Pub Date : 2023-01-01DOI: 10.32364/2587-6821-2023-7-5-2
M. Kruchinina, M. V. Parulikova, A. Belkovets, A. Gromov
Aim: to study the possibilities of using electrical and viscoelastic parameters of erythrocytes to differentiate steatohepatitis from liver steatosis. Patients and Methods: 84 men (48.9±2.5 years) with fatty liver disease diagnosed by abdominal ultrasound were examined. Liver fibrosis severity, which did not exceed grade 1, was determined by indirect elastometry on the FibroScan® 502 Echosens device (France), with confirmation using the FibroTest–ActiTest test system (BioPredictive, France). Patients were divided into 2 groups according to the severity of hepatic necroinflammatory activity, assessed using the same test system. Group 1 (n=44) included patients with hepatic steatosis with minimal histologic disease activity (A 0–1); group 2 (n=40) included patients with steatohepatitis with significant necro-inflammatory activity (A 2–3). The electrical and viscoelastic parameters of erythrocytes were determined by dielectrophoresis at 4 frequencies of an inhomogeneous alternating electric field. Results and Discussion: the most significant electrical and viscoelastic indicators allowing to differentiate steatohepatitis from fatty liver disease were reduced values of strain amplitude at a frequency of 1 MHz (p=0.0003), dipole moment (p=0.009), capacity (p=0.014) and cell polarizability at a frequency of 1 MHz (p=0.03) and more high summarized viscosity (p=0.006), rigidity (p=0.005) and electrical conductivity (p=0.008). Diagnostic panel, including a set of electrical and viscoelastic parameters of erythrocytes, for the differentiation of steatohepatitis from steatosis demonstrated the following: AUC 0.904, sensitivity 0.9, specificity 0.83. Correlations of erythrocyte parameters with indicators of cytolysis syndrome (transaminase activity, serum iron levels, direct bilirubin) and serum inflammatory markers (fibrinogen, C-reactive protein, ferritin) were established. Conclusion: the electrical and viscoelastic parameters of erythrocytes studied using the dielectrophoresis should be considered as a new promising method in determining the severity of fatty liver disease. KEYWORDS: fatty liver disease, steatohepatitis, steatosis, electrical and viscoelastic parameters, erythrocytes, dielectrophoresis, diagnostic model. FOR CITATION: Kruchinina M.V., Parulikova M.V., Belkovets A.V., Gromov A.A. Possibilities of using electrical and viscoelastic parameters of erythrocytes for the diagnosis of steatohepatitis in patients with fatty liver disease. Russian Medical Inquiry. 2023;7(5):249–257 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-2.
{"title":"Possibilities of using electrical and viscoelastic parameters of erythrocytes for the diagnosis of steatohepatitis in patients with fatty liver disease","authors":"M. Kruchinina, M. V. Parulikova, A. Belkovets, A. Gromov","doi":"10.32364/2587-6821-2023-7-5-2","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-5-2","url":null,"abstract":"Aim: to study the possibilities of using electrical and viscoelastic parameters of erythrocytes to differentiate steatohepatitis from liver steatosis. Patients and Methods: 84 men (48.9±2.5 years) with fatty liver disease diagnosed by abdominal ultrasound were examined. Liver fibrosis severity, which did not exceed grade 1, was determined by indirect elastometry on the FibroScan® 502 Echosens device (France), with confirmation using the FibroTest–ActiTest test system (BioPredictive, France). Patients were divided into 2 groups according to the severity of hepatic necroinflammatory activity, assessed using the same test system. Group 1 (n=44) included patients with hepatic steatosis with minimal histologic disease activity (A 0–1); group 2 (n=40) included patients with steatohepatitis with significant necro-inflammatory activity (A 2–3). The electrical and viscoelastic parameters of erythrocytes were determined by dielectrophoresis at 4 frequencies of an inhomogeneous alternating electric field. Results and Discussion: the most significant electrical and viscoelastic indicators allowing to differentiate steatohepatitis from fatty liver disease were reduced values of strain amplitude at a frequency of 1 MHz (p=0.0003), dipole moment (p=0.009), capacity (p=0.014) and cell polarizability at a frequency of 1 MHz (p=0.03) and more high summarized viscosity (p=0.006), rigidity (p=0.005) and electrical conductivity (p=0.008). Diagnostic panel, including a set of electrical and viscoelastic parameters of erythrocytes, for the differentiation of steatohepatitis from steatosis demonstrated the following: AUC 0.904, sensitivity 0.9, specificity 0.83. Correlations of erythrocyte parameters with indicators of cytolysis syndrome (transaminase activity, serum iron levels, direct bilirubin) and serum inflammatory markers (fibrinogen, C-reactive protein, ferritin) were established. Conclusion: the electrical and viscoelastic parameters of erythrocytes studied using the dielectrophoresis should be considered as a new promising method in determining the severity of fatty liver disease. KEYWORDS: fatty liver disease, steatohepatitis, steatosis, electrical and viscoelastic parameters, erythrocytes, dielectrophoresis, diagnostic model. FOR CITATION: Kruchinina M.V., Parulikova M.V., Belkovets A.V., Gromov A.A. Possibilities of using electrical and viscoelastic parameters of erythrocytes for the diagnosis of steatohepatitis in patients with fatty liver disease. Russian Medical Inquiry. 2023;7(5):249–257 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-2.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84514735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.32364/2587-6821-2022-6-2-72-78
N. Tataurshchikova, O. Letyaeva, A. S. Rusanova
Aim: to assess the efficacy and safety of Admera cream, a cosmetic skin solution for atopic dermatitis (AD). Patients and Methods: this open-label, prospective, observational study enrolled 32 patients aged 3–27 (mean age 14.6±2.4 years) with mild- to-moderate AD. Patients were followed up in the outpatient settings over 1 month. Disease severity was evaluated based on the SCORAD index. Xerosis severity was assessed using a visual analogue scale (VAS). A ≥25% reduction of SCORAD index was considered a significant effect. Admera cream was applied at least once daily. Patients were examined at baseline (screening), on days 1 (visit 1), 14±1 (visit 2), and 28±2 (visit 3). Treatment satisfaction was self-assessed using the 5-point Likert scale. A score of 5 illustrates high treatment satisfaction. Results: the mean SCORAD index was 28.4±7.1 at visit 1 and significantly decreased to 18.2±9.2 after 28 days (p<0.001). The mean VAS score was 5.0±1.0 at baseline, 3.5±1.1 after 14 days, and 2.8±1.4 after 28 days (p<0.001). The mean Likert score was 4.5±0.3 in mild AD and 3.7±0.1 in moderate AD. Among 32 participants, 21 patients (65.6%) rated treatment as "excellent,” 10 patients (31.2%) as "good,” and 1 patient (3.1%) as "satisfactory.” No adverse events were reported. Conclusion: Admera cream is characterized by an excellent safety profile and comfort use. This medication is recommended for long-term treatment of AD. KEYWORDS: atopic dermatitis, xerosis, filaggrin, filagrinol, emollient, care product. FOR CITATION: Tataurshchikova N.S., Letyaeva O.I., Rusanova A.S. Management of atopic dermatitis in routine clinical practice. Russian Medical Inquiry. 2022;6(2):72–78 (in Russ.). DOI: 10.32364/2587-6821-2022-6-2-72-78.
{"title":"Management of atopic dermatitis in routine clinical practice","authors":"N. Tataurshchikova, O. Letyaeva, A. S. Rusanova","doi":"10.32364/2587-6821-2022-6-2-72-78","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-2-72-78","url":null,"abstract":"Aim: to assess the efficacy and safety of Admera cream, a cosmetic skin solution for atopic dermatitis (AD). Patients and Methods: this open-label, prospective, observational study enrolled 32 patients aged 3–27 (mean age 14.6±2.4 years) with mild- to-moderate AD. Patients were followed up in the outpatient settings over 1 month. Disease severity was evaluated based on the SCORAD index. Xerosis severity was assessed using a visual analogue scale (VAS). A ≥25% reduction of SCORAD index was considered a significant effect. Admera cream was applied at least once daily. Patients were examined at baseline (screening), on days 1 (visit 1), 14±1 (visit 2), and 28±2 (visit 3). Treatment satisfaction was self-assessed using the 5-point Likert scale. A score of 5 illustrates high treatment satisfaction. Results: the mean SCORAD index was 28.4±7.1 at visit 1 and significantly decreased to 18.2±9.2 after 28 days (p<0.001). The mean VAS score was 5.0±1.0 at baseline, 3.5±1.1 after 14 days, and 2.8±1.4 after 28 days (p<0.001). The mean Likert score was 4.5±0.3 in mild AD and 3.7±0.1 in moderate AD. Among 32 participants, 21 patients (65.6%) rated treatment as \"excellent,” 10 patients (31.2%) as \"good,” and 1 patient (3.1%) as \"satisfactory.” No adverse events were reported. Conclusion: Admera cream is characterized by an excellent safety profile and comfort use. This medication is recommended for long-term treatment of AD. KEYWORDS: atopic dermatitis, xerosis, filaggrin, filagrinol, emollient, care product. FOR CITATION: Tataurshchikova N.S., Letyaeva O.I., Rusanova A.S. Management of atopic dermatitis in routine clinical practice. Russian Medical Inquiry. 2022;6(2):72–78 (in Russ.). DOI: 10.32364/2587-6821-2022-6-2-72-78.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74647362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.32364/2587-6821-2022-6-6-314-318
K. L. Murashko, A. Yurkovskiy, V. G. Sorokin, D. Gromov, E. V. Tavlueva
Aim: to evaluate the efficacy and safety of prior coagulation of the vein adjacent to the tumor node within ultrasound-directed percutaneous radiofrequency thermal ablation (RFTA) of perivascular liver metastases of colorectal cancer (CRC). Patients and Methods: in this open-label single-site retrospective study a medical health record analysis was performed to include CRC patients with perivascular liver metastasis who received ultrasound-directed RFTA within 2014–2020 timeframe. Total study population included 51 patients. Patients were stratified in two arms by the type of surgical intervention they have received: experimental arm — 23 (45%) subjects (mean age 62.0 years) who underwent RFTA with prior adjacent vein coagulation, and control arm — 28 (55%) subjects (mean age 60.5 years) who underwent RFTA with no prior vein coagulation. Study groups were similar by the main parameters. Results: as it was shown by the computed tomography scan the incidence of residual tumor after RFTA was remarkably low in experimental arm versus control (17,4% vs. 21,4%). Relapse free survival (RFS) rate in 6 and 12 months follow up period was also higher in the experimental group versus control: RFSmo. — 65,2% vs. 56,5% (p=0,03), RFSmo. — 56,5% vs. 39,3% (p=0,04) in experimental and control groups respectively. Periprocedural complications rate was similar in both arms. Conclusion: prior coagulation of the vein adjacent to the tumor node within ultrasound-directed RFTA of perivascular CRC liver metastases can reduce the heat removal effect in the RFTA area and, thereby, increase the ablation treatment outcomes without any additional significant changes in healthy hepatic tissue. As a result, we can see an improvement in the short– and long–term treatment outcomes: a decrease of residual tumor incidence i.e. improve radicality of tumor destruction within the area of RFTA, and PFS improvement through 6 and 12 months follow up period. KEYWORDS: radiofrequency thermal ablation, liver metastases, coagulation, local thermal exposure, ultrasound diagnostics, computed tomography. FOR CITATION: Murashko K.L., Yurkovskiy A.M., Sorokin V.G. et al. Preliminary coagulation of a vein adjacent to colorectal cancer metastases in the liver as a way to increase the effectiveness of radiofrequency ablation. Russian Medical Inquiry. 2022;6(6):314–318 (in Russ.). DOI: 10.32364/2587-6821-2022-6-6-314-318.
{"title":"Preliminary coagulation of a vein adjacent to colorectal cancer metastases in the liver as a way to increase the effectiveness of radiofrequency ablation","authors":"K. L. Murashko, A. Yurkovskiy, V. G. Sorokin, D. Gromov, E. V. Tavlueva","doi":"10.32364/2587-6821-2022-6-6-314-318","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-6-314-318","url":null,"abstract":"Aim: to evaluate the efficacy and safety of prior coagulation of the vein adjacent to the tumor node within ultrasound-directed percutaneous radiofrequency thermal ablation (RFTA) of perivascular liver metastases of colorectal cancer (CRC). Patients and Methods: in this open-label single-site retrospective study a medical health record analysis was performed to include CRC patients with perivascular liver metastasis who received ultrasound-directed RFTA within 2014–2020 timeframe. Total study population included 51 patients. Patients were stratified in two arms by the type of surgical intervention they have received: experimental arm — 23 (45%) subjects (mean age 62.0 years) who underwent RFTA with prior adjacent vein coagulation, and control arm — 28 (55%) subjects (mean age 60.5 years) who underwent RFTA with no prior vein coagulation. Study groups were similar by the main parameters. Results: as it was shown by the computed tomography scan the incidence of residual tumor after RFTA was remarkably low in experimental arm versus control (17,4% vs. 21,4%). Relapse free survival (RFS) rate in 6 and 12 months follow up period was also higher in the experimental group versus control: RFSmo. — 65,2% vs. 56,5% (p=0,03), RFSmo. — 56,5% vs. 39,3% (p=0,04) in experimental and control groups respectively. Periprocedural complications rate was similar in both arms. Conclusion: prior coagulation of the vein adjacent to the tumor node within ultrasound-directed RFTA of perivascular CRC liver metastases can reduce the heat removal effect in the RFTA area and, thereby, increase the ablation treatment outcomes without any additional significant changes in healthy hepatic tissue. As a result, we can see an improvement in the short– and long–term treatment outcomes: a decrease of residual tumor incidence i.e. improve radicality of tumor destruction within the area of RFTA, and PFS improvement through 6 and 12 months follow up period. KEYWORDS: radiofrequency thermal ablation, liver metastases, coagulation, local thermal exposure, ultrasound diagnostics, computed tomography. FOR CITATION: Murashko K.L., Yurkovskiy A.M., Sorokin V.G. et al. Preliminary coagulation of a vein adjacent to colorectal cancer metastases in the liver as a way to increase the effectiveness of radiofrequency ablation. Russian Medical Inquiry. 2022;6(6):314–318 (in Russ.). DOI: 10.32364/2587-6821-2022-6-6-314-318.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73976959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.32364/2587-6821-2022-6-1-5-11
A. Aliyeva, I. Baykova, E. Reznik, T. Pinchuk, L. M. Shnakhova, R. Valiev, M.N. Saryiev, A. M. Rakhaev, I. Nikitin, I. V. Kovtyukh
In recent decades, significant progress has been made in the study of cardiovascular biological markers. The introduction into clinical practice of studying the concentration of natriuretic peptides used as markers for the diagnostic and prognostic assessment of patients with chronic heart failure became the crucial event. At present, the assessment of the values concerning the ventricular natriuretic peptide and its N-terminal precursor is the gold standard in laboratory diagnosis of heart failure and predicting its course. However, there are limitations due to the influence of several factors on their indicators, the ambiguity of threshold values and rather low information content in heart failure with preserved ejection fraction. Even a special sub-study of the large-scale PROTECT protocol could not identify an ideal single biomarker among 48 different markers for prognostic evaluation of patients with acute heart failure. All this determines the need for further search for highly sensitive and more specific markers. This review is devoted to the study of the possibility of using heart-type fatty acid binding protein (H-FABP) as a diagnostic and prognostic biomarker in heart failure. To date, one of the possible applications of H-FABP may be in the diagnosis of the early stages of heart ischemia and inflammation. KEYWORDS: heart failure, biological marker, left ventricular ejection fraction, Heart-type fatty acid binding protein, troponin, natriuretic peptides. FOR CITATION: Aliyeva A.M., Baykova I.E., Reznik E.V. et al. Heart-type fatty acid binding protein: the promising biological marker in heart failure. Russian Medical Inquiry. 2022;6(1):5–11 (in Russ.). DOI: 10.32364/2587-6821-2022-6-1-5-11.
{"title":"Heart-type fatty acid binding protein: the promising biological marker in heart failure","authors":"A. Aliyeva, I. Baykova, E. Reznik, T. Pinchuk, L. M. Shnakhova, R. Valiev, M.N. Saryiev, A. M. Rakhaev, I. Nikitin, I. V. Kovtyukh","doi":"10.32364/2587-6821-2022-6-1-5-11","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-1-5-11","url":null,"abstract":"In recent decades, significant progress has been made in the study of cardiovascular biological markers. The introduction into clinical practice of studying the concentration of natriuretic peptides used as markers for the diagnostic and prognostic assessment of patients with chronic heart failure became the crucial event. At present, the assessment of the values concerning the ventricular natriuretic peptide and its N-terminal precursor is the gold standard in laboratory diagnosis of heart failure and predicting its course. However, there are limitations due to the influence of several factors on their indicators, the ambiguity of threshold values and rather low information content in heart failure with preserved ejection fraction. Even a special sub-study of the large-scale PROTECT protocol could not identify an ideal single biomarker among 48 different markers for prognostic evaluation of patients with acute heart failure. All this determines the need for further search for highly sensitive and more specific markers. This review is devoted to the study of the possibility of using heart-type fatty acid binding protein (H-FABP) as a diagnostic and prognostic biomarker in heart failure. To date, one of the possible applications of H-FABP may be in the diagnosis of the early stages of heart ischemia and inflammation. KEYWORDS: heart failure, biological marker, left ventricular ejection fraction, Heart-type fatty acid binding protein, troponin, natriuretic peptides. FOR CITATION: Aliyeva A.M., Baykova I.E., Reznik E.V. et al. Heart-type fatty acid binding protein: the promising biological marker in heart failure. Russian Medical Inquiry. 2022;6(1):5–11 (in Russ.). DOI: 10.32364/2587-6821-2022-6-1-5-11.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80379689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.32364/2587-6821-2022-6-9-523-527
I. V. Tereshchenko, P. E. Kayushev
Over the past years, the views on the role played by tumor necrosis factor α (TNF-α) in the body have changed. The aim of this review is to provide updates on TNF-α functions in various pathological conditions. While working on the review, the authors made search and analysis of full-text reviews and original articles in foreign (English) and Russian languages using such databases as eLIBRARY.RU, Google Scholar, Web of Science, Scopus and PubMed, mostly from 2018–2022. A priority was given to the original publications. TNF-α is a multifunctional pro-inflammatory cytokine which stimulates the production of other cytokines, chemokines, and interferon γ. Also, it is involved in the inflammatory processes during viral, bacterial, and autoimmune diseases. Its hypersecretion affects lipid, fat, and carbohydrate metabolism; promotes atherogenesis; leads to the development of arterial hypertension, type 2 diabetes mellitus, obesity, and non-alcoholic fatty liver disease; contributes to osteolysis; induces apoptosis of tumor cells in some types of cancer and stimulates metastatic spread and progression in other types. So far, the use of TNF-α inhibitors and the suppression of expression of TNF-α and its receptors has caused disappointment: approx. in 40–50% of cases the inhibition aggravated pathological conditions. The investigation of the cytokine activity is still going on. KEYWORDS: TNF-α, cytokines, inflammation, atherosclerosis, oncogenesis, obesity, diabetes mellitus, adipokines. FOR CITATION: Tereshchenko I.V., Kayushev P.E. Tumor necrosis factor α and its role in pathologies. Russian Medical Inquiry. 2022;6(9):523– 527 (in Russ.). DOI: 10.32364/2587-6821-2022-6-9-523-527.
近年来，人们对肿瘤坏死因子α (TNF-α)在机体中的作用的认识发生了变化。本文综述的目的是提供TNF-α在各种病理条件下功能的最新进展。在撰写综述的过程中，作者利用eLIBRARY等数据库对外文(英文)和俄文的全文综述和原创文章进行了检索和分析。RU, Google Scholar, Web of Science, Scopus和PubMed，主要来自2018-2022年。对原始出版物给予优先考虑。TNF-α是一种多功能促炎细胞因子，可刺激其他细胞因子、趋化因子和干扰素γ的产生。此外，它还参与病毒、细菌和自身免疫性疾病的炎症过程。其分泌过多影响脂质、脂肪和碳水化合物代谢;促进动脉粥样化形成;导致动脉高血压、2型糖尿病、肥胖和非酒精性脂肪肝的发展;有助于骨溶解;在某些类型的癌症中诱导肿瘤细胞凋亡，并刺激其他类型的转移扩散和进展。到目前为止，使用TNF-α抑制剂和抑制TNF-α及其受体表达的结果令人失望:在40-50%的病例中，抑制加重了病理状况。对细胞因子活性的研究仍在继续。关键词:TNF-α、细胞因子、炎症、动脉粥样硬化、肿瘤发生、肥胖、糖尿病、脂肪因子。引用本文:Tereshchenko i.v.， Kayushev P.E.肿瘤坏死因子α及其在病理中的作用。俄罗斯医学调查。2022;6(9):523 - 527(俄文)。DOI: 10.32364 / 2587-6821-2022-6-9-523-527。
{"title":"Tumor necrosis factor α and its role in pathologies","authors":"I. V. Tereshchenko, P. E. Kayushev","doi":"10.32364/2587-6821-2022-6-9-523-527","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-9-523-527","url":null,"abstract":"Over the past years, the views on the role played by tumor necrosis factor α (TNF-α) in the body have changed. The aim of this review is to provide updates on TNF-α functions in various pathological conditions. While working on the review, the authors made search and analysis of full-text reviews and original articles in foreign (English) and Russian languages using such databases as eLIBRARY.RU, Google Scholar, Web of Science, Scopus and PubMed, mostly from 2018–2022. A priority was given to the original publications. TNF-α is a multifunctional pro-inflammatory cytokine which stimulates the production of other cytokines, chemokines, and interferon γ. Also, it is involved in the inflammatory processes during viral, bacterial, and autoimmune diseases. Its hypersecretion affects lipid, fat, and carbohydrate metabolism; promotes atherogenesis; leads to the development of arterial hypertension, type 2 diabetes mellitus, obesity, and non-alcoholic fatty liver disease; contributes to osteolysis; induces apoptosis of tumor cells in some types of cancer and stimulates metastatic spread and progression in other types. So far, the use of TNF-α inhibitors and the suppression of expression of TNF-α and its receptors has caused disappointment: approx. in 40–50% of cases the inhibition aggravated pathological conditions. The investigation of the cytokine activity is still going on. KEYWORDS: TNF-α, cytokines, inflammation, atherosclerosis, oncogenesis, obesity, diabetes mellitus, adipokines. FOR CITATION: Tereshchenko I.V., Kayushev P.E. Tumor necrosis factor α and its role in pathologies. Russian Medical Inquiry. 2022;6(9):523– 527 (in Russ.). DOI: 10.32364/2587-6821-2022-6-9-523-527.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81421959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.32364/2587-6821-2022-6-11-612-617
N. Asfandiyarova, E. Filippov, V. G. Demikhov, O. V. Dashkevich, A. G. Yakubovskaya, K. A. Moseychuk, N. S. Zhuravleva, S. Kulikov
Aim: to assess the prevalence of various clinical manifestations in COVID-19 survivors, depending on the time interval after the disease, clinical severity, and the presence of polymorbidity. Patients and Methods: the study included 253 patients (187 females and 66 males), 18–85 years old, who survived COVID-19. The patients were split into two groups based on the disease severity during the acute phase: group 1 consisted of patients with mild COVID-19 illness (n=133); group 2 consisted of patients with moderate and severe COVID-19 illness (n=120). In addition, patients of each of the groups were divided into two subgroups, depending on the time elapsed from the acute phase of COVID-19 illness: in subgroups A the health assessment of patients was performed within 3 months (12 weeks) after the acute phase of the diseases and in subgroups B — 3 months (12 weeks) after the disease, i.e. the time interval ranged from 3 months to one year after COVID-19 illness. A multi-stage phone interview of the patients was used to reveal the presence of symptoms. Also, outpatient medical records of those patients who addressed therapists or narrow specialists, were reviewed. Results: symptoms were revealed both in patients of subgroup 1A (45/52 (86.5%)) and subgroup 2А (42/45 (93.3%)), or, in other words, the symptoms were absent in 7 (13.5%) and 3 (6.7%) patients, respectively. Three months after COVID-19 illness, the symptoms were absent in 34 (42%) patients of subgroup 1B and in 13 (17.3%) patients of subgroup 2B (p<0.001), while at least one symptom persisted in 47/81 (58%) patients of subgroup 1B and 62/75 (82%) patients of subgroup 2B. In both patient groups the most common symptoms comprised fatigue, shortness of breath, and cough. In group 2 patients central nervous and cardiovascular system consequences and arthralgia were frequently reported. The prevalence of comorbidities was higher in group 2 patients than that in group 1 patients, and the difference was statistically significant (p < 0.01). Conclusions: the development of post-COVID-19 syndrome does not depend on the illness severity during the acute phase, and it may occur both in mild and moderate or severe cases. However, in the latter category the patients will have more symptoms. In patients recovered from COVID-19, most of the disease sequela were revealed in central nervous, bronchopulmonary, and cardiovascular systems. Comorbidities are associated with the severity of the novel coronavirus disease during the acute phase. COVID-19 survivors need follow-up care during the first three months after the acute phase and in the later period which should be provided by multidisciplinary team of specialists for achieving complete recovery of the patients’ health and improving the quality of life. KEYWORDS: coronavirus infection, COVID-19, post-COVID-19 syndrome, comorbidities, central nervous system disorders, bronchopul - monary system disorders, cardiovascular system disorders. FOR CITATION: Asfand
{"title":"Clinical manifestations of post-COVID-19 syndrome","authors":"N. Asfandiyarova, E. Filippov, V. G. Demikhov, O. V. Dashkevich, A. G. Yakubovskaya, K. A. Moseychuk, N. S. Zhuravleva, S. Kulikov","doi":"10.32364/2587-6821-2022-6-11-612-617","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-11-612-617","url":null,"abstract":"Aim: to assess the prevalence of various clinical manifestations in COVID-19 survivors, depending on the time interval after the disease, clinical severity, and the presence of polymorbidity. Patients and Methods: the study included 253 patients (187 females and 66 males), 18–85 years old, who survived COVID-19. The patients were split into two groups based on the disease severity during the acute phase: group 1 consisted of patients with mild COVID-19 illness (n=133); group 2 consisted of patients with moderate and severe COVID-19 illness (n=120). In addition, patients of each of the groups were divided into two subgroups, depending on the time elapsed from the acute phase of COVID-19 illness: in subgroups A the health assessment of patients was performed within 3 months (12 weeks) after the acute phase of the diseases and in subgroups B — 3 months (12 weeks) after the disease, i.e. the time interval ranged from 3 months to one year after COVID-19 illness. A multi-stage phone interview of the patients was used to reveal the presence of symptoms. Also, outpatient medical records of those patients who addressed therapists or narrow specialists, were reviewed. Results: symptoms were revealed both in patients of subgroup 1A (45/52 (86.5%)) and subgroup 2А (42/45 (93.3%)), or, in other words, the symptoms were absent in 7 (13.5%) and 3 (6.7%) patients, respectively. Three months after COVID-19 illness, the symptoms were absent in 34 (42%) patients of subgroup 1B and in 13 (17.3%) patients of subgroup 2B (p<0.001), while at least one symptom persisted in 47/81 (58%) patients of subgroup 1B and 62/75 (82%) patients of subgroup 2B. In both patient groups the most common symptoms comprised fatigue, shortness of breath, and cough. In group 2 patients central nervous and cardiovascular system consequences and arthralgia were frequently reported. The prevalence of comorbidities was higher in group 2 patients than that in group 1 patients, and the difference was statistically significant (p < 0.01). Conclusions: the development of post-COVID-19 syndrome does not depend on the illness severity during the acute phase, and it may occur both in mild and moderate or severe cases. However, in the latter category the patients will have more symptoms. In patients recovered from COVID-19, most of the disease sequela were revealed in central nervous, bronchopulmonary, and cardiovascular systems. Comorbidities are associated with the severity of the novel coronavirus disease during the acute phase. COVID-19 survivors need follow-up care during the first three months after the acute phase and in the later period which should be provided by multidisciplinary team of specialists for achieving complete recovery of the patients’ health and improving the quality of life. KEYWORDS: coronavirus infection, COVID-19, post-COVID-19 syndrome, comorbidities, central nervous system disorders, bronchopul - monary system disorders, cardiovascular system disorders. FOR CITATION: Asfand","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86520688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.32364/2587-6821-2022-6-5-227-231
L. Kupkenova, N. Shamsutdinova, A. Odintsova, N. Cheremina, D. G. Iskhakova, D. Abdulganieva
Aim: to assess the presence and course of postcovid syndrome in patients with inflammatory bowel diseases (IBD), as well as to study the IBD course in the postcovid period. Patients and Methods: 125 patients with Crohn’s disease (CD) and ulcerative colitis (UC) in the postcovid period were sequentially included in the study. Assessment of the postcovid syndrome was conducted 3, 6, 9 or 12 months after acute period of COVID-19. A questionnaire included in an in-depth medical check-up for citizens who have experienced COVID-19 was used to identify the clinical symptoms of postcovid syndrome. The article presents the results of the following scales: Hospital Anxiety and Depression Scale (HADS) — to identify and evaluate the severity of depression and anxiety, Hamilton Depression Rating Scale (HAM-D) — to evaluate depression, Asthenic State Scale (ASS) — to diagnose asthenic condition, Mini Mental State Examination (MMSE) — to study the severity of cognitive disorder. The nature of the IBD course and the change in therapy were also evaluated. Results: 81 (64.8%) patients were diagnosed with CD, and 44 (35.2%) — with UC. The mean age of patients was 41.8±14.5 years, of which 68 (54.4%) were male, 57 (45.6%) — female. When filling up the questionnaire of the in-depth medical check-up 3 months after COVID-19, 47.8% of patients most commonly noted fatigue, and/or muscle pain, and/or headaches, and/or dysautonomia, and/or cognitive disorder, while 34.7% of patients — dyspnea, reduced exercise tolerance and/or chronic cough, and joint pain. Thus, postcovid manifestations occurred in approx. 47.8% of patients with IBD. An increase of complaints frequency, characteristic of postcovid syndrome, was noted by the 6th month after COVID-19. By the 9th and 12th month, the frequency of complaints decreased. When analyzing complaints related to asthenia, cognitive disorder, anxiety and depression, there was a tendency to the maximum number of disorders 6 months after COVID-19. Studying the activity in patients with IBD before, during and after COVID-19 (after 3, 6, 9 or 12 months), it was noted that the largest number of patients with acute IBD was 6 months after COVID-19. Conclusions: 47% of patients with IBD had complaints characteristic of postcovid syndrome, which persisted up to 12 months after COVID-19. Asthenia was the most common. Several complaints were increasing by the 6th month. IBD exacerbation rate reached its maximum value also by the 6th month after COVID-19. KEYWORDS: inflammatory bowel diseases, ulcerative colitis, Crohn’s disease, new coronavirus infection, COVID-19, postcovid syndrome, anxiety, depression, cognitive disorder, asthenia. FOR CITATION: Kupkenova L.M., Shamsutdinova N.G., Odintsova A.Kh. et al. Postcovid syndrome in patients with inflammatory bowel diseases. Russian Medical Inquiry. 2022;6(5):227–231 (in Russ.). DOI: 10.32364/2587-6821-2022-6-5-227-231.
{"title":"Postcovid syndrome in patients with inflammatory bowel diseases","authors":"L. Kupkenova, N. Shamsutdinova, A. Odintsova, N. Cheremina, D. G. Iskhakova, D. Abdulganieva","doi":"10.32364/2587-6821-2022-6-5-227-231","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-5-227-231","url":null,"abstract":"Aim: to assess the presence and course of postcovid syndrome in patients with inflammatory bowel diseases (IBD), as well as to study the IBD course in the postcovid period. Patients and Methods: 125 patients with Crohn’s disease (CD) and ulcerative colitis (UC) in the postcovid period were sequentially included in the study. Assessment of the postcovid syndrome was conducted 3, 6, 9 or 12 months after acute period of COVID-19. A questionnaire included in an in-depth medical check-up for citizens who have experienced COVID-19 was used to identify the clinical symptoms of postcovid syndrome. The article presents the results of the following scales: Hospital Anxiety and Depression Scale (HADS) — to identify and evaluate the severity of depression and anxiety, Hamilton Depression Rating Scale (HAM-D) — to evaluate depression, Asthenic State Scale (ASS) — to diagnose asthenic condition, Mini Mental State Examination (MMSE) — to study the severity of cognitive disorder. The nature of the IBD course and the change in therapy were also evaluated. Results: 81 (64.8%) patients were diagnosed with CD, and 44 (35.2%) — with UC. The mean age of patients was 41.8±14.5 years, of which 68 (54.4%) were male, 57 (45.6%) — female. When filling up the questionnaire of the in-depth medical check-up 3 months after COVID-19, 47.8% of patients most commonly noted fatigue, and/or muscle pain, and/or headaches, and/or dysautonomia, and/or cognitive disorder, while 34.7% of patients — dyspnea, reduced exercise tolerance and/or chronic cough, and joint pain. Thus, postcovid manifestations occurred in approx. 47.8% of patients with IBD. An increase of complaints frequency, characteristic of postcovid syndrome, was noted by the 6th month after COVID-19. By the 9th and 12th month, the frequency of complaints decreased. When analyzing complaints related to asthenia, cognitive disorder, anxiety and depression, there was a tendency to the maximum number of disorders 6 months after COVID-19. Studying the activity in patients with IBD before, during and after COVID-19 (after 3, 6, 9 or 12 months), it was noted that the largest number of patients with acute IBD was 6 months after COVID-19. Conclusions: 47% of patients with IBD had complaints characteristic of postcovid syndrome, which persisted up to 12 months after COVID-19. Asthenia was the most common. Several complaints were increasing by the 6th month. IBD exacerbation rate reached its maximum value also by the 6th month after COVID-19. KEYWORDS: inflammatory bowel diseases, ulcerative colitis, Crohn’s disease, new coronavirus infection, COVID-19, postcovid syndrome, anxiety, depression, cognitive disorder, asthenia. FOR CITATION: Kupkenova L.M., Shamsutdinova N.G., Odintsova A.Kh. et al. Postcovid syndrome in patients with inflammatory bowel diseases. Russian Medical Inquiry. 2022;6(5):227–231 (in Russ.). DOI: 10.32364/2587-6821-2022-6-5-227-231.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88797579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.32364/2587-6821-2022-6-11-626-634
A. Gorelov, A. Ploskireva, A. Muzyka
The review elucidates the evolution of the clinical and pathogenetic characteristics of the novel coronavirus infection COVID-19. Currently, the mutagenesis of SARS-CoV-2 which has led to natural selection of several mutations with distinct functional effects is considered as the key mechanism determining the major parameters of the disease pathogenesis, clinical course, and epidemiology. In general, as compared with the diseases caused by delta and beta variants, omicron variant infection is associated with a lower number of severe cases, a higher prevalence of sore throat and a lower prevalence of headache, diarrhea, taste loss, and anosmia. The evolution of the clinical course of coronavirus infection caused by SARS-CoV-2 is characterized by less severity of the disease in adult patients and a higher hospitalization risk in children, especially those under 5 years of age. The described evolution of pathogenetic aspects of the coronavirus disease COVID-19 supports the search for effective and safe antivirals with a broad spectrum of activity approved for using in children of different age groups. The list of such medications includes pentanedioic acid imidazolyl ethanamide. Its efficacy and safety have been proven for the treatment of a wide range of acute viral respiratory infections and COVID-19 in multiple clinical trials. KEYWORDS: SARS-CoV-2, COVID-19, acute viral respiratory infections, mutations, mutagenesis, omicron,delta, pentanedioic acid imidazolyl ethanamide. FOR CITATION: Gorelov A.V., Ploskireva A.A., Muzyka A.D. Evolution of the clinical and pathogenetic characteristics of the coronavirus disease COVID-19. Russian Medical Inquiry. 2022;6(11):626–634 (in Russ.). DOI: 10.32364/2587-6821-2022-6-11-626-634.
本文就新型冠状病毒感染COVID-19的临床和发病特点的演变作一综述。目前认为，SARS-CoV-2的诱变导致几种具有不同功能作用的突变的自然选择是决定疾病发病机制、临床病程和流行病学主要参数的关键机制。总的来说，与由δ和β变异引起的疾病相比，组粒变异感染与较低的严重病例数量、较高的喉咙痛患病率以及较低的头痛、腹泻、味觉丧失和嗅觉丧失患病率相关。SARS-CoV-2引起的冠状病毒感染的临床病程演变特点是成人患者病情严重程度较低，儿童特别是5岁以下儿童住院风险较高。所描述的冠状病毒病COVID-19的发病方面的演变支持寻找有效和安全的抗病毒药物，具有广泛的活性，被批准用于不同年龄组的儿童。这类药物包括戊二酸咪唑乙胺。多项临床试验已证明其治疗多种急性病毒性呼吸道感染和COVID-19的有效性和安全性。关键词:SARS-CoV-2、COVID-19、急性病毒性呼吸道感染、突变、诱变、组粒、德尔塔、戊二酸咪唑乙胺。引用本文:gorellov a.v.， Ploskireva a.a.， Muzyka ad .冠状病毒病COVID-19的临床和病理特征演变。俄罗斯医学调查。2022;6(11):626-634(俄文)。DOI: 10.32364 / 2587-6821-2022-6-11-626-634。
{"title":"Evolution of the clinical and pathogenetic characteristics of the coronavirus disease COVID-19","authors":"A. Gorelov, A. Ploskireva, A. Muzyka","doi":"10.32364/2587-6821-2022-6-11-626-634","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-11-626-634","url":null,"abstract":"The review elucidates the evolution of the clinical and pathogenetic characteristics of the novel coronavirus infection COVID-19. Currently, the mutagenesis of SARS-CoV-2 which has led to natural selection of several mutations with distinct functional effects is considered as the key mechanism determining the major parameters of the disease pathogenesis, clinical course, and epidemiology. In general, as compared with the diseases caused by delta and beta variants, omicron variant infection is associated with a lower number of severe cases, a higher prevalence of sore throat and a lower prevalence of headache, diarrhea, taste loss, and anosmia. The evolution of the clinical course of coronavirus infection caused by SARS-CoV-2 is characterized by less severity of the disease in adult patients and a higher hospitalization risk in children, especially those under 5 years of age. The described evolution of pathogenetic aspects of the coronavirus disease COVID-19 supports the search for effective and safe antivirals with a broad spectrum of activity approved for using in children of different age groups. The list of such medications includes pentanedioic acid imidazolyl ethanamide. Its efficacy and safety have been proven for the treatment of a wide range of acute viral respiratory infections and COVID-19 in multiple clinical trials. KEYWORDS: SARS-CoV-2, COVID-19, acute viral respiratory infections, mutations, mutagenesis, omicron,delta, pentanedioic acid imidazolyl ethanamide. FOR CITATION: Gorelov A.V., Ploskireva A.A., Muzyka A.D. Evolution of the clinical and pathogenetic characteristics of the coronavirus disease COVID-19. Russian Medical Inquiry. 2022;6(11):626–634 (in Russ.). DOI: 10.32364/2587-6821-2022-6-11-626-634.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89897823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.32364/2587-6821-2022-6-11-650-655
S. V. Nikolaeva, E. V. Kanner, I. D. Kanner, M. Maksimov, O. Pogorelova, E. K. Shushakova, Y. Khlypovka
Cough in children is one of the most common symptoms both in outpatient and hospital practices. It is the main reason why parents of these patients (especially of younger kids) seek for medical care. The article highlights the current view on the cough in pediatric practice. It elucidates cough classification, etiology, and therapy in children. The authors describe characteristics of the respiratory epithelium, a multicellular layer, that extends from the nasopharynx to the small airways and acts as a respiratory barrier coordinating immune response in the early childhood, undergoing the process of development, maturation, and regeneration to adapt to the changing environment. The article presents findings of the clinical studies assessing the medications of choice that were used for the treatment of coughs in children. The selection of right drugs should be based on individual patient’s needs and depend on the extent of cough impact on the patient condition. Also, it is necessary to consider whether the cough is intense, productive, for how long it lasts and to analyse bronchial mucus characteristics. KEYWORDS: cough, children, respiratory epithelium, immune response, immunity, antitussives, butamirate. FOR CITATION: Nikolaeva S.V., Kanner E.V., Kanner I.D. et al. Cough in children: the current approach to rational pharmacotherapy. Russian Medical Inquiry. 2022;6(11):650–655 (in Russ.). DOI: 10.32364/2587-6821-2022-6-11-650-655.
{"title":"Cough in children: the current approach to rational pharmacotherapy","authors":"S. V. Nikolaeva, E. V. Kanner, I. D. Kanner, M. Maksimov, O. Pogorelova, E. K. Shushakova, Y. Khlypovka","doi":"10.32364/2587-6821-2022-6-11-650-655","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-11-650-655","url":null,"abstract":"Cough in children is one of the most common symptoms both in outpatient and hospital practices. It is the main reason why parents of these patients (especially of younger kids) seek for medical care. The article highlights the current view on the cough in pediatric practice. It elucidates cough classification, etiology, and therapy in children. The authors describe characteristics of the respiratory epithelium, a multicellular layer, that extends from the nasopharynx to the small airways and acts as a respiratory barrier coordinating immune response in the early childhood, undergoing the process of development, maturation, and regeneration to adapt to the changing environment. The article presents findings of the clinical studies assessing the medications of choice that were used for the treatment of coughs in children. The selection of right drugs should be based on individual patient’s needs and depend on the extent of cough impact on the patient condition. Also, it is necessary to consider whether the cough is intense, productive, for how long it lasts and to analyse bronchial mucus characteristics. KEYWORDS: cough, children, respiratory epithelium, immune response, immunity, antitussives, butamirate. FOR CITATION: Nikolaeva S.V., Kanner E.V., Kanner I.D. et al. Cough in children: the current approach to rational pharmacotherapy. Russian Medical Inquiry. 2022;6(11):650–655 (in Russ.). DOI: 10.32364/2587-6821-2022-6-11-650-655.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90260422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.32364/2587-6821-2022-6-7-360-366
V. P. Zolotnitskaya, A. Speranskaya, N. Kuzubova, O. Titova, O. V. Amosova
Background: the majority of patients who experienced COVID-19, lung disorders persist for a long term. It remains unclear how reversible they are and what the clinical and radiation predictors of these changes are. Aim: to determine the consequences of pneumonia caused by the SARS-CoV-2 virus in patients who experienced COVID-19 during the period of 2020–2021; to evaluate possible clinical and radiation predictors of these changes and their reversibility. Patients and Methods: the article presents the analyzed results of radiation studies (computed tomography (CT), single-photon emission computed tomography (SPECT)), spirometry and diffusing capacity of the lungs for carbon monoxide (DLCO) performed in 68 patients who had COVID-19 during the period of 2020–2021 and complained of persistent shortness of breath, fatigue and disability. Results: 1–2 years after, there was a decrease in the bronchial patency to 39.2±4.5%pred in 63% of patients with mild COVID-19, which correlated (rs>0.92) with a decrease in microcirculation (MC) over 50% and mosaic attenuation (rs>0.77), air trapping (rs>0.89) and bronchiolectasis (rs>0.64). In mixed ventilatory defects (MEF75 to 46.8±3.6% of predicted, DLCO 62.4±3.1% of predicted), there were significant MC disorders over 70%, corresponding to zones of focal pneumosclerosis (rs>0.93). In the severe disease course, single areas of "frosted glass" were detected in 13% of patients, while mosaic attenuation and air trapping were detected in 34%, which was accompanied by a decrease in MEF75 to 37.4±3.7% of predicted. During a decrease in DLCO to 52.4±2.2% of predicted, there were a compaction of the interstitial by the type of usual interstitial pneumonia of small extent (65%), consolidation areas (34%), pneumosclerosis areas (54%), platelike atelectasis (31%), bronchiectasis (26%), signs of bronchiolitis obliterans (42%), and pulmonary hypertension development (38%). According to the single- photon emission computed tomography data, there were significant disorders of the MC. Irreversible changes were detected in lung areas with an inadequate perfusion of more than 50%, observed 6 months after the disease, and subsequently, after 1 year or more. Conclusions: a comprehensive functional lung imaging in radiation therapy increases the efficacy of clinical examination of patients in the postcovid period. The following type of patients need a comprehensive radiation monitoring: patients over 60 y.o., patients who had a severe COVID-19; patients who have respiratory complaints over 1 year, regardless of the COVID-19 severity. Microcirculation disorders over 50% detected 6 months after the disease are a predictor of changes in the lung parenchyma and may indicate long-term disease consequences. KEYWORDS: postcovid syndrome, microcirculation, computed tomography of the lungs, ventilation, artificial intelligence. FOR CITATION: Zolotnitskaya V.P., Speranskaya A.A., Kuzubova N.A. et al. Long-term effects of COVID-19 in patients
{"title":"Long-term effects of COVID-19 in patients according to the functional lung imaging in radiation therapy","authors":"V. P. Zolotnitskaya, A. Speranskaya, N. Kuzubova, O. Titova, O. V. Amosova","doi":"10.32364/2587-6821-2022-6-7-360-366","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-7-360-366","url":null,"abstract":"Background: the majority of patients who experienced COVID-19, lung disorders persist for a long term. It remains unclear how reversible they are and what the clinical and radiation predictors of these changes are. Aim: to determine the consequences of pneumonia caused by the SARS-CoV-2 virus in patients who experienced COVID-19 during the period of 2020–2021; to evaluate possible clinical and radiation predictors of these changes and their reversibility. Patients and Methods: the article presents the analyzed results of radiation studies (computed tomography (CT), single-photon emission computed tomography (SPECT)), spirometry and diffusing capacity of the lungs for carbon monoxide (DLCO) performed in 68 patients who had COVID-19 during the period of 2020–2021 and complained of persistent shortness of breath, fatigue and disability. Results: 1–2 years after, there was a decrease in the bronchial patency to 39.2±4.5%pred in 63% of patients with mild COVID-19, which correlated (rs>0.92) with a decrease in microcirculation (MC) over 50% and mosaic attenuation (rs>0.77), air trapping (rs>0.89) and bronchiolectasis (rs>0.64). In mixed ventilatory defects (MEF75 to 46.8±3.6% of predicted, DLCO 62.4±3.1% of predicted), there were significant MC disorders over 70%, corresponding to zones of focal pneumosclerosis (rs>0.93). In the severe disease course, single areas of \"frosted glass\" were detected in 13% of patients, while mosaic attenuation and air trapping were detected in 34%, which was accompanied by a decrease in MEF75 to 37.4±3.7% of predicted. During a decrease in DLCO to 52.4±2.2% of predicted, there were a compaction of the interstitial by the type of usual interstitial pneumonia of small extent (65%), consolidation areas (34%), pneumosclerosis areas (54%), platelike atelectasis (31%), bronchiectasis (26%), signs of bronchiolitis obliterans (42%), and pulmonary hypertension development (38%). According to the single- photon emission computed tomography data, there were significant disorders of the MC. Irreversible changes were detected in lung areas with an inadequate perfusion of more than 50%, observed 6 months after the disease, and subsequently, after 1 year or more. Conclusions: a comprehensive functional lung imaging in radiation therapy increases the efficacy of clinical examination of patients in the postcovid period. The following type of patients need a comprehensive radiation monitoring: patients over 60 y.o., patients who had a severe COVID-19; patients who have respiratory complaints over 1 year, regardless of the COVID-19 severity. Microcirculation disorders over 50% detected 6 months after the disease are a predictor of changes in the lung parenchyma and may indicate long-term disease consequences. KEYWORDS: postcovid syndrome, microcirculation, computed tomography of the lungs, ventilation, artificial intelligence. FOR CITATION: Zolotnitskaya V.P., Speranskaya A.A., Kuzubova N.A. et al. Long-term effects of COVID-19 in patients ","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90951515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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