Adipose tissue is now recognized as an important endocrine organ that secretes numerous protein hormones, including leptin, adiponectin, and resistin. Adiponectin is a hormone that is produced by white adipose tissue. Adiponectin has been isolated independently by several groups of scientists. In humans, this protein is encoded by the ADIPOQ gene. Adiponectin receptors are widely distributed in many organs and tissues including liver, heart, pancreas, kidneys, muscles and many other cell types. A serum concentration of adipocin correlates with body mass index (BMI). Decreased level of adiponectin leads to obesity, the development of gestational complications in pregnant women, as well as a high risk of diabetes mellitus development and atherosclerosis. A high concentration of this hormone has anti-inflammatory, antiatherogenic, antiproliferative and cancer-defense mechanisms. Adiponectin strongly suppresses hepatic gluconeogenesis by inhibiting genes involved in glucose production. Obese people have lower blood levels of adiponectin than normal weight individuals. Adiponectin’s anti-inflammatory and anti-apoptotic properties result in protection of the blood vessels, heart, lungs, and colon. Adiponectin, an abundant adipocyte-secreted factor with a wide-range of biological activities, improves insulin sensitivity in insulin target tissues, modulates inflammatory responses, and plays a crucial role in the regulation of energy metabolism.
In the Russian Federation, the proportion of children among all cases of new coronavirus infection is up to 8.6%. Mild forms are registered in 80% of cases, severe – 0.2%, as a rule, in children of the first year of life. The majority of deaths were recorded in children with an unfavorable background: 75% of those who died had one concomitant pathology, 45% – two or more. The problem of severe course and fatal outcomes from COVID-19 in children with comorbid pathology, for example, with various forms of leukemia, remains relevant. Severe infectious complications of bacterial nature are observed in 70–80% of sick children, viral and fungal genesis, respectively, in 4–12% and 18–20%. Myeloblastic leukemia is one of the factors that predispose to a severe course of COVID-19 and an unfavorable outcome. The article presents a clinical observation of the course of a critical form of a new coronavirus infection in a young child with acute myeloblastic leukemia. The layering of COVID-19 contributed to a sharp deterioration of the underlying disease. Despite the highly organized treatment process with the use of modern technologies, the child had a rapid deterioration of the condition with a fatal outcome. Key words: COVID-19, children, acute myeloblastic leukemia, pancytopenia, fatal outcome
Children get sick less often than adults with a new coronavirus infection (in the Russian Federation, they account for 7.6% of registered cases of COVID-19), with less severe clinical symptoms, they require hospitalization less often, their disease is milder. The frequency of severe and extremely severe cases of COVID-19 in children does not exceed 1%. A clinical case of the course of COVID-19 in a child aged 2 years 4 months is presented. with acute lymphoblastic leukemia. A feature of the presented case is the development of an extremely severe new coronavirus infection in a child with secondary immunodeficiency caused by a long-term course of malignant, treatment-resistant of acute lymphoblastic leukemia. Slow, within 3 months, the development of the infectious process with long-term preservation of normal indicators of the function of the respiratory system led to the formation of viral-bacterial pneumonia with the development of respiratory distress syndrome. Despite the modern complex of therapeutic measures, severe comorbidity led to the development of DIC and multiple organ failure, which was the direct cause of the childs death. A possible therapy strategy is discussed in a patient with severe comorbidity against the background of secondary immunodeficiency and long-term persistence of SARS-CoV-2 in the presence of IgG antibodies to SARS-CoV-2 in the blood. For the first time, data on morphological changes in the lungs with a long course of COVID-19 (more than 100 days) in a young child are presented.
BackgroundThe prevalence of overweight and obesity is rapidly increasing across the world. Women of childbearing age and pregnant women are at higher risk. Maternal obesity can lead to adverse fetal complications.
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