In vitro diagnostika uue määruse – IVDRi – tähendus laboritele kliinikumi ühendlabori vaates

Eesti Arst 2022; 101(3):19

Longitudinal proteomic profiling reveals increased early inflammation and sustained apoptosis proteins in severe COVID-19

SARS-CoV-2 infection has a risk to develop into life-threatening COVID-19 disease. Whereas age, hypertension, and chronic inflammatory conditions are risk factors, underlying host factors and markers for disease severity, e.g. requiring intensive care unit (ICU) treatment, remain poorly defined. To this end, we longitudinally profiled blood inflammation markers, antibodies, and 101 plasma proteins of hospitalized COVID-19 patients who did or did not require ICU admission. While essentially all patients displayed SARS-CoV-2-specific antibodies and virus-neutralization capacity within 12-15 days, a rapid, mostly transient upregulation of selective inflammatory markers including IL-6, CXCL10, CXCL11, IFN gamma, IL-10, and monocyte-attracting CCL2, CCL7 and CCL8, was particularly evident in ICU patients. In addition, there was consistent and sustained upregulation of apoptosis-associated proteins CASP8, TNFSF14, HGF, and TGFB1, with HGF discriminating between ICU and non-ICU cohorts. Thus, COVID-19 is associated with a selective inflammatory milieu within which the apoptotic pathway is a cardinal feature with potential to aid risk-based patient stratification.Peer reviewe

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Impact of the COVID-19 Pandemic on Estonian Elite Athletes: Survey on Mental Health Characteristics, Training Conditions, Competition Possibilities, and Perception of Supportiveness

Background: The postponement and cancellation of the competition season due to COVID-19 could cause significant mental health problems for an elite athlete. The aim of this study was to describe the mental health characteristics of Estonian elite athletes, their training conditions, competition possibilities, and the support they received during COVID-19. Methods: Athletes completed self-reported questionnaires (including Emotional State Questionnaire). The authors applied descriptive statistics, t-test, and χ2 test for comparison of study groups (p < 0.05). Results: Altogether 102 athletes (♂ = 44) were surveyed. The most disturbing issue for athletes was the closing of training centers (57.8%) and cancellation of competitions (50%); 64.7% of athletes reported a negative response from not being able to visit healthcare specialists. Fortunately, athletes could receive virtual coaching. Two-thirds of the athletes had some indication of distress (♀ > ♂): 25% of males and 39.7% of females had symptoms indicating depression; ♀ = 27.6%, ♂ = 13.6% anxiety; ♀ = 56.9%, ♂ = 31.8% fatigue (p = 0.021); ♀ = 55.1%, ♂ = 27.2% insomnia (p = 0.009); 27.5% thought about ending their career (frequency in high distress group compared with low: p = 0.022); and 2.9% were certain they would stop their training completely. Family members were the biggest emotional supporters; 16.7% did not get support from anyone. Conclusion: The Estonian sport community needs to adapt to life in a pandemic environment and help athletes to maintain training and competition activities and in turn, their mental health

Impact of the COVID-19 Pandemic on Estonian Elite Athletes: Survey on Mental Health Characteristics, Training Conditions, Competition Possibilities, and Perception of Supportiveness

Background: The postponement and cancellation of the competition season due to COVID-19 could cause significant mental health problems for an elite athlete. The aim of this study was to describe the mental health characteristics of Estonian elite athletes, their training conditions, competition possibilities, and the support they received during COVID-19. Methods: Athletes completed self-reported questionnaires (including Emotional State Questionnaire). The authors applied descriptive statistics, t-test, and χ2 test for comparison of study groups (p &lt; 0.05). Results: Altogether 102 athletes (♂ = 44) were surveyed. The most disturbing issue for athletes was the closing of training centers (57.8%) and cancellation of competitions (50%); 64.7% of athletes reported a negative response from not being able to visit healthcare specialists. Fortunately, athletes could receive virtual coaching. Two-thirds of the athletes had some indication of distress (♀ &gt; ♂): 25% of males and 39.7% of females had symptoms indicating depression; ♀ = 27.6%, ♂ = 13.6% anxiety; ♀ = 56.9%, ♂ = 31.8% fatigue (p = 0.021); ♀ = 55.1%, ♂ = 27.2% insomnia (p = 0.009); 27.5% thought about ending their career (frequency in high distress group compared with low: p = 0.022); and 2.9% were certain they would stop their training completely. Family members were the biggest emotional supporters; 16.7% did not get support from anyone. Conclusion: The Estonian sport community needs to adapt to life in a pandemic environment and help athletes to maintain training and competition activities and in turn, their mental health.</jats:p

Changes in the Mental Health Indicators and Training Opportunities for Estonian Elite Athletes Compared to the COVID-19 Isolation Period

Background: In spring 2020, two-thirds of Estonian elite athletes had symptoms of emotional distress. The aim of this study was to evaluate the mental health indicators and training opportunities for elite Estonian athletes a year after the complete COVID-19 isolation period compared to June 2020. Methods: In both cross-sectional studies, athletes completed self-reported questionnaires, including the Emotional State Questionnaire. Descriptive statistics, t-tests, and Chi2 tests were applied to compare the study groups (p &lt; 0.05). Results: A total of 172 out of approximately 600 elite Estonian athletes participated in the survey (102 in 2020 and 70 in 2021). More than a year after the COVID-19 lockdown period, the mental health problems of elite athletes (particularly the symptoms of depression and fatigue) are even greater concern than in June 2020, despite the recovery in training conditions and competition. Of all of the subjects, 80% had high levels of distress in 2021 compared to 36% in 2020. According to the athletes, the availability of health care services was good (78.6%), but there was a lack of close cooperation with the coach. However, the athletes considered their coaches to be their main supporters, along with their family members and partners. Only 4.3% of the respondents considered a sports psychologist to be their main supporter (n = 6). Conclusions: More than a year after the COVID-19 lockdown period, the mental health indicators of Estonian elite athletes were worrisome. Most of subjects had high levels of distress even though their training conditions had returned to normal (i.e., to as they had been before COVID-19)

Changes in the Mental Health Indicators and Training Opportunities for Estonian Elite Athletes Compared to the COVID-19 Isolation Period

Background: In spring 2020, two-thirds of Estonian elite athletes had symptoms of emotional distress. The aim of this study was to evaluate the mental health indicators and training opportunities for elite Estonian athletes a year after the complete COVID-19 isolation period compared to June 2020. Methods: In both cross-sectional studies, athletes completed self-reported questionnaires, including the Emotional State Questionnaire. Descriptive statistics, t-tests, and Chi2 tests were applied to compare the study groups (p &lt; 0.05). Results: A total of 172 out of approximately 600 elite Estonian athletes participated in the survey (102 in 2020 and 70 in 2021). More than a year after the COVID-19 lockdown period, the mental health problems of elite athletes (particularly the symptoms of depression and fatigue) are even greater concern than in June 2020, despite the recovery in training conditions and competition. Of all of the subjects, 80% had high levels of distress in 2021 compared to 36% in 2020. According to the athletes, the availability of health care services was good (78.6%), but there was a lack of close cooperation with the coach. However, the athletes considered their coaches to be their main supporters, along with their family members and partners. Only 4.3% of the respondents considered a sports psychologist to be their main supporter (n = 6). Conclusions: More than a year after the COVID-19 lockdown period, the mental health indicators of Estonian elite athletes were worrisome. Most of subjects had high levels of distress even though their training conditions had returned to normal (i.e., to as they had been before COVID-19).</jats:p