Psychophysiological Status and Life Quality in Individuals with Metabolic Syndrome Living in Central Kazakhstan

BACKGROUND: Morbidity rate of circulatory system diseases (CSD) in Kazakhstan continues to grow and the metabolic syndrome (MetS) contributes significantly to cardiovascular risk development. It was known that MetS altered autonomic nervous system (ANS) by decreasing parasympathetic activity and global heart rate variability (HRV), at the same time, the decrease in sympathetic modulation is unclear. Studies investigated associations between anxiety and MetS disorders are rather controversial. Research findings of the MetS influence on health-related quality of life (HRQoL) were also contradictory. The above-mentioned justifies the necessity of research to clarify and deepen the MetS etiology and pathogenesis, as well as to improve its diagnostics efficiency and treatment. AIM: The research goals were to study psychophysiological status and HRQoL in individuals with MetS living in Central Kazakhstan. MATERIALS AND METHODS: Three hundred MetS patients were examined in Karaganda city clinical hospital. Statistical methods and spectral analysis of HRV, simple visual-motor reaction (SVMR), the Spielberger State-Trait Anxiety Inventory, and the Lüscher color test were used. SF-36 questionnaire was used for HRQoL assessment. RESULTS: General decrease in the activity of both sympathetic and parasympathetic branches of ANS was observed in MetS patients. More than half of the examined MetS patients have had a high level of trait anxiety. Most MetS patients have had a low level of the central nervous system (CNS) functional activity. MetS patients are active both in physical and social spheres. Bodily pain syndrome greatly influences MetS patients’ life quality. The patients evaluate their health level as being low. CONCLUSION: Individuals with MetS living in Central Kazakhstan had decreased activity of ANS, prevalence of inhibition processes in CNS, high level of trait anxiety, and bodily pain syndrome affecting life quality

SPUTNIK-V REACTOGENICITY AND IMMUNOGENICITY IN THE BLOOD AND MUCOSA: A PROSPECTIVE COHORT STUDY

Sputnik-V (Gam-COVID-Vac) is a heterologous, recombinant adenoviral (rAdv) vector-based, COVID- 19 vaccine now used in > 70 countries. Yet there is a shortage of data on this vaccine’s performance in diverse populations. Here, we performed a prospective cohort study to assess the reactogenicity and immunologic outcomes of Sputnik-V vaccination in Kazakhstan. COVID-19-free participants (n = 82 at baseline) were followed at day 21 after Sputnik-V dose 1 (rAd5) and dose 2 (rAd26). Self-reported local and systemic adverse events were captured using questionnaires. Blood and nasopharyngeal swabs were collected to perform SARS-CoV-2 diagnostic and immunologic assays. We observed that most of the reported adverse events were mild-to-moderate injection site or systemic reactions, no severe or potentially life-threatening conditions were reported, and dose 1 appeared to be more reactogenic than dose 2. The seroconversion rate was 97% post-dose 1, remaining the same post-dose 2. The proportion of participants with detectable virus neutralization was 83% post-dose 1, increasing to 98% post-dose 2, with the largest relative increase observed in participants without prior COVID- 19 exposure. Dose 1 boosted nasal S-IgG and S-IgA, while the boosting effect of dose 2 on mucosal S-IgG, but not S-IgA, was only observed in subjects without prior COVID-19. Systemically, vaccination reduced serum levels of growth regulated oncogene (GRO), which correlated with an elevation in blood platelet count. Overall, Sputnik-V dose 1 elicited both blood and mucosal SARS-CoV-2 immunity, while the immune boosting effect of dose 2 was minimal. Thus, adjustments to the current vaccine dosing regimen are necessary to optimize immunization efficacy and cost-effectiveness. While Sputnik-V reactogenicity is similar to that of other COVID-19 vaccines, the induced alterations to the GRO/platelet axis warrant investigation of the vaccine’s effects on systemic immunology

Computation of Nonlinear Parameters of Heart Rhythm Using Short Time ECG Segments

We propose the method to compute the nonlinear parameters of heart rhythm (correlation dimension D2 and correlation entropy K2) using 5-minute ECG recordings preferred for screening of population. Conversion of RR intervals’ time series into continuous function x(t) allows getting the new time series with different sampling rate dt. It has been shown that for all dt (250, 200, 125, and 100 ms) the cross-plots of D2 and K2 against embedding dimension m for phase-space reconstruction start to level off at m=9. The sample size N at different sampling rates varied from 1200 at dt = 250 ms to 3000 at dt = 100 ms. Along with, the D2 and K2 means were not statistically different; that is, the sampling rate did not influence the results. We tested the feasibility of the method in two models: nonlinear heart rhythm dynamics in different states of autonomous nervous system and age-related characteristics of nonlinear parameters. According to the acquired data, the heart rhythm is more complex in childhood and adolescence with more influential parasympathetic influence against the background of elevated activity of sympathetic autonomous nervous system

Informative Nature and Nonlinearity of Lagged Poincaré Plots Indices in Analysis of Heart Rate Variability

Lagged Poincaré plots have been successful in characterizing abnormal cardiac function. However, the current research practices do not favour any specific lag of Poincaré plots, thus complicating the comparison of results of different researchers in their analysis of heart rate of healthy subjects and patients. We researched the informative nature of lagged Poincaré plots in different states of the autonomic nervous system. It was tested in three models: different age groups, groups with different balance of autonomous regulation, and in hypertensive patients. Correlation analysis shows that for lag l = 6, SD1/SD2 has weak (r = 0.33) correlation with linear parameters of heart rate variability (HRV). For l more than 6 it displays even less correlation with linear parameters, but the changes in SD1/SD2 become statistically insignificant. Secondly, surrogate data tests show that the real SD1/SD2 is statistically different from its surrogate value and the conclusion could be made that the heart rhythm has nonlinear properties. Thirdly, the three models showed that for different functional states of the autonomic nervous system (ANS), SD1/SD2 ratio varied only for lags l = 5 and 6. All of this allow to us to give cautious recommendation to use SD1/SD2 with lags 5 and 6 as a nonlinear characteristic of HRV. The received data could be used as the basis for continuing the research in standardisation of nonlinear analytic methods

HIGH SARS-COV-2 SEROPREVALENCE IN KARAGANDA, KAZAKHSTAN BEFORE THE LAUNCH OF COVID-19 VACCINATION

COVID-19 exposure in Central Asia appears underestimated and SARS-CoV-2 seroprevalence data are urgently needed to inform ongoing vaccination efforts and other strategies to mitigate the regional pandemic. Here, in a pilot serologic study we assessed the prevalence of SARS-CoV-2 antibody-mediated immunity in a multi-ethnic cohort of public university employees in Karaganda, Kazakhstan. Asymptomatic subjects (n = 100) were recruited prior to their first COVID-19 vaccination. Questionnaires were administered to capture a range of demographic and clinical characteristics. Nasopharyngeal swabs were collected for SARS-CoV-2 RT-qPCR testing. Serological assays were performed to detect spike (S)- reactive IgG and IgA and to assess virus neutralization. Pre-pandemic samples were used to validate the assay positivity thresholds. S-IgG and -IgA seropositivity rates among SARSCoV- 2 PCR-negative participants (n = 100) were 42% (95% CI [32.2–52.3]) and 59% (95% CI [48.8–69.0]), respectively, and 64% (95% CI [53.4–73.1]) of the cohort tested positive for at least one of the antibodies. S-IgG titres correlated with virus neutralization activity, detectable in 49% of the tested subset with prior COVID-19 history. Serologically confirmed history of COVID-19 was associated with Kazakh ethnicity, but not with other ethnic minorities present in the cohort, and self-reported history of respiratory illness since March 2020. Overall, SARS-CoV-2 exposure in this cohort was ~15-fold higher compared to the reported all-time national and regional COVID-19 prevalence, consistent with recent studies of excess infection and death in Kazakhstan. Continuous serological surveillance provides important insights into COVID-19 transmission dynamics and may be used to better inform the regional public health response