A serological survey of pathogens associated with the respiratory and digestive system in the Polish European bison (Bison bonasus) population in 2017-2022.

BACKGROUND: The European bison (Bison bonasus) is a near threatened species and requires health monitoring. The aim of the present study was to determine the prevalence of antibodies to pathogens known to cause respiratory and digestive illness in ruminants. RESULTS: In the studied 328 European bison, the highest seroprevalence was observed for Bovine herpesvirus-1 (BoHV-1) (50.27%), Bovine Coronavirus (BCoV) (26.36%), and Bluetongue Virus (BTV) (12.83%). For Mycoplasma bovis strains and Bovine Viral Diarrhea Virus (BVDV), positive results were rare. Interestingly, a higher prevalence of BTV antibodies was noted in the northeastern populations and older animals. CONCLUSIONS: Our findings indicate that the Polish European bison population appears to have considerable contact with BoHV-1; however, this does not appear to be of great significance, as clinical symptoms and post-mortem lesions are rarely noted in Polish European bison population. The high seroprevalence of BTV in the north-east of Poland is an ongoing trend, also noted in previous studies. It is possible that European bison may perpetuate the virus in this region. This is the first report of antibodies for BCoV in European bison.

Role of antiviral therapy in respiratory infections in children: Analysis of clinical and laboratory observations.

Objective. To evaluate the efficacy of therapy for acute respiratory viral infections (ARVIs) in children with antiviral medications: inosine pranobex (Groprinosin, Gedeon Richter) and Kagocel (Kagocel, Niarmedic Pharma LLC) in comparison with symptomatic treatment without etiotropic agents based on clinical and laboratory parameters. Patients and methods. The clinical and laboratory observation was conducted in an outpatient setting in the pre-COVID-19 period between 2018 and 2020. Acute respiratory infections were diagnosed using licensed testing systems by multiplex polymerase chain reaction (PCR) with detection of nucleic acid viral genomes: influenza, rhinovirus, respiratory syncytial virus, metapneumovirus, parainfluenza, seasonal coronaviruses, adenoviruses, and bocavirus). A total of 151 children aged 3 to 15 years were examined and monitored in dynamics, with 78.7% of positive and 21.3% of negative results detected by PCR in the nasopharyngeal and oropharyngeal swabs. The patients were randomized into three groups depending on the antiviral medication prescribed: group 1 (53 children) received Groprinosin;group 2 (52 children) received Kagocel;group 3 (control, 46 children) received only symptomatic therapy without antiviral agents. Results. The study demonstrated a significant positive effect in patients in group 1 treated with Groprinosin (n = 53). At the end of therapy for both mono- and mixed infections, there were 95.8% of negative results (according to PCR diagnosis, that is, the absence of viral genome). In children in group 2 (n = 52) treated with Kagocel, the absence of viral nucleic acids (NAs) was observed less frequently (in 77.3% of cases). In children in group 3 (n = 46) who did not receive etiotropic antiviral therapy, there were only 40.3% of negative results after the end of treatment, and viral NAs were detected in 59.7% of patients. In this case, a 5-day course of Groprinosin was prescribed, after which the PCR results became negative in all patients. Therefore, children with recurrent respiratory infections, mixed infections, and herpesvirus infections require longer therapy. Additionally, a high frequency of ARVI complications was noted in group 3 (5 (10.9%) patients, where otitis was observed in 1 case, sinusitis - in 2 cases, bronchitis - in 2 cases), whereas 1 (1.8%) patient taking Groprinosin had otitis, and 1 (1.9%) patient taking Kagocel had pneumonia. Conclusion. This study was the first to investigate antibody titers to respiratory viruses in dynamics at 3, 6 and 12 months after the onset of ARVI. It showed that the development of antibodies to respiratory viruses is very unstable and does not occur in all patients. Antibodies almost disappeared by the third month after ARVI and were no longer detectable by the sixth month. After 12 months, patients suffered a new ARVI and developed the corresponding antibodies. This information will be especially relevant in conditions of the rise in the incidence of ARVIs, as well as the COVID-19 pandemic observed in recent years.Copyright © 2022, Voprosy Prakticheskoi Pediatrii. All rights reserved.

Case report: Acute liver failure in children and the human herpes virus 6-? A factor in the recent epidemic.

The 2022 worldwide epidemic of acute hepatitis and liver failure in young children has led to a focus on unusual causes for childhood acute hepatitis. In the UK epidemic, human herpes virus subtype 6B (HHV-6B) was detected along with adenovirus subtype-41F in severely affected children, especially in those requiring liver transplantation (LT). The lifting of COVID lock-down measures has coincided with the rise in these common childhood infections with a higher than expected rate of systemic complications. The sudden exposure of young children to common childhood infections from which they were protected during the pandemic may have induced an abnormal immune mediated response potentiated by multiple pathogen exposure. Primary HHV-6 infection is one such common childhood infection. Classically known as Roseola infantum due to the appearance of a widespread erythematous rash on fever subsidence (exanthema subitem), it has a peak incidence of 6-12 months of age and almost all children will have been infected by age 2. It is the virus most frequently associated with febrile convulsions but the more serious complications of hepatitis and liver failure are rare. We report on the historic cases of three female infants who had suspected primary HHV-6B infection, acute hepatitis and rapid progression to acute liver failure (ALF) requiring LT. Appearances of their native liver were identical to those described in children in the recent hepatitis epidemic. Deteriorating clinical trajectories of recurrent graft hepatitis and rejection-like episodes followed and all three succumbed to graft failure with HHV-6B detected posthumously in their liver allografts. Our case series and the serious complications observed with the recent rise in common childhood infections is a reminder that these routinely encountered pathogens can be deadly especially in the young immunologically untrained. We advocate for HHV-6 to be screened for routinely in children with acute hepatitis and the use of effective HHV-6 anti-viral prophylaxis to prevent recurrence post-transplant.

Clinical and laboratory features of patients with post-COVID- 19 condition and reactivation of herpesvirus infections

Background: After infection with SARS-CoV- 2 is observed short-term and long-term post-acute sequelae of COVID-19 (PASC). A systematic review of 57 studies comprising more than 250 000 survivors of COVID-19 indicates that more than half of COVID-19 survivors experienced PASC 6 months after recovery. The most common PASC involved functional mobility impairments, pulmonary abnormalities, and mental health disorders [Groff D et al]. It has been suggested that co-infection of SARS-CoV- 2 with EBV or other herpes viruses (HSV1 / 2, HHV6, CMV) contributes to both severe COVID-19 and post-COVID symptoms. Method(s): 88 patients with the post-COVID- 19 condition were examined, including 52.3 % female, 47.7 % male, mean age 41.4 +/- 6.7 years. Patients underwent the following studies: anamnestic, clinical, general laboratory, biochemical and immunological analysis. PCR DNA of EBV, HHV6, CMV in blood, saliva, and the posterior pharyngeal mucosa was performed by Rotor-Gene 6000 (Corbett Research, Australia) and EBNA-IgG, VCAEBV-IgG, HHV6-IgG was performed by ELISA. Result(s): There were 2 groups of patients: the first included 68 patients with the post-COVID- 19 condition and active phase of herpesviruses. They were found positive EBV DNA -in 29 (42.6%) patients, positive HHV6 DNA -17 (25.0%) patients, positive EBV DNA, and HHV6 -in 22 (32, 4%) patients;the second group included 20 patients with the post-COVID- 19 condition and latent phase of herpesviruses and negative DNA EBV and/or HHV6 were found. In patients of the first group compared with the second group, patients were found COVID-19 had a severe course, pneumonia was diagnosed more often (77.9% vs. 40.0%), patients needed oxygen support and inpatient treatment lasted longer (16 +/- 7 vs. 10 +/- 4 days). In the first group patients compared with the second group patients were subfebrile temperature, headache, irritability, depression, myalgia, arthralgia, shortness of breath (p < 0.05). In patients of the first group compared with the second group in serum blood, we found elevated ESR, lymphopenia, monocytosis, increased activity of liver enzymes ALT and AST, CRP, D-dimer (p < 0.05) Conclusion(s): 1. Reactivation of herpesvirus infections is common in 72.3% of patients with the post-COVID- 19 condition: the EBV DNA positive were found in 42,6% of patients, the HHV6 DNA positive in 25,0% of patients, and EBV+HHV6 DNA positive in 32,4% of patients. 2. Patients with the post-COVID- 19 condition and reactivation of herpesviruses were characterized by severe COVID-19, manifestations of subfebrile, impaired mobility, mental disorders, and pulmonary abnormalities, as well as changes in laboratory parameters. 3. Our studies confirm the possible participation of reactivated herpesvirus infections (EBV, HHV6) in the formation of post-COVID- 19 conditions, which suggests the need for diagnosis of these infections and specific treatment. (Figure Presented).

Role of antiviral therapy in respiratory infections in children: Analysis of clinical and laboratory observations.

Objective. To evaluate the efficacy of therapy for acute respiratory viral infections (ARVIs) in children with antiviral medications: inosine pranobex (Groprinosin, Gedeon Richter) and Kagocel (Kagocel, Niarmedic Pharma LLC) in comparison with symptomatic treatment without etiotropic agents based on clinical and laboratory parameters. Patients and methods. The clinical and laboratory observation was conducted in an outpatient setting in the pre-COVID-19 period between 2018 and 2020. Acute respiratory infections were diagnosed using licensed testing systems by multiplex polymerase chain reaction (PCR) with detection of nucleic acid viral genomes: influenza, rhinovirus, respiratory syncytial virus, metapneumovirus, parainfluenza, seasonal coronaviruses, adenoviruses, and bocavirus). A total of 151 children aged 3 to 15 years were examined and monitored in dynamics, with 78.7% of positive and 21.3% of negative results detected by PCR in the nasopharyngeal and oropharyngeal swabs. The patients were randomized into three groups depending on the antiviral medication prescribed: group 1 (53 children) received Groprinosin;group 2 (52 children) received Kagocel;group 3 (control, 46 children) received only symptomatic therapy without antiviral agents. Results. The study demonstrated a significant positive effect in patients in group 1 treated with Groprinosin (n = 53). At the end of therapy for both mono- and mixed infections, there were 95.8% of negative results (according to PCR diagnosis, that is, the absence of viral genome). In children in group 2 (n = 52) treated with Kagocel, the absence of viral nucleic acids (NAs) was observed less frequently (in 77.3% of cases). In children in group 3 (n = 46) who did not receive etiotropic antiviral therapy, there were only 40.3% of negative results after the end of treatment, and viral NAs were detected in 59.7% of patients. In this case, a 5-day course of Groprinosin was prescribed, after which the PCR results became negative in all patients. Therefore, children with recurrent respiratory infections, mixed infections, and herpesvirus infections require longer therapy. Additionally, a high frequency of ARVI complications was noted in group 3 (5 (10.9%) patients, where otitis was observed in 1 case, sinusitis - in 2 cases, bronchitis - in 2 cases), whereas 1 (1.8%) patient taking Groprinosin had otitis, and 1 (1.9%) patient taking Kagocel had pneumonia. Conclusion. This study was the first to investigate antibody titers to respiratory viruses in dynamics at 3, 6 and 12 months after the onset of ARVI. It showed that the development of antibodies to respiratory viruses is very unstable and does not occur in all patients. Antibodies almost disappeared by the third month after ARVI and were no longer detectable by the sixth month. After 12 months, patients suffered a new ARVI and developed the corresponding antibodies. This information will be especially relevant in conditions of the rise in the incidence of ARVIs, as well as the COVID-19 pandemic observed in recent years.Copyright © 2022, Voprosy Prakticheskoi Pediatrii. All rights reserved.

Primary Human Herpes Virus-6 Causing Recalcitrant Pyrexia after Pilocytic Astrocytoma Resection.

INTRODUCTION: Human herpes virus-6 (HHV-6) is a ubiquitous virus but can lead to deleterious clinical manifestations due to its predilection for the pediatric central nervous system. Despite significant literature describing its common clinical course, it is rarely considered as a causative agent in CSF pleocytosis in the setting of craniotomy and external ventricular drainage device. Identification of a primary HHV-6 infection allowed for timely treatment with an antiviral agent along with earlier discontinuation of antibiotic regimen and expedited placement of a ventriculoperitoneal shunt. CASE PRESENTATION: A two-year-old girl presented with 3 months of progressive gait disturbance and intranuclear ophthalmoplegia. Following craniotomy for removal of 4th ventricular pilocytic astrocytoma and decompression of hydrocephalus, she suffered a prolonged clinical course due to persistent fevers and worsening CSF leukocytosis despite multiple antibiotic regimens. The patient was admitted to the hospital during the COVID-19 pandemic and isolated with her parents in the intensive care unit with strict infection control measures. FilmArray Meningitis/Encephalitis (FAME) panel ultimately detected HHV-6. Clinical confirmation of HHV-6-induced meningitis was proposed given improvement in CSF leukocytosis and fever reduction following the initiation of antiviral medications. Pathologic analysis of brain tumor tissue failed to show HHV-6 genome positivity, suggesting a primary peripheral etiology of infection. CONCLUSION: Here, we present the first known case of HHV-6 infection detected by FAME following intracranial tumor resection. We propose a modified algorithm for persistent fever of unknown origin which may decrease symptomatic sequelae, minimize additional procedures, and shorten length of ICU stay.

Herpesvirus infections and SARS-CoV-2-associated multisystem inflammatory syndrome in children: case series

SARS-CoV-2-associated multisystem inflammatory syndrome in children (MIS-C) is a rare condition developing 2 to 6 weeks after initial infection. Most of the patients require treatment in the intensive care unit. The disease manifests itself with fever and lesions to several organs and systems, primarily gastrointestinal tract, skin, mucous membranes, and cardiovascular system. Given the non-specific clinical manifestations of MIS-C, absence of reliable laboratory tests to detect it, and immunosuppressive therapy used in these patients, differential diagnosis of this condition is highly important. In this article, we provide the summary of literature on differential diagnosis between MIS-C and other pathological conditions and report cases of herpesvirus reactivation in patients with SARS-CoV-2. We provide a rationale for administering meglumine acridone acetate (Cycloferon) in patients with herpesvirus reactivation during the COVID-19 pandemic. We describe clinical and laboratory markers that can be used by clinicians for differential diagnosis between MIS-C and other viral infections, such as herpesvirus infections. Copyright © 2022, Dynasty Publishing House. All rights reserved.

Neuropathology of the temporal lobe.

Neuropathological examination of the temporal lobe provides a better understanding and management of a wide spectrum of diseases. We focused on inflammatory diseases, epilepsy, and neurodegenerative diseases, and highlighted how the temporal lobe is particularly involved in those conditions. Although all these diseases are not specific or restricted to the temporal lobe, the temporal lobe is a key structure to understand their pathophysiology. The main histological lesions, immunohistochemical markers, and molecular alterations relevant for the neuropathological diagnostic reasoning are presented in relation to epidemiology, clinical presentation, and radiological findings. The inflammatory diseases section addressed infectious encephalitides and auto-immune encephalitides. The epilepsy section addressed (i) susceptibility of the temporal lobe to epileptogenesis, (ii) epilepsy-associated hippocampal sclerosis, (iii) malformations of cortical development, (iv) changes secondary to epilepsy, (v) long-term epilepsy-associated tumors, (vi) vascular malformations, and (vii) the absence of histological lesion in some epilepsy surgery samples. The neurodegenerative diseases section addressed (i) Alzheimer's disease, (ii) the spectrum of frontotemporal lobar degeneration, (iii) limbic-predominant age-related TDP-43 encephalopathy, and (iv) α-synucleinopathies. Finally, inflammatory diseases, epilepsy, and neurodegenerative diseases are considered as interdependent as some pathophysiological processes cross the boundaries of this classification.

Nigella sativa (Black Seed) as a natural remedy against viruses

The currently available antiviral agents are associated with serious adverse effects, coupled with the increasing rate of viral resistance to the existing antiviral drugs. Hence, the search for alternative natural remedies is gaining momentum across the globe. Nigella sativa Linnen, also called black seed, is a medicinal plant that is gaining worldwide recognition and has been extensively investigated. The present work is aimed to review the existing literature on the antiviral efficacy of Nigella sativa extracts (oil and bioactive compounds). The findings reveal that numerous articles have been published on Nigella sativa and its beneficial effects against different kinds of diseases. However, the antiviral efficacy of Nigella sativa is yet to be given the proper research attention it deserves.

Recurrence of adverse events of special interest after COVID-19 vaccines rechallenge: A Vigibase® study

Introduction: Since the beginning of vaccination against COVID-19 in 2020, the occurrence of adverse events of special interest (AESI) after the 1st dose of vaccine raises the question of the potential risk associated with the following injections. Real-life vaccine data collected in pharmacovigilance databases can provide information about the safety of a rechallenge with COVID-19 vaccines. In order to help physicians to decide whether another injection is at risk, we analyzed the cases reported in the WHO pharmacovigilance database, Vigibase®. Material and methods: We identified AESI with major concerns about the safety of a rechallenge with COVID-19 vaccines: facial paralysis, immune thrombocytopenia, herpes viral infections, hypertension, hearing loss, Guillain-Barré syndrome (GBS), convulsions, myelitis, encephalitis, myocarditis, pericarditis and acute pancreatitis. We extracted cases with rechallenge of these AESI from VigiBase®, whether the AESI recurred or not, until 24 November 2021. The rate of recurrence of the initial AESI according to the vaccine platform was calculated. Results: 676 cases of AESI with COVID-19 vaccines reported information of recurrence after rechallenge, 320 with positive recurrence and 356 with no recurrence. Facial paralysis, herpes viral infection, GBS and myocarditis mostly did not reccur whatever the vaccine type. Whereas hypertension, hearing loss, convulsion and pericarditis seemed to reoccur only after rechallenge of mRNA vaccines, compared to others vaccines. There were few data for immune thrombocytopenia, encephalitis, myelitis and acute pancreatitis. Discussion/Conclusion: This study provided information about the safety of rechallenge of COVID-19 vaccines after first occurrence of AESI. Such information is of great importance considering that several booster shots are being proposed to populations to improve protection against COVID-19 variants. In case of AESI after COVID-19 vaccine, the decision to maintain the following dose must take into account the patient's individual risk benefit balance as well as his history. Although limited, our results provide clinical elements that may help decision-making.

Varicella-Zoster virus reactivation following severe acute respiratory syndrome coronavirus 2 vaccination or infection: New insights.

INTRODUCTION: Varicella zoster virus (VZV) reactivation has been reported following vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the real extent remains unknown. METHODS: We conducted a systematic review to summarize evidence of VZV reactivation or infection following SARS-CoV-2 vaccination. Episodes after coronavirus disease-2019 (COVID-19) were also identified. Related articles were identified in PubMed and EMBASE databases till December 31, 2021 using the terms "varicella zoster" and "COVID-19″. PROSPERO Register Number: CRD42021289399. RESULTS: The search revealed 314 articles, of which 55 met the inclusion criteria. VZV manifestations were documented in 179 (82.1%) subjects following SARS-CoV-2 vaccination and in 39 (17.9%) patients with COVID-19. Among the vaccinated, median (IQR) age was 56.5 (42-70) years, and 56.8% were female. Twenty-one (16.8%) were immunosuppressed. The median (IQR) latency time after vaccination was 6 (3-10) days, and 84.4% received mRNA vaccines. VZV reactivation occurred following a first dose (68.2%), a second dose (12.8%) or a booster (0.6%). The most important VZV manifestation was dermatome herpes zoster rash, which accounted for 86.4% of events in vaccinated subjects. Twenty patients (11.3%) presented serious VZV events after vaccination, with Herpes Zoster ophthalmicus (5.6%) and post-herpetic neuralgia (3.4%) predominating. No VZV pneumonia or deaths were recorded. Antiviral prescriptions were made in 96.2% of vaccinated subjects. No significant differences between vaccinated and infected subjects were found. CONCLUSION: This study indicates that the occurrence of VZV reactivation is clinically relevant. However, our findings suggest that COVID-19 vaccination is safe, and remains strongly recommended.

Lung changes in a patient with combination of HIV infection and COVID-19

The COVID-19 pandemic is now a global medical and social problem. Little is known about COVID-19 impact on some vulnerable subgroups, such as immunocompromised patients. Therefore, scientists worldwide show interest in studying the impact of SARS-CoV-2 infection on HIV-positive individuals. We report an autopsy clinical case of a deceased 60-year-old HIV-infected patient with lung damage caused by a combination of the SARS-CoV-2 virus, human herpesvirus 6, cytomegalovirus, and pneumocystis with severe fatal respiratory failure. © 2022, MDV Group. All rights reserved.

Herpesvirus infections and post-COVID-19 manifestations: a pilot observational study.

The global spread of SARS-CoV-2 points to unrivaled mutational variation of the virus, contributing to a variety of post-COVID sequelae in immunocompromised subjects and high mortality. Numerous studies have reported the reactivation of "sluggish" herpes virus infections in COVID-19, which exaggerate the course of the disease and complicate with lasting post-COVID manifestations CMV, EBV, HHV6). This study aimed to describe clinical and laboratory features of post-COVID manifestations accompanied by the reactivation of herpes virus infections (CMV, EBV, HHV6). 88 patients were recruited for this study, including subjects with reactivation of herpes viruses, 68 (72.3%) (main group) and 20 (27.7%) subjects without detectable DNA of herpesviruses (control group): 46 (52.3%) female and 42 (47.7%) male; median age was 41.4 ± 6.7 years. Patients with post-COVID manifestations presented with reactivation of EBV in 42.6%, HHV6 in 25.0%, and EBV plus HHV6 in 32.4%. Compared with controls, patients with herpes virus infections presented with more frequent slight fever temperature, headache, psycho-neurological disorders, pulmonary abnormalities and myalgia (p < 0.01), activation of liver enzymes, elevated CRP and D-dimer, and suppressed cellular immune response (p ≤ 0.05). Preliminary results indicate a likely involvement of reactivated herpes virus infections, primarily EBV infections in severe COVID-19 and the formation of the post-COVID syndrome. Patients with the post-COVID syndrome and reactivation of EBV and HHV6 infections are at high risk of developing various pathologies, including rheumatologic diseases.

Pityriasis rosea-like rash after messenger RNA COVID-19 vaccination: A case report and review of the literature.

A spectrum of cutaneous reactions to SARs-CoV-2 (COVID-19) vaccines have been reported in the literature. We present a case of a pityriasis rosea-like rash occurring after Pfizer COVID-19 vaccination and review cases of pityriasis rosea (PR)/PR-like eruption (PR-LE) after mRNA COVID-19 vaccine published in the medical literature. Of the 30 cases found, none experienced severe adverse effects and the rash resolved in an average of 5.6 weeks. It is important for physicians to be aware of this self-limited reaction so they can reassure and appropriately counsel patients that it is safe to receive subsequent vaccine doses despite the cutaneous eruption. Additionally, differences in incidence of this reaction after Pfizer and Moderna vaccination may suggest a differing host immune response incited by these vaccines which warrants further investigation.

Manifestation of Herpetic Eye Disease after COVID-19 Vaccine: A UK Case Series.

PURPOSE: To highlight the potential risk of herpetic eye disease (HED) reactivation following COVID-19 vaccine. METHODS: Retrospective analysis of all patients who presented with HED within 28 days post-first dose COVID-19 vaccination. RESULTS: Eleven eyes (n = 10 patients) were included. The mean interval between COVID-19 vaccination and ocular symptoms/signs was 12.3 ± 10.3 days. Four (40%) patients presented with HSV keratitis, and six (60%) patients presented with VZV keratitis (five had concurrent other signs of herpes zoster ophthalmicus). Common ocular signs included multiple scattered dendritic/pseudodendritic corneal epitheliopathy (90.9%), anterior uveitis (63.6%), and endothelitis (27.3%). All cases were successfully treated with topical and systemic antiviral treatment and/or topical corticosteroids (mean healing time = 3.9 ± 1.6 weeks). CONCLUSIONS: Our case series highlights the potential temporal association between HED and COVID-19 vaccine. Prophylactic antiviral treatment is recommended in patients with a history of HED prior to COVID-19 vaccination.

Antiviral, immunomodulatory, and neuroprotective effect of lithium.

Currently, in psychiatry, lithium is a drug of choice as a mood stabilizer in the maintenance treatment of bipolar disorder for the prevention of manic and depressive recurrences. The second most important psychiatric use of lithium is probably increasing the efficacy of antidepressants in treatment-resistant depression. In addition to its mood-stabilizing properties, lithium exerts antisuicidal, antiviral, immunomodulatory, and neuroprotective effects. The goal of the review is to describe the experimental and clinical studies on the last three properties of lithium. Antiviral effects of lithium pertain mostly to DNA viruses, especially herpes viruses. The therapeutic effects of lithium in systemic and topical administration on labial and genital herpes were demonstrated in clinical studies. There is also some evidence, mostly in experimental studies, that lithium possesses antiviral activity against RNA viruses, including coronaviruses. The immunomodulatory effect of lithium can mitigate "low-grade inflammatory" conditions in bipolar illness. The neuroprotective properties of lithium make this ion a plausible candidate for the prevention and treatment of neurodegenerative disorders. A favorable effect of lithium was shown in experimental models of neurodegenerative disorders. On the clinical level, some preventive action against dementia and moderately therapeutic activity in Alzheimer's disease, and mild cognitive impairment were observed. Despite promising results of lithium obtained in animal models of Huntington's disease and amyotrophic lateral sclerosis, they have not been confirmed in clinical studies. A suggestion for common mechanisms of antiviral, immunomodulatory, and neuroprotective effects of lithium is advanced.

Infections in the structure of comorbid pathology in patients with inflammatory diseases of the joints

Objective: To evaluate the significance of infections in the structure of comorbid pathology in patients with inflammatory diseases of the joint (IDJ) during a single-stage retrospective study. Methods: The study included 437 patients with IDJ (259 women, 178 men, mean age 45 y): 172 -rheumatoid arthritis, 169 -ankylosing spondylitis, 74 -psoriatic arthritis, 22 -undifferentiated spondylarthritis. The majority of patients (n=343) received immunosuppressive therapy (glucocorticoids, methotrexate, leflunomide, biological drugs). The patients were interviewed by a research doctor with the completion of a unified questionnaire. Additional information was obtained from medical records. Results: The following comorbid pathology was documented in patients with IDJ: cardiovascular diseases -30.1%, gastrointestinal diseases -27.2%, respiratory diseases -12.5%, endocrine system diseases -10.9%, urogenital diseases -9.1%, skin diseases, except for psoriasis -4.2%. 653 cases of respiratory tract infections (RTI) and ENT organs and 537 cases of infections of other localization were diagnosed. RTI and ENT organs included acute nasopharyngitis (n=273), tonsillitis (n=110), pneumonia (n=69, including 29 caused by the SARS-CoV2 virus), acute bronchitis (n=54), sinusitis (n=52), influenza (n=47), otitis (n=41), tuberculosis (n=7). Infections of other localizations were represented by herpes-viral infections (n=184), mycoses (n=121), urinary tract infections (n=84), conjunctivitis and blepharitis (n=63), skin infections (n=26), intestinal infections (n=25), genital infections (n=22), osteomyelitis, purulent arthritis, nervous system infections (2 cases each), chronic hepatitis A, B and C, rubella, measles, HIV infection (1 case each). After the debut of IDJ, an increase in the frequency of acute nasopharyngitis, acute bronchitis, sinusitis, herpes-viral infections, and mycoses was noted. Serious infections requiring hospitalization and/or intravenous administration of antibiotics were diagnosed in 78 patients. of these, 64%of cases were caused by RTJ and ENT organs (pneumonia, including those caused by the SARS-CoV2 virus, acute bronchitis, sinusitis, purulent otitis), 36% -by other infections (intestinal infections, purulent paraproctitis, acute salpingitis, purulent endometritis). Conclusion: The problem of infections in patients with IDJ still remains relevant. Further studies are needed on large samples of patients with the aim of studying the prevalence of infections depending on the therapy (primarily, biological drugs), as well as the search for significant risk factors.

Humoral Immunity and Adverse Events after Vaccination Against COVID-19 By a Vector Based Vaccine Sputnik V in Patients with Chronic Myeloid Leukemia

Introduction Data on the effectiveness and safety of new vaccines against COVID-19 in patients (pts) with hematological diseases are just beginning to accumulate. We planned to obtain such information for pts with chronic myeloid leukemia (CML) during vaccination. Objective. To evaluate the antibodies formation and adverse events (AEs) after vaccination against COVID-19 in pts with CML Materials and methods. All pts with CML diagnosis who applied to the National Research Center for Hematology (NRCH, Moscow, Russia) for outpatient or remote consultations were suggested to prospectively report the AEs after getting a vaccination against COVID-19 by the most frequently used vector-based vaccine GamCovidVac (Sputnik V). Two vaccine components with the interval of 21 days were given at the vaccination facilities, as prescribed. At least after 3 weeks after the 2 nd injection, pts were advised to perform a blood test for the specific antibodies against spike (S) protein of SARS-CoV-2. A semi-quantitative test detecting the SARS-CoV-2 S1 subunit (RBD) IgG antibodies by enzyme-linked immunoassay (ELISA) kit was used in the clinic. The results were considered positive with the cutoff index >1,1. The use of any other lab tests detecting antibodies to S protein of SARS-CoV-2 was acceptable as well. Results. In total, 66 pts with chronic phase of CML received a vaccination by Sputnik V in the 7 months period (from 18.12.2020 to 20.07.2021). Me age was 54 years (range 29 - 89 years), 34 (52%) were males. Median (Me) CML duration was 8 years (from the moment of diagnostics up to 20 years). Fifty one (77%) pt received TKI therapy and 15 (23%) were off-therapy at the time of vaccination, including 12 (18%) in a treatment-free remission and 3 (4,5%) pts in the process of diagnosis. Deep and major molecular response (MMR) was in 46 (70%) and 7 (11%) pts, respectively. Two (3%) pts had a molecular response MR2, 11 (17%) had no MR2. Eight (12%) pts had a history of COVID-19 manifestation prior to vaccination. Me time for testing for the antibodies was 27 days (range 5-77) after the 2 nd vaccine injection. The tests were done in 44 (67%) of pts and revealed positive by any of the test systems in 42 (95%) pts. ELISA test was used in 30 (45%) pts and was positive in 25 (83%) of 30 pts. Me cutoff index in the positive samples was 7,7 (range 1,1 - 12) and corresponded to the value observed in healthy people after vaccination (medical stuff, data not shown). In all 3 pts with the history COVID 19, the index of positivity was above the Me value (Fig. 1, 2). Other test systems were used in 14 (21%) pts, in all 14 (100%) the antibodies were found. In 3 of 5 patients with the cutoff index<1 the antibodies were detected by using other test systems, but all with a level slightly above the detection threshold. Me age of these 5 pts was 63 years (range 59- 70), Me time of analysis was 49 days (range 23-59) after 2 nd vaccine shot. All these pts were on treatment by tyrosine kinase inhibitors, 3 pts with MMR and deeper, 1 pt with MR2 and 1 pt without MR2. A weak reverse correlation of the antibody levels with the time after vaccination was noted ( r = - 0,39, p = 0,033). A very weak reverse correlation with age was observed ( r = - 0,28, p = 0,127) (Fig. 1, 2). No AEs after the vaccination were observed in 25 (38%) pts while 41 (62%) pts reported the AEs and 7 (10%) pts did not report their reactions. The AEs were as follows: local pain/discomfort in the injection site in 19 (29%) pts, weakness and/or drowsiness in 20 (30%), fever and/or chills in 16 (24%), other reactions in 8 (12%) including headache, heartbeat, lower back pain, pain in limbs, activation of herpes infection. Conclusion: The single center study revealed no unusual or unexpected AEs in CML pts after the vaccination against COVID-19 by Sputnik V vaccine. The proportion of CML pts with specific antibodies after was 95% which is close to the published results of the 3rd phase study. No significant correlation was found with age (r = -0,28, p = 0,127), however, the absence or very low a tibody levels were detected in individual patients aged about 60-70 years. This data raise a question of a necessity for a non-specific protection (masks, respirators, distance etc) and probably considering additional vaccination in some elderly persons. The duration of a humoral response against COVID-19, protective antibody titer and connection with clinical outcomes in CML pts need further evaluation in parallel with a common population. [Formula presented] Disclosures: Chelysheva: Pfizer: Speakers Bureau;Pharmstandart: Speakers Bureau;Bristol Myers Squibb: Speakers Bureau;Novartis Pharma: Speakers Bureau. Petrova: Pfizer: Speakers Bureau;Novartis Pharma: Speakers Bureau. Gurianova: Pfizer: Speakers Bureau. Turkina: Pharmstandart: Speakers Bureau;Pfizer: Speakers Bureau;Novartis Pharma: Speakers Bureau;Bristol Myers Squibb: Speakers Bureau.

The Pfizer-BNT162b2 mRNA-based vaccine against SARS-CoV-2 may be responsible for awakening the latency of herpes varicella-zoster virus.

BACKGROUND: To prevent the invasion and transmission of SARS-CoV-2, mRNA-based vaccines, non-replicating viral vector vaccines, and inactivated vaccines have been developed. The European Medicines Agency (EMA) authorized the use of the anti-SARS-CoV-2 vaccine in January 2021, the date on which the vaccination program began in Spain and across Europe. The aim of this study is to monitor the safety of anti-SARS-CoV-2 vaccines and report any cases of undesirable effects that have occurred, that are not included in the health profile of mRNA-based vaccines for commercialisation in humans. Furthermore, a brief review is given of the mechanism of action of the anti-SARS-CoV-2 vaccine on the host's immune system in triggering the reactivation of the herpes varicella-zoster infection. METHODS: Follow-up of patients under the care of the southern health district of Seville of the SAS (Andalusian Health Service) during the Spanish state of alarm over the COVID-19 pandemic. RESULTS: Two patients, a 79-year-old man and a 56-year-old woman, are reported who, after 4 and 16 days respectively of receiving the Pfizer-BNT162b2 vaccine against SARS-CoV-2, presented a state of reactivation of herpes varicella-zoster virus (VZV). DISCUSSION: The immunosenescence of the reported patients, together with the immunomodulation generated by administering the anti-SARS-CoV-2 vaccines, that depress certain cell subpopulations, could explain the awakening of VZV latency.