AIMS: Antiviral drugs are considered as potentially cardiotoxic, due to prolongation of QT interval which may affect incidence of severe ventricular arrhythmias. The main aim of this retrospective study was to assess the influence of treatment by three antiviral drugs on QT interval and to find patients who are at an increased risk of developing malignant ventricular arrhythmias. METHODS: The study included 23 patients (14 men, 9 women) who were treated with a combination of interferon alpha, ribavirin, and an NS3/4A protease inhibitor. The parameters from the 12 leads electrocardiograms were evaluated before treatment, and then 3 ± 1 and 6 ± 1 months after treatment. RESULTS: Heart rate (HR) 69 ± 12 / min and corrected QT interval (QTc) 412 ± 35 ms were obtained before the treatment and there was not observed a significant prolongation of intervals after 3 months (HR 72 ± 11 / min, QTc 412 ± 33 ms) and after 6 months (HR 64 ± 12 / min, QTc 405 ± 28 ms) respectively. In total QTc interval was prolonged from the baseline in 53% and in 43% of the patients 3 months respectively 6 months after treatment. A QTc prolongation over of 450 ms and new treatment-related repolarization change was noted in 1 (4%) patient. CONCLUSION: The study demonstrates that a combination therapy of 3 antiviral drugs does not significantly prolong the QTc interval and does not cause severe pathological changes on the ECG. Patients undergoing this treatment are not at risk of developing heart disease as an undesirable side effect.
- MeSH
- antivirové látky škodlivé účinky MeSH
- chronická hepatitida C * farmakoterapie MeSH
- elektrokardiografie MeSH
- hepatitida C * farmakoterapie MeSH
- lidé MeSH
- retrospektivní studie MeSH
- srdeční arytmie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
AIMS: Antiviral drugs are considered as potentially cardiotoxic, due to prolongation of QT interval which may affect incidence of severe ventricular arrhythmias. The main aim of this retrospective study was to assess the influence of treatment by three antiviral drugs on QT interval and to find patients who are at an increased risk of developing malignant ventricular arrhythmias. METHODS: The study included 23 patients (14 men, 9 women) who were treated with a combination of interferon alpha, ribavirin, and an NS3/4A protease inhibitor. The parameters from the 12 leads electrocardiograms were evaluated before treatment, and then 3 ± 1 and 6 ± 1 months after treatment. RESULTS: Heart rate (HR) 69 ± 12 / min and corrected QT interval (QTc) 412 ± 35 ms were obtained before the treatment and there was not observed a significant prolongation of intervals after 3 months (HR 72 ± 11 / min, QTc 412 ± 33 ms) and after 6 months (HR 64 ± 12 / min, QTc 405 ± 28 ms) respectively. In total QTc interval was prolonged from the baseline in 53% and in 43% of the patients 3 months respectively 6 months after treatment. A QTc prolongation over of 450 ms and new treatment-related repolarization change was noted in 1 (4%) patient. CONCLUSION: The study demonstrates that a combination therapy of 3 antiviral drugs does not significantly prolong the QTc interval and does not cause severe pathological changes on the ECG. Patients undergoing this treatment are not at risk of developing heart disease as an undesirable side effect.
- MeSH
- antivirové látky škodlivé účinky MeSH
- chronická hepatitida C * farmakoterapie MeSH
- elektrokardiografie MeSH
- hepatitida C * farmakoterapie MeSH
- lidé MeSH
- retrospektivní studie MeSH
- srdeční arytmie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Nákaza virem SARS-CoV-2 probíhá ve většině případů asymptomaticky nebo jen s mírnými respiračními příznaky. U pacientů s rizikovými faktory, mezi které patří zejména vysoký věk, obezita, kardiovaskulární choroby a imunosuprese, může dojít v důsledku rozvoje cytokinové bouře k závažnému průběhu onemocnění. COVID-19 je spojován se zvýšeným rizikem krvácivých a tromboembolických komplikací. Mezi nejčastější místa krvácení patří gastrointestinální trakt a CNS. Jednou z příčin ruptury cévní stěny a následného krvácení při COVID-19 může být dysfunkce poškozeného endotelu. Virové infekce jsou jedny z nejsilnějších spouštěčů autoimunitních onemocnění. Jednou z možných příčin hemoragické CMP je virem indukovaná akutní vaskulitida.
Most cases of SARS-CoV-2 infection are asymptomatic or have only mild respiratory symptoms. Patients with risk factors, including but not limited to advanced age, obesity, cardiovascular disease and immunosuppression, may develop a severe course of disease due to the development of a cytokine storm. COVID-19 is associated with an increased risk of bleeding and thromboembolic complications, with the gastrointestinal tract and CNS being among the most frequent sites of bleeding. One of the causes of vessel wall rupture and subsequent bleeding in COVID-19 may be dysfunction of the damaged endothelium. Viral infections are one of the most potent triggers of autoimmune diseases. One of the possible causes of haemorrhagic CMP is virus-induced acute vasculitis.
- MeSH
- autoimunitní nemoci etiologie MeSH
- cerebrální krvácení etiologie MeSH
- cévní mozková příhoda * diagnóza etiologie terapie MeSH
- COVID-19 * komplikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- SARS-CoV-2 MeSH
- vaskulitida etiologie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
- MeSH
- antifungální látky farmakologie terapeutické užití MeSH
- dospělí MeSH
- flukonazol farmakologie terapeutické užití MeSH
- kryptokoková meningitida * diagnóza farmakoterapie komplikace MeSH
- lidé MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- kazuistiky MeSH
BACKGROUND: The diagnosis of SARS-CoV-2 is almost exclusively performed by PCR or antigen detection. The detection of specific antibodies has not yet been considered in official diagnostic guidelines as major laboratory evidence for a case definition. The aim the present study is to analyze antibody responses in outpatient and inpatient cohorts of COVID-19 patients in the Czech Republic over a 12-month period, and assess the potential of antibodies as a diagnostic tool. METHODS: A total of 644 patients was enrolled in the prospective study. IgA, IgM and IgG antibody levels, as well as virus neutralization titers, were analyzed over a 12-month period. RESULTS: Our study showed low antibody positivity levels at the admission. However, at 2 weeks after infection, 98.75% and 95.00% of hospitalized patients were IgA and IgG positive, respectively. Even in the outpatient cohort characterized by milder disease courses, the IgG antibody response was still sustained at 9 and 12 months. The data show a high correlation between the IgG levels and virus neutralization titers (VNTs). Samples from later time-points showed positive antibody responses after vaccination in both cohorts characterized by high IgG levels and VNT over 1:640. The samples from unvaccinated persons indicated a relatively high level of reinfection at 6.87%. CONCLUSIONS: Our results show that the detection of antibodies against the SARS-CoV-2 shows an increasing sensitivity from week 2 after infection and remains highly positive over the 12-month period. The levels of IgG antibodies correlate significantly with the VNTs. This suggests that the serological data may be a valuable tool in the diagnosis of SARS-CoV-2 infection.
- MeSH
- COVID-19 * diagnóza epidemiologie MeSH
- lidé MeSH
- prospektivní studie MeSH
- protilátky virové MeSH
- SARS-CoV-2 MeSH
- tvorba protilátek * MeSH
- vakcinace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Pandemie COVID-19 zasáhla v roce 2020 celý svět. Na konci dubna 2021 podle Světové zdravotnické organizace (WHO) prodělalo na celém světě COVID-19 140 332 386 lidí, z toho je evidováno 3 004 088 úmrtí. Je proto předmětem intenzivních výzkumů nejen v oblasti medicíny, ale vzhledem k významnému ovlivnění života protiepidemickými opatřeními se na toto téma diskutuje i z pohledu vzdělávání, ekonomiky a mezi širokou laickou veřejností. Původcem onemocnění je koronavirus SARS-CoV-2, který je zařazen do čeledi Coronaviridae a patří k dalším šesti dosud objeveným koronavirům, které způsobují také respirační onemocnění lidí. Asociace mezi virovými onemocněními a autoimunitními chorobami je dobře známá, přestože přesné mechanismy zatím zůstávají nejasné. V literatuře se začínají objevovat práce, které dokumentují vznik autoimunitního onemocnění i v důsledku nákazy SARS-CoV-2. Mimo neurologických a revmatologických komplikací jsou hlášeny i případy nově diagnostikovaného diabetes mellitus 1. typu. Ve Fakultní nemocnici v Hradci Králové jsme v letech 2020 a 2021 zaznamenali celkem 4 mladé pacienty, u nichž byl nově zjištěn diabetes. Podíl COVID-19 na vzniku diabetu je vzhledem ke klinické souslednosti možný.
The COVID-19 pandemic in 2020 affected the whole world. According to the World Health Organization (WHO), more than 140 million people worldwide have been infected and over 3 million people have died. COVID-19 has affected medicine, education, economics and social life. COVID-19 is caused by the SARS-CoV-2 coronavirus. It belongs to the family Coronaviridae. Six other coronaviruses are known to cause respiratory disease in man. The association between viral diseases and autoimmune diseases is well known, although the exact mechanisms remain unclear. Even the SARS-CoV-2 coronavirus can cause various autoimmune disorders, including type 1 diabetes mellitus. At the University Hospital in Hradec Kralove, we diagnosed new-onset diabetes mellitus in four young patients.
- MeSH
- autoimunitní nemoci epidemiologie virologie MeSH
- COVID-19 imunologie komplikace MeSH
- diabetes mellitus 1. typu * epidemiologie imunologie MeSH
- dítě MeSH
- lidé MeSH
- mladý dospělý MeSH
- SARS-CoV-2 imunologie růst a vývoj účinky léků MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
We stratified post-COVID patients into four newly established clinical groups based on the presence or absence of at least one subjective respiratory symptom and at least one objective sign of pulmonary involvement. Nearly half of outpatients and one third of hospitalized post-COVID patients had objective signs of pulmonary involvement without accompanying subjective respiratory symptoms three months after diagnosis.
- MeSH
- COVID-19 * komplikace epidemiologie patologie MeSH
- hospitalizace MeSH
- lidé MeSH
- plíce patofyziologie MeSH
- prospektivní studie MeSH
- SARS-CoV-2 MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Background: Chronic hepatitis C (CHC) is associated with altered cell-mediated immune response. Objective: The aim of the study was to characterize functional alterations in CD4+ T cell subsets and myeloid-derived suppressor cells (MDSCs) during chronic hepatitis C virus (HCV) infection. Methodology. The expression levels of the lineage-defining transcriptional factors (TFs) T-bet, Gata3, Rorγt, and Foxp3 in circulating CD4+ T cells and percentages of MDSCs in peripheral blood were evaluated in 33 patients with CHC, 31 persons, who had spontaneously cleared the HCV infection, and 30 healthy subjects. Analysis. The CD4+ T cells TFs T-bet (T-box expressed in T cells), Foxp3 (Forkhead box P3 transcription factor), Gata3 (Gata-binding protein 3), and Rorγt (retinoic-acid-related orphan receptor gamma) and activation of CD8+ T cells, as well as percentages of MDSCs, were measured by multicolor flow cytometry after intracellular and surface staining of peripheral blood mononuclear cells with fluorescent monoclonal antibodies. Result: The patients with CHC had significantly lower percentages of CD4+ T cells expressing Rorγt and Gata3 and higher percentages of Foxp3-expressing CD4+ T cells than healthy controls and persons who spontaneously cleared HCV infection. The ratios of T-bet+/Gata3+ and Foxp3+/Rorγt+ CD4+ T cells were the highest in the patients with CHC. In the patients with CHC, the percentages of Gata3+ and Rorγt+ CD4+ T cells and the percentages of T-bet+ CD4+ T cells and CD38+/HLA-DR+ CD8+ T cells demonstrated significant positive correlations. In addition, the percentage of CD38+/HLA-DR+ CD8+ T cells correlated negatively with the percentage of MDSCs. Conclusion: Chronic HCV infection is associated with downregulation of TFs Gata3 and Rorγt polarizing CD4+ T cells into Th2 and Th17 phenotypes together with upregulation of Foxp3 responsible for induction of regulatory T cells suppressing immune response.
- Publikační typ
- časopisecké články MeSH
