Comparative analysis of laboratory data of 46 patients suffering from pneumonia caused by SARS-CoV-2 and 12 patients - pneumonia of bacterial etiology is given. It was established that in patients with COVID-19 compared to patients with bacterial pneumonia, the level of direct bilirubin is 84% more, and thrombocrit is three times more, which can indicate intravascular hemolysis and activation of the hemostasis system. Sex differences in laboratory indicators in patients with COVID-19, which go beyond the known limits of the physiological norm, were not detected. However, in men, hematocrit, hemoglobin, and plasma creatinine values were statistically higher than in women, but the amount of C-reactive protein in women was 5 times greater. However, these laboratory measures in COVID-19 have low prognostic significance. Therefore, conventional laboratory measures do not reveal clinic-critical differences in bacterial pneumonia and pneumonia caused by SARS-CoV-2. When conducting multifactorial analysis, it turned out that the laboratory indicators of patients suffering from bacterial pneumonia are not clustered and it is impossible to form predictor models from them. While laboratory indicators of patients suffering from pneumonia caused by COVID-19 form a directed pathogenetic response of the body as a whole, which causes multi-branch associated changes in homeostasis. Unfortunately, the amount of data available to us did not allow a qualitative discriminant analysis, which, with a very large amount of data, could lead to discriminant equations that are resistant to random emissions. This would allow, according to the available key individual laboratory indicators, to identify patients suffering from COVID-19 in the early stages already in the first hours of admission to the clinic.
Background. Obstructive sleep apnea (OSA) is frequently associated with hypertension (HTN), and about 50 % hypertensive patients have concomitant OSA. Episodes of transient upper airway obstruction affect the daily blood pressure profile, leading to nocturnal HTN. Although the general relationship between OSA and the daily blood pressure profile is known, the association between the frequency of various daily blood pressure profiles and OSA severity as well as the age-specific differences remain unknown. The aim of the study was to determine the daily blood pressure profiles in patients with HTN and OSA, depending on the OSA severity and age. Design and methods. The study included 236 HTN patients underwent treatment in the period from 2008 to 2021 years and were diagnosed with OSA by cardiorespiratory monitoring: 84 patients had mild OSA (apnea/hypopnea index (AHI) < 15 episodes/h), 46 patients — moderate OSA (15 ≤ AHI < 30 episodes/h), and 106 patients — severe OSA (AHI ≥ 30 episodes/h). The control group included 140 HTN patients without OSA. Both groups were divided into 3 age subgroups: younger than 45 years, 45–59 years and ≥ 60 years. At baseline, all patients underwent cardiorespiratory monitoring (“Kardiotekhnika‑07–3/12P”, Inkart, St Petersburg, Russia) and 24-hour blood pressure (BP) monitoring (BPLab, Nizhny Novgorod, Russia). Results. We found an association between the distribution of daily BP profiles and age, which differs from that in HTN patients without OSA. Non-dipper and night-peaker BP profiles are predominant in young and middle age. Among OSA patients, the severity of OSA was associated with the BP profiles only in the young and middleage groups. Unfavorable BP profiles (non-dipper and night-peaker) were more common in patients with severe OSA, which was not observed in elderly subgroup. In the elderly, compared to younger patients, the overdipper profile was the most common and its frequency was not associated with OSA severity. Conclusions. The study shows the relationship between the age of patients with HTN and OSA, the OSA severity and the distribution of daily BP profiles.
The work analyzed the polymorphisms of the HLA-DRB1 and IL28 genes in 100 patients who underwent COVID-19 with the development of infection with varying degrees of severity. To a mild degree of severity were patients without complications in the form of infectious pneumonate, to moderate and severe degrees - with the development of pneumonate with varying degrees of lung damage. In general, the distribution of alleles in patients with COVID-19 did not differ from the distribution of average values in Russia. However, the HLA-DRB1 *01 и *07 alleles were more common. Comparison of the frequency of HLA-DRB1 alleles in patients with COVID-19 with varying severity revealed more common alleles of *13 and *07 in the severety severe group. However, with OR of 3.2 and 1.8, their confidence intervals (CL) were in the range of 0.9-9.8 and 0.7-4.5 respectively. At severe severity, the presence of homozigotic variants of allele *07 is noted. (Fisher exact test, r.0.04). As for the IL28B gene, no statistically significant differences from the control group were found.
The review presents data on the importance of mitochondrial DNA in aging of cardiomocytes. The mechanisms of accumulation of mutations in mtDNA and reduction of its content, as well as the consequences of these phenomena in cardiomyocytes are described. The similarity of the aging processes of cardiomyocytes and skeletal muscle cells and comparison with the aging processes occurring in mononuclear cells of peripheral blood is indicated. The death of cardiomyocytes and skeletal muscle cells leads to the destruction of mutant forms of mtDNA, as a result of which the content of mutant forms of mtDNA, constantly increasing with age, does not exceed 1-2% of the total number of mtDNA molecules. In addition, the death of cardiomyocytes and myocytes is accompanied by the release of CpG-motive cells mtDNA, which can cause local and general inflammation in old age. It is concluded, that in the treatment of elderly patients it is desirable to take into account the degree of aging ("biological age”) of their myocardial and their presence of chronic myocarditis, for which appropriate diagnostic methods should be developed.
About 85% of all sudden death are of cardiological origin. Predisposition to sudden cardiac death is known for the young and adult patients with a hereditary heart disease that can cause sudden cardiac arrest. The purpose of the work was to study the genetic predisposition for cardiovascular diseases in people with a risk of sudden cardiac death. We examined patients aged 19,7±2,1 years with a risk of sudden cardiac death based on specific complaints and medical history, and considering the known markers of the life-threatening arrhythmias. Of the 1000 patients, 167 with a risk of sudden cardiac death were selected according to the questionnaire. In 80 randomly selected patients from this group, gene polymorphisms associated with the development of thrombophilia and hypertension were studied by real time PCR, and in 59 patients the polymorphisms of genes associated with impaired carbohydrate and lipid metabolism were studied. A number of differences were revealed according to the standard 12-channel electrocardiography in comparison with practically healthy individuals. In the study of genetic factors predisposing the development of thrombophilia, hypertension, type 2 diabetes mellitus, lipid metabolism disorders, a high percentage of hetero- and homozygous individuals was revealed by the risk allele of the PAI-1 (83.3%), ITGA2 (69.2%), AGT genes (72.5%), NOS3 (58.8%), PON1 (56%), LEPR (64.3%). The data obtained indicate a significant role of genetic factors in the development of sudden cardiac death, and the synergistic effect of genes, as a result of which the presence of a risk allele in one gene can enhance the expression of another gene.
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