Seromarkers of synthesis and collagen degradation, electrophysiological heart parameters among patients with syndrome of preexcitation of ventricles

The results of examination of 43 patients withsyndrome of preexcitation of ventricles are introducedin the article. The aim of the studywas to optimize diagnostics and prediction of the developmentof arrhythmia in this cohort and to find out thepossible role of disorder of fibrous matrix in the developmentof disorder of cardiac arrhythmias. The main groupconsisted of 43 patients with syndrome of preexcitationof ventricles (phenomenon WPW, syndrome WPW) and15 practically healthy people of the same age were in thegroup of comparison. The average age of the examinedpatients from the main group was 25,3±9,15 years old,among them 29 men (67%) and 14 women (33%). Theaverage age in the comparison group was 27,9±7,9 yearsold. All groups included into the examination were comparableby gender distribution (р=0,45, Fisher’s test) andby age (р=0,27, U-criterion). The highest figures of matrixmetal proteinase-9 (MMP-9) were found among patientswith syndrome WPW – 96,1±33,2ng/ml and in the groupof phenomenon WPW (54,3±21,8ng/ml; р=0,0003). Practicallyhealthy people had minimal values of the MMP-9 -27,4±10,9ng/ml (р=0,00014; р=0,000002). Maximal valuesof tissue inhibitor of matrix metal proteinase (TIMP-1)are introduced in the group of phenomenon WPW and inthe group of practically healthy people (418,5±69,8 ng/mland 461,7±72,2ng/ml; р=0,27). Patients with syndromeWPW have lower TIMP-1 – 341,1±90,1 ng/ml (р=0,002;р=0,00012). The level of propeptideprocollagenof thetype I(PICP) among patients with syndrome WPW was179,9±76,2ng/ml and 97,8±31,7 ng/ml (р=0,00014) inthe group of phenomenon WPW. All examined patientsaccording to the level of PICP differed from practicallyhealthy people 69,4±23,9ng/ml (р<0,05, U-criterion).The examined patients have changes of fibrous matrix.That includes an increasing the concentration of MMP-9,PICP and reducing TIMP-1. The syndrome WPW is characterizedby more expressed disbalanceof seromarkers ofsynthesis and collagen degradation than phenomenon is.It is possible that the examined seromarkers of fibrosistake place in forming disorders of cardiac arrhythmias inactual syndromes

International register “Dynamics analysis of comorbidities in SARS-CoV-2 survivors” (AKTIV SARS-CoV-2): analysis of predictors of short-term adverse outcomes in COVID-19

The international AKTIV register presents a detailed description of out- and inpatients with COVID-19 in the Eurasian region. It was found that hospitalized patients had more comorbidities. In addition, these patients were older and there were more men than among outpatients. Among the traditional risk factors, obesity and hypertension had a significant negative effect on prognosis, which was more significant for patients 60 years of age and older. Among comorbidities, CVDs had the maximum negative effect on prognosis, and this effect was more significant for patients 60 years of age and older. Among other comorbidities, type 2 and 1 diabetes, chronic kidney disease, chronic obstructive pulmonary disease, cancer and anemia had a negative impact on the prognosis. This effect was also more significant (with the exception of type 1 diabetes) for patients 60 years and older. The death risk in patients with COVID-19 depended on the severity and type of multimorbidity. Clusters of diseases typical for deceased patients were identified and their impact on prognosis was determined. The most unfavorable was a cluster of 4 diseases, including hypertension, coronary artery disease, heart failure, and diabetes mellitus. The data obtained should be taken into account when planning measures for prevention (vaccination priority groups), treatment and rehabilitation of COVID-19 survivors

International register “Dynamics analysis of comorbidities in SARS-CoV-2 survivors” (AKTIV) and the register “Analysis of hospitalizations of comorbid patients infected during the second wave of SARS-CoV-2 outbreak” (AKTIV 2)

The organizer of the registers “Dynamics analysis of comorbidities in SARSCoV-2 survivors” (AKTIV) and “Analysis of hospitalizations of comorbid patients infected during the second wave of SARS-CoV-2 outbreak” (AKTIV 2) is the Eurasian Association of Therapists (EAT). Currently, there are no clinical registries in the Eurasian region designed to collect and analyze information on long-term outcomes of COVID-19 survivors with comorbid conditions. The aim of the register is to assess the impact of a novel coronavirus infection on long-term course of chronic non-communicable diseases 3, 6, 12 months after recovery, as well as to obtain information on the effect of comorbidity on the severity of COVID-19. Analysis of hospitalized patients of a possible second wave is planned for register “AKTIV 2”. To achieve this goal, the register will include men and women over 18 years of age diagnosed with COVID-19 who are treated in a hospital or in outpatient basis. The register includes 25 centers in 5 federal districts of the Russian Federation, centers in the Republic of Armenia, the Republic of Kazakhstan, the Republic of Kyrgyzstan, the Republic of Belarus, the Republic of Moldova, and the Republic of Uzbekistan. The estimated capacity of the register is 5400 patients

Clinical features of post-COVID period. Results of an International Register "Dynamics Analysis of Comorbidities in SARS-CoV-2 Survivors (ACTIV SARS-CoV-2)" (12-month follow-up)

Aim. To investigate on post-COVID period in patients of the Eurasian region.Material and methods. A total of 9364 consecutively hospitalized patients were included in ACTIV registry. Enrollment of patients began on June 29, 2020, and was completed on March 30, 2021, corresponding to the first and second waves of the pandemic. Demographic, clinical, and laboratory data, computed tomography (CT) results, information about inhospital clinical course and complications of COVID-19 during hospitalization were extracted from electronic health records using a standardized data collection form. The design included follow-up telephone interviews with a standard questionnaire at 3, 6, and 12 months to examine the course of post-COVID period.Results. According to ACTIV register, 63% of patients after COVID-19 had new adverse symptoms or exacerbations of the existing symptoms lasting for up to 1 year. After hospital discharge, 79,8% of patients sought unscheduled medical attention in the first 3 months, 79,1% at 4-6 months, and 64,8% at 7-12 months. Readmission rate was 11,8% in the first 3 months, 10,9% at 4-6 months, and 10,1% at 7-12 months. The most common reasons for unscheduled treatment in the first 3 months were uncontrolled hypertension, decompensated type 2 diabetes, destabilization of coronary artery disease, gastrointestinal disease, AF episodes, exacerbation of asthma and chronic obstructive pulmonary disease, decompensated heart failure (HF). The 12-month mortality of COVID-19 survivors after the discharge was 3,08%. Multivariate analysis showed that independent risk factors for fatal outcome were age (direct correlation), the levels of hemoglobin (inverse correlation), oxygen saturation (inverse correlation), and aspartate aminotransferase (direct correlation), as well as class III-IV HF, prior stroke, cancer, inhospital acute kidney injury. Based on these identified risk factors, a nomogram was constructed to determine the 3-month mortality risk after discharge.Conclusion. Analysis of ACTIV register showed that end of the acute phase of COVID-19 does not imply a complete recovery