The treatment of coronavirus disease (COVID-19) and COVID-19-associated diarrhea remains challenging. This study aimed to evaluate the efficacy of a multi-strain probiotic in the treatment of COVID-19. This was a randomized, controlled, single-center, open-label trial (NCT04854941). Inpatients with confirmed COVID-19 and pneumonia were randomly assigned to a group that received a multi-strain probiotic (PRO group) or to the control group (CON group). There were 99 and 101 patients in the PRO and CON groups, respectively. No significant differences in mortality, total duration of disease and hospital stay, incidence of intensive care unit admission, need for mechanical ventilation or oxygen support, liver injury development, and changes in inflammatory biomarker levels were observed between the PRO and CON groups among all included patients as well as among subgroups delineated based on age younger or older than 65 years, and subgroups with chronic cardiovascular diseases and diabetes. Diarrhea on admission was observed in 11.5% of patients; it resolved earlier in the PRO group than in the CON group (2 [1–4] vs. 4 [3–6] days; p = 0.049). Hospital-acquired diarrhea developed less frequently in the PRO group than in the CON group among patients who received a single antibiotic (0% vs. 12.5%; p = 0.023) unlike among those who received > 1 antibiotic (10.5% vs. 13.3%; p = 0.696). The studied probiotic had no significant effect on mortality and changes in most biomarkers in COVID-19. However, it was effective in treating diarrhea associated with COVID-19 and in preventing hospital-acquired diarrhea in patients who received a single antibiotic. Supplementary Information The online version contains supplementary material available at 10.1007/s12602-021-09858-5.

РезюмеЦель исследования. Оценка диагностической значимости цистатина С сыворотки крови в развитии гипертрофии мио-карда левого желудочка (ГЛЖ) у пациентов с хронической болезнью почек (ХБП). Материалы и методы. В исследование включили 86 больных ХБП недиабетической этиологии (53% мужчин, 47% женщин, средний возраст 45±13 лет). В зависимости от степени снижения СКФ всех больных разделили на 3 группы: 1-я (n=33) -СКФ 89-45 мл/мин, 2-я (n=33) -СКФ 44 -15 мл/мин, 3-я (n=20, лечение гемодиализом) -СКФ <15мл/мин. В кон-трольную группу включили 20 лиц с СКФ >90 мл/мин. Всем провели общеклиническое обследование и трансторакальную эхокардиографию, определяли уровень цистатина С в сыворотке крови. Результаты. В 1-й группе ГЛЖ выявлена у 42,4%, во 2-й группе -у 63,6%, в 3-й группе -у 80%, в контрольной группе не выявлено. Уровень цистатина С в сыворотке крови в 1-й группе составлял 1489,49±520,76 нг/мл, во 2-й группе -2533,13±621,66 нг/мл, в 3-й группе -5166,02±1586,61 нг/мл, в контрольной -820,08±224,54 нг/мл. Выявлена связь между цистатином С и ГЛЖ (ρ=0,5; р<0,0001). Показано, что уровень цистатина С позволяет прогнозировать с чувстви-тельностью 78% и специфичностью 62% развитие ГЛЖ у пациентов с ХБП додиализной стадии. При многофакторном ана-лизе, включающем индекс массы миокарда левого желудочка (ИММЛЖ), Е/А, артериальную гипертонию, уровень циста-тина С независимо коррелировал лишь с ИММЛЖ (р<0,05; β=0,3) во всех группах. Заключение. Цистатин С в сыворотке может рассматриваться в качестве раннего маркера ГЛЖ, выявляемого на самых ранних стадиях у пациентов с ХБП. Ключевые слова: цистатин С, гипертрофия миокарда левого желудочка, хроническая болезнь почек.Aim. To estimate the diagnostic value of serum cystatin C in the development of left ventricular hypertrophy (LVH) in patients with chronic kidney disease (CKD). Subjects and methods. The investigation enrolled 86 patients (53% men, 47% women; mean age, 45±13 years) with nondiabetic CKD. According to the magnitude of glomerular filtration rate (GFR) decrease, the patents were divided into 3 groups: 1) 33 patients with a GFR of 89-45 ml/min; 2) 33 with a GFR of 15 ml/min; 3) 20 hemodialysis patients with a GFR of <15 ml/min. A control group included 20 individuals with a GFR of >90 ml/min. In all the patients, physical examination and transthoracic echocardiography were performed and serum cystatin C levels were measured. Results. In Groups 1, 2, and 3, LVH was detected in 42.4, 63.6, and 80% of cases, respectively. It was not found in the control group. In these groups, serum cystatin C levels were 1489.49±520.76, 2533.13±621.66, 5166.02±1586.61, and 820.08±224.54 ng/ml, respectively. An association was found between cystatin C and LVH (p=0.5; p<0.001). The level of cystatin C was shown to predict the development of LVH with a sensitivity of 78% and a specificity of 62% for predialysis CKD patients. Multivariate analysis of left ventricular mass index (LVMI), E-velocity/A-velocity, (E/A) ratio, and hypertension showed that the cystatin C levels were independently corr...

Purpose of the study. To examine the frequency and risk factors for the development of diastolic dysfunction (DD) of the left ventricle (LV) of the heart in patients with chronic kidney disease (CKD). Materials and methods. The study included 225 patients with stage I-CKD of non-diabetic etiology (median age 47.0 years, 50.2% of women). Depending on the degree of decrease in the glomerular filtration rate (GFR), all patients were divided into 3 groups. Group 1 (n=70) consisted of patients with GFR 89-45 ml / min / 1.73 m2, group 2 (n=120) - patients with GFR 44-15 ml / min / 1.73 m2, group 3 (n=35) - patients with GFR

EchoCG reveals PH in almost 25% of the patients with CKD, which occurs at its predialysis stage. Elevated PASP is associated with myocardial structural changes. Traditional risk factors (hypertension) and diminished kidney function affect the development of PH.

No abstract