The first human cases of coronavirus disease (COVID-19), a disease caused by the new coronavirus, was reported on December 31, 2019 in China for the first time. Тhe virus was named temporarily as 2019 new coronavirus (2019 novel coronavirus-2019 -nCoV), or  finally as SARS-CoV-2. The aim of this paper is to give an overview of the laboratory detection of SARS-CoV-2 virus with reverse transcriptase - polymerase chain reaction (RT-PCR) in real time, as well as detection of viral mutations in the Laboratory for virology at the Institute of Public Health. The samples used in the study were taken from all geographical regions in North Macedonia, including the 10 regional Centers for Public Health throughout the country, from hospital patients, from COVID19 hospitals across the country and from the COVID19 checkpoint at the Institute of Public Health. All samples were tested using RT-PCR in real time. Additional assays were applied for identification of the circulating variants. The continuous surveillance of the variants of concern (VOC), as well as the newly emerged variants can allow the public health officials to modify their approach to disease control and management and intervene more effectively as well as in a timely manner in order to prevent major morbidity and mortality from COVID-19.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a persistent negative impact on both the public health and the global economy. To comprehend the origin, transmission routes and discover the mutations that alter the virus’s transmissibility and pathogenicity, full-length SARS-CoV-2 genomes have to be molecularly characterized. Focusing on a two-year time frame (2020-2021), we provide an in-depth virologic and epidemiological overview of the SARS-CoV-2 pandemic in the Republic of North Macedonia by assessing the frequency and distribution of the circulating SARS-CoV-2 variants. Using genetic characterization and phylogenetic analysis we shed light on the molecular evolution of the virus as well as test for a possible connection between specific SARS-CoV-2 haplotypes and the severity of the clinical symptoms. Our results show that one fifth (21.51%) of the tested respiratory samples for SARS-CoV-2 were positive. A noticeable trend in the incidence and severity of the COVID-19 infections was observed in the 60+ age group between males and females. Of the total number of positive cases, the highest incidence of SARS-CoV-2 was noticed in 60+ males (4,170.4/100,000), with a statistically significant (0,0001) difference between the two sexes. Additionally, a 1.8x increase in male mortality and consequentially significantly higher number of death cases was observed compared to females of the same age group (0.001). A total of 327 samples were sequenced in the period March 2020 - August 2021, showing the temporal distribution of SARS-CoV-2 variants circulating in North Macedonia. The phylogenetic analysis showed that most of the viral genomes were closely related and clustered in four distinctive lineages, B.1, B.1.1.7, B.1.351 and B.1.617.2. A statistically significant difference was observed in the 2C_1 haplotype (p=0.0013), where 10.5% of the patients were hospitalized due to severe clinical condition. By employing genetic sequencing, coupled with epidemiological investigations, we investigated viral distribution patterns, identified emerging variants and detected vaccine breakthrough infections. The present work is the first molecular study giving a comprehensive overview of the genetic landscape of circulating SARS-CoV-2 viruses in North Macedonia in a period of two years.

Introduction:The aim of this study was to analyze the function of left atrium (LA) 1 in patients with left bundle branch block (LBBB). Patients and Methods:20 patients without verified cardiovascular disease and 20 with LBBB were examined for left ventricular (LV) and LA function quantification. Results:We obtained lower values of EF of LV, 38.33% in patients with LBBB, against 60.81% in patients without LBBB ( Table 1). The global systolic strain of LV in patients without LBBB was 18.50% against 11.80% of the group with LBBB. The global circumferential strain of LV in patients without LBBB was 30.86% compared to 26.57% in patients with LBBB. EF of LA was 69.9% in patients without LBBB compared to 71.38% in patients with LBBB. The endsystolic volume of LA (ESVLA) in patients without LBBB was 30.1 ml/m 2 compared to 45.5 ml/m 2 in patients with LBBB. The enddiastolic volume of LA (EDVLA) in patients without LBBB was 6.5 ml/m 2 compared to 12.53 ml/m 2 in patients with LBBB. LA function timing intervals, expressed through dV/dT of early diastolic atrial emptying volume (EDAEV) in patients without LBBB was 221.5 ml/ m 2 compared to 95.46 ml/m 2 in patients with LBBB, whereas dV/dT of atrial contraction emptying volume (ACEV) in patients without LBBB was 135.8 ml/m 2 compared to 203.46 ml/ m 2 in patients with LBBB. The dV/dt of EDAEV and ACEV ratio is 1.63 in patient without LBBB against 0.46 in patients with LBBB. EDAEV in patients without LBBB was 20.66 ml compared to 9.23 ml in patients with LBBB, whereas the ACEV for the group without LBBB was 10 ml compared to 23.84 ml for the group with LBBB. The EDAEV/ACEV ratio for patients without LBBB was 2.1 compared to 0,4 for the group with LBBB. The systolic expansion time of LA (SET) was 333.33 msec vs 504.76 msec of subjects with LBBB, whereas the RR interval (msec) in patients without LBBB was 780 msec against 744.53 msec in patients with LBBB. The ratio between the LA (SET) and the RR interval (SET/RR interval index) for the group without LBBB was 0.42 against 0.69 for the group with LBBB.

No abstract

No abstract