[Predictive role of erythrocytes in assessment of COVID-19 outcomes].

INTRODUCTION: The search for affordable and accurate predictors of the outcome of COVID-19 is extremely important, as it provides the possibility to effectively correct the patient treatment tactics. AIM OF THE STUDY: To develop simple and accurate criteria based on the dynamics of red blood counts that predict the outcome of COVID-19. MATERIALS AND METHODS: Observations were carried out in 125 patients with severe and extremely severe COVID-19, in whom indicators characterizing the state of red blood were determined in dynamics on days 1, 5, 7, 10, 14 and 21 after the hospitalization. ROC analysis was performed to calculate the threshold predictive values for survival and mortality. RESULTS: The total number of erythrocytes and the level of hemoglobin in severe and extremely severe patients did not go beyond the acceptable limits, although showed a tendency to decrease in the group of fatal cases. On the 1st and 21st days, the number of MacroR in the deceased patients was reduced compared to those in group of survivors. It has been established that the RDW-CV test can predict the outcome of the COVID-19 with a high degree of probability at a relatively early stage of disease. RDW-SD test can be an additional predictive criterion of COVID-19 outcome. CONCLUSION: The RDW-CV test can be used as an effective predictor of disease outcome in patients with severe COVID-19.

[Morphological compound and indicators of the blood clotting system in severe COVID-19 patients of middle aged and elderly during treatment of Tocilizumab and Thymalin.]

The aim of the work was a comparative study of Tocilizumab and Thymalin effects on the morphological composition and indicators of the blood clotting system in COVID-19 of middle aged and elderly patients. Severe COVID-19 patients were divided into 3 groups: 1st - control (basic therapy), 2nd - basic therapy +Tocilizumab, 3rd - basic therapy +Thymalin. Hospital mortality in COVID-19 patients after standard therapy, Tocilizumab and Thymalin application was 40,9; 28,4 and 20,6% accordingly. The number of platelets increased by 1,5 times, the concentration of fibrinogen in blood decreased by 78% and activated partial thromboplastin time decreased by 9,3% in patients taking Tocilizumab. Under the influence of Tocilizumab, the platelet/white blood cell and platelet/lymphocyte ratios increased by 1,6 and 1,4 times, which may be a predictor of an unfavorable outcome of COVID-19. Thymalin increased the number of lymphocytes and monocytes by 2 times, the number of leukocytes - by 1,3 times, the number of platelets in the blood - by 1,5 times. Thymain decreased the platelet/lymphocyte and neutrophil/lymphocyte ratios by 1,4 times and 2 times. The use of Thymalin decreased the level of fibrinogen, lactate dehydrogenase and D-dimer in the blood by 1,2; 1,8 and 1,7 times, respectively. Thymalin, compared with Tocilizumab, meets the principles of pathogenic therapy for severe COVID-19 of middle aged and elderly patients to a greater extent, having a normalizing effect on the morphological composition and indicators of the blood clotting system.

Integrative Approach to Assessing the Complex of Correlations between Indicators of Physiological Functions.

We present the results of application of the combined correlation matrix method in some clinical studies. A practical algorithm is proposed for constructing a correlation matrix that compactly reflects a large number of interconnections for the situations when several diagnostic methods are used in an experimental clinical or preclinical trial. Several approaches to assessing and displaying the relationships are demonstrated for comparison.

Method for Determining Microcirculatory Hemodynamics by Laser Speckle Interferometry in Small Animals.

We performed experimental evaluation of various positions (ear, paw, and tail) of the of dynamic light scattering sensor of near-infrared laser radiation (840 nm) using speckle interferometry in rats. Dynamic monitoring of the reactions to prolonged ultrasound exposure (7 days) showed that the base of the tail is most suitable for this purpose. Additionally, analysis of microcirculation parameters on the surface of skin autograft was performed. The method of analysis of hemodynamics in humans was adapted for animals.

[The role of «Youth and aging proteins¼ in essential hypertension pathogenesis.]

Essential hypertension (EG) is an age-associated disease. Often EG of elderly patients haven't good way of treatment. Thus, the search of new target molecules for EG therapy is an actual goal of gerontology and molecular medicine. It was shown, that during EG concentrations of GDF11 «youth protein¼ decreased in 3,3 times and GDF15, JAM-A/1, CCL11 «aging proteins¼ increased in 1,4-2,4 times. EG patients have abnormal microcirculation processes. It was shown as decreasing in 1,3 and 1,7 times of hemodynamic HI1 and H1-H3 indexes. EG patients have negative correlation of GDF15 concentration with arterial pressure. EG patients have no correlation of JAM-A/1 concentration with arterial pressure. Normal is positive correlation with GDF15, JAM-A/1 concentration with arterial pressure. GDF15 blood level during EG have positive correlation with HI1-HI3 and negative correlation with NEUR_HI2 and MAYER_HI3 indexes. It can show on pathogenesis mechanisms of endothelial and smooth muscles function of vessels tissues. We suppose, that the regulation of GDF11, GDF15, JAM-A/1, CCL11 «youth and aging proteins¼ can be target object of EG therapy.

[The Association of Gene Polymorphisms of Matrix Metalloproteinases (-9, -12 and -20) and Collagen Type I Degradation Products With the Remodeling of the Left Ventricle in Patients With Acute Myocardial Infarction].

OBJECTIVE: to study associations of polymorphism of the genes MMP9 rs17576, MMP12 rs2276109, MMP20 rs2245803, COL1A1 rs1800012, COL1A1 rs1107946 with remodeling of the left ventricle in patients with acute myocardial infarction. MATERIALS AND METHODS: We examined 84 patients with myocardial infarction (MI). Type of early postinfarction left ventricular (LV) remodeling was determined by echocardiography on the third day of the disease. Concentration of matrix metalloproteinases (MMP) was measured by enzyme immunoassay using commercial kits; content of C-terminal telopeptide of collagen type I degradation products (ICTP) was measured by chemiluminescent immunoassay. Polymorphisms of the genes MMP9 rs17576, MMP12 rs2276109, MMP20 rs2245803, COL1A1 rs1800012 and rs1107946 were identified by PCR using primers. Statistical analysis was performed using the language R (http://cran.r-project.org) version 3.4.0, and additional packages (stats, forest plot, ROC). RESULTS: Significant association was found between A allele of MMP 20 rs2245803 and dilation type of LV remodeling (odds ratio [OR] 2.82, 95% confidence interval [CI] 1.186-6.695). The prognostic model containing systolic pulmonary artery pressure (SE=0.339) and G allele of MMP9 rs17576 (SE=1.097) was associated with LV dilation. The model containing C allele of the MMP20 rs2245803 (SE=-0.279) showed its relationship with LV hypertrophy. Combined carriage of the minor allele G of MMP9 rs17576 and C allele of MMP20 rs2245803 (SE=-2.228) was associated with hypertrophic modification of the LV geometry. CONCLUSION: In this work we revealed association of A allele of MMP20 rs2245803 with formation of dilative type of LV remodeling and established relationship between C allele of MMP20 rs2245803 and the hypertrophic morpho-functional modification of the left ventricle. Carriage of the G allele of MMP9 rs17576, along with other factors, increased the likelihood of LV myocardial hypertrophy. The role of this allele was augmented by cocarrying C allele of the MMP20 rs2245803. Identified gene associations can be used as additional early predictors of LV myocardial remodeling in patients with acute MI.

Impact of Fitness Status on the Optically Measured Hemodynamic Indexes.

The physiological characteristics of skin blood flow can be described in terms of the hemodynamic indices (HI). The HI is derived from the laser speckle characteristics, which are governed by the cutaneous blood flow. A miniaturized dynamic light-scattering sensor was used to measure the speckle pattern from the finger root. Three groups of subjects from 15 to 25 years of age were tested. The first group included subjects who are actively engaged in sport activities; the second group included subjects with low level of physical activity; and the third group included healthy controls with moderate physical activity. The HI parameters were measured prior to and after the performance of a determined physical load. As a marker of cardiovascular fitness (CVF), we used the postload decay rate of HI. We found that the hemodynamic response to the physical load provides a statistically significant correlation with the postload heart rate decay. It was also found that postocclusion increase of the arterial HI is more prominent in the group with higher physical activity. These results indicate that hemodynamic indices can be used as an additional marker for cardiovascular fitness level.