Physiological health indexes predict deterioration and mortality in patients with COVID-19: a comparative study.

Old age is a crucial risk factor for severe coronavirus disease 2019 (COVID-19), with serious or fatal outcomes disproportionately affecting older adults compared with the rest of the population. We proposed that the physiological health status and biological age, beyond the chronological age itself, could be the driving trends affecting COVID-19 severity and mortality. A total of 155 participants hospitalized with confirmed COVID-19 aged 26-94 years were recruited for the study. Four different physiological summary indices were calculated: Klemera and Doubal's biological age, PhenoAge, physiological dysregulation (PD; globally and in specific systems), and integrated albunemia. All of these indices significantly predicted the risk of death (p < 0.01) after adjusting for chronological age and sex. In all models, men were 2.4-4.4-times more likely to die than women. The global PD was shown to be a good predictor of deterioration, with the odds of deterioration increasing by 41.7% per 0.5-unit increase in the global PD. As for death, the odds also increased by 68.3% per 0.5-unit increase in the global PD. Our results are partly attributed to common chronic diseases that aggravate COVID-19, but they also suggest that the underlying physiological state could capture vulnerability to severe COVID-19 and serve as a tool for prognosis that would, in turn, help inpatient management.

TLRs Gene Polymorphisms Associated with Pneumonia before and during COVID-19 Pandemic.

BACKGROUND: The progression of infectious diseases depends on the characteristics of a patient's innate immunity, and the efficiency of an immune system depends on the patient's genetic factors, including SNPs in the TLR genes. In this pilot study, we determined the frequency of alleles in these SNPs in a subset of patients with pneumonia. METHODS: This study assessed six SNPs from TLR genes: rs5743551 (TLR1), rs5743708, rs3804100 (TLR2), rs4986790 (TLR4), rs5743810 (TLR6), and rs3764880 (TLR8). Three groups of patients participated in this study: patients with pneumonia in 2019 (76 samples), patients with pneumonia caused by SARS-CoV-2 in 2021 (85 samples), and the control group (99 samples). RESULTS: The allele and genotype frequencies obtained for each group were examined using four genetic models. Significant results were obtained when comparing the samples obtained from individuals with pneumonia before the spread of SARS-CoV-2 and from the controls for rs5743551 (TLR1) and rs3764880 (TLR8). Additionally, the comparison of COVID-19-related pneumonia cases and the control group revealed a significant result for rs3804100-G (TLR2). CONCLUSIONS: Determining SNP allele frequencies and searching for their associations with the course of pneumonia are important for personalized patient management. However, our results need to be comprehensively assessed in consideration of other clinical parameters.

Salmonella sepsis in a patient with TLR4 gene polymorphisms.

Non-typhoid Salmonella gastroenteritis is one of the most common forms of intestinal infections among the population of developed countries and generalized forms of infection are rare. We present a case of 67-year-old woman with salmonaella sepsis, deep venous thrombosis, and septic thromboembolism of pulmonary artery complicated with development of necrotizing pneumonia. Generalization of the infectious process was mediated by the presence of polymorphisms in the TLR4 gene. Development of pulmonary infarction is infrequent. Even rarer is a formation of cavities in infarcted lung tissue, usually in the background of the infectious disease. A combination of 2 rare conditions in 1 patient demonstrates the need of multidisciplinary approach in treatment of severe and atypical forms of infectious diseases to evaluate the primary etiology of such state. The article will discuss various aspects of lung tissue damage caused by Salmonella and give a brief overview of the literature on this topic.