VACCINATION against NEW CORONAVIRUS INFECTION in PATIENTS with CARDIOVASCULAR and AUTOIMMUNE DISEASES.

The review article is devoted to a discussion of the issues of vaccination against a new coronavirus infection in patients with cardiovascular and autoimmune diseases. Presented at the time of this writing are data on domestic vaccines safety in the Russian Federation: combined vector vaccines "Gam-COVID-Vac" and "Gam-COVID-Vac-Lyo", peptide-based vaccine "EpiVacCorona", concentrated, purified and inactivated whole-virion "KoviVac" vaccine, and a standalone vaccine/booster shot "Sputnik Light". The analysis of the main contraindication applicable to the vaccines in different categories of patients has been carried out. A number of consensus documents published by Russian and foreign professional medical associations and communities on the issues of vaccination of patients with cardiovascular and autoimmune diseases are considered in detail.Copyright © 2021 Infectious Diseases: News, Opinions, Training. All rights reserved.

[Features of the course of non-ST elevation myocardial infarction in patients with a history of COVID-19].

Aim      To study the clinical course of non-ST segment elevation myocardial infarction (NSTEMI) in hospitalized patients after COVID-19 and to evaluate the effect of baseline characteristics of patients on the risk of complications.Material and methods  The study included 209 patients with NSTEMI; 104 of them had had COVID-19. The course of myocardial infarction (MI) was analyzed at the hospital stage, including evaluation of the incidence rate of complications (fatal outcome, recurrent MI, life-threatening arrhythmias and conduction disorders, pulmonary edema, cardiogenic shock, ischemic stroke, gastrointestinal bleeding).Results Mean age of patients after COVID-19 was 61.8±12.2 years vs. 69.0±13.0 in the comparison group (p<0.0001). The groups were comparable by risk factors, clinical data, and severity of coronary damage. Among those who have had СOVID-19, there were fewer patients of the GRACE high risk group (55.8 % vs. 74.3 %; p<0.05). Convalescent COVID-19 patients had higher levels of C-reactive protein and troponin I (p<0.05). The groups did not significantly differ in the incidence of unfavorable NSTEMI course (p>0.05). However, effects of individual factors (postinfarction cardiosclerosis, atrial fibrillation, decreased SpO2, red blood cell concentration, increased plasma glucose) on the risk of complications were significantly greater for patients after COVID-19 than for the control group (p<0.05).Conclusion      Patients with NSTEMI, despite differences in clinical history and laboratory data, are characterized by a similar risk of death at the hospital stage, regardless of the past COVID-19. Despite the absence of statistically significant differences in the incidence of in-hospital complications, in general, post-COVID-19 patients showed a higher risk of complicated course of NSTEMI compared to patients who had not have COVID-19. In addition, for this category of patients, new factors were identified that previously did not exert a clinically significant effect on the incidence of complications: female gender, concentration of IgG to SARS-CoV-2 ≥200.0 U/l, concentration of С-reactive protein ≥40.0 mg/l, total protein <65 g/l. These results can be used for additional stratification of risk for cardiovascular complications in patients with MI and also for development of individual protocols for evaluation and management of NSTEMI patients with a history of COVID-19.

Comparative assessment of efficacy and immunogenicity of Gam-COVID-Vac and CoviVac vaccines against SARS-CoV-2

The medical community is interested in the duration of immune protection and the level of specific antibodies (AB) that can pre-vent reinfection with SARS-CoV-2. Objective. To perform a comparative evaluation of efficacy and immunogenicity of Gam-COVID-Vac and CoviVac vaccines against SARS-CoV-2 in a prospective observational study. Material and methods. The following vaccines were used for the vaccination of subjects (n=3322) aged 18 years and older: Gam-COVID-Vac - 1,622 (48.8%) subjects (group I), CoviVac - 1,700 (51.2%) subjects (group II). Vaccinated subjects were fol-lowed up for 6 study visits: before the 1st component of the vaccine, before the 2nd component of the vaccine, 42 days, 3 months, 6 months, and 12 months after the 1st component of the vaccine. Immunoglobulin G (IgG) levels of AB to S protein were compared after the injection of Gam-COVID-Vac and CoviVac vaccines using an enzyme immunoassay. Statistical processing of the obtained data was performed using IBM SPSS Statistics v. 24 and MedCalc v. 20.104 software. Results. Group I subjects showed an increase in specific AB (IgG) levels to SARS-CoV-2 S protein from visit 1 to visits 2 and 3 (p<0.05). In more extended follow-up periods (visits 5, 6), AB levels in groups I and II did not differ significantly and remained sufficiently high by visit 6. Within one year of follow-up, the incidence of COVID-19 (confirmed by polymerase chain reaction) was significantly (p<0.01) lower in the Gam-COVID-Vac group (group I): 22.2% vs. 45.2% in the CoviVac group (group II). The maximum number of days (p<0.05) before the COVID-19 infection was observed in those vaccinated with Gam-COVID-Vac (221 days) compared to those immunized with CoviVac (159 days). Conclusion. The Gam-COVID-Vac vaccine is more effective against COVID-19 and induces a more rapid response of the hu-moral immune system than the CoviVac vaccine. However, the duration of the humoral immune response after administration of Gam-COVID-Vac and CoviVac was similar. Copyright © 2022, Media Sphera Publishing Group. All rights reserved.

Analysis of the coupling of autonomic regulatory loops of blood circulation in patients with Covid and cardiovascular pathologies

The work aims to study the features of autonomic control of the cardiovascular system in two groups of patients with Covid-19: with and without arterial hypertension. A total of 15 pairs of 20-minute electrocardiogram and photoplethysmogram signals were registrated in each group. We used the methods of spectral analysis, as well as the previously proposed method for assessing the phase synchronization of 0.1-Hz rhythms of signals of autonomic control of heart rate and blood pressure. The data of patients with chronic arterial hypertension showed a lower level of synchronization than patients without it. This is probably due to the peculiarities of autonomic control of the cardiovascular system in patients with chronic arterial hypertension. © 2022 SPIE.

Thrombodynamics parameters in individuals vaccinated against SARS-CoV-2

During the ongoing COVID-19 pandemic, with a significant variety of available vaccines, it is crucial to consider their effects on the hemostasis system. Objective. To study thrombodynamics features of individuals vaccinated against SARS-CoV-2 with Gam-COVID-Vac and Covi-Vac vaccines in a prospective observational study. Materials and methods. Data from 99 vaccinated individuals who completed the first three visits were analyzed. Of these, 18 were vaccinated with Gam-COVID-Vac, and 81 with CoviVac. Venous blood was collected before injection of the components I and II of the vaccine and 42 days after administration of the component I to analyze thrombodynamics parameters using the Thrombo-dynamics Analyzer System T2 (Hemacore, Russia). Results. In the analysis of thrombodynamics test data, no significant differences were found between the Gam-COVID-Vac group and the CoviVac group at any of the three stages of the study. Moreover, no significant increase in any of the parameters from the visit 1 to visit 3 was observed in both groups. Conclusion. The obtained study data suggest that such plasma hemostasis parameters as stationary rate of clot growth and ini-tial rate of clot growth, lag-time, clot density and clot size, spontaneous clots formation time show no significant changes during 42 days after the component I of Gam-COVID-Vac and CoviVac vaccines injection. © 2021, Media Sphera Publishing Group. All rights reserved.

Longterm dynamics of the levels of antiSARSCoV2 Sprotein IgG antibodies in vaccinated individuals

Aim. As part of a prospective observational study, to study the levels of antiSARSCoV2 Sprotein IgG antibodies in individuals vaccinated with the GamCOVIDVac and CoviVac vaccines. Material and methods. The data of 93 people who completed the first 3 visits were analyzed, 23 of whom were vaccinated with the GamCOVIDVac vaccine and 70 people ' with the CoviVac vaccine. We collected blood before the injection of vaccine doses I and II, as well as 42 days after the injection of dose I in order to quantitatively determine Results. A significant increase in antiSARSCoV2 Sprotein IgG antibodies was observed in those vaccinated with GamCOVIDVac. In the group of CoviVac vaccine, an increase in the level antiSARSCoV2 Sprotein IgG antibodies in absolute values was recorded, however, this increase did not reach statistical significance. Conclusion. The data obtained show that the level of antiSARSCoV2 Sprotein antibodies 42 days after GamCOVIDVac vaccination is significantly higher than after CoviVac vaccination. However, an increase in the level of IgG in both groups indicates the ability of both vaccines to stimulate the production of antiSARSCoV antibodies. Keywords: vaccination, coronavirus infection, COVID19, GamCOVIDVac, CoviVac, antiSARSCoV2 IgG antibodies.

VACCINATION against NEW CORONAVIRUS INFECTION in PATIENTS with CARDIOVASCULAR and AUTOIMMUNE DISEASES

The review article is devoted to a discussion of the issues of vaccination against a new coronavirus infection in patients with cardiovascular and autoimmune diseases. Presented at the time of this writing are data on domestic vaccines safety in the Russian Federation: combined vector vaccines “Gam-COVID-Vac” and “Gam-COVID-Vac-Lyo”, peptide-based vaccine “EpiVacCorona”, concentrated, purified and inactivated whole-virion “KoviVac” vaccine, and a standalone vaccine/booster shot “Sputnik Light”. The analysis of the main contraindication applicable to the vaccines in different categories of patients has been carried out. A number of consensus documents published by Russian and foreign professional medical associations and communities on the issues of vaccination of patients with cardiovascular and autoimmune diseases are considered in detail. © 2021 Infectious Diseases: News, Opinions, Training. All rights reserved.

Acute coronary syndrome in COVID-19 patients

Acute coronary syndrome (ACS) is caused by an acute mismatch between myocardial oxygen demand and its supply. This mechanism is largely associated with the progression of coronary atherosclerosis in combination with an inflammatory response, hypoxemia, and blood procoagulation. Patients with the coronavirus disease 2019 (COVID-19), aggravated by cardiovascular diseases and comorbidities, are at high risk of ACS. Aim. To analyze the publications, which reflects the development of ACS in patients with COVID-19, its pathogenesis, and clinical course. Material and methods. Literature data were searched using Google Scholar, PubMed, ScienceDirect, and Cyberleninka services. The analysis included data from clinical guidelines on COVID-19, data from clinical studies, reports, and systematic reviews. Results. This literature review summarizes and systematizes the data presented in modern publications, highlights the aspects of the clinical course and pathogenetic mechanisms underlying ACS in patients with COVID-19. Conclusion. The pathogenesis of COVID-19 is inextricably associated with the widespread cytopathic effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), uncontrolled immune response that causes systemic inflammation, as well as the coagulation system activation. In patients with COVID-19, along with the atherosclerosis, these mechanisms significantly increase the risk of ACS and can worsen its in-hospital course.