Assessment of life quality and health perception among recovered COVID-19 patients: multivariate analysis - own material and a review of previous reports on life quality assessment among convalescents.

BACKGROUND: The SARS-CoV-2 virus, causing acute respiratory disease, is responsible for the COVID-19 pandemic, which began in early 2020. In addition to symptoms typical of respiratory tract infections, the virus causes a number of non-specific, often long-lasting effects that hinder the daily functioning of individuals. The aim of the study was a subjective assessment of life quality and health perception among recovered COVID-19 patients. MATERIAL AND METHODS: The study included 337 subjects who had been infected with SARS-CoV-2 confirmed by a positive RT-PCR test. The study participants were of legal age. The convalescents completed a questionnaire that contained 26 questions about gender, height, body weight, blood type, general and specific symptoms, comorbidities, hospital stay and duration of specific symptoms, the severity of which was assessed on the Visual Analogue Scale (VAS). The subjects determined whether the COVID-19 infection influenced their health perception and life quality. RESULTS: According to 46% of the respondents, COVID-19 had an impact on their quality of life and health. The chance for patients to notice the negative effects of COVID-19 on their current health status and life quality increased with each subsequent symptom of the disease by 49%, with each day of its occurrence by 3%, and with each VAS point of the severity of all infection symptoms by 30%. CONCLUSIONS: The study shows that COVID-19 disease affects life quality and overall health perception after recovery. Significant impact of COVID-19 on the quality of life should be a signal to create mental support and rehabilitation programs for convalescents to minimize discomfort and shorten the duration of absenteeism from work. Med Pr. 2022;73(6):449-56.

Local and Systemic Immunity Are Impaired in End-Stage-Renal-Disease Patients Treated With Hemodialysis, Peritoneal Dialysis and Kidney Transplant Recipients Immunized With BNT162b2 Pfizer-BioNTech SARS-CoV-2 Vaccine.

Vaccination against COVID-19 in patients with end-stage renal disease (ESRD) on replacement therapy and kidney transplant recipients (KTRs) is particularly important due to the high mortality rate. Here, we tested the local and systemic immunity to the novel Pfizer BioNTech (BNT162b2) messenger RNA (mRNA) in ESRD, KTR patients, and healthy individuals (150 subjects). The ESRD group was divided into: hemodialysis (HD) and peritoneal dialysis (PD). We investigated the local and systemic immunity based on anti-N (nucleoprotein) and anti-S (spike1/2) Immunoglobulin A (IgA) and Immunoglobulin G (IgG) antibodies, respectively. Additionally, we performed an Interferon gamma (IFN-γ) release test Interferon-gamma release assay (IGRA) to monitor the cellular component of vaccine response. The control group had the highest level of anti-S IgG antibodies (153/2,080 binding antibody units (BAU)/ml) among all analyzed patients after the 1st and 2nd dose, respectively. The HD group (48/926 BAU/ml) had a diminished antibody level compared to PD (93/1,607 BAU/ml). Moreover, the seroconversion rate after the 1st dose was lower in HD than PD (56% vs. 86%). KTRs had extremely low seroconversion (33%). IgA-mediated immunity was the most effective in the control group, while other patients had diminished IgA production. We observed a lower percentage of vaccine responders based on the IFN-γ level in all research participants (100% vs. 85% in control, 100% vs. 80% in PD, 97% vs. 64% in HD). 63% of seropositive KTRs had a positive IGRA, while 28% of seronegative patients produced IFN-γ. Collectively, PD patients had the strongest response among ESRD patients. Two doses of the Pfizer vaccine are ineffective, especially in HD and KTRs. A closer investigation of ESRD and KTRs is required to set the COVID-19 vaccine clinical guidance. Clinical Trial Registration Number: www.ClinicalTrials.gov, identifier: NCT04 905 862.

Patients with chronic venous insufficiency in the times of COVID-19 and the risk of thrombus formation - suggestions on conservative treatment of such patients based on the principles of pathophysiology.

The current limitations of surgical treatment, as well as restrictions on professional and sport activities related to COVID-19 pandemic require seeking therapeutic solutions for the vast population of patients with chronic venous insufficiency (CVI, chronic venous insufficiency). To understand the principles of pharmacotherapy of this disease, the authors used data related to epidemiology and pathophysiology of CVI. They provided the latest data on venoactive drugs and recommendations that should be followed and summarized the literature based on the EBM. The article should provide the answer to the question of how to deal with patients with varicose veins or, more broadly, chronic venous insufficiency during the pandemic.