Objective: To investigate the level and relationship of specific immunoglobulin G (IgG) antibodies to SARS-CoV-2 with laboratory parameters of vascular inflammatory response (VIR) during follow-up of patients with arterial hypertension (AH) in 3 months after disease onset. Design and method: Retrospective, single-center observational study included 76 confirmed cases of COVID-19 associated with pneumonia (April-May 2020). Gr.1 consisted of 32 patients without AH; Gr.2 involved 44 AH patients, including 18 patients with metabolic disorders (abdominal obesity and impaired carbohydrate metabolism). Complete blood count, biochemical and hemostatic parameters were determined on the day of admission. Comprehensive analysis of clinical instrumental and laboratory parameters, including blood pressure, heart rate, IgG (positivity rate), cytokines, NT-pro BNP, endothelial dysfunction markers, cystatin C, glucose and others was performed in 3 months after discharge. Results: In Gr.1, IgG was negatively associated with hemoglobin, red blood cell volume, neutrophils, creatine phosphokinase, homocysteine, those were supplemented by NT-pro BNP, interleukin-6, lactate dehydrogenase, creatinine (p < 0.0001–0.034) in Gr.2 and additionally, D-dimer level, transforming growth factor and P-selectin (p < 0.001–0.036) in metabolic disorders subgroup. Therewith, in patients aged over 40 years, positive association of IgG with levels of SBP and DBP (p < 0.011 and 0.034), MDRD (p < 0.01) was registered. Correlation and regression analysis revealed greater association of IgG level < 12.9 with vascular inflammatory markers, and IgG level > 12.9 with thrombogenic parameters. Conclusions: IgG might be a sensitive indicator of VIR and can play a role in predicting possible unwanted vascular complications in AH patients after suffering from SARS-CoV-2.
Identification of signs of intracranial venous stasis using ultrasound methods in combination with determination of headache intensity according to the visual-analogue scale allows us to suspect the venous genesis of ischemic stroke before using neuroimaging methods, which can contribute to the selection of adequate therapy and to improve the prognosis and long-term outcomes of the disease. Objective: To study the prognostic value of a complex of clinical demographic and instrumental indicators for developing a model for early differential diagnosis of ischemic stroke of arterial and venous origin. Material and Methods: Examined 124 patients with ischemic stroke: 22 with venous stroke due cerebral venous sinus thrombosis (VIS), 53.5±16.7y and 102 with atherothrombotic stroke (AIS), 68.3±12.1y which were verified by native CT; CT-angiography, PCT (perfusion CT: CBF, CBV, MTT), brachiocephalic vessels ultrasound index of arteriovenous ratio (IAVR) and transcranial duplex scanning for all. IAVR was obtained due duplex scanning of carotid common arteries (CCA) and internal jugular veins (IJV) according to the formula: V max IJV optimal =2S CCA × Vps CCA/ 3S IJV……… (1) IAVR = max IJV actual / V max IJV optimal × 100%, where……… (2) IAVR-index of arteriovenous ratio, (%) Vps CCA-peak systolic velocity of the CCA, cm/s Vmax IJV-maximum blood flow velocity, cm/s. S-vessel cross-sectional area, cm 2 , as well as. To assess the neurological status of patients, rating scales were used, including a visually analog headache intensity scale. Results: The greatest prognostic significance was possessed by such parameters as the indicator of arteriovenous blood flow ratio and the value of headache intensity on a visual-analogue scale. A model for the differential diagnosis of AIS and VIS, which has high specificity and sensitivity, has been developed. Velocity indicators in the veins of Rosenthal and the vein of Galen are additional signs of intracranial venous stasis.
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