Background and Aims A new coronavirus infection has become a serious threat leading to increased mortality worldwide. COVID-19 is an acute airborne disease caused by severe acute respiratory syndrome virus (SARS-Cov-2). Evolution of the virus, emergence of new mutant strains, changes in virulence dictate the need to search for new tools both in treatment and prevention of severe disease. The aim of our study was evaluation of the efficacy of Regdanvimab (Regkirona, Samsung BioLogics) to prevent severe COVID-19 in patients receiving ambulatory hemodialysis in the period of increasing morbidity. Method The study included 20 patients on program hemodialysis, mean age 54.9±17.6 years, vaccinated or who underwent COVID-19 more than six months ago. All subjects of the study received Regkirona at a standard dose of 40 mg/kg of body weight intravenously once at the end of the hemodialysis procedure after the physician assessed the feasibility of prophylaxis. All subjects were assessed for humoral immunity before Regkirona administration and after Regkirona administration according to the level of total SARS-CoV-2 IgG and IgG antibodies to the subunit of the S1 receptor-binding domain of the SARS-CoV-2 protein. Results Total SARS-CoV-2 IgG level and IgG level of antibodies to SARS-CoV-2 receptor-binding subunit S1 was 83.9±69.5 U/ml and 260.7±199.5 BAU/ml respectively before drug administration. During the 6-month follow-up period from July to November 2022, which paralleled the next round of increased morbidity, four patients with SARS-CoV-2 PCR test positive reported mild to moderate symptoms of SARS (marked weakness, fever, loss of smell, catarrhal symptoms, cough, shortness of breath, and chest pain unassociated with other causes). None of the subjects required hospitalization. We evaluated IgG antibody titers to the receptor-binding domain of the SARS-CoV-2 protein subunit S1 after 1, 3 and 6 months and demonstrated a nonlinear decline titers from 5104±2257.1 BAU/ml, 1988.7±1440.4 BAU/ml to 407,0±350,2 BAU/ml respectively, which may indirectly reflect short half-life of Regkirona. Conclusion The results of our study showed the efficacy of Regdanvimab to prevent the severe disease of COVID-19 in high-risk patients during the period of rising morbidity.

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Background and Aims The quality of life and survival of patients on hemodialysis significantly depend on modern technology. Treatment requires control of dynamically changing large volume of data, which must be analyzed and interpreted in real time. Achieving the ideal balance between adequate fluid removal, effective dialysis dose, and low risk of adverse events on the hemodialysis procedure is a complex multifactorial problem. The heterogeneity of the dialysis population, comorbid burden, the use of concomitant medications, nutritional status and adherence to diet, patient compliance are a noncomplete list of factors that must be considered when setting the dialysis regimen. Thus, despite significant progress in the technical aspects of the “artificial kidney devices”, personalization of the treatment regimen remains an important and difficult task. Introduction of modern automated medical information systems (MIS) for management of treatment and diagnostic process can provide invaluable assistance in treatment process and improve treatment outcomes. The aim of our study was to improve the prevention and treatment of hemodynamic disorders in hemodialysis patients using a special own program “Maximus”, which collects and analyzes indicators from dialysis machines in real time. Method The study was conducted from May to November 2022. The study included 120 patients on hemodialysis. The average age of the participants was 62.3±25.4 years. All participants underwent bioimpedance testing with a hydration score (InBody S10) compared to the prescribed dry weight at inclusion. A total of 9360 hemodialysis procedures (all HDF) were analyzed. The data of all procedures were collected directly from dialysis machines and analyzed in MIS in real time, identifying deviations from the target values. Episodes of both hypertension (140/90 mm Hg) and hypotension (100/60 mm Hg) were considered. MIS analyzed the actual duration of the procedure, blood flow rate, volume of fluid removal, rate of ultrafiltration and level of Na. In case of deviations from the established normal values, the system actively notified the doctor (via SMS/messengers) about detected deviations and proposed solutions. The medical staff timely corrected dry weight, duration of procedures, UF rate, volume of fluid removal, sodium content and blood pressure. Results In patients with arterial hypertension (63% of patients), mean systolic BP decreased by 12±6 mmHg and diastolic BP by 10±8 mmHg before dialysis procedure. In this group mean systolic BP decreased by 11±10 mmHg and diastolic BP by 9±8 mmHg during the procedure of hemodialysis. In patients with hypotension, due to “dry weight” increase, correction of Na level, stabilization of BP level was achieved, and mean systolic BP increased by 14±5 mmHg, and diastolic BP by 9±5 mmHg before dialysis procedure. Correction of hemodynamically significant parameters led to a decrease in the incidence of both intradialytic hypotension and hypertension during the hemodialysis procedure. Conclusion Correction of treatment, carried out using MIS with SMS notification of medical staff, improved hemodynamic parameters. Modern medical information systems with a Decision Support System can improve the quality and efficiency of treatment, reduce the risk of cardiovascular complications in patients on hemodialysis.

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