Mechanisms of Atrial Fibrillation in Covid-19

Atrial fibrillation (AF) is the most frequent form of cardiac arrhythmia in COVID-19 infected patients. The occurrence of AF paroxysms is often associated with the acute period of infection in time. At the same time, the pathophysiological mechanisms of the occurrence of AF associated with COVID-19 remain insufficiently studied. The review considers the available literature data on the influence of factors such as reduced availability of angiotensin-converting enzyme 2 receptors, interaction of the virus with the cluster of differentiation 147 and sialic acid, increased inflammatory signaling, "cytokine storm", direct viral damage to the endothelium, electrolyte and acid-alkaline balance in the acute phase of severe illness and increased sympathetic activity.Copyright © Autors 2023.

Advantages and disadvantages of lockdown (Self-isolation regime) introduced during the first wave of coronaviral infection for patients with polymorbid pathology

BACKGROUND: Due to the rapid spread of the new coronavirus infection, the development of severe forms, especially among patients with polymorbid pathology, lack of resources to ensure optimal treatment of patients, in many countries, including the Russian Federation, self-isolation regime was introduced, or the so-called lockdown. Polymorbidity increases the risk of death, especially during a pandemic. Patients with multiple chronic diseases are the most vulnerable part of the population. Mortality among this group during the period of self-isolation has not been studied. AIM: To study the structure of mortality not caused by coronavirus infection, in patients with polymorbid pathology during the period of self-isolation (lockdown). MATERIALS AND METHODS: Outpatient records of 2,423 patients with polymorbid pathology (841 males and 1,582 females, aged from 18 to 99 years) were examined. The mortality and its causes during three years including a period of lockdown were investigated. RESULTS: The overall mortality rate among patients with polymorbid pathology was 10.2% without differences in gender. The structure of the causes of death in patients with polymorbidity: cardiovascular diseases accounted for 50.8%, oncological diseases — 21%, nervous system diseases — 7.3%. During the lockdown, an increase in overall mortality by 34.3% was recorded (p < 0.05), with an increase in the number of deaths of patients with cardiovascular diseases by 19.5% (p > 0.05) (mostly patients with ischemic heart disease). CONCLUSION: An increase in the number of deceased patients with polymorbidity during the lockdown may be due to the limitation of physical activity, of the possibility of examination and consultation by profile specialists. Taking into account the vulnerability of this group of patients, there is an urgent need to develop preventive measures when the situation recurs. © 2021, Eco-Vector LLC. All rights reserved.