Aim. To identify the predictors of atrial fibrillation (AF) recurrence after simultaneous Maze V procedure in combination with coronary artery bypass grafting.Methods. Medical records of 102 patients with coronary artery disease and concomitant AF were retrospectively reviewed. All patients underwent coronary artery bypass grafting and the combined Maze V procedure. The patients were divided into 2 groups: 51 patients with paroxysmal AF (group I), and 51 patients with non-paroxysmal AF (group II). In group I, 6 cases of AF recurrence were detected (subgroup IA), while 45 patients (subgroup IB) maintained sinus rhythm for the entire follow-up period. Accordingly, in group II, the return of AF was noted in 9 patients (subgroup IIA), sinus rhythm - in 42 patients (subgroup IIB). The follow-up period was 36 months. Clinical and echocardiographic parameters were studied as predictors of AF recurrence.Results. A significant predictor in patients with paroxysmal AF was a recurrence of AF at the hospital stage (odd ratio (OR) 10,25; 95% confidence interval (CI) 1,53-68,20; р=0.032). The duration of the AF history was the main predictor in patients with non-paroxysmal AF (OR 8,8; 95% CI 1,01-76,1; р=0.04). ROC analysis revealed a significant effect on the AF recurrence of left atrium (LA) dimension >48.5 mm, LA volume index >44.4 ml/m2 for patients with paroxysmal AF, and left ventriclular end-diastolic volume > 150 ml for patients with non-paroxysmal AFConclusion. A recurrence of AF at the hospital stage, LA dimension, LA volume index were significant predictors of AF recurrence after coronary artery bypass grafting + Maze V procedure in patients with paroxysmal AF. А long AF history and left ventriclular end-diastolic volume played the role of predictors for patients with non-paroxysmal AF.

Cardiovascular diseases (CVDs) are one of the most common causes of death in the developed as well as in the developing world. Despite improvements in primary prevention, the prevalence of CVD has continued to rise in recent years. Thus, the issues of molecular pathophysiology of CVD and search for new biomarkers related to early and reliable prevention and diagnosis of these diseases still hold relevance today. New genomic techniques provide innovative tools to solve this problem. A research of the current scientific literature clearly indicates that among transcriptomic biomarkers, micro-ribonucleic acids (miRNAs) are the most promising. The microRNAs (miRNAs) are small (~22 nucleotides) non-coding RNAs which regulate gene expression at the post-transcriptional level via inhibition of the translation of messenger RNA (mRNA) or by inducing the degradation of specific miRNAs. The lack of consensus regarding methodologies used for miRNA quantification is one of the main limiting factors in the application of these transcripts. Various studies have proposed the use of circulating miRNAs as biological markers of the acute coronary syndrome, coronary artery disease, heart failure, arrhythmias, myocardial infarction, etc. MiRNAs are involved in many cellular processes such as proliferation, vasculogenesis, apoptosis, cell growth and differentiation, and tumorigenesis.This review considers the most fully studied and clinically significant miRNAs, which physiological role makes them potential biomarkers for various CVDs.

Background: As the severity of comorbid diseases increases, risks of cardiopulmonary bypass (CPB) complications significantly increase. A complex of the procedure’s damaging factors provokes a systemic inflammatory response that in some cases is accompanied by the damage to target organs, transitioning from chronic organ dysfunctions into acute ones. Some studies on the use of minimal invasive extracorporeal circulation (MiECC) systems show their advantage over conventional extracorporeal circulation (CECC); however, the diversity of MiECC systems, patients, and outcomes precludes us from confidently extrapolating these data to older comorbid patients.Objective: To compare the severity of systemic inflammation and treatment outcomes in comorbid patients who underwent cardiac surgery with CECC and MiECC.Methods: We conducted a retrospective cohort study of 760 patients who consecutively underwent elective cardiac operations in 2019-2022. Inclusion criteria: comorbid status (age-adjusted Charlson Comorbidity Index score of ≥6); CPB time ≥90 min. Exclusion criteria: emergency surgery, refusal to participate in the study. A total of 68 patients met the inclusion criteria. We formed 2 study groups based on the extracorporeal circulation method: CECC group (n = 51) and MiECC group (n = 17). Control points: before CPB and 24 hours after the surgery (lactate; creatinine; oxygenation index, hemolysis level). For systemic inflammatory response markers: 1 hour after the CPB start and 24 hours after the CPB end (interleukin 6; interleukin 10; procalcitonin; C-reactive protein; soluble Triggering Receptor Expressed on Myeloid Cells-1 [sTREM-1]). We evaluated respiratory and renal complications, drainage-related hemorrhages, hemostatic disorders, the need for sympathomimetic drugs, and the length of stay in an intensive care unit and inpatient hospital.Results: Between the groups there were no statistically significant differences in gender and anthropometric characteristics, surgery types, and main perfusion parameters. In the CECC group, we observed significantly higher doses of vasoconstrictors (norepinephrine) as well as a decrease in urine output and lung injury and an increase in lactate and hemolysis. The systemic inflammatory response markers were also significantly higher.Conclusion: Compared with CECC, MiECC does not significantly affect the frequency of organ dysfunctions; however, it reduces the severity of the systemic inflammatory response and immune suppression that are trigger mechanisms for multiple organ dysfunction syndrome. It is particularly important for patients with chronic organ dysfunctions. A range of indications for MiECC systems should be defined given its high cost and off-target effect on pleiotropic factors of systemic inflammatory response development. Received 6 April 2023. Revised 17 August 2023. Accepted 18 August 2023. Funding: The study was conducted within the framework of the research project "Development of minimally invasive and hybrid technologies for surgical treatment of heart diseases". Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: A.Sh. Revishvili, G.P. Plotnikov, V.A. PopovData collection and analysis: R.A. Kornelyuk, L.B. Berikashvili, I.P. Komkov, E.S. Malyshenko, V.M. ZemskovStatistical analysis: L.B. BerikashviliDrafting the article: R.A. Kornelyuk, G.P. Plotnikov, L.B. Berikashvili Critical revision of the article: G.P. PlotnikovFinal approval of the version to be published: A.Sh. Revishvili, R.A. Kornelyuk, G.P. Plotnikov, L.B. Berikashvili, I.P. Komkov, E.S. Malyshenko, V.M. Zemskov, V.A. Popov

The review addresses debatable issues of myocardial revascularization in chronic forms of ischemic heart disease, shows major differences between percutaneous coronary intervention and coronary artery bypass grafting in terms of long-term prognosis, and the dependence of the results on the clinical profile of the disease. The review of current publications demonstrates advantages of open surgery in long-term survival and prevention of adverse outcomes in target groups of patients.

A classification of monocyte subpopulations developed in 2010 with coverage of the immunobiological properties of cells, their functional activity and participation in various pathological processes (inflammatory, cardiovascular diseases, strokes, myocardial infarctions, aortic aneurysms, surgical modification of heart valves, diabetes, burns, etc.). The diagnostic and prognostic aspects of the analysis of monocytic subpopulations are considered. The unique data obtained by the staff of the Gamaleya Institute of epidemiology and microbiology. They consist in the fact that various physical forms of unmodified native type 1 collagen are powder, i.e. crushed bundles of collagen fibers, a hydrogel or a solution of extracellular matrix peptides, as well as a suspension of collagen fibers obtained from a powder, when applied to the surface of acute and chronic and diabetic wounds, bedsores, trophic ulcers, etc., can provide a pronounced anti-inflammatory, reparative, remodulating and regenerative effect on condition of wounds, providing their accelerated healing due to the local accumulation of “regenerative” subpopulations of Mon3 monocytes, which can be most directly used in burn tissue lesions. In this case, the analysis of monocytic subpopulations is of paramount importance. Moreover, possible potentiating effects of additional use in burns under the control of the analysis of monocyte subpopulations of powerful modern pluripotent immunomodulators – polyoxidonium, galavit and their possible combination with local use of collagen preparations are discussed. Finally, we obtained preliminary data indicating the development in burned patients of a deficiency in the absolute and relative content of the most important “patrolling” non-classical subpopulation of CD14+CD16++ monocytes compared with healthy primary (non-professional) donors, which can be a very important finding in the diagnosis and prognosis and substantiation of new methods of treatment of burns.

A general nonspecific adaptive reaction, stress developing during the sequential implementation of the stages “anxiety,” “resistance,” and “resolution,” is considered in a limited cohort of patients who died and survived after cardiac surgery with cardiopulmonary bypass. Immune markers of the stress reaction and its ambiguous changes in patients died and discharged from the clinic with improved health are considered. Interesting innovations for changing the condition of patients are found; they can be used for assessing and predicting the outcome of cardiac surgery, as well as for substantiating immunomodulatory therapy in alternative clinical and immunological changes in the state of health.

In patients undergoing cardiosurgical operations under conditions of extracorporeal circulation, continued high-volume controlled hemodiafiltration was used, the content of subpopulations of M1, M2, M3, CD4+ monocytes, and total monocytes was studied in the circulation before surgery and on days 3 and 10 after it. Previously unknown data have been discovered that can be used in the diagnosis and prognosis of cardiac surgery.

Highlights. Maze V significantly reduces the recurrence of AF compared to bipolar RFA for PVI in the short and mid-term period. Aim. To assess the effectiveness and safety of pulmonary vein isolation (PVI) in comparison with Maze V for treating paroxysmal atrial fibrillation (AF) concomitant to coronary artery bypass grafting (CABG). Methods. Medical records of 139 patients with coronary artery disease and concomitant paroxysmal AF were retrospectively analyzed. All patients were divided into two groups: Group 1 patients (n = 71) underwent CABG + bipolar radiofrequency ablation for PVI, and Group 2 patients (n = 68) underwent Maze V + CABG. Propensity score-matched (PSM) analysis with a 1:1 nearest-neighbor matching was done. 30 patients were selected from each group. The exclusion criteria were as follows: emergent CABG, concomitant valvular heart disease, non-paroxysmal AF, decompensation of chronic diseases, and cancer. On-pump CABG was performed at normothermia with warm blood hyperkalemia cardioplegia. RFA for PVI and Maze V were performed before CABG under parallel perfusion without aortic cross-clamping. The primary and secondary endpoints included recurrent AF/atrial flutter, sinus rhythm at discharge and in the long-term period, permanent pacemaker implantation, major cardiovascular and cerebrovascular events. Results. After the PSM analysis, the CABG+Maze V group and CABG+RFA for PVI differed significantly in the duration of surgery (330 [310; 375] vs. 255 [225; 270] min, p = 0.0001), cardiopulmonary bypass time (131 [113; 144] min vs. 89 [74; 98] min, p = 0.0001), duration of AF treatment (53 [44; 59] min vs. 10 [9; 12] min, p = 0.0001). The structure and rate of complications in both groups were comparable. There were no in-patient deaths. Recurrent AF/atrial flutter significantly reduced in the CABG+Maze V group compared to the CABG+RFA for PVI group (13.3% vs. 33.3%, respectively; p = 0.044). Sinus rhythm was restored in all cases. The rate of transient sinus node dysfunction (no more than 5 days) was 6.7% in the Group 1 and 16.6% in the Group 2. The difference did not reach statistical significance (p = 0.128). The 12-months cumulative freedom from AF/atrial flutter without antiarrhythmic drug therapy was significantly higher in the CABG+Maze V group compared to the CABG+RFA for PVI group (97% vs. 83.5%, respectively; p = 0.020). The freedom from MACE in both groups was 96.7%. Conclusion. Maze V for treating concomitant paroxysmal AF prolonged the duration of cardiopulmonary bypass and the surgery itself, but did not affect the postoperative period, indicating its safety and effectiveness. Maze V procedure concomitant to CABG significantly reduced the recurrence of AF compared to RFA for PVI both in the short- and mid-term period. Thus, it is reasonable to perform Maze V+CABG in patients with paroxysmal AF and a high risk of disease progression.

The aim of this work is to analyze the effectiveness of thoracoscopic ablation (TSA) of atrial fibrillation (AF) and to define the risk factors for the return of atrial tachyarrhythmias after TSA in the long-term follow-up period. Methods. From January 2019 to December 2021, 150 patients with symptomatic atrial fibrillation (persistent 29.3% monitoring at the control points of the study, the results of which evaluated the effectiveness of the procedure. Results. The overall efficiency of TSA in the long-term follow-up period was 72.5%. After off-antiarrhythmic drugs, freedom from any atrial tachyarrhythmias was 79.2%, 70.5% and 68.9% after 6, 12 and 24 months, respectively. Additional catheter ablations after 3 months increase the effectiveness of the procedure to 82.9%. Important risk factors for the return of arrhythmia after TSA should be considered the patient’s age, duration of AF, previous catheter ablations and the left atria diameter of more 40 mm. Conclusion. The hybrid approach significantly improves the effectiveness of TSA for patients with non-paroxysmal forms of AF. The results obtained require further study of this problem in order to improve the quality of TSA and determine the optimal set of ablation lines, considering the risk factors for the return of arrhythmia.

Цель – оценить эффективность симультанного хирургического лечения фибрилляции предсердий (ФП) при коррекции митрально-аортальных пороков сердца.

Цель. Изучить эффективность и безопасность сочетанной биполярной радиочастотной аблации (РЧА) при хирургическом лечении осложненных форм ишемической болезни сердца (ИБС) в сочетании с фибрилляцией предсердий (ФП).

Adhesion in the anterior mediastinum following previous heart surgeries is a predictor of fatal trauma of the heart chambers, large vessels and lungs during redo cardiac procedures. The approaches used to prevent such complications have evolved over the past decades, but the need for their improvement remains. Annual increase in heart surgeries, coupled with the phenomenon of “aging population” in economically developed countries, predetermines the growth of redo cardiac surgical procedures. An important role in this process is also played by the recent more active use of various biological implants (for example, bioprosthetic heart valves), which makes the search for new technologies for safe redo sternotomy even more urgent.The publication presents a case of redo surgery in a patient with primary degeneration of the homograft in the aortic root position implanted 13 years ago for aortic stenosis using the Full Root technique. The original technique applied (Method for endoscopic prevention of traumatisation of cardiac, lung and major vessels of anterior mediastenum accompanying repeated cardiosurgical operations. Patent No. RU 2726605 C1) provides for a combination of minimally invasive and classic surgical approaches. Total adhesiolysis of the anterior mediastinum was performed thoracoscopically: the posterior surface of the sternum and the cartilaginous part of the ribs were completely freed from adhesions with the right ventricle, the aorta, lungs and innominate vein. The redo sternotomy was made using a standard electric saw under direct visual control and protection of the right ventricle and the ascending aorta with endoscopic retractors. The risk of surgical trauma of the anterior mediastinum organs was fully eliminated and the intraoperative blood loss was comparable to a traditional sternotomy approach. Received 27 January 2022. Revised 23 April 2022. Accepted 20 May 2022. Informed consent: The patient’s informed consent to use the records for medical purposes is obtained. Funding: The study did not have sponsorship. Conflict of interest: Authors declare no conflict of interest. Contribution of the authorsLiterature review: S.A. Petko, V.A. Popov, E.S. MalyshenkoDrafting the article: E.S. Malyshenko, S.A. PetkoCritical revision of the article: E.S. Malyshenko, V.A. Popov, A.Sh. RevishviliSurgical treatment: E.S. Malyshenko, M.G. Gasangusenov, V.A. PopovFinal approval of the version to be published: E.S. Malyshenko, S.A. Petko, V.A. Popov, M.G. Gasangusenov, A.Sh. Revishvili

Спаечный процесс в переднем средостении после ранее перенесенных оперативных вмешательств на сердце является предиктором фатальной травматизации камер сердца, крупных магистральных сосудов и легких при повторных кардиохирургических операциях. Используемые для профилактики подобных осложнений подходы за прошедшие десятилетия эволюционировали, но необходимость их улучшения сохраняется. Ежегодное увеличение количества операций на сердце, старение населения экономически развитых стран и активное использование имплантов биологического происхождения (например, биопротезов клапанов сердца) предопределяют рост количества повторных кардиохирургических вмешательств и актуализируют поиск новых технологий безопасной рестернотомии. Представлен случай репротезирования у пациента с первичной дегенерацией гомографта в позиции корня аорты, имплантированного 13 лет назад по поводу аортального стеноза по методике full root. Применяемая оригинальная методика (патент РФ RU 2726605 C1: «Способ эндоскопической профилактики травматизации сердца, легких и крупных сосудов переднего средостения при повторных кардиохирургических операциях») предусматривает сочетание минимально инвазивных и классических хирургических подходов. Торакоскопически выполнили тотальный адгезиолиз переднего средостения: заднюю поверхность грудины и хрящевую часть ребер полностью освободили от сращений с правым желудочком, аортой, легкими и безымянной веной. Рестернотомию выполнили стандартным электрическим стернотомом под прямым визуальным контро­лем с защитой правого желудочка при помощи эндоскопических ретракторов. При этом удалось полностью исключить риск хирургической травмы органов переднего средостения и сделать объем интраоперационной кровопотери сопоставимым со стандартной (первичной) стернотомией. Поступила в редакцию 27 января 2022 г. Исправлена 23 апреля 2022 г. Принята к печати 20 мая 2022 г. Информированное согласие Получено информированное согласие пациента на публикацию и использование его медицинских данных в научных целях. Финансирование Исследование не имело спонсорской поддержки. Конфликт интересов Авторы заявляют об отсутствии конфликта интересов. Вклад авторов Обзор литературы: С.А. Петко, В.А. Попов, Е.С. Малышенко Написание статьи: Е.С. Малышенко, С.А. Петко Исправление статьи: Е.С. Малышенко, В.А. Попов, А.Ш. Ревишвили Выполнение операций: Е.С. Малышенко, М.Г. Гасангусенов, В.А. Попов Утверждение окончательного варианта статьи: все авторы

Review purpose: to study the occurrence predictors of postoperative atrial fibrillation (PAF), effective predicting and treating methods according to global literature.Currently, PAF is considered one of the most frequent events among all cardiovascular complications as it develops in 30–65% of cases in patients after heart surgery. In recent decades, the PAF incidence has steadily increased despite advances in surgery and anesthesiology. PAF is a significant complication that affects the course of the postoperative period and requires special attention, since it leads to a longer hospital stay, increased treatment costs and can also lead to lethal outcomes in patients in this category. Considering PAF consequences, many studies have been performed to identify factors associated with the atrial fibrillation pathophysiology, to develop preventive measures aimed at treating high risk patients and minimize the side effects of antiarrhythmic drugs. The review and analysis of the global literature on the PAF causes, prevention and treatment are presented.

Aim. To evaluate the in-hospital results of the epicardial bipolar radiofrequency ablation of the pulmonary vein in the prevention of new-onset postoperative atrial fibrillation (POAF) in coronary artery disease (CAD) patients undergoing coronary artery bypass graft (CABG) surgery in a pilot randomised multi-centre controlled Pulmonary Vein Ablation (PULVAB).Methods. The pilot study was conducted for the organisation of a multi-centre randomised PULVAB trial. We enrolled 63 CAD patients without a history of AF. The inclusion criterion was CAD demanding CABG; the exclusion criteria were as follows: AF history, antiarrhythmic therapy in anamnesis, significant heart valve disease, severe renal failure and decompensating diabetes mellitus. The patients were randomised into 2 groups. Group I comprised 34 patients who underwent CABG alone, and Group II had 29 patients who underwent CABG combined with radiofrequency ablation (RFA) as the initial tool for POAF prevention. All the procedures were performed by a single surgical team using standardised anaesthetic and perfusion support.Results. There was no in-hospital mortality in either group. There were differences in the duration of the intervention, cardiopulmonary bypass time and the aorta clamping time between groups (p > 0.05). A higher incidence of POAF was observed (11 %–32.4 %) in the isolated CABG group than in the CABG combined with PULVAB group (6 %–20.7 %), although the difference was not significant (p = 0.29). In most cases (91 %), AF occurred on the second to third postoperative day, irrespective of the observation group.Conclusion. The combination of CABG and RFA does not complicate the operation and does not increase the duration of the surgery or time of cardiopulmonary bypass. There were no significant differences in the postoperative course or the incidence and structure of complications between the groups. This may indicate the safety of our method. The positive tendency of POAF-cases decrease after preventive epicardial RFA observed in the present study allows us to continue the PULVAB study to gain more statistically significant results.Clin.Trials.gov Identifier: NCT03857711 Received 20 February 2020. Revised 29 June 2020. Accepted 2 July 2020. Funding: The study did not have sponsorship. Conflict of interest: Authors declare no conflict of interest. Author contributionsConception and design: A.Sh. Revishvili, V.A. PopovData collection and analysis: M.M. Anishchenko, E.S. Malyshenko, N.V. PopovaStatistical analysis: M.M. AnishchenkoDrafting the article: G.P. Plotnikov, M.M. AnishchenkoCritical revision of the article: A.Sh. Revishvili, V.A. PopovFinal approval of the version to be published: A.Sh. Revishvili, V.A. Popov, E.S. Malyshenko, G.P. Plotnikov, M.M. Anishchenko, N.V. Popova

Objective. To evaluate the effectiveness of epicardial bipolar radiofrequency ablation (RFA) of pulmonary vein ostia (PV) in comparison with its being combined with amiodarone administration for post-CABG atrial fibrillation (AF) prevention.Methods. A single-centre, prospective randomized study (PULVAB), including 96 CAD patients with no history of AF, was conducted between January 2015 and December 2018. Group 1 (control; n=34) had standard CABG alone. Group 2 (n=29) received RFA of PV as an adjunct to CABG for prevention of postoperative AF (POAF). Group 3 patients (n=33) had RFA at the time of CABG and were given amiodarone. Allocation was concealed using sequentiallynumbered opaque envelopes. The efficacy and safety of RFA concomitant with CABG were assessed, as both performed independently and combined with amiodarone administration, as well as intra-and postoperative course.Results. No differences were seen in operation length (p=0.937), cardiopulmonary bypass (CPB) or the aorta clamping times (р=0.377 and p=0.072, respectively). The study groups (CABG, CABG-RFA, CABG-RFA-amiodarone) did not differ statistically in the number of shunts placed - 3.17±0.61, 3.10±0.51 and 2.94±0,6 (p=0,121). No significant difference was noted in RFA duration between Groups 2 and 3 - 11.7±3.7 and 11.4±6.3 min, respectively (p=0,834).AF was found to occur most commonly at postoperative days two or four. The isolated CABG surgery group patients developed POAF most often of all (32,4%). The incidence of POAF was lower after RFA concomitant to CABG - 20.7% (р=0,29). A significant difference was identified in POAF incidence between Groups 1 and 3- 32.4% and 6.1%, respectively (p = 0.0065). Differences between Groups 2 and 3 proved not to be statistically significant (р= 0,086). Sinus rhythm in most of those who had developed arrhythmias was restored by pharmacological cardioversion except for three patients (one in each group). At discharge, 97.1% , 96.7% and 97% of the subjects in Groups 1, 2 and 3, respectively, exhibited sinus rhythm (p>0,05).There was no in-hospital mortality in any of the groups. Neither were there any wound complications, reoperations, perioperative myocardial infarction or cerebral circulatory disorders observed. No difference was revealed in the severity and frequency of renal or respiratory failure. The mechanical lung ventilation time and duration of stay in the ICU in the isolated CABG group were shown to be increased as compared with the CABG-RFA and CABG-RFA-amiodarone groups (p<0.05).Conclusion. The evidence from the pilot study (PULVAB) suggests that bipolar ablation of PV does not significantly complicate CABG, while being combined with amiodarone administration for prevention of rhythm disorders it significantly reduces the incidence of POAF. The in-hospital incidence of POAF tended to decrease, which was not statistically significant, though. Evaluating the efficacy of RFA concomitant with CABG, as performed independently, invites further investigation with more data analysis.

An analysis of the immune status in 53 patients that underwent coronary artery bypass grafting under cardiopulmonary bypass was carried out in the preoperative period and on day 1 and 7 after the surgical intervention. Significant changes in innate and adaptive immunity were revealed. In the first case, they were expressed as an inflammatory process developed throughout the postoperative period; it was confirmed with an increase in leukocytes, total and stab granulocytes, monocytes, oxidative stress of phagocytes, CD64+ and CD40+ granulocytes, endogenous intoxication with the developed significant deficiency in CD4+ monocytes, and regulatory NK cells; while immediately after the surgery, it was confirmed by IgG and IgM levels.Some changes in adaptive immunity manifested through its activation, confirmed by an increased CD4+, CD11b+, HLA-DR+, and CD4+CD25+lymphocyte content, together with a deficiency noted in total lymphocytes and CD8+ lymphocytes.

Purpose. The research goal comprises primary analysis of CT examinations results and their interpretation by comparing with the data already available in the literature.Material and methods. During the period from April 17, 2020 to May 18, 2020, 830 chest CT scans were performed and results of 123 CDs with CT scans made by other institutions were interpreted. Follow-up examinations were carried out every 3–4 days or when clinical presentation changed. At the primary stage, we have analysed in a more detail way a group of 69 patients, who were diagnosed with CT-3 or CT-4 volume of lung damage at least once during hospitalization. The patients underwent PCR analysis three times during hospitalization. Among 69 patients, 34 patients had a positive PCR test at least once, the remaining 35 patients had a clinic, corresponding with this disease.Results. At the initial examination, ground-glass opacity prevailed, as it was observed in 44 cases (64%), and lung tissue consolidation was observed in 25 cases (36%) in a group of 69 patients. When comparing the two groups, the average age of the patients with consolidation changes was statistically significantly lower than one of the group where ground-glass opacity prevailed – 51.7 and 59.4 years, respectively (p = 0.01) In the group of patients with pulmonary tissue consolidation, there were fewer concomitant diseases, fatal outcomes, positive PCR test results, a shorter hospitalization period, and fewer cases of tocilizumab administration were noted. At the initial examination the average percentage of pulmonary parenchyma involvement in the group of patients with lung tissue consolidation was higher (63.3%; p = 0.04), follow-up examinations showed c statistically significantly lower average values of the increase in the percentage of involvement of the parenchyma, which acquired negative values after the third CT scan (8.3 after the 2nd CT and −5.2 after the 3rd CT versus 18.5 and 3 in the GGO glass group; p = 0.02 and 0.03, respectively). No visible differences in CT between the period from the onset of the disease and the predominant symptom in CT were revealed. Meanwhile, on the 5th day (the day of the check-up CT examination) the largest number of patients was determined in both groups.Conclusion. An analysis of our experience during the first month of operation of Covid-19 Hospital is presented. According to our data, the appearance of consolidation at the initial CT examination is probably not related to the period, when the disease has been in progress, and may be associated with a more favorable course of the process.