Background: Our study aimed to assess the relationship between the parameters of the lipid profile, atherogenic index of plasma (AIP), anthropometry influence with the severity of the new coronavirus infection COVID-19 in women. Material and methods. The study design was a cross-sectional study. The research included 138 women aged 29–82 years who had undergone a new coronavirus infection COVID-19 at least two months ago. Participants were divided into three groups by severity of infection: mild (n = 61), moderate (n = 70) and severe (n = 7). Body mass index, waistline and hip circumference, waistline circumference to hip circumference index, total cholesterol, triglycerides, HDL, LDL, AIP were calculated. Statistical processing of the obtained results was carried out using the SPSS software package (version 20.0) using the Mann-Whitney test, univariate logistic regression analysis, Pearson chi-squared test. Results. The levels of HDL-cholesterol were significantly lower in group 3 compared with the level of HDL-cholesterol in women in group 2 (p2-3 = 0.046). BMI was higher in the moderately severe group compared to the mild one (26.32 [23.305; 30.4] versus 28.78 [24.72; 34.77], p1-2 = 0.026). Hip circumference was higher in patients with severe COVID-19 than in patients with mild course (104 [98; 112] versus 114 [109.5; 126], p1-3 = 0.039), AIP was higher in women with severe course compared to women with moderate and mild course (p1-3 = 0.043, p2-3 = 0.04). The results of the logistic regression analysis showed that the moderate course of COVID-19 is associated with BMI (OR = 1.09, 95 % CI 1.019–1.166, p1-2 = 0.012), and the severe course with WC (OR = 1.041, 95 % CI 1.001–1.084, p1-3 = 0.046), AIP value ≥ 0.11 (OR = 13.824, 95 % CI 1.505–126.964, p1-3 = 0.02; OR = 11,579, 95 % CI 1,266–105,219, p2-3 = 0.03) and HDL level < 40 mg/dl (OR = 14,750, 95 % CI 2,317–93,906, p1-3 = 0.004; OR = 8,000, 95 % CI 1,313– 48,538, p1-3 = 0.024). Conclusion. Patients from the group with moderate and severe course of the new coronavirus infection have higher body mass index, hip circumference, AIP, lower HDL values. The chance of a moderate course of COVID-19 is associated with an increased BMI value, and a severe course with WC, AIP ≥ 0.11 and HDL level < 40 mg/dl.
Background. Sleep disorders have a negative impact on many aspects of life. COVID-19 exacerbates this problem in the context of the post-COVID syndrome where sleep disorder is one of the common complaints.Objective. We aimed to assess the frequency of sleep disorders after COVID-19 and the presence of associations between post-COVID sleep disorders and the severity of COVID-19.Material and methods. A cross-sectional study was carried out in Novosibirsk. It included 115 people aged 26 to 74 years (an average age of 54.22 ± 12.48 years) after recovery from COVID-19, which occurred two to eleven months before. Patients underwent questionnaire survey (Spiegel sleep score questionnaire, HADS Anxiety and Depression Scale, International Restless Legs Syndrome (RLS) Severity Scale), examination by a somnologist, and screening night computer pulse oximetry. If an index of desaturations was more than five per hour, we performed overnight somnography by WAtch PAT 200 or polysomnography. Patients were divided into groups depending on the presence of sleep disorders, COVID-19 severity, and their age. Statistical analysis included a descriptive analysis. Odds ratio was assessed by determining the risk measure for dichotomous variables in the contingency table.Results. RLS was the most common post-COVID sleep disorder (n = 63, 75%). However, primary insomnia was diagnosed only in patients with moderate-to-severe course of COVID-19 (n = 3, 9%). There were 40 patients with post-COVID sleep disorder; they had significantly lower sleep time on workdays (7.00 [6.00; 7.50] vs. 7.50 [6.50; 8.00] hours, p = 0.021) and significantly higher mean HADS depression score (5.00 [3.00; 7.00] vs. 3.00 [1.00; 6.00] points, p = 0.006) compared with the corresponding parameters in patients without deterioration of sleep quality. The chance of reduced sleep quality was 11.6 times higher after moderate-to-severe COVID-19 infection than that after mild infection only in patients aged 26-59 years (95% confidence interval 1.42–94.32, p = 0.007).Conclusion. The chance of worsening sleep quality was significantly higher after a moderate-to-severe COVID-19 infection than after mild infection in 26-59-year-old old patients. At the same time, RLS was the most common post-COVID sleep disorder according to our study. Given the importance of sleep disorders, working-age patients after moderate-to-severe COVID-19 infection require active monitoring by doctors in order to timely correct emerging complaints.
Цель исследования: изучить показатели эластичности печени, уровни водорода и метана в выдыхаемом воздухе, их ассоциации с клинико-биохимическими показателями у пациентов, перенесших COVID-19.Материалы и методы. Обследовано 30 пациентов (средний возраст 51,8±2,91), перенесших COVID-19 (подтвержден тестом на РНК SARS-CoV-2 или наличием антигена SARS-CoV-2) через 12-16 недель после появления первых симптомов, из них у 11 была выявлена пневмония. 19 человек (средний возраст 47,1±3,09), не перенесшие COVID-19, составили группу сравнения. Пациентам выполнено клинико-биохимическое исследование, определена степень фиброза печени (FibroScan® 502 Echosens, Франция), проведено измерение уровней водорода (H2) и метана (CH4) в выдыхаемом воздухе (базисное и после приема раствора лактулозы) (GastroCheck Gastrolyzer, Bedfont Scientifi c Ltd., England).Результаты. Перенесенная инфекция COVID-19 прямо коррелировала с возрастом (r=0,331, p=0,022), мужским полом (r=0,324, p=0,025), наличием фиброза печени (r=0,291, p=0,044). Пациенты, перенесшие COVID-19, чаще имели фиброз печени (p<0,001) и более высокие значения эластичности печени в кПа (p=0,018) на фоне избыточной массы тела и ожирения (63,3%) и повышенного индекса массы тела (p=0,03) по сравнению с группой контроля. Наличие фиброза печени ассоциировано с перенесенной пневмонией средней степени тяжести (p<0,001). Среди перенесших COVID-19 достоверно больше не-продуцентов метана (p=0,02), меньше лиц со средним уровнем метана в выдыхаемом воздухе (p=0,016). У реконвалесцентов COVID-19 реже выявлялся синдром избыточного бактериального роста (СИБР) по сравнению с контролем (p=0,04), но чаще регистрировались признаки замедленного транзита по кишечнику (p<0,05). Наличие фиброза печени у перенесших COVID-19 ассоциировано с выявлением СИБР (23,3% против 5,2%, p<0,001), который, вероятно, вносит вклад в патогенез повреждения печени. Уровни водорода через 120 мин и метана через 60 мин после приема раствора лактулозы различали реконвалесцентов COVID-19 и не перенесших COVID-19 с AUC 0,683 и 0,660, соответственно.Выявлены ассоциации уровней газов в выдыхаемом воздухе с клинико-биохимическими показателями: наличие избыточной массы тела и ожирения обнаружило обратные ассоциации с уровнем продукции метана (r= -0,342, p<0,05), его концентрацией после приема лактулозы в различные временные промежутки, а также базисным уровнем водорода (r= -0,313, p<0,05); степень ожирения также обратно коррелировала с уровнем выделения метана (r= -0,368, p=0,038). Установлены прямые связи между показателями эластичности печени в кПа и уровнем продукции водорода (r=0,275, p<0,05). Кручинина Маргарита Витальевна, д. м. н., доцент; ведущий научный сотрудник, заведующая лабораторией гастроэнтерологии; доцент кафедры пропедевтики внутренних болезней Светлова Ирина Олеговна, к. м. н., доцент; доцент кафедры терапии, гематологии и трансфузиологии факультета повышения квалификации и переподготовки врачей Логвиненко Ирина Ивановна, д. м. н., профессор; заместитель руководителя по лечебной работе; профессор кафедры неотл...
Aim. To study the associations of changes in lipid metabolism parameters and the severity of a coronavirus disease 2019 (COVID-19).Material and methods. This cross-sectional study included 270 patients aged 26-84 years (mean age, 53,09±13,22 years) who had COVID-19 within prior two months, which were divided into 3 groups: mild (1, n=128), moderate (2, n=128) and severe (3, n=14) COVID-19. Patients were assessed for body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C). In addition, atherogenic index of plasma (AIP) was calculated. Statistical processing was performed using the SPSS software package (version 13.0).Results. Patients with severe COVID-19 had significantly higher levels of TG and AIP compared with patients with moderate and mild course. BMI and WC were significantly higher in patients in groups 2 and 3 compared with patients in group 1. In women, BMI and AIP levels were significantly higher in the severe COVID-19 group compared to groups 1 and 2. HDL-C levels were lower in patients with severe COVID-19 compared to those with moderate disease. WHR was higher among men in group 3 compared with group 1.Conclusion. Patients with severe COVID-19 have higher BMI, WC, AIP, TG levels, and lower HD-C levels. The relative odds for severe COVID-19 are associated with increased WC, AIP, TG, and lower HDL-C.
Both in Russia and worldwide, morbidity and mortality from acute coronary syndrome (ACS) remain high. The emergence of a new coronavirus infection, the active participation of medical workers in its elimination, determined a new phenotype of patients, which determines the relevance of the problem and of a more detailed assessment of this cohort of patients. Aim of the study was to identify and determine the clinical and functional features, phenotype and endotype of the course of ACS in medical workers who have had a new coronavirus infection. Material and methods. An open cohort comparative study was conducted. It included 60 healthcare workers with ACS and a previous novel coronavirus infection, who were selected based on the identification of SARS-CoV-2 and/or its antibodies (positive PCR test) in anamnesis. All patients were admitted to the regional vascular center № 7 of the City Clinical Hospital № 2, Novosibirsk. The comparison group consisted of 60 healthcare workers with ACS without positive PCR test in anamnesis. General clinical and instrumental, coronary angiography with possible stenting. Results. Of the 60 medical workers with ACS after a new coronavirus infection, myocardial infarction with ST segment elevation was detected in 21 people, myocardial infarction without ST segment elevation – in 31, unstable angina pectoris – in 8 people. Within 6 months of undergoing COVID-19, they developed complex rhythm disorders, such as paroxysm of fibrillation or atrial flutter, more frequently than in the comparison group, as well as a full AV-blockade (n = 25, 41.6 %, p = 0.020), bradyarrhythmias and conductivity disturbances (n = 8, 13.3 %, p = 0.045), revealed a more than 2-fold increase in the pro-brain natriuretic peptide (proBNP) (n = 21, 35 %, p = 0.033), observed myocardial dysfunction (ejection fraction less than 50 %) (n = 6, 10 %, p = 041). Conclusions. The data obtained indicate the formation of a new ACS phenotype in medical workers who have undergone a new coronavirus infection.
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