Pulmonary arterial hypertension (PAH) is common in severe coronavirus disease 2019 (COVID-19) and worsens the prognosis. Sildenafil, a phosphodiesterase-5 inhibitor, is approved for PAH treatment but little is known about its efficacy in cases of severe COVID-19 with PAH. This study aimed to investigate the clinical efficacy of sildenafil in patients with severe COVID-19 and PAH. Intensive care unit (ICU) patients were randomly assigned to receive sildenafil or a placebo, with 75 participants in each group. Sildenafil was administered orally at 0.25 mg/kg t.i.d. for one week in a placebo-controlled, double-blind manner as an add-on therapy alongside the patient’s routine treatment. The primary endpoint was one-week mortality, and the secondary endpoints were the one-week intubation rate and duration of ICU stay. The mortality rate was 4% vs. 13.3% (p = 0.078), the intubation rate was 8% and 18.7% (p = 0.09), and the length of ICU stay was 15 vs. 19 days (p < 0.001) for the sildenafil and placebo groups, respectively. If adjusted for PAH, sildenafil treatment significantly reduced mortality and intubation risks: OR = 0.21 (95% CI: 0.05–0.89) and OR = 0.26 (95% CI: 0.08–0.86), respectively. Sildenafil demonstrated some clinical efficacy in patients with severe COVID-19 and PAH and should be considered as an add-on therapy in these patients.

Background: Cytokine storm in COVID-19 is heterogenous. There are at least three subtypes: cytokine release syndrome (CRS), macrophage activation syndrome (MAS), and sepsis. Methods: A retrospective study comprising 276 patients with SARS-CoV-2 pneumonia. All patients were tested for ferritin, interleukin-6, D-Dimer, fibrinogen, calcitonin, and C-reactive protein. According to the diagnostic criteria, three groups of patients with different subtypes of cytokine storm syndrome were identified: MAS, CRS or sepsis. In the MAS and CRS groups, treatment results were assessed depending on whether or not tocilizumab was used. Results: MAS was diagnosed in 9.1% of the patients examined, CRS in 81.8%, and sepsis in 9.1%. Median serum ferritin in patients with MAS was significantly higher (5894 vs. 984 vs. 957 ng/mL, p < 0.001) than in those with CRS or sepsis. Hypofibrinogenemia and pancytopenia were also observed in MAS patients. In CRS patients, a higher mortality rate was observed among those who received tocilizumab, 21 vs. 10 patients (p = 0.043), RR = 2.1 (95% CI 1.0–4.3). In MAS patients, tocilizumab decreased the mortality, 13 vs. 6 patients (p = 0.013), RR = 0.50 (95% CI 0.25–0.99). Conclusions: Tocilizumab therapy in patients with COVID-19 and CRS was associated with increased mortality, while in MAS patients, it contributed to reduced mortality.

The aim of this study was to analyse medical management in geriatric patients in the Hospital Emergency Departments in the Biała Podlaska County and Chełm County (Poland) between 2016 and 2018 in a group of patients ≥65 years of age. We analysed medical records of 829 patients transported to Hospital Emergency Departments by Medical Emergency Teams. The research was conducted in the period from June 2019 to March 2020. We analysed emergency medical procedure forms and medical records of patients transported to the hospitals. Cardiovascular diseases were diagnosed in 40% of patients. Mortality cases accounted for 3.1% of the 1200 interventions analysed. Ambulance dispatch resulted in the patient being transported to the Hospital Emergency Departments in more than ²/₃ of cases. The concordance between the diagnoses made by the Medical Emergency Teams and those made at the Hospital Emergency Departments was confirmed for 78% patients admitted to the department (n = 647), whereas the concordance of classification at the group level was estimated at 71.7% (n = 594). Further in-patient treatment was initiated in some of the patients admitted to the department (n = 385). The mean time of hospital stay was 10.1 days. In conclusion, differences between the initial diagnosis made by the heads of the Medical Emergency Teams and the diagnosis made by the doctor on duty in the Hospital Emergency Departments depended on the chapter of diseases in the ICD-10 classification, but they were acceptable. The majority of the patients were transported to Hospital Emergency Departments. The most common groups of diseases that require Hospital Emergency Departments admission include cardiovascular diseases, injuries due to external causes, and respiratory diseases. A moderate percentage of patients were qualified for further specialist treatment in hospital departments.

Introduction: Geriatric patients account for a large proportion of interventions of medical emergency teams (METs). The aim of this study was to analyse medical emergency interventions in the Biała Podlaska and Chełm (Poland) between 2016 and 2018 in a group of patients ≥ 65 years of age. Materials and Methods: We analysed medical records of 1200 older patients treated by METs in Biała Podlaska and Chełm (Lublin Province, Poland). The research was conducted from June 2019 to March 2020 at the Emergency Medical Service Station in Biała Podlaska and the Medical Rescue Station in Chełm (Independent Public Complex of Health Care Facilities). Results: A total of 92.5% of medical emergency service interventions took place at the patient’s home. The mean time of stay at the scene was 20 min. The highest number of interventions occurred between 8:00 p.m. and 8:59 p.m. There were no statistically significant differences in the type of ambulance used depending on the patient’s sex, while there was a statistically significant relationship between priority code and sex. Cardiovascular diseases were diagnosed in 40% of patients, and the symptoms were not precisely classified in almost the same percentage of patients. Mortality cases accounted for 3.1% of the 1200 interventions analysed. Ambulance dispatch resulted in the patient being transported to the hospital emergency department in 69.1% of cases. Conclusions: METs were called for a variety of diseases due to the fact that geriatric patients are not able to distinguish a life-threatening condition. Medical procedures performed by METs from Biała Podlaska and Chełm were closely related to the initial diagnoses made by these teams. It was irrelevant whether a specialist or non-specialist medical emergency service was used. Paramedics are very well trained to practice their profession and are able to provide treatment to older patients in a state of sudden life threat.

Purpose: To assess the health-related quality of life (HRQL) in parents of children with autism spectrum disorder (ASD). Materials and methods: The sample consisted of 83 families with children with ASD, including 30 families from Poland, 25 from Belarus, and 28 from France. Parental HRQL was surveyed with the World Health Organization Quality of Life–BREF (WHOQOL–BREF) and KINDLR questionnaires. Results: This study showed that Polish parents reported the lowest quality of life according to the WHOQOL–BREF. Parents from Belarus reported slightly worse HRQL than parents from France, though other aspects of quality of life (e.g, social sphere, somatic sphere) did not differ significantly between these parents. Parents from Poland also reported lower HQOL according to the KINDLR questionnaire, while parents from Belarus had a higher HQRL in the mental, physical, and self-esteem domains compared to parents from Poland and France. Conclusion: Parents from Poland with children with ASD reported lower HRQL both on the WHOQOL–BREF and KINDL R questionnaires compared to parents from Belarus and France.

Introduction: The COVID-19 (coronavirus disease 2019) affected individuals and society and caused disruption, anxiety, stress, and loneliness. Being hospitalized during the pandemic increase a patient’s negative feelings. This study aimed to evaluate the impact of the COVID-19 pandemic on patients’ feelings (loneliness, depression, hope, self-efficacy) during a hospital stay. Materials and methods: This study included 207 women, aged from 15 to 83 years (55 ± 21.2) that were hospitalized during the pandemic in Białystok, Łomża, and Biała Podlaska, Poland at internal medicine departments. The main reasons for hospitalization were cardiovascular diseases, abdominal pain, chronic obstructive pulmonary disease, pneumonia, diabetes, and unknown fever. Respondents were asked to complete the following questionnaires: Sense of Loneliness (the DJGLS), Depression Beck Inventory (BDI), Basic Hope (BHI-12), and Self-Efficacy (GSES). Results: Most of the studied group of women had an average sense of loneliness. A greater sense of loneliness was found among hospitalized women living in the countryside—the lowest sense of loneliness and depression was among women with higher education and the highest sense of effectiveness. One-third of respondents had a moderate degree of depression. Of the respondents, 39% had a relatively high level of basic hope. The assessment of self-efficacy demonstrated that 52% of the respondents showed a high sense of self-efficacy, an average sense of self-efficacy was shown by 35.5% of the respondents, and a low sense of self-efficacy was shown by 12.6% of the respondents. Conclusions: Numerous hospitalized women during the COVID-19 pandemic, despite experiencing moderate depression, had an average sense of loneliness and a high level of hope and self-efficacy.