A significant portion of the fatal outcomes during COVID-19 have been traced mainly to cytokine storm, the uncontrolled hyperactivation of the immune system. During a SARS-CoV-2 infection, the blood plasma levels of microRNAs (miRNAs), a class of short regulatory RNAs, get significantly changed. However, it still remains unknown how the levels and characteristics of these molecules are altered in various blood cells during severe COVID-19. The aim of this research was to compare the microRNA levels in erythro cytes, monocytes, and lymphocytes in normal blood cells and those in patients with severe COVID-19-induced by cytokine storm. Erythrocytes and monocytes (five healthy donors and five patients with severe COVID-19) and lymphocytes (four healthy donors and four patients with severe COVID-19) were obtained by fluores cence-activated cell sorting. RNA was isolated from the obtained cells, and next-generation short RNA se quencing was performed. Both the known miRNAs and the novel miRNAs whose expression had changed in severe COVID-19 were analyzed and identified. In the erythrocytes, seven miRNAs had changed expres sions (five downregulated; two upregulated); all 13 miRNAs were upregulated in lymphocytes; in monocytes, 11 miRNAs were downregulated and three miRNAs were upregulated. An analysis of the novel miRNAs showed that three, previously unknown miRNAs, were downregulated in lymphocytes and one was upregu lated. In monocytes and erythrocytes, no novel, differentially expressed miRNAs were detected. Additionally, we analyzed the signaling pathways altered by miRNAs by performing a miRNA enrichment analysis (MIEAA) using the Gene Ontology miRNA target database (miRTarBase). We observed that in lymphocytes, four pathways were significantly (Q-value < 0.05) enriched and 339 were depleted; in monocytes, 118 path ways were enriched and six were depleted. No significantly altered signaling pathways were detected in erythrocytes.
Echocardiographic (EchoCG) assessment of LV DF remains a complex difficult task. The application of the algorithm proposed by current guidelines (ASE/EACVI, 2016), which involves the assessment of transmitral flow, tissue Doppler myocardial velocities, LA maximum volume index, LAVI, and tricuspid regurgitation (TR) velocity, leads to the fact that the presence and severity of LV diastolic dysfunction (DDF) remain uncertain in a significant proportion of patients. The maximum LAVI index is certainly a marker of the duration and severity of LV DDF, but it cannot serve as the only parameter for diagnosing early phases of LV DDF, before the formation of LA remodeling. Left atrial (LA) function assessment is an important part of the left ventricular (LV) diastolic dysfunction (DF) the assessment and heart failure with preserved ejection fraction. Since the main function of the LA is to modulate LV filling, it is logical that at the earliest stages of LV DDF, LA functional changes first appear. LA function testing may be useful not only for diagnosing LV DDF, but also for assessing its severity and monitoring treatment effectiveness. In this review the evolution of approaches to assessing LV DF, as well as the key role of LA parameters in assessing LV DDF are considered.
OBJECTIVE. To evaluate the effectiveness and safety of transseptal access (transseptal puncture, TSP) for left-sided catheter interventions and left atrial appendage occluder implantation, and to compare single- versus double-puncture techniques. MATERIALS AND METHODS. We retrospectively analyzed procedures performed in 2013–2023. Overall, 775 TSPs were performed: group A (n=710) – double TSP under fluoroscopy using an in-house technique; group B (n=38) – single TSP guided by transesophageal or intracardiac echocardiography; group C (n=27) – single TSP under fluoroscopy for high-density mapping-guided ablation. Statistical significance was set at p<0.05.RESULTS. TSP success rate was 100 % across groups. Single puncture reduced puncture time. Early complications (hemopericardium/tamponade, cerebrovascular events, access-site hematoma) were infrequent and did not differ between groups.CONCLUSION. TSP is an effective and safe method for left heart catheterization. Adjunct imaging (TEE/ICE) may improve safety in challenging anatomy.
The legacy of the COVID-19 pandemic may represent an even more serious global health challenge than the acute infection itself. The neurological consequences of SARS-CoV-2 infection may progress to chronic brain tissue damage, leading to clinical manifestations of neurodegenerative diseases. Post-COVID-19 neurological syndrome and neurodegenerative disorders, such as Alzheimer disease and Parkinson disease, share common pathological features, risk factors, and underlying mechanisms. Immune-mediated mechanisms constitute a key component of the post-COVID-19 neurological syndrome and may initiate a neurodegenerative cascade. Chronic inflammatory processes triggered by SARS-CoV-2 infection promote the aggregation of misfolded proteins and neuronal loss, which are hallmark features of neurodegeneration. Given the high global prevalence of COVID-19 during the pandemic, health care systems should be prepared for a potential increase in the incidence of neurodegenerative diseases in the coming years. Addressing this challenge requires interdisciplinary collaboration integrating immunology, neurology, virology, and systems biology to develop effective individualized therapeutic strategies for one of the most persistent consequences of the COVID-19 pandemic. This review examines the complex relationship between COVID-19 and neurodegenerative diseases. SARS-CoV-2, its RNA, and proteins act as potent immunomodulatory agents capable of inducing chronic neuroinflammation even after viral clearance. Advances in modern biomedical technologies have enabled the identification of proteomic, genetic, and imaging biomarkers that may serve as predictors of risk and potential therapeutic targets. Elucidation of these molecular interactions provides important insights for future research aimed at developing innovative therapeutic and rehabilitation interventions.
The clinical manifestations of the cytokine storm (CS) associated with COVID-19 resemble the acute phase of sepsis. Metabolomics may contribute to understanding the specific pathobiology of these two syndromes. The aim of this study was to compare serum metabolomic profiles in CS associated with COVID-19 vs. septic surgery patients. In a retrospective cross-sectional study, serum samples from patients with CS associated with COVID-19, with and without comorbidity, as well as serum samples from patients with surgical sepsis were investigated. Targeted metabolomic analysis was performed on all samples using LC-MS/MS. Analysis revealed that similar alterations in the serum metabolome of patients with COVID-19 and surgical septic patients were associated with amino acid metabolism, nitrogen metabolism, inflammatory status, methionine cycle and glycolysis. The most significant difference was found for serum levels of metabolites of kynurenine synthesis, tricarboxylic acid cycle, gamma-aminobutyric acid and niacinamide. The metabolic pathway of cysteine and methionine metabolism was significantly disturbed in COVID-19 and surgical septic patients. For the first time, the similarities and differences between the serum metabolomic profiles of patients with CS associated with COVID-19 and patients with surgical sepsis were investigated for patients from the Northwest of the Russian Federation.
