Changes in the Urine Metabolomic Profile in Patients Recovering from Severe COVID-19.

Metabolomics is a relatively new research area that focuses mostly on the profiling of selected molecules and metabolites within the organism. A SARS-CoV-2 infection itself can lead to major disturbances in the metabolite profile of the infected individuals. The aim of this study was to analyze metabolomic changes in the urine of patients during the acute phase of COVID-19 and approximately one month after infection in the recovery period. We discuss the observed changes in relation to the alterations resulting from changes in the blood plasma metabolome, as described in our previous study. The metabolome analysis was performed using NMR spectroscopy from the urine of patients and controls. The urine samples were collected at three timepoints, namely upon hospital admission, during hospitalization, and after discharge from the hospital. The acute COVID-19 phase induced massive alterations in the metabolic composition of urine was linked with various changes taking place in the organism. Discriminatory analyses showed the feasibility of successful discrimination of COVID-19 patients from healthy controls based on urinary metabolite levels, with the highest significance assigned to citrate, Hippurate, and pyruvate. Our results show that the metabolomic changes persist one month after the acute phase and that the organism is not fully recovered.

Persistence of Metabolomic Changes in Patients during Post-COVID Phase: A Prospective, Observational Study.

Several relatively recently published studies have shown changes in plasma metabolites in various viral diseases such as Zika, Dengue, RSV or SARS-CoV-1. The aim of this study was to analyze the metabolome profile of patients during acute COVID-19 approximately one month after the acute infection and to compare these results with healthy (SARS-CoV-2-negative) controls. The metabolome analysis was performed by NMR spectroscopy from the peripheral blood of patients and controls. The blood samples were collected on 3 different occasions (at admission, during hospitalization and on control visit after discharge from the hospital). When comparing sample groups (based on the date of acquisition) to controls, there is an indicative shift in metabolomics features based on the time passed after the first sample was taken towards controls. Based on the random forest algorithm, there is a strong discriminatory predictive value between controls and different sample groups (AUC equals 1 for controls versus samples taken at admission, Mathew correlation coefficient equals 1). Significant metabolomic changes persist in patients more than a month after acute SARS-CoV-2 infection. The random forest algorithm shows very strong discrimination (almost ideal) when comparing metabolite levels of patients in two various stages of disease and during the recovery period compared to SARS-CoV-2-negative controls.

Parasitic and Vector-Borne Infections in HIV-Positive Patients in Slovakia-Evidence of an Unexpectedly High Occurrence of Anaplasma phagocytophilum.

In HIV (human immunodeficiency virus) infected people, the immunodeficiency caused by a reduced level of CD4 (cluster of differentiation 4) T-lymphocytes increases the risk of infectious diseases. Additionally, in individuals with immunologically compromising conditions, tick-borne or some parasitic pathogens may cause chronic, debilitating opportunistic infections and even death. The study aimed at determining the IgG seropositivity of HIV-infected patients to Toxoplasma gondii, Toxocara spp., Echinococcus multilocularis, and E. granulosus s.l. and performing the molecular identification of T. gondii and some tick-borne pathogens, namely, Borrelia spp., Babesia spp., Anaplasma phagocytophilum, Rickettsia spp., and Bartonella spp. Out of 89 HIV-positive patients, specific IgG antibodies to T. gondii were detected in 17 (19.1%) and to Borrelia spp. in 12 (13.5%) individuals. Seropositivity to Toxocara spp., E. multilocularis, and E. granulosus s.l. was not recorded. Molecular approaches showed positivity to T. gondii in two (2.2%) patients, and 11 (12.4%) individuals had positive PCR signal for the msp2 gene of A. phagocytophilum. Relatively high prevalence of A. phagocytophilum in HIV-positive patients suggests that these people are more susceptible to some vector-borne pathogens. The presence of opportunistic infections may pose a health risk for patients with weakened immune systems, and should not be neglected during the regular monitoring of the patient's health status.

Attitudes and Perspectives of People Living With Human Immunodeficiency Virus: Findings From the Positive Perspectives Survey in Slovakia.

Objectives: To investigate the perspectives and attitudes of people living with human immunodeficiency virus (PLHIV) in Slovakia. Methods: A cross-sectional, computer-assisted web survey on health status, emotional support, stigmatisation, communication with physician, treatment, perception, decision-making, concerns, and treatment history. A representative sample of >10% of all PLHIV (N = 895) in Slovakia was invited to participate. Results: Mean age of the 117 respondents was 35.4 (±8.9) years, 52.8% had higher education, and 67.0% were in full-time employment. Most (89.4%) were receiving antiretroviral therapy (ART), and 81.8% had undetectable viral load. Most (85.1%) were satisfied with their ART, and side effects were the primary reason for switching therapies. Most (60.8%) had informed only close friends or relatives about their HIV status, only 3 (2.9%) spoke openly about it, and 60.0% hid their ART from others. Of the 31 respondents (31.6%) who experienced stigmatisation, it was primarily from dentists and other physicians who refused to treat them. Conclusion: In general, PLHIV in Slovakia receive ART and are satisfied with it. They do not speak openly about their HIV status, and some have experienced discrimination.

Human Taeniases in Slovakia (2010-2019): Genetic Analysis of Taenia saginata Isolates.

Taenia saginata and Taenia solium, known as beef and pork tapeworm, are foodborne pathogens of global importance having a substantial impact on human health and economy. The study aimed to summarize the occurrence of human Taenia spp. infection in past 10 years in Slovakia based on reports of clinicians and diagnostic laboratories to Public Health Authority of the Slovak Republic. Altogether, 19 human cases were reported in Slovakia in 2010-2019, with the incidence of infection ranging from 0.00 to 0.12/100,000 inhabitants per year. In two patients T. saginata infection was confirmed molecularly. Nucleotide sequences of the analyzed nad1 gene fragments derived from both patients were identical and in a phylogenetic tree clustered together with T. saginata Tsa isolate (AM503345), as well as with a homologous sequence of the completely sequenced mitochondrial genome of T. saginata. Similarly, cox1 nucleotide sequences derived from one of the patients and isolates from Asia and/or Europe were identical. A cluster for cox1 partial gene sequence was placed separately from closely related Taenia asiatica and/or T. solium isolates in the phylogenetic tree.

Clinical Course of Opportunistic Infections-Toxoplasmosis and Cytomegalovirus Infection in HIV-Infected Patients in Slovakia.

: The HIV/acquired immunodeficiency syndrome (AIDS) pandemic has affected the health status of the population in many countries. Early symptomatic HIV infection includes persistent generalized lymphadenopathy (PGL), which can be associated with opportunistic infections, e.g., toxoplasmosis and Cytomegalovirus (CMV) infection. This study followed the occurrence of PGL, toxoplasmosis, and Cytomegalovirus infection in 32 HIV-positive patients and analyzed the clinical signs of disease in relation to the number of CD4 T lymphocytes. In monitored patients, the average number of CD4 T lymphocytes was 940.8 ± 396.7/µL of blood. Severe immunodeficiency was recorded in four persons, who also suffered from colitis and/or retinitis and pneumonitis. The number of CD4 T cells in patients with PGL was significantly lower than that in patients without lymphadenopathy. In 6 (18.8%) IgM and 11 (34.4%) IgG Toxoplasma gondii seropositive patients, the number of CD4 T lymphocytes was significantly lower than that in seronegative patients. The presence of IgM and IgG antibodies to Cytomegalovirus was recorded in all examined patients, and CMV infection clinically manifested in five persons. The occurrence of PGL, the higher viral load, and seropositivity to T. gondii were significantly related to decline in the CD4 T lymphocyte number. The clinical course of the diseases was influenced by the status of the patient's immunodeficiency and suggests ongoing immunosuppression and possible reactivation of both infections in all patients.

Imported skin parasitosis.

Larva migrans cutanea is a typical skin parasitosis of tropical and subtropical regions. In Central European countries, such as Slovakia and Czech Republic, larva migrans cutanea is just an imported disease. Its clinical symptoms are characterized by formation of erythematous focus with serpiginous morphology, which is caused by migration of helminth in epidermis. The disease does not threaten the patient's life, but causes significant discomfort, especially in form of pruritus in the affected area. Thanks to growing trend of today's tourism more tourists are exposed to the harmful effects of the environment in final destinations. This leads to an increase in frequency of imported diseases, with which physicians in our latitudes may not have enough experience.

Contribution to the Diagnosis and Treatment of Life-Threatening Parasitosis Caused by the Parasite Echinococcus multilocularis.

Echinococcosis is a serious parasitic disease that ends lethally in 95% of untreated infected patients. It was first diagnosed in Slovakia in the year 2000. It is caused by the larval stage of a tapeworm belonging to the genus Echinococcus, which was assigned to the group "A" of zoonoses in the year 2004. The number of new infections is rising because of increasing percentage of infected red foxes (Vulpes vulpes). Early and accurate diagnosis of infections with this parasite is essential for proper initiation of adequate therapy. Thanks to professional multidisciplinary efforts and new laboratory procedures, the number of correctly diagnosed cases has increased. Antimicrobial therapeutic approaches can lead to improved quality of life and better prognosis even if radical surgery is refused by the patient.

[Cyst of Echinococcus etiology localised in the spleen]. / Cysta echinokokovej etiológie lokalizovaná v slezine.

Cystic form in the spleen was diagnosed accidentally in a 44 years old patient during ultrasonography of the abdomen. It reached 6.0 cms in diameter. The mass was localised superficially, closely beneath the capsule of the spleen. The diagnose was confirmed serologically. Because of the localisation and the size of the cyst, the surgical approach - splenectomy - was indicated and performed.

Analysis of the direct and indirect costs of treatment of imported malaria in the Slovak Republic.

This study analyzed the approximate cost of treatment of patients hospitalized with a diagnosis of imported malaria in Slovakia. Between 2003 and 2007, 15 patients with imported malaria were hospitalized. The mean direct cost of the treatment was 970.75 euros and the mean indirect cost was 53.15 euros. For the patient with the highest cost of treatment, the use of mefloquine prophylaxis would have represented only 0.5% of the total direct cost of treating the disease. Despite the partial resistance of plasmodia, malaria chemoprophylaxis is unequivocally a cheaper choice than subsequent treatment of malaria.

Analysis of the direct and indirect costs of treatment of imported malaria in the Slovak Republic / Análise dos custos diretos e indiretos do tratamento da malária importada na República Eslovaca

This study analyzed the approximate cost of treatment of patients hospitalized with a diagnosis of imported malaria in Slovakia. Between 2003 and 2007, 15 patients with imported malaria were hospitalized. The mean direct cost of the treatment was 970.75 euros and the mean indirect cost was 53.15 euros. For the patient with the highest cost of treatment, the use of mefloquine prophylaxis would have represented only 0.5 percent of the total direct cost of treating the disease. Despite the partial resistance of plasmodia, malaria chemoprophylaxis is unequivocally a cheaper choice than subsequent treatment of malaria.

Análise do custo aproximado do tratamento dos doentes hospitalizados na Eslováquia com malária importada. Entre 2003 a 2007, foram internados 15 doentes com malária importada. Os custos médios diretos do tratamento foram avaliados em 920,75 euros e indireto em 53,15 euros. No doente com o custo mais elevado de tratamento, a utilização da profilaxia com mefloquina representaria somente 0,5 por cento do total dos custos diretos do tratamento da doença. Apesar da resistência parcial do plasmódio, a quimioprofilaxia da malária é inequivocamente uma opção mais econômica do que o tratamento posterior da malária.

[Viral hepatitis D imported to the Czech Republic by the citizen from the Moldavian Republic.].

Viral hepatitis D (HDV) is a serious acute inflammatory liver damage, which frequently is transmitting to the chronic phase, cirrhosis and hepatocellular carcinoma. This disease can be found in the Czech Republic only rarely. The authors present the case of viral hepatitis D imported to the Czech Republic from Moldavia in 28-year old man. According to the examinations of the markers of HBV and HDV, the most probably it is a HDV superinfection in patient after acute HBV with HBsAg carriers.