Clinical and laboratory characteristics of SARS-CoV-2 infection in overweight and obese patients.

Objective. To assess the impact of obesity and overweight on the course of COVID-19. Patients and methods. This prospective study included 218 patients with SARS-CoV-2 infection aged 18 to 94 years hospitalized between June 2020 and March 2021. We evaluated their clinical and laboratory parameters and their association with body weight. All patients were divided into 3 groups depending on their body mass index (BMI). Group 1 included 81 patients with grade 1-3 obesity (BMI >=30);group 2 comprised 71 overweight patients (BMI >=25 and <30);group 3 included 66 patients with normal body weight (BMI >=18.5 and <25). We analyzed clinical symptoms (including shortness of breath, fever, myalgia, headache, fatigue, changes in the oropharynx, cough, rhinorrhea, sore throat, anosmia, and diarrhea), prevalence of concomitant disorders and complications, findings of computed tomography and pulse oximetry, and findings of instrumental and laboratory examinations (complete blood count, urine test, electrocardiography, echo cardiography, biochemical assays, including C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, lactate, lactate dehydrogenase, activated partial thromboplastin time, prothrombin index, D-dimer, ferritin). Data analysis was performed using the Statistica 6.0 software. Results. We found that overweight and obese patients were more likely to have the main COVID-19 symptoms and comorbidities than those with normal weight. Overweight and obese patients also required respiratory support more frequently than patients with normal weight. Obese and overweight patients had more severe systemic inflammation (CRP, procalcitonin), cytolysis (ALT, AST), and thrombosis (D-dimer). Conclusion. Our findings suggest that obesity and overweight are the factors associated with a more severe SARS-CoV-2 infection, which should be considered when planning their treatment and developing resource strategies.Copyright © 2022, Dynasty Publishing House. All rights reserved.

SARS-CoV-2 VIRAL LOAD IN NEWBORNS WITH COVID-19

The article presents the results of investigation of SARS-CoV-2 viral load in newborns with RT-PCR confirmed COVID-19 of different severity. It has been revealed that total amount of SARS-CoV-2 RNA on nasopharyngeal mucosa of newborns is significantly higher as compared to elder children and is not associated with disease severity and lung injury.

Clinical and laboratory characteristics of SARS-CoV-2 infection in overweight and obese patients.

Objective. To assess the impact of obesity and overweight on the course of COVID-19. Patients and methods. This prospective study included 218 patients with SARS-CoV-2 infection aged 18 to 94 years hospitalized between June 2020 and March 2021. We evaluated their clinical and laboratory parameters and their association with body weight. All patients were divided into 3 groups depending on their body mass index (BMI). Group 1 included 81 patients with grade 1-3 obesity (BMI >=30);group 2 comprised 71 overweight patients (BMI >=25 and <30);group 3 included 66 patients with normal body weight (BMI >=18.5 and <25). We analyzed clinical symptoms (including shortness of breath, fever, myalgia, headache, fatigue, changes in the oropharynx, cough, rhinorrhea, sore throat, anosmia, and diarrhea), prevalence of concomitant disorders and complications, findings of computed tomography and pulse oximetry, and findings of instrumental and laboratory examinations (complete blood count, urine test, electrocardiography, echo cardiography, biochemical assays, including C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, lactate, lactate dehydrogenase, activated partial thromboplastin time, prothrombin index, D-dimer, ferritin). Data analysis was performed using the Statistica 6.0 software. Results. We found that overweight and obese patients were more likely to have the main COVID-19 symptoms and comorbidities than those with normal weight. Overweight and obese patients also required respiratory support more frequently than patients with normal weight. Obese and overweight patients had more severe systemic inflammation (CRP, procalcitonin), cytolysis (ALT, AST), and thrombosis (D-dimer). Conclusion. Our findings suggest that obesity and overweight are the factors associated with a more severe SARS-CoV-2 infection, which should be considered when planning their treatment and developing resource strategies.Copyright © 2022, Dynasty Publishing House. All rights reserved.

Pro-and Antioxidant Status in Newborn with COVID-19.

There is practically no information on the state of oxidative stress reactions in newborns with coronavirus infections. At the same time, such studies are extremely important and can contribute to better understanding of the process of reactivity in patients of different ages. The content of pro- and antioxidant status indicators was assessed in 44 newborns with confirmed COVID-19. It was found that the content of compounds with unsaturated double bonds, primary, secondary, and final LPO products were elevated in newborns with COVID-19. These changes were accompanied by higher SOD activity and retinol level and reduced activity of glutathione peroxidase. Contrary to popular opinion, newborns can be a COVID-19-susceptible age group and require more close monitoring of metabolic reactions during the period of neonatal adaptation that is an aggravating background during infection.

COGNITIVE AND EMOTIONAL IMPAIRMENTS ASSOCIATED WITH COVID-19 (LITERATURE REVIEW)

Background. Currently, there are two main areas ofstudy ofthe impactofa new coronavirus infection on mental processes: the first is in connection with the regime of self-isolation and restrictions in a pandemic;the second – with the impact ofthe pathological process itselfandthe post-covidsyndrome on the centralnervous system. The results of the studies indicate the relationship of this infection with local lesions ofthe brain andthe corresponding disturbances in the functioning ofmental processes. The aim of the research. To systematize and analyze the results of studies onthemainroutesofpenetrationoftheSARS-CoV-2virusintothecentralnervoussystem, cognitiveandemotionaldisordersin peoplewhohaverecoveredfromCOVID-19, and to discuss the areas of psychological rehabilitation for this group of patients. Materialsandmethods. InformationsearchwascarriedoutusingInternetresources (PubMed, WebofScience, Scopus, bmj.com, eLibrary.ru, frontiersin.org, sciencedirect. com, ncbi.nlm.nih.gov), literature sources were analyzed for the period from May of 2020 to November of 2021 for the following keywords: COVID-19, SARS-CoV-2, cognitive functions, cognitions, cognitive impairments, emotional dysfunction, affective dysfunction. Results. According to the analysis ofthe literature, mostresearchers identify the neurogenic pathway of SARS-CoV-2 penetration into the CNS, as well as penetration through the bloodstream or through cerebral lymphatic drainage, which are a possible cause ofmentaldisorders ofa neurologicalnature. Correction ofthese violations involves the creation of a comprehensive system of rehabilitation with the inclusion of psychotherapeutic methods. Conclusions. Despite the lackofa single picture describing the specifics ofcognitive and affective symptoms in COVID-19, in the most general terms, there is a certain consensus. So, quite often, post-COVIDcognitive symptoms are characterizedby impairedmemory andattention, andpost-COVIDaffective symptoms are characterized by increasedlevels ofanxiety, depression, andfatigue. Theissues ofdiagnosis andcorrection of disorders in post-COVID syndrome and the admissibility of the existence of this diagnosis are still relevant. © 2022 Arkheologiia Evraziiskikh Stepei. All rights reserved.

ASSESSMENT OF THE GENERAL CONDITION AND QUALITY OF LIFE OF WOMEN OF POST-REPRODUCTIVE AGE AFTER ASYMPTOMATIC COVID-19 AND 12 MONTHS AFTER MODERATE COVID-19

The aim. To assess the general condition, laboratory parameters, quality of life of women of post-reproductive age after asymptomatic COVID-19 and 12 months after moderate COVID-19. Material and methods. We examined 47 women (45-69 years old), divided into 3 groups: those who did not have COVID-19, not vaccinated (group 1- control;n = 15);women 12months after moderate COVID-19, accompanied by pneumonia (group2;n = 19);women with IgG in theirblood who deny anysymptoms of COVID-19 (group 3;n = 13). Results and discussion. An assessment of the general condition of women in postreproductive age was carried out. In women 12 months after COVID-19 we found a lower level of total bilirubin compared to the group with asymptomatic COVID-19 (p = 0.004). An increase in thrombin time was determined in the groups of patients with symptomatic (p = 0.014) and asymptomatic (p = 0.025) COVID-19 course compared with the control group. Patients with asymptomatic COVID-19 course had a higherlevelofhigh-density lipoprotein cholesterolcompared with thecontrolgroup (p = 0.016) and thegroup 2 (p = 0.006). Compared with the controlgroup, the group 2 had lower scores for general health (p = 0.006), vital activity (p = 0.013), general physical well-being (p = 0.039), physical functioning (p = 0.046);and the group 3 had higher scores in role functioning due to physical condition (p = 0.049). When comparing groups 2 and 3, lower scores in the group of women who recovered from the moderate COVID-19 were found in physical functioning (p = 0.002), pain intensity (p = 0.034), role functioning due to physical condition (p = 0.049), general health (p = 0.003), vital activity (p = 0.018), general physical well-being (p = 0.001). Conclusion. 12months after moderate COVID-19, there is a pronounced deterioration inphysicalandemotionalhealth;and in asymptomaticpatients, betterprotective functions of an organism can be assumed. © 2022 Acta Biomedica Scientifica. All rights reserved.

SMELL AND TASTE DISORDERS IN PREGNANT WOMEN WITH COVID-19

Background. Smelldisorder is a recognizedclinicalsymptom of COVID-19 infection. The problem of the loss of sense of smell in the structure of COVID-19 pathogenesis during pregnancy remains unresolved. The aim of the study. To determine thesense of smell and taste in pregnant women with COVID-19, as well as to evaluate the relationship between the sense of smell and the number of SARS-CoV-2 genome equivalents in then a sopharyngeal secretion. Material and methods. In the case-control study, 121 pregnant women participated: 40 of them were infected with COVID-19;81 were not infected with COVID-19 earlier and at the time of the study. The survey was conducted in July 2021. Sense of smell was assessed using the Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test, which includes olfactory threshold determination and odor identification assessment. Taste was measuredaccording to the O. Massarellimethod. Viral load was calculated using a standardized method for determining the number of SARS-CoV-2 RNA copies in 1ml of nasopharyngeal secretion. Results. The incidence of olfactory disorders (moderate/severeand anosmia) in pregnant women with COVID-19 is 62.5% compared to22.23% among pregnant women who have neverhad COVID-19 (p = 0.002). No significant tastedisorders were identified. The threshold value for the manifestation of olfactory disorders was 17794 RNA copies of the SARS-CoV-2 virus, which corresponds to the 37th threshold cycle (Ct). Conclusion. During pregnancy in the acute phase of COVID-19, sense of smell is significantly impaired, but not sense of taste. Decreased sense of smell is associated with SARS-CoV-2 viral load. © This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Oxidative Stress Intensity in Children and Adolescents with a New Coronavirus Infection

The aim of our research was to assess the intensity of oxidative stress (OS) in children and adolescents with COVID-19 using the oxidative stress index (OSI). Methods and Results: The study was conducted between May 2020 and March 2021. The main group included 17 children and adolescents [8(47.1%) boys and 9(52.9%) girls;mean age of 12.35-14.01 years] with diagnosed COVID-19 infection (mild to moderate course) selected as a result of the primary diagnostic examination from among those admitted to hospitalization at the Irkutsk Regional Infectious Diseases Clinical Hospital. The control group included 17 healthy children and adolescents (average age of 12.35-14.01 years) matched by copy-pair type. The obtained data indicated statistically significant differences in a number of parameters between children and adolescents with COVID-19 and the contiol groups. We found statistically significant higher levels of lipid peroxidation (LPO) products (CDs, P<0.0001;KD and CT, P=0.006;and TBARs, (P=.013) in the study group than in the control group. Among antioxidant defense (AOD) system parameters, the levels of retinol (P=0.015) and reduced glutathione (P=0.048) and SOD activity (P<0.0001) were statistically lower in the study group than in the control group. The OSI level was significantly greater (by 8.5 times, P=0.028) in the study group than in the control group, which confirms the development of antioxidant deficiency in COVID-19. Conclusion: The results of the assessment of OSI in children and adolescents with COVID-19 indicate insufficient activity of some critical components of AOD and a shift of the redox balance toward pro-oxidant factors, which can have extremely negative consequences in the development of the disease. In this regard, we recommend carrying out corrective measures to stabilize LPO/AOD parameters by including drugs with antioxidant properties in the treatment complex.

Superoxide Dismutase Activity in Male and Female Patients of Different Age with Moderate COVID-19.

The study involved 271 patients (132 men and 139 women) with moderate COVID-19. Superoxide dismutase (SOD) activity in erythrocytes was measured spectrophotometrically. In total group of patients (divided into age groups of 18-35, 36-45, 46-60, and 61-90 years), higher SOD activity was found in the 18-35 age group in comparison with the groups 46-60 years (p<0.01) and 61-90 years (p<0.05). Then, the groups were additionally divided by sex. In men, no differences in enzyme activity were found between the age groups. In women of early reproductive age, SOD activity was higher than in groups 36-45, 46-60, and 61-90 years. The sex differences consisted in higher SOD activity in women aged 18-35 years in comparison with men of this age. These data should be taken into account when choosing the tactics of therapy for patients with moderate COVID-19 course.

A Method for Evaluation of the Level of Circulating Mitochondrial DNA by ND1 and ND2 Genes.

The measurement of the level of mitochondrial DNA (mtDNA) in the blood is a difficult problem due to high variability of mitochondrial genes, deletions in the mitochondrial genome in some pathological conditions, different sources of mtDNA into the bloodstream (mtDNA from tissues, from blood cells, etc.). We designed primers and TaqMan probes for highly conserved regions of the ND1 and ND2 genes outside the mitochondrial deletions "hot zones". For standardizing the technique, the true concentration of low-molecular-weight mtDNA was determined by real-time PCR for two targets: a fragment of the ND2 gene (122 bp) and the ND1 and ND2 genes (1198 bp). The sensitivity and specificity of the developed approach were verified on a DNA pool isolated from the blood plasma of healthy donors of various nationalities. The concentration of low-molecular-weight mtDNA in the blood plasma of two patients with COVID-19 was monitored over two weeks of inpatient treatment. A significant increase in the content of low-molecular-weight mtDNA was observed during the first 5 days after hospitalization, followed by a drop to the level of healthy donors. The developed technique makes it possible to assess the blood level of low-molecular-weight mtDNA regardless of the quality of sampling and makes it possible to standardize this biological marker in a wide range of infectious and non-infectious pathologies.

Antioxidant status in children and adolescents with COVID-19

Background. The COVID-19 pandemic has raised the importance of this problem to the first stage and has affected healthcare system around the world. Despite the more favorable COVID-19 course, the child population should be at focus of special attention, due to the active participation in its distribution. The course of COVI D-19 includes a cascade of pathological processes accompanied by the generation of reactive oxygen species, which can have extremely negative consequences for the developing organism. The research of these processes in children is vital and will improve the effectiveness of preventive and therapeutic measures. The aim: to analyze changes in enzymatic and non-enzymatic links in the antioxidant defense in children and adolescents with diagnosed COVID-19 infection. Materials and methods. 17 children and adolescents (average age - 12.35 ± 4.01 years) were examined, including 8 boys (47 %) and 9 girls (53 %) with COVID-19 infection. The control group of children and adolescents (practically healthy) according to the «copy-pair» principle was selected. We used spectrophotometric methods. Results. In the group of children and adolescents with diagnosed COVID-19 infection, there were lower levels of total antioxidant activity (p < 0.0001), superoxide dismutase activity (p < 0.0001), content of reduced glutathione (p = 0.048) and retinol (p = 0.015), increase in glutathione reductase activity (p = 0.015) relative to the control. Conclusion. The obtained data indicate the insufficiency of antioxidant system components number in children and adolescents with diagnosed COVID-19 infection and indicate the advisability of antioxidant therapy using to stabilize these indicators. © Acta Biomedica Scientifica 2021.

COVID-19-associated coagulopathy in children and adolescents (literature review)

The pandemic of the new coronavirus infection COVID-19 in 2020 has become the main health problem across the globe. A special characteristic of the SARS-CoV-2 virus is tropism to the vascular endothelium with the development of endotheliitis, which entails a number of typical disorders of the blood coagulation system: coagulopathy with increased thrombin generation, D-dimer, decreased fibrinolysis and prolonged prothrombin time. The coagulation disorder in COVID-19 is called thromboinflammation. Hyperinflammation, increased blood levels of von Willebrand factor, coagulation factor VIII, neutrophil extracellular traps, platelet activation, microvesicles play a significant role in the pathogenesis of hypercoagulation in COVID-19. To date, it is known that cases of COVID-19 in children and adolescents constitute a small part of the total number of patients with diagnosed COVID-19, and disorders of the blood coagulation system are similar to those in adults. The degree of hypercoagulable syndrome and the risk of thrombosis depend on the severity of COVID-19. And for children they are most expressed with the development of a hyperinflammatory immune response, called multisystem inflammatory syndrome. At the same time, clinical studies of the pathogenesis of COVID-19 in adults and children and the search for optimal methods of therapy for thrombus inflammation, which underlies the pathogenesis of COVID-19, continue. © 2021 Novosibirsk State University. All rights reserved.

SNP rs657152 Is Not Associated with the Level of Viral Load in COVID-19 or the Probability of Disease in the Population of Caucasians in Eastern Siberia.

Cross-replicating associations with rs657152 at the 9q34.2c locus and rs11385942 at the 3p21.31 locus found in patients with severe COVID-19 in the Caucasian population require the study of the discovered phenomenon in various populations, including as an independent biological marker. Primers and TaqMan probes for PCR discrimination of the A and C alleles in single nucleotide polymorphism (SNP) rs657152 have been developed. The polymorphism of the rs657152 A/C locus was determined in 129 patients with COVID-19 and in a control group of 466 healthy individuals. There were no significant differences in the frequency of distribution of the A and C alleles, 0.47/0.53 and 0.45/0.55, between patients and healthy subjects, respectively. Also, no differences were found in the distribution of alleles in patients with a high viral load in the smear (Ct in the range of 16-25) in comparison with an average and low viral load (Ct in the range of 26-40).

Indicators of the Immune Status in Children after a New Coronavirus Infection

Background. The mechanism of the immune response in patients with COVID-19 is still poorly understood and differs from other respiratory infections. Immunodeficiencies and age-related characteristics of immunity can be regarded as factors influencing reinfection and a predisposition to prolonged persistence of SARS-CoV-2. Most of the studies report about post-infection immunity to SARS-CoV-2 for adults and less for children. However, understanding the dynamics of antibody production to SARS-CoV-2 among children as well as other unique features of immune response is extremely important, because this provides to avoid possible complications and long-term outcomes of COVID-19, and predict the epidemic spread of the new coronavirus in the organized groups of children such as kindergartens, schools, study groups and clubs. Aim: to evaluate the humoral and cellular immunity after SARS-CoV-2 infection in children. Materials and methods. We reported data of the first phase prospective cohort study of immunity among 60 children living in Irkutsk, Russia within a month after SARS-CoV-2 infection, which took place in October and November 2020. Results. Immunity of children one month after SARS-Cov-2 infection was characterized by suppressed cell-mediated and humoral immunity, and phagocytosis dysfunction. Reduced phagocytosis by neutrophils was noted for 61.6 % of individuals. Conclusions. Children after COVID-19 had impaired immunity to SARS-CoV-2, which may be a predictor of chronic infection and other long-term outcomes of COVID-19. © 2021 Sovero Press Publishing House. All rights reserved.

Retrospective of international serological studies on the formation and dynamics of the humoral immune response to SARS-CoV-2: From 2020 to 2021

Last year the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has started. The new coronavirus is highly contagious and causes severe complications. The mechanisms of humoral immunity and kinetics of SARS-CoV-2 specific antibodies in a population are not well understood. Therefore, we aimed to summarize and analyze numerous global and Russian serological studies for understanding dynamics of the SARSCoV-2 humoral immune response and getting an accurate picture of the seroprevalence to SARS-CoV-2 in the world population. The PubMed and e-library databases were searched from February 2020 to March 2021 using terms "SARS-CoV-2", "antibodies", "humoral immunity". At the beginning of the pandemic first studies were cross-sectional by design and were responsible for determination of the seropositivity and for understanding the fundamental humoral immunity parameters of SARS-CoV-2. Since then, longitudinal seroepidemiological studies have been studying antibody kinetics. Seroconversion time for IgM, IgG antibodies varies, but most researchers report the seroconversion of IgM from the 1stto 14thdays after the onset of clinical manifestations, and the seroconversion for IgG is around the 14thday with a concentration peak by the 21stday. Regarding seroprevalence we may say about low herd immunity at the COVID-19 pandemic. Thus, global seroprevalence is about 10 %, and more than 20 % for regions with high incidence and among healthcare workers. Seroprevalence studies have to be continued for more accurate monitoring of long-term humoral immunity to SARS-CoV-2, because the majority of the world's population is still susceptible to SARS-CoV-2 infection. © 2021 Sovero Press Publishing House. All rights reserved.

[Novel coronavirus disease (COVID-19) and obstructive sleep apnea: age aspects of comorbidity]. / Novaya koronavirusnaya infektsiya (COVID-19) i sindrom obstruktivnogo apnoe sna: vozrastnye aspekty komorbidnosti.

In connection with the spread of the novel coronavirus infection (COVID-19) pandemic and the increase in the development of severe acute respiratory syndrome, works are published around the world that determined the risk factors for complications and poor outcomes in this disease. Among the main comorbidities in COVID-19, scientists distinguish hypertension, diabetes, obesity, etc. Recently, more and more physicians and researchers are concerned about the high frequency of severe and critical complications of COVID-19 in patients with obstructive sleep apnea (OSA). In this review, we present some data on COVID-19 and OSA in the age aspect, show the general pathophysiological pathways leading to increased systemic inflammation and adverse consequences in the comorbid course of these diseases. Special attention is paid to such studies in the pediatric population, but only a few works of foreign scientists were found that did not reveal the essence of the problem under discussion, which requires further research in this area.

Viral load in COVID-19: Underestimated clinical and epidemiological marker

Background. The viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of the new coronavirus infection, is becoming increasingly important in clinical and epidemiological contexts. Despite this, there are significant complexities in the implementation of viral load quantitative measurement into clinical practice due to the limited approaches to its assessment. The aim of this work was to develop an approach for SARS-CoV-2 viral load analysis by the value of sample threshold cycles (Ct) relative to the Ct of the internal control sample obtained in routine PCR diagnostics of the COVID-19, and to use this approach for quantitative monitoring of viral load in patients with first positive SARS-CoV-2 test from the Irkutsk region. Materials and methods. Using regression models based on the least squares method, an approach to determine the number of copies of SARS-CoV-2 RNA in 1 ml of nasopharyngeal secretion was developed. The viral load of SARS-CoV-2 was assessed in nasopharyngeal and pharyngeal samples obtained from 1370 patients from Irkutsk and Angarsk with primary diagnosed positive PCR result in the period from July 1 to November 10, 2020. Results. A tenfold increase in the average monthly viral load among patients in September-October 2020 was revealed. We assume that the change in the epidemiological pattern of the spread of the new coronavirus infection during this period is associated with an increase in the number of contacts in the population due to the school year beginning. Higher viral loads are observed in populations at risk for COVID-19 - among healthcare workers and adults/elderly patients. Conclusion. The development of a standardized quantification of SARS-CoV-2 viral load in the nasopharyngeal samples can be a predictive clinical marker and a reliable tool for improving COVID-19 surveillance using the proposed approach to assess average viral load in a local population. © 2021 Acta Biomedica Scientifica. All rights reserved.