Despite ongoing vaccination COVID-19 is a global healthcare problem because of the lack of an effective targeted therapy. In severe COVID-19 manifesting as acute respiratory distress syndrome, uncontrolled innate immune system activation results in cytokine deregulation, damage-associated molecular patterns release upon tissue damage and high occurrence of thrombotic events. These pathomechanisms are linked to neutrophil function and dysfunction, particularly increased formation of neutrophil extracellular traps (NETs). While the association of NETs and severity of COVID-19 has been shown and proved, the causes of NETs formation are unclear. The aim of this review is to summarize potential inducers of NETs formation in severe COVID-19 and to discuss potential treatment options targeting NETs formation of removal.

OBJECTIVES: To investigate real-world data on warfarinisation rates and results in the elderly patients with atrial fi brillation (AF). BACKGROUND: AF is the most frequent arrhythmia in the elderlies with considerable risk of devastating stroke-related consequences. Guidelines prefer non-vitamin K antagonist oral anticoagulants (NOAC) to warfarin for thromboprophylaxis. Nevertheless, warfarin is still widely used, even if it is challenging, especially in polymorbid elderlies, to achieve the therapeutic international normalised ratio (INR). There are only scarce real-world data on INR in warfarinised elderly AF patients. METHODS: The study was based on multicentric observational Slovak audit of atrial fi brillation in seniors (SAFIS) performed on 4,252 hospitalised AF patients aged over 64 years (mean age 80.9 yrs.). INR data from warfarinised patients were analysed (955 at admission and 870 at discharge). RESULTS: At hospital admission and discharge, the warfarin medication rates were 22.6 % and 23.5 %, respectively, INR lower than 2 was present in 41.8 % and 30.6 % of patients, respectively, and INR higher than 3 was in 27.0 % and 7.7 %, respectively and altogether, 68.8 % and 38.3 % of warfarinised patients, respectively, were out of therapeutic range. CONCLUSION: Warfarin is still frequently used in the elderlies with AF, but the success rates are unsatisfactory in a huge number of patients. It is urgent to improve seniors' access to NOAC (Fig. 2, Ref. 34).

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Mortalita je najtvrdší výstup charakterizujúci závažnosť ochorení a výsledok zdravotnej starostlivosti. Je spájaná najmä so staršími pacientmi. Informácie o 24-hodinovej nemocničnej mortalite (M24) u seniorov hospitalizovaných na nechirurgických pracoviskách sú limitované. Pacienti a metódy: V retrospektívnej observačnej štúdii sme skúmali M24 u 65-ročných a starších pacientov, ktorých hospitalizácia na geriatrickej klinike (geriatria) bola ukončená v rokoch 2016-2018. Určovanie chorôb, ktoré primárne spôsobili M24 a ich taxonomizáciu nezávisle vykonali autori z geriatrie a internistka z iného pracoviska. Výsledky: Potvrdili sme, že M24 sú pomerne časté (2,3 % zo všetkých hospitalizovaných). Ich incidencia od veku 65-69 rokov po vek 90 a viac rokov vzrastá 2,4-násobne (z 1,4 na 3,3 %). Priemerný vek M24 zosnulých (n = 101) bol 80,8 rokov a nelíšil sa od veku zosnulých po 24. hodine hospitalizácie. Väčšina M24 (58,4 %) nastáva už v prvých 12 hodinách od prijatia pacienta. Ochorenia primárne vedúce k M24 boli početné (n = 25), dominovali kardiovaskulárne patológie (39,6 %), tesne nasledované infekčnými ochoreniami (33,7 %). Terapeuticky nezvratné pokročilé chronické ochorenia boli príčinou M24 až v 15,8 %. Medzi príčinami M24 bolo viac akútnych ochorení terapeuticky nezvratne dekompenzujúcich preexistujúce ochorenia (43,6 %) ako akútnych ochorení nezlučiteľných so životom (33,7 %).

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