики, методш лшшного програмування, теорп нечггких множин i методiв експертного оцшювання, теорй' шкал, Байесовський п1дх1д до моделей прогнозування, комп'ютерне моделювання. Результаты. Проаналiзована динамiка споживання електрично! енергп за рiзнi перiоди часу, встановлено вплив фактору пандемп на процес формування попиту на електричну енерпю. Розроблена вербально-числова шкала для комплексного оцшювання впливу на попит на електричну енерпю такого складного сощального явища, як пандемш. Сформована модель прогнозування попиту на електричну енерпю з використанням Байесовського подходу та ощнки експерта, що дозволила використати ретроспективш данi споживання електрично! енергп та врахувати невизначенiсть соцiального фактору впливу пандемп. Наукова новизна. Набула подальшого розвитку модель прогнозування попиту на електричну енерпю, яка, на вщмшу в1д iнших, ураховуе фактор випадковостi соцiальних процеив i вербально-числову шкалу, що дозволяе зменшити похибку прогнозування споживання електрично! енергп. Практична значимтсть. Результата дослщження кориснi для пщприемств, що спецiалiзуються на генерацй', передачi й розподшу електрично! енергп споживачам. Представленi результата надають можливють зменшити похибку прогнозування попиту на електричну енерпю при врахуванш фактору випадковосл сощальних процешв.Alternate :Purpose. Taking into account the factor of randomness of social processes when forecasting the demand for electric energy to reduce the error. Methodology. Apparatus of mathematical statistics, linear programming methods, fuzzy set theory and expert assessment methods, scale theory, Bayesian approach to forecasting models, computer modeling. Findings. The dynamics of consumption of electric energy for different periods of time is analyzed, the influence of the pandemic factor on the process of formation of demand for electric energy is established. A verbal-numerical scale has been developed for a comprehensive assessment of the impact on the demand for electric energy of such a complex social phenomenon as a pandemic. A model for forecasting the demand for electrical energy was formed using the Bayesian approach and an expert's assessment, which made it possible to use retrospective data on electrical energy consumption and take into account the uncertainty of the social factor influencing the pandemic. Originality. The model for forecasting the demand for electrical energy has been further developed, which, unlike others, takes into account the factor of randomness of social processes and a verbal-numerical scale, which makes it possible to reduce the error in predicting the consumption of electrical energy. Practic l value. The research results are useful for enterprises specializing in the generation, transmission and distribution of electrical energy to consumers. The presented results make it possible to reduce the error in forecasting the demand for electric energy, taking into account the factor of randomness of social processes.

Assessment under Covid-19: Exploring Undergraduate Students' Attitudes towards Their Online Thesis Proposal Presentations vs. Face-to-face

This study conducted in an EFL setting investigates students' perception of the thesis proposal presentation in an online format due to safety concerns during the Covid-19 pandemic. Fifty-five students aged 20-22 years old, level B2-C1 in English, in their fourth year of a Business Informatics Bachelor's programme at HSE University, Moscow, were surveyed regarding their end-of-course assessment experience, which involved a Skype online presentation, rather than the usual face-to-face presentation. Data were collected using a researcher-made questionnaire consisted of 3 sections and 12 items. A mixed-method approach using quantitative and qualitative data was employed. The findings indicate that emergency transition to the new format did not affect students' satisfaction or results of the presentation. Overall, students were more than satisfied with the online format, and the results were similar, if not better, than in previous years. To minimise the disadvantages of this format, recommendations for teachers and students were offered. This study might offer new insight on the most appropriate and beneficial oral testing system for students and staff.

A case of acute liver failure secondary to remdesivir in the treatment of sars-cov-2

Introduction: To date, there have been over 32 million cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the United States alone. Remdesivir is the only drug approved by the US Food and Drug Administration for the treatment of SARS-CoV-2. Although safety data is limited, hepatotoxicity has been reported in 5-37% with most cases being mild. We present a case of acute liver failure (ALF) from remdesivir, successfully treated with N-acetylcysteine (NAC) infusion. Case Description/Methods: An 83-year-old obese male with chronic kidney and cardiac disease presented with cough and diarrhea for one week and was diagnosed with SARS-CoV-2. Due to hypoxemia, he was started on remdesivir and dexamethasone on hospital day 1. Compared to normal transaminases on admission, on hospital day 6, the patient had an acute elevation of his aspartate aminotransferase (AST) to 3539, alanine aminotransferase (ALT) to 2246, international normalized ratio (INR) to 4.77 and mild elevations in alkaline phosphatase (ALP) to 207 and total bilirubin to 2.9. This was consistent with a hepatocellular pattern of injury. He concurrently developed altered mental status with no asterixis. Acute viral hepatitis serologies and autoimmune markers were negative and liver ultrasound demonstrated a patent portal vein and normal biliary ducts. Remdesivir and dexamethasone were discontinued. Intravenous vitamin K was administered to reverse his coagulopathy and a 5-day course of NAC was completed. The patient had significant improvement in his mental status, AST, ALT, and INR within 24 hours of NAC initiation, with continued improvement over the next two weeks of hospitalization (Figure 1a,b). Discussion: Transaminase elevation is a known side effect of remdesivir, and close monitoring of liver tests is recommended. However, ALF is a rare complication with only two other published cases and with no approved therapy. In our case of an elderly gentleman with SARS-CoV-2 who developed ALF with grade 1 encephalopathy 6 days after initiation of remdesivir, the discontinuation of the drug along with NAC treatment was successful in reversing the ALF. Furthermore, this patient's obesity may have increased his risk of Remdesivir hepatotoxicity through impaired cytochrome P450 metabolism. While seemingly rare, more research on the mechanism and risk profile of remdesivir hepatotoxicity is needed as this drug becomes more commonly used in the treatment of SARS-CoV-2. (Figure Presented).

Demographic and digestive laboratory characteristics predict mortality among hospitalized COVID-19 patients

Introduction: Digestive laboratory abnormalities related to COVID-19 have been previously described, but most reports came from single centers and findings have been conflicting. We conducted a multi-center study using data from three large urban VA centers (New York Harbor VA, New Orleans VA and Detroit VA) to examine the association between demographics and digestive laboratory values with mortality on index hospitalization among individuals diagnosed with COVID-19. Methods: We manually extracted data on individuals hospitalized for COVID-19 between December 2019 and June 2020 at the three facilities. For this analysis, data on demographics and seven digestive laboratory values (highest AST, ALT, alkaline phosphatase, total bilirubin, and INR during admission, as well as lowest hemoglobin and platelets) were analyzed in relation to index hospitalization mortality. We performed descriptive statistics and conducted a multivariable logistic regression model. Results: Out of a total of 390 individuals who were hospitalized with COVID-19, 168 (43%) died and 222 survived. The median age of patients who died was higher than those who survived (75 vs. 69 years). The vast majority (94%) of patients were male. Black patients accounted for a higher proportion of those who died than those who survived (61% vs. 55%), whereas the opposite was true for Whites (26% vs. 31%) and Hispanics (9% vs. 12%). In the multivariable model (Table), mortality was associated with older age (OR 1.07, 95% CI 1.03-1.10), higher BMI (OR 1.05, 95% CI 1.01-1.10), higher AST (OR 1.01, 95% CI 1.004-1.02), lower ALT (OR 0.99, 95% CI 0.98-0.996), higher alkaline phosphatase (OR 1.02, 95% CI 1.01-1.02), and lower hemoglobin (OR 0.83, 95% CI 0.72-0.97). Conclusion: In this multicenter VA study of patients hospitalized with COVID-19 during the first half of 2020, overall mortality was 43%. For mortality during index hospitalization, we observed a positive association with age, BMI, AST, and alkaline phosphatase, and an inverse association with ALT and hemoglobin. Every 1 unit increase in hemoglobin was associated with 17% decreased odds of death. These findings suggest that commonly used digestive laboratory tests have prognostic significance for COVID-related survival.

The assessment of thrombotic complication in patients with COVID-19

Background : COVID-19 frequently associated thrombotic complication that could determine severe evolution. Inflammation was proved as important pathogenic mechanism of thrombosis. Aims : The main objective was to evaluate the role of inflammation in increased risk of thrombosis in COVID 19 patients. Methods : Our study was prospective and included all patients diagnosed with COVID 19 between April-September 2020 in Hematology, Pneumology and Intensive Care Unit from Colentina Clinical Hospital (285 patients). The diagnosis was established using molecular test for SARS-Cov2. Results : Thrombotic complication was presented in 56 COVID-19 patients (19, 65%), The higher incidence of thrombosis was observed in severe form of COVID-19: stage 3 (66%) and stage 2 (26.3%), Comorbidities: diabetes mellitus, obesity and arterial hypertension were presented in majority of COVID 19 patients with thrombosis. Acute thrombosis (stroke, myocardial infarction or pulmonary embolism) was diagnosed in 14 patients;all of them were admitted in Intensive care unit due severe form of COVID-19. Inflammatory markers including C reactive protein (CRP), procalcitonin, ferritin are significantly increased in COVID-19 group with acute thrombosis compared with COVID -19 patients with thrombosis in medical history CRP 148.86 mg/L (2.96-386.5) vs. 58.24 mg/L (min 0.25, max 212.98) P = 0.005;procalcitonin 0.93 ng/ml (0.04-784) vs 0.18 (min 0.02, max 14.1) P = 0.02;ferritin 702 ng/ml (min 102, max 4070) vs. 1195 ng/ml (min 358, max 12800) P = 0.03. There is no significant difference between haematological parameters in COVID-19 patients with acute thrombosis or in their medical history. D Dimers are significant increased in patients with acute thrombosis 4.79 ug/ml (0.51-20) vs patients with medical history of thrombosis 2.12 (0.31-20), P = 0.02. The level of protein C, protein S and antitrombine III, antiphospholipid antibodies are not significant modified in the both groups. Conclusions : The assessment of inflammation parameters are very important in COVID-19 patients especially those with a history of thrombosis or who have significant comorbidities (diabetes mellitus, arterial hypertension or obesity).

Evaluation of the impact of Covid-19 infection on the evolution and prognosis of patients with acute leukaemia

Introduciton: COVID19 is one of the largest pandemics. Since December 2019 until now the coronavirus has infected over 131 million people. The mortality rate in the general population varies between 1 to 5%, with a potential of over 30% in patients with neoplasms. Methods: The main objective of the study was to identify some peculiarities of the evolution, complications and treatment of patients with acute leukaemia and COVID-19. The study was retrospective and included 50 patients with acute leukaemia and COVID-19. Results: Recent administration of chemotherapy was identified in 20 patients with acute myeloblastic leukaemia and 4 patients with acute lymphoblastic leukaemia. The newly diagnosed patients or those undergoing intensive chemotherapy, in particular elderly patients, had a severe form of COVID-19 and an unfavourable evolution, and these clinical situations were identified as predictive factors for adverse outcomes. Patients with acute lymphoblastic leukaemia had a shorter survival curve compared to patients with acute myeloblastic leukaemia. Pneumonia was present especially in patients with acute myeloblastic leukaemia, most patients having over 30% of lung fields affected (55.26%). Patients with an unfavourable outcome had significantly increased median values of C-reactive protein, procalcitonin and interleukin6. Conclusions: Patients with acute leukaemia, especially acute myeloblastic leukaemia who have been diagnosed with COVID-19 infection require special attention because they may associate complications and adverse outcomes of COVID-19. The results we obtained require evaluation in a larger group of patients and analysis in the follow-up period after COVID-19.