[The survival prediction of hospitalized patients with COVID-19: the role of chitotriosidase level in peripheral blood]

AIM

To assess the relationship between plasma chitotiosidase (CHIT) level and mortality in hospitalized patients with COVID-19.

MATERIALS AND METHODS

347 hospitalized patients with COVID-19 were enrolled in our single-center cohort prospective observational study. On the first day of hospitalization the patients were assessed by the level of CHIT in the venosus blood to addition to default laboratory examinations. The primary endpoint was all-cause death. The survival after hospital discharge were assessed via phone calls on 90 and 180 days since inclusion to the study (NCT04752085).

RESULTS

Our study included 347 patients. The first symptoms appeared in 7 days [5; 7] before hospitalization; 283 (84.3%) patients had less than 50% of the involvement of the lung tissue to the inflammation process (CT 0-2); 36 (10.4%) patients had died since the start of our investigation; 30 (83.3%) of them died during hospitalization, others -no later than 60 days; 68 (19%) people didn't answer during phone call. The survivor's activity of the enzyme in the deceased was significantly lower in compare to deceased patients (90.5 [40.2; 178.0] nmol/h/mL vs 180.0 [77.2; 393.2] nmol/h/mL; p=0.001). Survivor of the patients with a higher level of the activity of the CHIT (more than 171 nmol/h/mL) was statically significantly lower.

CONCLUSION

Rising of the CHIT's activity more than 171 nmol/h/mL might be an early independent predictor of the bad prognosis of the patients, who were hospitalized with COVID-19 infection.

[An objective relation approach in the modeling of dispensary registration of patients with tuberculosis]

The designing of an integrated information system of a tuberculosis dispensary (TD) has resulted in the construction and introduction of a model that is based on the concept of a uniform patient card, combines information on dispensary registration (DR) and striking off, as well as on the shifting of the TD-attached contingents between different DR groups. The system also contains a logic group that includes formalized descriptions of a tuberculous process. In addition, this model serves to integrate geoinformation technologies, as other information technologies (such as digital image acquisition, postprocessing, storage, and transmission) into its based information systems. This integrated information system permits a real-time quantitative analysis of the basic indices of the tuberculosis epidemic situation, which is necessary while planning tuberculosis-controlling measures, controlling their implementation, and correcting them at all levels.

[Circadian rhythm of arterial pressure and state of target-organs in patients with mild and moderate hypertension]

AIM

To assess the state of target-organs in males with mild and moderate forms of essential hypertension (EH) in normal and disturbed 24-h rhythm of arterial pressure (AP).

MATERIAL AND METHODS

Target-organs were examined in 70 males aged 30-62 years (mean age 49 +/- 1 years) with mild (n = 54) or moderate (n = 16) EH. The following tests were performed: ophthalmoscopy, echo-CG with estimation of the left-ventricular myocardial mass index (LVMMI), duplex scanning of the carotid arteries (DS), AP monitoring, measurements of plasma creatinine, relative density of the urine, glomerular filtration rate, examination of the neurological status. Circadian rhythm of AP was evaluated by a night fall (NF) of systolic pressure (SP). Patients with inadequate NF of SP (< 10%) entered group 1, those with normal NF of SP (10% < NF SP < 20%) were allocated to group 2.

RESULTS

Patients of group 1 had a significantly higher LVMMI, more frequent occurrence of left ventricular hypertrophy and carotid artery affection (local thickening "intima-media"). In group 1 there was also a complex of unfavourable changes in AP circadian profile, especially at night.

CONCLUSION

Mild/moderate EH with insufficient NF of SP is associated with more pronounced and frequent changes in the target-organs (left-ventricular hypertrophy, "intima-media" thickeing). Insufficient NF of AP initiates higher pressor load on the target-organs, on the one side, and reflects defective regulation which affects target-organs, on the other. Both these factors contribute to damage of the target-organs.