Features of the immune response formation to SARS-CoV-2 in patients who have recovered from COVID-19

This study was conducted to assess the presence of an immune response in staff of DILA Medical Laboratory who have recovered from COVID-19, to study the features of monitoring indicators in different clinical variants of the disease. The obtained results allowed analyzing various types of the immune response in patients with a new coronavirus disease. In staff who has reco­vered from COVID-19, an immune response study was performed by determining the presence of immunoglobulins M and G to va­rious coronavirus target proteins by a semiquantitative method on a chemiluminescence immunoassay analyzer. The findings allowed us to assess not only the intensity of the immune response, but also the relationship with clinical manifestations, disease duration, age, which will be important for further comparative analysis with the immune response of vaccinated employees. The findings showed that most patients with COVID-19 produce protective antibo­dies, more often to the S-target, and also allowed determining the ave­rage duration of circulation of both immunoglobulin M and G antibodies.

O12 Dactylitis is associated with greater disease severity, CRP, ultrasound determined synovitis, and erosive damage in DMARD-naïve early PsA

Background/Aims Dactylitis, a hallmark feature of psoriatic arthritis (PsA), is defined as uniform swelling of a finger or toe ('sausage digit'). Understanding of the phenotypical significance of dactylitis and association with PsA disease activity/severity is still lacking. The aim of this study was to characterise and evaluate a DMARD-naïve early PsA cohort based on the clinical presence or absence of dactylitis. Methods Early PsA patients achieving CASPAR criteria, were recruited into a prospective observational study; the Leeds Spondyloarthritis Register for Research and Observation (SpARRO). The cohort was evaluated based on presence/absence of dactylitis. Dactylitis was recorded per digit; tender (hot)/ non-tender (cold). Synovitis was graded via the semiquantitative method (0-3) for grayscale (GS) and power Doppler (PD) at 50 joints: wrists, MCP1-5, PIP1-5, DIP2-5, MTP1-5, elbows, knees, ankles, subtalar and talonavicular joints. Bone erosions were determined by US if cortical bone discontinuity was present in two perpendicular planes (longitudinal/transverse). Enthesitis was determined via OMERACT definitions/ modified Glasgow Ultrasound Enthesitis Severity Score (GUESS). Statistical calculations (STATA/SPSS): student’s t-test, quantile regression, one-sample tests, Pearson Chi-squared test and Fischer’s exact test. Results Of the 177 PsA patients recruited, PsA with dactylitis recorded significantly higher median difference in TJC (p < 0.01), SJC (p < 0.001), and CRP (p < 0.01) compared to PsA without dactylitis. Dactylitis was present in 81/177 (46%) patients and 214 digits. Multiple digits (>1) were involved in 51/81 (63%) patients, asymmetrical in 52/81 (64%). Dactylitis was more prevalent in toes (146/214; 68.2%) than fingers (68/214; 31.8%). Hot dactylitis was more prevalent (179/214; 83.6%) than cold dactylitis (35/214; 16.4%). The most frequent sites for hot dactylitis were 2nd finger (23/179; 12.8%), 4th toe (40/179; 22.3%) and for cold dactylitis, 3rd finger (2/35; 8.5%), 4th toe (10/35; 28.5%). Significantly greater US synovitis was identified in PsA with dactylitis (p < 0.01). PsA with dactylitis recorded more patients in high DAPSA state and greater DAPSA scores (median 24.4 vs 20.8; p = 0.07). Joints affected by dactylitis had a high prevalence of US synovitis; 190/255 (74.5%). Synovitis was more prevalent in hot dactylitis than cold dactylitis; 180/227 (79.3%) versus 10/28 (35.7%). Ultrasound erosions were significantly greater in joints in PsA with dactylitis (p < 0.001) and identified in significantly greater PsA patients with dactylitis [22/69 (31.9%) versus 11/86 (12.8%) patients (p = 0.004)]. The sites most prone to erosive damage were MCP2 (9/33, 27.3%), MTP5 (11/33, 33.3%). No significant differences were found for enthesitis determined by OMERACT/ modified GUESS. Conclusion This study identifies dactylitis as a clinical indicator for an aggressive phenotype with significantly greater TJC, SJC, CRP, US synovitis and US defined erosions in DMARD-naïve early PsA. Longitudinal follow-up will determine if dactylitis represents poor prognosis. Dactylitis may be a useful discriminator for risk stratification in future PsA management strategies and clinical trials. Disclosure S. Dubash: None. O.A. Alabas: None. X. Michelena: None. L. Garcia-Montoya: None. R. Wakefield: None. A. Tan: None. P. Helliwell: None. P. Emery: None. D. McGonagle: None. H. Marzo-Ortega: None.

A Systematic Review of Correlates of the Moderate-to-Vigorous Physical Activity of Students in Elementary School Physical Education

This study systematically summarize existing literature focusing on the correlates of students’ moderate-to-vigorous physical activity (MVPA) during elementary school physical education (PE). A systematic search was initiated to identify studies investigating the physical activity correlates in students during elementary PE. Two researchers independently screened the studies, assessed their methodological quality, and extracted relevant data. The correlates were synthesized and further assessed using the semiquantitative method. A total of 42 studies were included in the review. Out of 44 variables identified from these studies, 10 were consistently associated with MVPA. Gender (boys), PE activities (team games), PE context (fitness activities, game play, and skill practice), class location (outdoors)and perceived competence were consistently and positively associated with the MVPA of students in PE. Other variables, namely body mass index, larger class size, and PE activities (movement activities), were consistently and negatively related to MVPA. In conclusion, this study improves our understanding of the correlates of students’ physical activity from the demographic,biological, instructional, physical environment, social support, and psychological perspectives. These variables should be focused on when designing new or improving current interventions.

Clinical significance of diagnostic algorithm in detection of mild hemostasis disorders in women with menorrhagia

Background/Aim. Coagulation disorders could be a cause of menorrhagia in women of reproductive age. The aim of the study was to estimate frequency of coagulation disorders and design an appropriate algorithm for detection of coagulation disorders. Methods. We investigated coagulation in 115 women (36.1 ? 9.6 years) with anamnestic data of menorrhagia, verified using semiquantitative method ? Pictorial Bleeding Assessment Chart (PBAC) with score ? 100. Results. Menorrhagia was objectively verified in sixty-four women (55.7%) and in comparison with those with normal menstruation they had higher PBAC score of menstrual cycle [median (Md) = 150.0 vs. Md = 50.0; p < 0.001] but not its duration (7.2 ? 2.1 days vs. 7.3 ? 1.9 days; p > 0.05). Coagulation defects was found in 12 (10.4%) women ? decreased F IX: Ac in 4 (3.5%), decreased F VII: Ac in 1 (0.9%), decreased F X: Ac in 1 (0.9%), decreased F XI: Ac in 1 woman (0.9%), while 5 (4.3%) women matched criteria for mild von Willebrand disease (VWD) type 1. Women with coagulation disorders had prolonged prothrombin time (PT) [Md = 13.1 s, range: 12.2?14.8 s vs. Md = 12.5 s, range 10.6?18.3 s; p = 0.032]. Anemia was diagnosed in 61 (53.0%) women. The strongest predictor of the hemostasis disorder was menorrhagia (Quotient of probability 0.018), then anemia presence (12.43), P? (2.35), menstrual cycle duration (1.16) and the PBAC score (0.98). Conclusion. The results of the study indicate the need to form a diagnostic algorithm for hemostasis disorders, primarily VWD. Sophisticated analysis of hemostasis is required, especially if predictive factors of statistical models are detected: objectively verified menorrhagia, anemia, prolonged menstrual cycle, PBAC score > 100 and extended PT.

Vertebral Heart Score in Rhesus Macaques (Macaca mulatta): Generating Normal Reference Intervals and Assessing its Validity for Identifying Cardiac Disease

Vertebral heart scoring (VHS) is a semiquantitative method to assess the presence and severity of cardiomegaly by usingthoracic radiographs. VHS in rhesus macaques (Macaca mulatta) has not been validated or used routinely in the clinical orresearch setting. We hypothesized that rhesus macaques with cardiac disease diagnosed by using echocardiography wouldhave higher VHS than animals without cardiac disease. A total of 150 rhesus macaques were enrolled in this study. All animalsunderwent echocardiography and thoracic radiography (right lateral [RL], dorsoventral [DV], and ventrodorsal [VD] views).According to echocardiography, 121 rhesus macaques had no cardiac disease and were used to establish reference intervalsfor VHS. The remaining 29 macaques had hypertrophic cardiomyopathy (n = 20) or other cardiac disease (n = 9). Resultsshowed that VHS of RL and VD views were significantly higher in macaques with any of the identified cardiac diseases andin the cardiac disease group that excluded hypertrophic cardiomyopathy. VHS of animals with HCM was not significantlydifferent than that of control animals. In the RL view, VHS was moderately accurate for predicting the presence of cardiacdisease, with an AUC of 0.71 and an optimal cut-off value of 10.25 (sensitivity: 62%, specificity: 77%). In the VD view, VHSwas a mildly accurate test for cardiac disease, with an AUC of 0.654 and an optimal cut-off value of 10.65 (sensitivity, 66%;specificity, 63%). Study results indicated that VHS could be a useful screening tool for clinically identifying rhesus macaqueswith cardiac disease. However, VHS is unlikely to replace echocardiographic examination for determining the presence, type,and severity of cardiac disease in this species.