ABSTRACT
The aim of this review was to present the mechanism of infection with severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) and its possible effect on the course of arterial hypertension. Another aim was to evaluate the relationship of the renin-angiotensin-aldosterone system with the pathogenetic stages of infection caused by SARS-CoV-2 virus.
Subject(s)
COVID-19 , Hypertension , Renin-Angiotensin System , SARS-CoV-2 , Humans , COVID-19/complications , COVID-19/epidemiology , Hypertension/epidemiology , Hypertension/physiopathology , Renin-Angiotensin System/physiology , PandemicsABSTRACT
AIM: To evaluate the efficacy and safety of a combination of virus neutralizing monoclonal antibodies in the treatment of patients with confirmed COVID-19 and risk factors for disease progression and severe disease course. MATERIALS AND METHODS: The study was carried out in the Sokolniki temporary hospital of the Inozemtsev City Clinical Hospital. A retrospective comparative case-control study included 400 patients hospitalized for confirmed COVID-19 infection from November 01, 2022 to March 31, 2023. Patients were divided into two groups depending on the treatment given: the first control group (n=200) and the second group (n=200), where patients received a single intramuscular injection of tixagevimab + cilgavimab within the first days of hospitalization. RESULTS: When analyzing the concomitant pathology, C-reactive protein level and CT scans at the time of hospitalization, it was revealed that patients in the tixagevimab + cilgavimab treatment group were more severe compared to the control group. On the 2nd day of hospitalization, there was a decrease in the level of C-reactive protein in the control group by 36.2%, in the group receiving tixagevimab + cilgavimab - by 45.2%; p<0.05. Standard treatment was supplemented with antibacterial therapy in 47 (23.5%) patients of the first group and in 32 (16.0%) patients of the second group, which was due to the accession of bacterial infection; p<0.05. Significant differences were found in the duration of hospitalization, which averaged 8.0±0.21 bed-days in group 1 and 6.4±0.13 (p<0.05) bed-days in group 2. No adverse reactions to intramuscular injection of tixagevimab + cilgavimab were detected. CONCLUSION: The use of a combination of neutralizing monoclonal antibodies in patients with COVID-19 reduce the average bed-day in hospitalization of patients with comorbid pathology and/or immunodeficiencies and high risk of progression of infection.
Subject(s)
C-Reactive Protein , COVID-19 , Humans , Case-Control Studies , Retrospective Studies , Prognosis , Antibodies, MonoclonalABSTRACT
At present reperfusion therapy in ST-elevation (STE) acute coronary syndrome (ACS) is carried out in majority of countries not more than in 70% of cases. We analyzed predictors of non-fulfillment of reperfusion therapy in patients with STEACS included into ACS registry conducted in the Kemerovo cardiological dispensary. Reperfusion therapy was not carried out in 154 patients with STEACS (36.2%). Main predictors of non-fulfillment of reperfusion were age older than 75 years (odds ratio [OR] 47.97, 95% confidence interval [CI] 19.47-118.21), admission later than in 12 hours after onset of disease (OR 4.29, 95%CI 1.52-12.13), history of myocardial infarction (OR 2.68, 95%CI 1.11-6.48). Thus there are factors including subjective ones which preclude full-fledged use of contemporary recommendations on the management of patients with STEACS.
Subject(s)
Acute Coronary Syndrome , Case Management/standards , Myocardial Reperfusion/statistics & numerical data , Refusal to Treat/statistics & numerical data , Acute Coronary Syndrome/diagnosis , Acute Coronary Syndrome/epidemiology , Acute Coronary Syndrome/therapy , Age Factors , Aged , Confidence Intervals , Critical Pathways/standards , Delivery of Health Care/organization & administration , Electrocardiography , Female , Health Services Needs and Demand , Health Status , Humans , Male , Myocardial Reperfusion/methods , Registries , Risk Factors , Siberia/epidemiology , Survival Analysis , Time FactorsABSTRACT
According contemporary conceptions, the key role in the development of atherosclerosis play the low density oxidative modified lipoproteins and its antibodies. The purpose of the study was to discover the characteristics of changes in lipid metabolism indicators, including the low density oxidative modified lipoproteins and their antibodies. The factors of oxidative status in patients with cardiac infarction with complicated and non-complicated course were considered. It is established that the development of cardiac infarction is followed the increase of concentration of low density oxidative modified lipoproteins and their antibodies both during the first day after acute pain syndrome and stabilization period. The evaluation of content of low density oxidative modified lipoproteins and their antibodies broaden the possibilities of diagnostics, prognosis and decrease of risk of development both acute and recurrent coronary events.
