Cytokine Storm in COVID-19: Immunopathogenesis and Therapy

A cytokine storm is a hyperinflammatory state secondary to the excessive production of cytokines by a deregulated immune system. It manifests clinically as an influenza-like syndrome, which can be complicated by multi-organ failure and coagulopathy, leading, in the most severe cases, even to death. The term cytokine storm was first used in 1993 to describe the graft-versus-host disease following allogeneic hematopoietic stem cell transplantation. It was then reused to define the adverse syndromes secondary to the administration of immunostimulating agents, such as anti-CD28 antibodies or bioengineered immune cells, i.e., CAR T-cell therapy. Currently, the concept of cytokine storm has been better elucidated and extended to the pathogenesis of many other conditions, such as sepsis, autoinflammatory disease, primary and secondary hemophagocytic lymphohistiocytosis, and multicentric Castleman disease. Moreover, cytokine storm has recently emerged as a key aspect in the novel Coronavirus disease 2019, as affected patients show high levels of several key pro-inflammatory cytokines, such as IL-1, IL-2, IL-6, TNF-α, IFN-γ, IP-10, GM-CSF, MCP-1, and IL-10, some of which also correlate with disease severity. Therefore, since the onset of the pandemic, numerous agents have been tested in the effort to mitigate the cytokine storm in COVID-19 patients, some of which are effective in reducing mortality, especially in critically ill patients, and are now becoming standards of care, such as glucocorticoids or some cytokine inhibitors. However, the challenge is still far from being met, and other therapeutic strategies are being tested in the hope that we can eventually overcome the disease

Temperature solidification preparations from polymeric composite materials at the microwave oven heating

Розглянуто використання електромагнітного поля надвисокої частоти при виготовленні виробів із склопластику. Для експериментального відпрацювання технологічного процесу отвердіння обрано джерело електромагнітного випромінювання – мікрохвильова піч. Розглянуто методи визначення властивостей заготовок із полімерно-композиційних матеріалів при НВЧ нагріванні. Приведено порівняльні дані НВЧ і конвекційного нагрівів.The analysis of prospects of development space-rocket hardware technicians speaks about increase in a share of polymeric composite materials in designs of flying machines. But their manufacture is connected with certain expenses of energy. And it puts forward a problem of working out of new technologies of reception of products from polymeric composite materials on time reduction solidification polymeric binding without decrease in the quality of polymeric composite materials. Wide application space-rocket hardware technicians have found fibreglasses in products on a basis epoxy binding and fibrous filler (fabrics, fibres, plaits).For experimental working off of technological process solidification polymeric composite materials on samples the microwave, as a source of electromagnetic radiation of ultrahigh frequency has been chosen. Researches spent at different values of capacity on an exit of a microwave and heating time. The influence of the microwave oven electromagnetic field on process of solidification thermosetting polymers leads to the creation of more sewed and more ordered structures that promotes the increase of physicomechanical properties of a material. Studying of structural changes in polymers spent a method X-ray. In work supervised volume shrinkage hydrostatic weighing binding by a method. The received results have allowed to choose the optimal mode of solidification binding under the influence of electromagnetic field the microwave oven whom the microwave oven whom the microwave oven to temperature 130°C in a current of 14 minutes with the subsequent free cooling in the furnace to temperature 60° and after that - consists in heating electromagnetic field at the open furnace - cooling to room temperature. This mode provides fuller solidification compositions (degree solidification - 97,5 %) after the comparison with a convection method.Рассмотрено использование электромагнитного поля сверхвысокой частоты при изготовлении изделий из стеклопластика. Для экспериментальной отработки технологического процесса отверждения выбран источник электромагнитного излучения - микроволновая печь. Рассмотрены методы определения свойств заготовок из полимерных композиционных материалов при СВЧ нагреве. Приведены сравнительные данные СВЧ и конвективного нагрева

Single‐breath counting test predicts non‐invasive respiratory support requirements in patients with covid‐19 pneumonia

The use of non‐invasive respiratory strategies (NIRS) is crucial to improve oxygenation in COVID‐19 patients with hypoxemia refractory to conventional oxygen therapy. However, the absence of respiratory symptoms may delay the start of NIRS. The aim of this study was to determine whether a simple bedside test such as single‐breath counting test (SBCT) can predict the need for NIRS in the 24 h following the access to Emergency Department (ED). We performed a prospective observational study on 120 patients with COVID‐19 pneumonia. ROC curves were used to analyze factors which might predict NIRS requirement. We found that 36% of patients had normal respiratory rate and did not experience dyspnea at rest. 65% of study population required NIRS in the 24 h following the access to ED. NIRS‐requiring group presented lower PaO2/FiO2 (235.09 vs. 299.02), SpO2/FiO2 ratio (357.83 vs. 431.07), PaCO2 (35.12 vs. 40.08), and SBCT (24.46 vs. 30.36) and showed higher incidence of dyspnea at rest (57.7% vs. 28.6%). Furthermore, SBCT predicted NIRS requirement even in the subgroup of patients without respiratory symptoms (AUC = 0.882, cut‐off = 30). SBCT might be a valuable tool for bedside assessment of respiratory function in patients with COVID‐19 pneumonia and might be considered as an early clinical sign of impending respiratory deterioration

Lock, stock and barrel: role of renin-angiotensin-aldosterone system in coronavirus disease 2019

Since the end of 2019, the medical-scientific community has been facing a terrible pandemic caused by a new airborne viral agent known as SARS-CoV2. Already in the early stages of the pandemic, following the discovery that the virus uses the ACE2 cell receptor as a molecular target to infect the cells of our body, it was hypothesized that the renin-angiotensin-aldosterone system was involved in the pathogenesis of the disease. Since then, numerous studies have been published on the subject, but the exact role of the renin-angiotensin-aldosterone system in the path-ogenesis of COVID19 is still a matter of debate. RAAS represents an important protagonist in the pathogenesis of COVID19, providing the virus with the receptor of entry into host cells and deter-mining its organotropism. Furthermore, following infection, the virus is able to cause an increase in plasma ACE2 activity, compromising the normal function of the RAAS. This dysfunction could con-tribute to the establishment of the thrombo-inflammatory state characteristic of severe forms of COVID19. Drugs targeting RAAS represent promising therapeutic options for COVID19 sufferers