Impact of Alteplase on Mortality in Critically Ill Patients with COVID-19 and Pulmonary Embolism

Impact of the COVID-19 pandemic on the clinical features of patients with chronic obstructive pulmonary disease: an observational cross-sectional study

The presence of chronic obstructive pulmonary disease (COPD) and COVID-19 infection is a detrimental combination for patients and can cause negative clinical consequences. The investigation aimed to compare sociodemographic and clinical parameters of COPD individuals hospitalized for exacerbations before and at the end of the COVID-19 pandemic. An observational cross-sectional study including 222 patients with COPD was conducted in two stages: a survey and assessment of clinical and laboratory data of patients hospitalized from September 2022 to March 2023 (n=98) and processing of the medical histories of patients with COPD who received hospital treatment in 2017 and 2018 (n=124). A comparative analysis of patients who received inpatient treatment for COPD showed that the frequency of patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) I was half as high after the COVID-19 pandemic, whereas the individuals with GOLD IV were more frequent during the same period (p<0.05). Multiple regression analysis proved the effects of smoking status and previous COVID-19 infection on the health status of patients with COPD according to COPD Assessment Test data (p<0.05). There was an increase in the frequency of comorbid pathologies in the post-COVID period: hypertension, coronary heart disease, gastrointestinal diseases, anemia (p<0.05), and other diseases. This study highlights the significant influence of the COVID-19 infection on people with COPD, which manifested as impaired lung function and an increased incidence of comorbidities.

Post-COVID syndrome and type 2 diabetes mellitus in Kazakhstan: clinical manifestations and vaccine efficacy

PURPOSE

In this article, we report the results of a survey investigating post-coronavirus disease 2019 (COVID-19) syndrome in patients with type 2 diabetes mellitus and the impacts of vaccination on long-term manifestations. From February 2022 to April 2023, a survey of patients with type 2 diabetes and people without diabetes who were treated for a coronavirus infection was conducted in Kazakhstan.

METHODS

Participants were invited via social media to voluntarily participate in this study. A total of 417 surveys were included in this study, comprising 212 patients with type 2 diabetes and 205 without diabetes. We compared persistent complaints after recovery in patients with and without diabetes mellitus (DM), as well as vaccination status.

RESULTS

The results of this study on self-reported symptoms of prolonged COVID show that more than half of those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Kazakhstan have at least one persistent symptom after recovery. Based on the list of prolonged COVID-19 symptoms reported by patients with type 2 DM (T2DM), exertional dyspnoea, fatigue, respiratory discomfort, headaches, and sleep disturbances are among the most common ongoing conditions, and in many cases last more than 3 months after COVID-19.

CONCLUSION

Patients with T2DM experience more severe and prolonged symptoms than those without diabetes. Additionally, vaccination lowers COVID-19 hospitalization risk and decreases the need for adjusting hypoglycemic therapy, such as insulin treatment, after recovering from SARS-CoV-2 infection.

Immune response variation in mild and severe COVID-19 patients

Sixty patients with COVID-19 infection were categorized into mild and severe groups, and their immune response was analyzed using flow cytometry and complete blood count. An observed increase in immune activation parameters, notably a higher percentage of CD4 lymphocytes co-expressing CD69 and CD25 molecules, and enhanced activity of the macrophage-monocyte cell line was noted in the mild group. Although Group 2 (severe COVID) had fewer CD4 cells, significant migration and proliferation were evident, with increased CD4CD69, CD8 HLA-DR+, and CD8CD69 lymphocytes. The CD4 to CD8 ratio in Group 1 suggested potential autoimmune reactions, while Group 2 indicated potential immunosuppression from severe infection and employing immunosuppressive drugs. Additionally, Group 2 exhibited an increased neutrophil count, hinting at possible bacterial co-infection. Group 1 showed differences in CD4RO and CD8RA lymphocyte populations, implying that cellular immunity plays a role in developing efficient postinfectious immunity. This intimation suggests that vaccination might mitigate the severity of the coronavirus infection and prevent complications, including long-term COVID-19.