COVID-19: ETIOLOGY, CLINICAL PICTURE, TREATMENT [COVID-19: ЭТИОЛОГИЯ, КЛИНИКА, ЛЕЧЕНИЕ]

Whereas the XX century marked the history of acute respiratory disease investigation as a period for generating in-depth system of combating influenza viruses (Articulavirales: Orthomyxoviridae, Alpha-/Betainfluenzavirus) (based on environmental and virological monitoring of influenza A virus in its natural reservoir — aquatic and semi-aquatic birds — to supervising epidemic influenza), a similar system is necessary to build up in the XXI century with regard to especially dangerous betacoronaviruses (Nidovirales: Coronaviridae, Betacoronavirus): Severe acute respiratory syndrome-related coronavirus (SARS-CoV) (subgenus Sarbecovirus), Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) (Sarbecovirus), Middle East respiratory syndrome-related coronavirus (MERS-CoV) (Merbecovirus). This became particularly evident after pandemic potential has been revealed in 2020 by the SARS-CoV-2. This review provides an insight into the historic timeline of discovering this virus, its current taxonomy, ecology, virion morphology, life cycle, molecular biology, pathogenesis and clinical picture of the etiologically related COVID-19 (Coronavirus disease 2019) as well as data available in the scientific literature on the anti-SARS-CoV-2-effectiveness of passive immunotherapy and most debated drugs used to treat COVID-19: Chloroquine, Hydroxychloroquine, Nitazoxanide, Ivermectin, Lopinavir and Ritonavir, Camostat mesilate, Remdesivir, Ribavirin, Tocilizumab, Anakinra, corticosteroids, and type I interferons. The pathogenesis of SARS-CoV-2 infection implicates decreased efficacy of artificial respiration, which, in this case might be replaced by more efficient extracorporeal membrane blood oxygenation supplemented with nitrogen oxide and/or Heliox inhalations. © 2020 Saint Petersburg Pasteur Institute. All rights reserved

PROPERTIES OF RBD SPECIFIC IGG FROM COVID-19 PATIENTS AND SPUTNIK V VACCINATED INDIVIDUALS [СВОЙСТВА АНТИТЕЛ К RBD У ПЕРЕБОЛЕВШИХ COVID-19 И ВАКЦИНИРОВАННЫХ ПРЕПАРАТОМ «СПУТНИК V»]

SARS-CoV-2 specific antibody response is a generally accepted measure of postinfection and vaccination-induced immunity assessment. The dynamics of avidity maturation and neutralizing activity of virus-specific immunoglobulins G during the SARS-CoV-2–associated coronavirus infection was studied in cohorts of vaccinated volunteers and COVID-19 patients. 4–6 months after vaccination, neutralization activity was low compared to hospitalized patients (medians 57.4% vs 86.4%). On the opposite, the avidity indices in vaccinated volunteers were significantly higher (median 76.7%) than among hospitalized patients (median 61.4%). During the acute phase of the disease (14–16 days PI), post-vaccination patients have also higher avidity indices than primary patients (medians 43.5% vs 20.4%). Our results suggest that in long-term perspective antibody affinity maturation rate is higher after vaccination than after a natural infection. We demonstrated that Sputnik V vaccination leads to formation of high-avidity IgG, which persists for at least 6 months of observation. These results also indicate the presence of protective efficacy markers for at least 4–6 months after the vaccination or a previous illness and gives grounds for the half-year time period chosen for booster immunization with Sputnik V in Russia. © 2022 Pirogov Russian National Research Medical University. All rights reserved

ASSESSMENT OF COVID-19 CLINICAL COURSE IN PATIENTS VACCINATED WITH SPITNIK V, SARS-COV-2 S PROTEIN RBD DOMAIN VARIATION AND SERUM VIRUS NEUTRALIZING ACTIVITY

The COVID-19-associated mortality remains high. Studying the features of the COVID-19 course in vaccinated patients, who have got ill on different dates after vaccination, compared to unvaccinated individuals is relevant. The study was aimed to assess clinical and immunological features of the COVID-19 course, as well as to assess humoral immunity (virus neutralizing activity, VNA) and SARS-CoV-2 S protein RBD domain variation in the groups of patients, previously vaccinated with Sputnik V, and unvaccinated patients. A total of 251 patients with confirmed diagnosis of COVID-19 were enrolled, of them 116 individuals were previously vaccinated with one or two Sputnik V vaccine components, and 135 patients were not vaccinated (comparison group). Individuals over 50 years of age prevailed (82.8%). The patients, who received two vaccine components, had mild to moderate COVID-19 (92.1%). In the group of unvaccinated patients, 11 individuals received treatment in the ICU, 10 of them died. The viral load was significantly lower in vaccinated patients. Mutations of SARS-CoV-2, such as S477N, S477N+A522S, E484K and E484K+S494P, were identified both in vaccinated and unvaccinated patients. Assessment of the neutralizing activity of sera revealed no significant differences in VNA against different variants of SARS-CoV-2 mutations. The data obtained demonstrate that the lack of vaccination is an aggravating factor and is capable of increasing the risk of severe course and death in patients with COVID-19

A Deep Look Into COVID-19 Severity Through Dynamic Changes in Blood Cytokine Levels

An excessive inflammatory response to SARS-CoV-2 is thought to be a major cause of disease severity and mortality in patients with COVID-19. Longitudinal analysis of cytokine release can expand our understanding of the initial stages of disease development and help to identify early markers serving as predictors of disease severity. In this study, we performed a comprehensive analysis of 46 cytokines (including chemokines and growth factors) in the peripheral blood of a large cohort of COVID-19 patients (n=444). The patients were classified into five severity groups. Longitudinal analysis of all patients revealed two groups of cytokines, characterizing the “early” and “late” stages of the disease course and the switch between type 1 and type 2 immunity. We found significantly increased levels of cytokines associated with different severities of COVID-19, and levels of some cytokines were significantly higher during the first three days from symptom onset (DfSO) in patients who eventually required intensive care unit (ICU) therapy. Additionally, we identified nine cytokines, TNF-α, IL-10, MIG, IL-6, IP-10, M-CSF, G-CSF, GM-CSF, and IFN-α2, that can be used as good predictors of ICU requirement at 4-6 DfSO. Copyright © 2021 Kleymenov, Bykonia, Popova, Mazunina, Gushchin, Kolobukhina, Burgasova, Kruzhkova, Kuznetsova, Shidlovskaya, Divisenko, Pochtovyi, Bacalin, Smetanina, Tkachuk, Logunov and Gintsburg

Clinical and laboratory profile of patients with COVID-19 admitted to hospital in Moscow between may and july 2020

Objective. Data of the clinical picture forms of the disease, management and diagnostic capabilities of patients with COVID-19 continue to be studied. Our study presents results from the analysis of clinical and laboratory parameters of patients with COVID-19 in the period May-June 2020, who were treated in an infectious diseases hospital in Moscow. Patients and methods. The analytical cohort included 444, 198 men, 246 women aged 18 to 95 years, who were identified with SARS-CoV-2 RNA. The severity of the disease was determined in accordance with the temporary clinical recommendations (version 6 effective April 28, 2020), NEWS. Results. The study of the clinical picture showed the variability of the spectrum of clinical manifestations of COVID-19. The most common symptoms were fever, weakness, myalgia, dry cough, shortness of breath, diarrhea. The severity of the infection was not associated with the patient's gender, but was significantly correlated with age and the presence of comorbid status, which included chronic lung diseases, obesity, diabetes mellitus, and cardiovascular diseases. Observations of patients with severe and extremely severe course revealed characteristic laboratory markers of severity. The main method of etiological diagnosis was the RT-PCR method for detecting SARS-CoV-2 RNA in the nasopharyngeal secret. To verify COVID-19, we used an additional PCR method, fecal testing for the detection of SARS-CoV-2 RNA. © 2021, Dynasty Publishing House. All rights reserved