Background and aims. Many patients with SARS-CoV-2 virus infection have various comorbidities. Their presence in the background of coronavirus has a tendency to worsen the course of the disease and increase the risk of unfavorable outcomes. Understanding the interactions between SARS-CoV-2 and the most common comorbidities is key to the successful management of these patients. Methods. We systematically searched Medline, Springer and Elsevier databases and accessed the full text on SARS-CoV-2 virus infection and the following conditions: cardiovascular, renal, immunosuppression, metabolic disorder and hematological in order to prepare a narrative review on this topic. Results. Patients with underlying cardiovascular diseases are more likely to suffer from severe forms of COVID-19. Cardiovascular diseases were also noted as the most frequent comorbidities among coronavirus patients. Metabolic syndrome and its components have been identified as the second most common comorbidity among fatal cases of COVID-19. Infected patients with acute kidney injury also show a higher mortality rate among the others. Immunocompromised patients, such as organ recipients and cancer and hematologic patients, develop more severe forms of COVID-19 and are at higher risk of admission to ICUs and requiring mechanical ventilation. Higher mortality rates among those patients have also been observed. Conclusions. Based on recent studies, patients with co-existing diseases are at higher risk for severe courses of COVID-19 virus infection and unfavorable outcomes. Cardiovascular diseases, metabolic syndrome and immunosuppressive and kidney diseases in the presence of coronavirus may lead to longer and more aggressive treatment in the ICU and increased mortality rate.

Background and Aims Postoperative pain management after major orthopedic surgeries such as total hip arthroplasty (THA) is one of the biggest considerations [1]. Suprainguinal fascia iliaca block (SFIB) might be beneficial for postoperative pain control after THA, but the value persists controversial [2]. This prospective, randomized, double-blinded study aimed to investigate the analgesic efficiency of SFIB after THA compared to control group (C). Methods LUHS Bioethics Committee granted the research (No. BEC-MF-250). 36 patients scheduled for THA were randomized into two groups: 16 in SFIB and 20 in C group. After the operation, a blinded observer recorded pain, extent of motor block (Bromage scale), opioid consumption and additional painkillers. Evaluation of pain: at 3, 6, 24 and 48 hours postoperatively, patients were assessed using a visual analog scale (VAS) on the operated leg at rest, in active and passive 45°flexion positions. Results 36 patients were assessed, 19 (52,8%) men and 17 (47,2%) women. There were no differences between the groups with respect to demographics. Opioid consumption after 24 hours postoperatively was reduced in SFIB group, unfortunately not statistically significantly (p>0,05). The VAS scores at rest and in motion also were similar at all-time points as well as the extent of motor block. Consumption of additional painkillers was less after 24 hours in SFIB (38,9%) than C (50%) and after 48 hours SFIB (27,8%), C (44,4%) but statistically insignificant (p>0,05). Conclusions We conclude that postoperative pain management with SFIB may be valuable after THA. However, a larger study is needed to make the data more reliable.

Background and aims: Preanesthetic assessment is an inseparable part of every anesthesiologist practice. There are some tools and tests to anticipate the possible risks and prepare an appropriate anesthesia plan and latest guidelines encourage using them by system. The aim of this study was to investigate preanesthetic evaluation of cardiac risk possibilities based on the patient’s labo­ratory and instrumental tests available on a day of hos­pitalization and applying Revised Cardiac Risk Index. Materials and Methods: Research was conducted from June 2021 to September 2021 and data was collected from the depersonalized medical documentation of 117 patients, for whom elective surgery was planned in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics (LUHS), Department of Surgery. The gathered data include sex, age, comorbidities, opera­tion type, ASA score, revised cardiac risk index (RCRI) and both laboratory and instrumental tests. These tests involve general and biochemical blood tests, coagu­lation panels, electrocardiograms (ECG) and others. Results: The study involved 117 patients: 27.4% men and 72.6% women. The analysis of available preopera­tive laboratory and instrumental tests showed that only 67 patients (57%) had their ECG on a day when opera­tion was scheduled, 64% of them had general and 62% had biochemical blood tests. The most important fin­ding in our research was that 72% of patients who were at increased cardiac risk according to RCRI (2 or more points) had ECG when they came for surgical treatment. Conclusion: Majority of the patients with a higher car­diac risk according to RCRI score present ECG for their preanesthetic evaluation. No significant associations were found between patients ASA, RCRI scores, and preope­rative tests.