Features of inflammatory periodontal diseases course in combination with a new coronavirus disease. A systematic review

Risk factors for severe COVID-19 are also associated with periodontitis. They are smoking, older age, obesity, diabetes mellitus, hypertension and cardiovascular diseases. The aim of the study was to select and analyze publications that consider a possible relationship between inflammatory periodontal diseases and the severity of COVID-19. Material and methods. The search for publications by the key words was conducted using the electronic databases: Cochrane Library;MEDLINE, eLIBRARY for systematic review. We selected 94 publications, the systematic review included 10 scientific articles presenting the results of randomized trials. Results. The results of the analysis showed the connection between COVID-19 severity and inflammatory periodontal diseases presence. In the patients with severe COVID-19 on the background of periodontitis it was established a high risk for artificial lung ventilation prescription. The course of COVID-19 is possibly depending on high expression of ACE2 receptors in oral mucosal cells and aspiration of pathogenic bacteria from periodontal tissues with saliva on the background of SARS-CoV-2 viral infection. The bacterial etiology of periodontitis plays important role of an immunological trigger that causes hyperreaction of humoral and cellular immunity, NETosis activation and NLRP3 inflammation. Conclusion. The presence of periodontitis in patients with overweight and obesity, DM or hypertension may be associated with severe COVID-19 course, possible development of complications and pneumonia.Copyright © Eco-Vector, 2023. All rights reserved.

Survey of medical university staff: assessment of COVID-19 manifestations in periods of peak and convalescence

The aim of the study was to assess the frequency of symptoms of post-COVID syndrome by means of a questionnaire among medical university employees. Material and methods. From March 2021 to February 2022, an anonymous online survey was conducted at the A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation. Only 313 fully completed questionnaires were selected for analysis. Results and discussion. A wide range of asthenic, infectious-inflammatory, respiratory, cardiovascular, neuropsychiatric, gastroenterological and dermatological symptoms were noted both during the peak period and during the convalescence of COVID-19. According to the subjective data of respondents, for more than 3 months, various symptoms associated with deterioration of health after recovering from a new coronavirus infection persisted in 25.9% of cases. Within 3-6 months after the illness and more than 6 months, 44.6% and 55.4% of respondents noted the presence of symptoms of post-COVID syndrome, respectively. During the analysis, it was found that with an increase in the volume of lung damage according to CT data, there was a tendency to increase the proportion of respondents with a long-term (more than 6 months) persistent symptoms of post-COVID syndrome from 20% with CT score 0, up to 29% with CT score 1-2 and up to 58% with CT score 3-4. In this regard, apparently, it is necessary to develop additional screening programs as part of the medical examination of COVID-19 patients. Conclusion. SARS-CoV-2 infection causes a wide range of symptoms both during the period of the disease and during the period of convalescence. Attention should be paid to the need for a targeted survey of patients who have undergone COVID-19 to identify the manifestations of post-COVID syndrome and conduct their medical examination with the participation of a multidisciplinary team.Copyright © Eco-Vector, 2022.

Features of the diagnosis and course of COVID-19 in HIV-infected patients hospitalized in a hospital

The global pandemic of coronavirus infection (COVID-19) has set complex diagnostic tasks for doctors of polyclinics and hospitals. Considering the simultaneous pandemic spread of two infectious diseases - COVID-19 and HIV infection, the problem of studying the clinical features of combined COVID-19/HIV infection becomes urgent. The aim of the study was to determine the features of the diagnosis and course of COVID-19 against the background of HIV infection in patients undergoing inpatient treatment. Material and methods. The study was conducted on the basis of the temporary Clinical Medical Center COVID-19 of the A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation in Moscow from October 2020 to January 2022. The study included 31 233 patients with COVID-19 complicated by pneumonia. To analyze the features of the course of combined COVID-19/HIV infection, a group of 51 HIV-infected patients was identified. The diagnosis of COVID-19 was determined based on the detection of SARS-CoV-2 RNA by PCR in nasal/oropharyngeal smears and/or according to computed tomography of the lungs (CT). During the study, age, gender, anamnesis, objective examination data were analyzed, taking into account the results of CT scans of the chest organs, data from routine laboratory blood tests, oxygen support regimens, treatment outcomes and duration of detection of SARS-CoV-2 RNA. All patients were treated according to the Temporary Clinical Guidelines for the Diagnosis and Treatment of COVID-19, 14 version dated 12/27/2021. Results. The number of patients with combined HIV infection and SARS-CoV-2 out of the total number of hospitalized COVID-19 patients (n=31 233) was 0.16%. Upon admission, 30 (59%) patients reported having HIV infection and receiving antiretroviral therapy (ART). HIV infection was first diagnosed in 21 patients at 2-3 weeks of inpatient treatment. The average age of patients with SARS-Cov-2/HIV co-infection was 1.5 times less than in patients without HIV (41.1+/-5.3 and 64.4+/-10.1, respectively) (p<=0.05). Concomitant pathology (hypertension, type 2 diabetes mellitus, chronic kidney disease and chronic lung diseases) was less common (51%) in the group of combined infection than in the group without HIV (83%). However, in 41% of patients with coinfection, chronic viral hepatitis B, C was detected, in contrast to 0.3% of cases of COVID-19 patients without HIV. 26 (51%) patients were discharged with improvement, while the average bed-day did not differ from patients without HIV infection (13.4+/-4.5 days and 11.7+/-5.2, respectively) (p>=0.05). 7 (24%) patients at the time of discharge (16.8+/-4.2 days) with clinical and laboratory improvement maintained a positive result of PCR RNA on SARS-Cov-2. In 22 (43%) patients with coinfection, hospitalization was fatal for 3 to 21 days of treatment, with ARDS with respiratory and multiple organ failure, which is 3.6 times higher than in patients without HIV infection. The analysis showed that, regardless of the result of PCR on SARS-CoV-2 RNA, in non-specialized hospitals, HIV testing is indicated for young patients with fever for more than 14 days, with lung damage in the form of bilateral interstitial changes according to CT, a history of chronic hepatitis C, B, with progressive severity of the condition on against the background of COVID-19 therapy. Early consultation of an infectious disease specialist, examination of sputum/lavage by PCR for pathogens of opportunistic infections and the appointment of ART and drugs for the treatment of opportunistic diseases will improve the quality of medical care for patients in a non-core HIV hospital will improve the prognosis of COVID-19.Copyright © Eco-Vector, 2022.

Features of inflammatory periodontal diseases course in combination with a new coronavirus disease. A systematic review.

Risk factors for severe COVID-19 are also associated with periodontitis. They are smoking, older age, obesity, diabetes mellitus, hypertension and cardiovascular diseases. The aim of the study was to select and analyze publications that consider a possible relationship between inflammatory periodontal diseases and the severity of COVID-19. Material and methods. The search for publications by the key words was conducted using the electronic databases: Cochrane Library;MEDLINE, eLIBRARY for systematic review. We selected 94 publications, the systematic review included 10 scientific articles presenting the results of randomized trials. Results. The results of the analysis showed the connection between COVID-19 severity and inflammatory periodontal diseases presence. In the patients with severe COVID-19 on the background of periodontitis it was established a high risk for artificial lung ventilation prescription. The course of COVID-19 is possibly depending on high expression of ACE2 receptors in oral mucosal cells and aspiration of pathogenic bacteria from periodontal tissues with saliva on the background of SARS-CoV-2 viral infection. The bacterial etiology of periodontitis plays important role of an immunological trigger that causes hyperreaction of humoral and cellular immunity, NETosis activation and NLRP3 inflammation. Conclusion. The presence of periodontitis in patients with overweight and obesity, DM or hypertension may be associated with severe COVID-19 course, possible development of complications and pneumonia.Copyright © Eco-Vector, 2023. All rights reserved.

Prospects for studying the role of some essential and toxic trace elements in the pathogenesis of COVID-19

Introduction. Factors affecting the severity of the course of a new coronavirus infection remain unexplored to the end Aim. To study the factors associated with the transition of COVID-19 from moderate to severe form of the disease in patients undergoing inpatient treatment Materials and methods. The diagnosis of COVID-19-associated pneumonia was made by a clinician on the basis of PCR test data and an up-to-date chest CT scan. A total of 195 consecutively recruited patients were examined. The average age of the surveyed was 54 (12.1) years. Results. Significantly more patients with severe coronavirus infection at the time of hospitalization were active tobacco smokers (33 (29.73%) vs 67 (79.6%);p < 0.002) and had a BMI consistent with pre-obesity/obesity (42 (37.84%) vs 44 (52.38%);p = 0.027). In patients with severe COVID-19, a significantly higher content of leukocytes was noted in the complete blood count (6.054 (2.813) vs 7.307 (4.707);p = 0.021). The groups also differed significantly in the content of micro-and macroelements. The imbalance of minerals revealed in our study is published for the first time, because. The study of the content of Al, B, Li, Co, Sr and Si in patients with COVID-19 was not carried out. Conclusion. The revealed changes in the microelement status require further study to confirm their significance in the development of a severe form of a new coronavirus infection in patients. © 2022, Remedium Group Ltd. All rights reserved.

Prospects for studying the role of some essential and toxic trace elements in the pathogenesis of COVID-19

Introduction. Factors affecting the severity of the course of a new coronavirus infection remain unexplored to the end Aim. To study the factors associated with the transition of COVID-19 from moderate to severe form of the disease in patients undergoing inpatient treatment Materials and methods. The diagnosis of COVID-19-associated pneumonia was made by a clinician on the basis of PCR test data and an up-to-date chest CT scan. A total of 195 consecutively recruited patients were examined. The average age of the surveyed was 54 (12.1) years. Results. Significantly more patients with severe coronavirus infection at the time of hospitalization were active tobacco smokers (33 (29.73%) vs 67 (79.6%);p < 0.002) and had a BMI consistent with pre-obesity/obesity (42 (37.84%) vs 44 (52.38%);p = 0.027). In patients with severe COVID-19, a significantly higher content of leukocytes was noted in the complete blood count (6.054 (2.813) vs 7.307 (4.707);p = 0.021). The groups also differed significantly in the content of micro-and macroelements. The imbalance of minerals revealed in our study is published for the first time, because. The study of the content of Al, B, Li, Co, Sr and Si in patients with COVID-19 was not carried out. Conclusion. The revealed changes in the microelement status require further study to confirm their significance in the development of a severe form of a new coronavirus infection in patients. © 2022, Remedium Group Ltd. All rights reserved.

Features of the diagnosis and course of COVID-19 in HIV-infected patients hospitalized in a hospital

The global pandemic of coronavirus infection (COVID-19) has set complex diagnostic tasks for doctors of polyclinics and hospitals. Considering the simultaneous pandemic spread of two infectious diseases – COVID-19 and HIV infection, the problem of studying the clinical features of combined COVID-19/HIV infection becomes urgent. The aim of the study was to determine the features of the diagnosis and course of COVID-19 against the background of HIV infection in patients undergoing inpatient treatment. Material and methods. The study was conducted on the basis of the temporary Clinical Medical Center COVID-19 of the A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation in Moscow from October 2020 to January 2022. The study included 31 233 patients with COVID-19 complicated by pneumonia. To analyze the features of the course of combined COVID-19/HIV infection, a group of 51 HIV-infected patients was identified. The diagnosis of COVID-19 was determined based on the detection of SARS-CoV-2 RNA by PCR in nasal/oropharyngeal smears and/or according to computed tomography of the lungs (CT). During the study, age, gender, anamnesis, objective examination data were analyzed, taking into account the results of CT scans of the chest organs, data from routine laboratory blood tests, oxygen support regimens, treatment outcomes and duration of detection of SARS-CoV-2 RNA. All patients were treated according to the Temporary Clinical Guidelines for the Diagnosis and Treatment of COVID-19, 14 version dated 12/27/2021. Results. The number of patients with combined HIV infection and SARS-CoV-2 out of the total number of hospitalized COVID-19 patients (n=31 233) was 0.16%. Upon admission, 30 (59%) patients reported having HIV infection and receiving antiretroviral therapy (ART). HIV infection was first diagnosed in 21 patients at 2–3 weeks of inpatient treatment. The average age of patients with SARS-Cov-2/HIV co-infection was 1.5 times less than in patients without HIV (41.1±5.3 and 64.4±10.1, respectively) (p≤0.05). Concomitant pathology (hypertension, type 2 diabetes mellitus, chronic kidney disease and chronic lung diseases) was less common (51%) in the group of combined infection than in the group without HIV (83%). However, in 41% of patients with coinfection, chronic viral hepatitis B, C was detected, in contrast to 0.3% of cases of COVID-19 patients without HIV. 26 (51%) patients were discharged with improvement, while the average bed-day did not differ from patients without HIV infection (13.4±4.5 days and 11.7±5.2, respectively) (p≥0.05). 7 (24%) patients at the time of discharge (16.8±4.2 days) with clinical and laboratory improvement maintained a positive result of PCR RNA on SARS-Cov-2. In 22 (43%) patients with coinfection, hospitalization was fatal for 3 to 21 days of treatment, with ARDS with respiratory and multiple organ failure, which is 3.6 times higher than in patients without HIV infection. The analysis showed that, regardless of the result of PCR on SARS-CoV-2 RNA, in non-specialized hospitals, HIV testing is indicated for young patients with fever for more than 14 days, with lung damage in the form of bilateral interstitial changes according to CT, a history of chronic hepatitis C, B, with progressive severity of the condition on against the background of COVID-19 therapy. Early consultation of an infectious disease specialist, examination of sputum/lavage by PCR for pathogens of opportunistic infections and the appointment of ART and drugs for the treatment of opportunistic diseases will improve the quality of medical care for patients in a non-core HIV hospital will improve the prognosis of COVID-19. © Eco-Vector, 2022.

Survey of medical university staff: assessment of COVID-19 manifestations in periods of peak and convalescence

The aim of the study was to assess the frequency of symptoms of post-COVID syndrome by means of a questionnaire among medical university employees. Material and methods. From March 2021 to February 2022, an anonymous online survey was conducted at the A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation. Only 313 fully completed questionnaires were selected for analysis. Results and discussion. A wide range of asthenic, infectious-inflammatory, respiratory, cardiovascular, neuropsychiatric, gastroenterological and dermatological symptoms were noted both during the peak period and during the convalescence of COVID-19. According to the subjective data of respondents, for more than 3 months, various symptoms associated with deterioration of health after recovering from a new coronavirus infection persisted in 25.9% of cases. Within 3–6 months after the illness and more than 6 months, 44.6% and 55.4% of respondents noted the presence of symptoms of post-COVID syndrome, respectively. During the analysis, it was found that with an increase in the volume of lung damage according to CT data, there was a tendency to increase the proportion of respondents with a long-term (more than 6 months) persistent symptoms of post-COVID syndrome from 20% with CT score 0, up to 29% with CT score 1–2 and up to 58% with CT score 3–4. In this regard, apparently, it is necessary to develop additional screening programs as part of the medical examination of COVID-19 patients. Conclusion. SARS-CoV-2 infection causes a wide range of symptoms both during the period of the disease and during the period of convalescence. Attention should be paid to the need for a targeted survey of patients who have undergone COVID-19 to identify the manifestations of post-COVID syndrome and conduct their medical examination with the participation of a multidisciplinary team. © Eco-Vector, 2022.

[Composition of oropharyngeal microbiota in patients with COVID-19 of different pneumonia severity].

AIM: To identify features of the taxonomic composition of the oropharyngeal microbiota of COVID-19 patients with different disease severity. MATERIALS AND METHODS: The study group included 156 patients hospitalized with confirmed diagnosis of COVID-19 in the clinical medical center of Yevdokimov Moscow State University of Medicine and Dentistry between April and June 2021. There were 77 patients with mild pneumonia according to CT (CT1) and 79 patients with moderate to severe pneumonia (CT2 and CT3). Oropharyngeal swabs were taken when the patient was admitted to the hospital. Total DNA was isolated from the samples, then V3V4 regions of the 16s rRNA gene were amplified, followed by sequencing using Illumina HiSeq 2500 platform. DADA2 algorithm was used to obtain amplicon sequence variants (ASV). RESULTS: When comparing the microbial composition of the oropharynx of the patients with different forms of pneumonia, we have identified ASVs associated with the development of both mild and severe pneumonia outside hospital treatment. Based on the results obtained, ASVs associated with a lower degree of lung damage belong predominantly to the class of Gram-negative Firmicutes (Negativicutes), to various classes of Proteobacteria, as well as to the order Fusobacteria. In turn, ASVs associated with a greater degree of lung damage belong predominantly to Gram-positive classes of Firmicutes Bacilli and Clostridia. While being hospitalized, patients with severe pneumonia demonstrated negative disease dynamics during treatment significantly more often. CONCLUSION: We have observed differences in the taxonomic composition of the oropharyngeal microbiota in patients with different forms of pneumonia developed outside hospital treatment against COVID-19. Such differences might be due to the presumed barrier function of the oropharyngeal microbiota, which reduces the risk of virus titer increase.

Evaluation of the efficacy and safety of remdesivir in hospitalized patients with a new coronavirus infection COVID-19: data from a Russian university clinic

Introduction. The use of remdesivir in patients with the new coronavirus infection COVID-19 is known to improve the prognosis of the disease. But there is not enough data on efficacy and safety of remdesivir use in patients from Russia. Aim. To evaluate the efficacy and safety of remdesivir in patients with COVID-19. Materials and methods. A comparative prospective study was conducted in two parallel groups. The study enrolled 300 patients diagnosed with COVID-19 (grade 1–3 severe pneumonia according to CT scan), who were divided into two groups (n = 150 in each) according to the prescription of remdesivir. Treatment efficacy was assessed by recording cases of disease progression and adverse outcomes. The safety of therapy was assessed by hepatotoxicity and nephrotoxicity. Results. Patients receiving remdesivir were significantly less likely to be transferred to the intensive care unit (OR 0.3884, 95% CI: 0.1645–0.9175) and to be on artificial ventilation (OR 0.3830, 95% CI: 0.1539–0.9527). Treatment with remdesivir had no significant effect on mortality (OR 0.4932, 95% CI: 0.08897–2.7346) and complications (OR 0.4391, 95% CI: 0.1623–1.1879), including acute respiratory distress syndrome (OR 0.3919, 95% CI: 0.07483–2.0524). The duration of hospitalization was significantly short-er in group 1 patients – 12.2533 days (95% CI: 11.4101–13.0966) compared to group 2 – 14.5267 days (95% CI: 13.5125–15.5408). Hepatotoxicity with remdesivir (OR 1.5376, 95% CI: 0.8035–2.9426), nephrotoxicity (OR 1.6338, 95% CI: 0.522–5.1141) were noted, but no statistically significant difference was found (p > 0.05). Conclusions. The addition of remdesivir to the basic regimen of patients with new coronavirus infection COVID-19 improved the course of the disease, reducing the risks of patients being transferred to the intensive care unit and of receiving artificial ventilation. © 2022, Remedium Group Ltd. All rights reserved.

Mental disorders and the state of the blood-brain barrier in patients with the new coronavirus infection

An open prospective study to determine the clinical features of mental disorders in patients with the new coronavirus infection and its connection with the permeability of the blood-brain barrier included 97 patients hospitalized with COVID-19 of varying severity, but without signs of mental disorders in the anamnesis. Somatoform, neurotic and depressive disorders of mild or moderate severity were detected in 45.4% of cases, however, a number of patients (13.4%) had severe degree of disorders, including those with pronounced suicidal ideation. During the immunochemical study, an increase of the level of neurospecific proteins (GFAP and NSE) in blood serum has been detected, however, no reliable correlation of psychopathological symptoms with the results of the analysis of neurospecific proteins could be detected at the present stage. It is assumed that when the blood-brain barrier is permeated, a direct toxic effect on the nervous tissue makes such an oppressive impact that it prevents the development of structurally complex psychopathological formations. © 2021, V. Serbsky National Medical Research Centre for Psychiatry and Narcology. All rights reserved.