Metabolic disorders and the risk of COVID-19

In the present review the analysis of the world literature devoted to the study of metabolic disorders in the body and the risk of COVID-19 disease. It is known that metabolic syndrome is an independent risk factor for the severe course of new coronavirus infection. This review summarizes data on the mechanisms of metabolic dysfunction in a new coronavirus infection, analyzes the results of studies that investigated the issues of associations between the course of COVID-19 and various metabolic disorders, such as hyperglycemia and diabetes mellitus, dyslipidemia, obesity, non-alcoholic fatty liver disease, their severity, potential targets of therapy, predictors of the development of a severe course of new coronavirus infection are considered. These metabolic disorders increase the impairment of the immune system and make patients more susceptible to the development of infectious diseases, in particular, to infection with a new coronavirus infection. Taking into account the obtained data, it becomes obvious the need to identify and monitor patients with pre-existing metabolic diseases, as well as their development during and after COVID-19. The information on the topic from publications based on PubMed, PubMed Central, Scopus, Google Scholar, Medscape, UpYoDate, eLIBRARY.RU data were used

Associations of changes in lipid metabolism parameters and the severity of COVID-19 infection in Novosibirsk residents

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

Non-alcoholic fatty liver disease and metabolic liver dysfunction in the new coronavirus infection COVID-19

Our study aimed to explore associated non-alcoholic fatty liver disease (NAFLD) and metabolic liver dysfunction influence on the severity of the new coronavirus infection COVID-19. Material and methods. The study design was a cross-sectional study. The research included 215 patients (39.50 % of men) aged 26–60 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 = 99), moderate and severe (n = 116) by anamnesis. Hepatic steatosis index (HIS), body mass index (BMI), waist circumference, alanine aminotransferase and gamma-glutamyl transpeptidase activity, glucose and triglyceride content, systolic and diastolic pressure were calculated and abdominal ultrasound examination was done. Results. In the group with moderate and severe course of COVID-19, the proportion of patients diagnosed with NAFLDaccording to the HSI index was significantly higher compared to patients with mild coronavirus infection. Patients with mild COVID-19, who were diagnosed with NAFLD, had higher alanine aminotransferase and gamma-glutamyl transpeptidase activity, glucose and triglyceride content, BMI, systolic and diastolic pressure, waist circumference compared to patients without NAFLD. Similar differences persisted for patients with moderate and severe course. With the step-by-step exclusion of cardiometabolic parameters from the logistic regression model, the triglyceride content and BMI retained association with steatohepatosis according to ultrasound data, regardless of severity. When creating a similar model for the HSI index, significant correlation was shown for alanine aminotransferase activity in patients with mild COVID-19, for alanine aminotransferase activity and BMI – in patients with moderate and severe COVID-19. Conclusions. Patients with NAFLD have a more severe course of COVID-19. In addition, associations of the severity of COVID-19 with a combination of NAFLD and other cardiometabolic changes in the body, such as arterial hypertension, obesity, dyslipidemia, were revealed

Profile of subpopulation composition of regulatory T lymphocytes and intestinal microbiota in patients with irritable bowel syndrome

The following specificcharacteristics of the composition of intestinal microbiota in patients with irritable bowel syndrome (IBS) were identified using a metagenomic analysis (16 S rRNA): 1) an increase in the representation of Actinobacteria, including Bifidobacterium spp., Firmicutes, including representatives of Streptococcaceae (Streptococcus), Lachnosperaceae (Dorea), Veillonellaceae (Dialister), Proteobacteria (Enterobacteriaceae and Desulfovibrionaceae families); 2) a decrease in the population of Bacteroidetes, including representatives of the families Prevotellacea (Prevotella spp.), Bacteroidaceae (Bacteroides spp.). Firmicutes belonging to the families Clostridiaceae and Ruminococcaceae (Fecalibacterium spp.).Flow cytometry in the study of the subpopulation composition of T regulatory (Treg) lymphocytes in patients with IBS revealed an increase in the number of CD45R0+CD62L+ central memory cells (CM), which can regulate the processes of maturation and differentiation of lymphocytes in lymphoid tissue. A decrease in the expression of exonucleases CD39 and CD73 was detected, which can have a significant effect on their activity. A reduction in effector memory cells (EM) Treg was observed.Changes in the expression level of exonucleases CD39 and CD73 were inversely correlated with the content of Proteobacteria and the representation of the genera Bifidobacterium spp. and Faecalibacterium spp. The content of СЫ Treg was directly correlated with the content of Dorea spp.The results may be indicative of impairment in the processes of Treg differentiation, which are closely related to changes in key components of intestinal microbiocenosis in IBS

Associative connection of infectious and inflammatory diseases in pregnancy and severe preeclampsia

Materials and methods. This retrospective case-control study enrolled 50 women with severe preeclampsia and 50 control women with spontaneous singleton pregnancy. Median age of women ranged from 20 to 35 years. All women did not have a history of hypertension, autoimmune, metabolic, renal, or cardiac diseases, and preeclampsia before this pregnancy. We have analyzed χ2, odds ratio (OR) and its 95% confidence intervals (95% Cl). Results. We found significant association between maternal systemic infectious and severe preeclampsia (OR = 49.6; 95% Cl 13.05-188.64). The risk of severe preeclampsia were significantly lower in patients with local infections of the lower genital tract (OR = 4.5; 95% Cl 1.49-6.71). Asymptomatic bacteriuria is associated with the highest risk of severe preeclampsia (OR = 17.0; 95% Cl 4.66-61.81). Acute gravidarum pyelonephritis showed lower association with severe preeclampsia (OR = 5.4; 95% Cl 1.69-10.54). We did not observe increased risk of severe preeclampsia with acute respiratory infections (OR = 2.0; 95% Cl 0.71-4.69). Acute non-specific bacterial vaginitis and acute candidiasis vulvovaginitis were found to be risk factors of severe preeclampsia (OR = 6.7; 95% Cl 1.90-11.02 and OR = 4.3; 95% Cl 1.45-9.99 respectively). Cytomegalovirus infection (2 %), toxoplasmosis (2 %), Chlamydia trachomatis cervicitis (4 %), acute Trichomonas colpitis (2 %) and bacterial vaginosis (4 %) were found only in patients with severe preeclampsia. Conclusion. Our data support that acute maternal infection is associated with an increased risk of severe preeclampsia in healthy women with singleton pregnancy. Systemic inflammatory response might be the main potential mechanisms related to infections and enhanced development of severe preeclampsia. Further research is required to elucidate the underlying mechanism of this association

Effect of the qualitative composition of a high-fat diet in rats with systemic inflammatory response syndrome upon myocardial resistance to ischemic-reperfusion injury and cytokine levels

Overweight and obesity are among the main factors of cardiovascular risk, but the prospective studies on the dependence between high-fat diets and weight gain yielded contradictory results. Different types of fats exert varying metabolic effects, and this fact leads to a difference in the risk associated with increasing body weight. The effects of fat quality in the daily diet on immunological status and resistance of myocardium to ischemic-reperfusion damage should be studied experimentally in biomedical models. The purpose of this work was to assess the effect of the qualitative composition of a high-fat diet used for induction of primary visceral obesity (PVO) in rats with systemic inflammatory response syndrome (SIRS) upon myocardial resistance to ischemic-reperfusion injury, and levels of pro- and anti-inflammatory cytokines.The experiments were performed on adult male Wistar rats with PVO caused by 28-day consumption of any fat types: hydrogenated fats (HF), vegetable oils (VO), animal fats (AF) or milk fat (MF). The SIRS model included a combination of chemically induced colitis (CIC) and intragastric injection of a broad-spectrum antimicrobial agent (AMA) for three days. Five days later, immunological and biochemical studies were conducted, as well as composition of intestinal microbiota in faecal samples, morphological changes in the structure of the large intestine, hemodynamic parameters and myocardial resistance to ischemic-reperfusion injury were studied in the model of isolated heart perfusion, by Langendorff technique.There was a significant increase in the concentration of anti-inflammatory cytokines in animals with SIRS, i.e., TNFα, IL-1α, IL-2, IL-8, as well as a decrease in TGF-1β, an anti-inflammatory cytokine. SIRS was accompanied by severe dietary disorders and evacuatory function of the gastrointestinal tract. Minimal changes in the intestinal microbiota composition, as well as the most pronounced regeneration signs of intestinal epithelium was observed in rats in the group with MF injection. There was a trend for increasing size of infarction in all the groups as compared with control, directly correlating with increase in BDNF and IL-2 production. However, a significant increase in the infarction size was found only in the group receiving milkfat, thus suggesting a decrease in myocardial resistance to ischemic reperfusion injury (IRI).Thus, the presence of SIRS in the primary obesity model is characterized by controllable change of inflammation markers and depends on the quality of dietary fats. The degree of morphofunctional deterioration of isolated heart, including a decrease in resistance to ischemia-reperfusion injury, correlates with the concentration of BDNF and IL-2 during the studied observation terms

Limitations and opportunities of cancer treatment in the COVID-19 pandemic

The COVID-19 pandemic has affected all medical fields and brought up a lot of serious problems. The features of the COVID-19 infection in patients with cancer are important to understand. According to many articles, patients with cancer are more vulnerable to COVID-19 infection. Patients undergoing anticancer treatment have 1-4% morbidity rate. Patients with hematological diseases and lung cancer are at higher risk of SARS-CoV-2 infection and also have more severe symptoms and complications. In this article we discuss the effect of the tumors on the immune system and comprehend the pathogenesis of the coronavirus disease according to its impact on the immunity. Moreover, in the review we analyze available data about the influence of the different types of cancer therapy (chemotherapy, target therapy, radiotherapy and immunotherapy) on the severity of the COVID-19 infection. Evidence on the effect of chemotherapy on severity and mortality from COVID-19 is contradictory. Whereas there are some authors concluding that chemotherapy treatment is not affecting the severity of COVID-19 disease, there are also some works where the connection between these facts was established. At the same time target therapy, radio- and immunotherapy most likely do not worsen the SARS-CoV-2 infection and are not associated with the development of complications. But it’s important to say that the amount of data available for today is insufficient to make a unambiguous conclusion

Modeling of systemic inflammatory response syndrome by chemical induction of colon injury in rats

Our objective was to develop a model of systemic inflammatory response syndrome (SIRS) by chemical induction of colon injury and antibiotic-associated intestinal dysbiosis in rats with primary visceral obesity (PVO) for studies of myocardial resistance to ischemia-reperfusion injury. The experiments were performed with adult Wistar male rats with PVO under improved conditions of a conventional animal clinic. The chemically induced inflammatory colon disease (CIICD) was accomplished by intragastric administration of a mixture of broad-spectrum antimicrobial agents (AMA) for 3 days. Five days later, immunological and biochemical studies were carried out, as follows: composition of the intestinal microbiota in feces and shortchain fatty acids in blood, morphological changes in the structure of the colon, hemodynamic parameters and myocardial stability with modified Langendorff system. In PVO rats, the mass of visceral fat deposits and the content of lipopolysaccharides (LPS) in the blood were significantly increased when giving them fatcarbohydrate diet (FCD). In animals with CIICD, in addition to LPS, there was a significant increase in proinflammatory cytokine concentration (TNF, IL-8, MCP-1), and after oral administration of the AMA mixture, pronounced disturbances of food behavior and evacuatory function of gastrointestinal tract, deep destructive changes in colon, as well as qualitative and quantitative composition of intestinal microbiota with characteristics typical to the first-grade dysbiosis. High levels were shown for IL-8 cytokine only. An increase in acetic and propionic acid concentrations were shown in blood in animals with CIICD, and, to a greater extent, in rats with antibiotic-induced dysbiosis (AID). FCD was followed by significantly reduced levels of lactobacilli and bifidobacteria in colonic contents. CIICD leads to detection of Escherichia coli, and intestinal dysbiosis leads to the manifestation of Proteus. A comorbid combination of pathological changes in the immune and digestive systems caused a significant increase in the area of myocardial necrosis (by 35 percent) in isolated heart by, thus presuming decreased myocardial resistance to ischemia-reperfusion injury (IRI). The SIRS model induced by chemical trauma to large intestine is aggravated by the introduction of AMAs mixture, and it is characterized by a controlled change in inflammatory markers. Deterioration of morphofunctional characteristics in isolated heart included decrease in resistance to IRI seems to correspond to acute inflammatory bowel disease with induced intestinal dysbiosis. This model can be used in experimental medicine in the field of cardiology, endomicroecology, gastroenterology, and immunology