Introduction. Pneumonia is the most severe form of the new coronavirus infection (COVID-19). The large area of damage and the high mortality rate in COVID-19 pose the challenge of rapid bedside diagnosis and dynamic monitoring of the volume and nature of lung tissue damage. Objectives. The goal of the study was to compare the data obtained with computed tomography and ultrasound of the lungs, as well as the accuracy of ultrasound segment-by-segment verification of damage zones in patients with pneumonia caused by SARS-CoV-2. Material and methods. The observational prospective clinical study included 388 patients aged 18–75 years; with a confirmed diagnosis of pneumonia caused by COVID-19 or suspected COVID-19. Lung ultrasound was performed within 24 hours after computed tomography (CT) of the chest. During the CT scan, pathological signs, infiltration, and consolidation of the lungs were determined, which were recorded by lung segments. Ultrasound of the lungs was performed according to the “Russian Protocol”, ultrasound signs in the lines and consolidation were also recorded based on the projection of the lung segments on the chest wall. An analysis was performed to describe and generalize the distributions of variables. The sensitivity and specificity of ultrasound methods were evaluated with ROC analysis against CT as a “gold standard”. Results. Bilateral involvement was found in 100 % of cases. Typical signs of pneumonia caused by coronavirus infection on CT were a “ground glass” pattern, thickened pleura, consolidation, reticular pattern, and a “crazy paving” pattern. During ultrasound examination of the lungs and pleura, the detected signs corresponded to the signs of CT. B-lines (multifocal, discrete, or confluent) and consolidation of various volumes of lung tissue were most frequently encountered during ultrasound. The sensitivity of ultrasound of the lungs in the accuracy of the segment-by-segment diagnosis of damage by the sign of infiltration is 87.9 %, and the specificity is 91.5 % (the area under the ROC curve is 0.939; p < 0.001). The sensitivity of the ultrasonic sign of consolidation was 84.6 %, and the specificity was 79.2 % (the area under the ROC curve is 0.846; p < 0.001). Conclusions. The use of ultrasound of the lungs during the COVID-19 allows us to identify and assess the volume and nature of lung damage. Thus, lung ultrasonography has demonstrated accuracy comparable to chest CT in detecting lung damage in patients with COVID-19.

Background: The aim was examination of the intimamedia thickness of carotid arteries in COVID-19 infection. Methods: In 50 patients, the thickness of the intimomedial complex (IMT) in the common carotid arteries was measured. The values were compared with the control group in 2006-9. The condition of the lungs was assessed by ultrasound score (It score) (0-42) as mild (0-14) or mediumsevere (15-28) Covid. IMT thickening risk factors and the value of fibrinogen, IL-6 and CRP were recorded. Two IMT prediction models were formed. The socio-epidemiological model predicts the development of IMT based on epidemiological factors. Apart from these factors, the second model also includes the values of the mentioned biomarkers. Results: It score 20±6, IMT values right: median 0.99 mm, p25=0.89, p75=1.14; left: 1±0.22 mm. Control: IMTright: median 0.7 mm, p25=0.68 mm; p75=0-9 mm; left: median=0.75 mm, p25=0.6 mm, p75=1.0 mm. The group/control difference is highly significant. Epide mio - logical model: logit (IMT)= 4.463+(2.021+value for GEN)+(0.055x AGE value)+(-3.419x RF value)+(-4.447x SM value)+(5.115x HTA value)+(3.56x DM value)+ (22.389x LIP value)+(24.206x CVD value)+(1.449x other value)+(-0.138x It score value)+(0.19xBMI value). Epidemiological-inflammatory model: logit (IMT)=5.204+ (2.545x GEN value)+(0.076x AGE value)+(-6.132x RF value)+(-7.583x SM value)+(8.744x HTA value)+(6.838x DM value)+(25.446x LIP value)+(28.825x CVD value)+ (2.487x other value)+(-0.218xIt score value)+(0.649x BMI value) +(-0.194x fibrinogen value)+(0.894x IL-6 value)+(0.659x CRP value). Values for both models Exp(B)=4.882; P of sample=0.83; logit=-0.19; OR= 23.84; model accuracy for the first model 87% and for the second 88%; Omnibus test of the first model c2=34.324; p=0.000; reliability coefficient -2LogLH=56.854; Omnibus test of the second model c2=39.774; p=0.000; and -2LogLH=51.403. Conclusions: The ageing of blood vessels in COVID-19 can be predicted.

Background: The vagus nerve plays an important role in neuroimmune communication. This study aimed to examine whether systemic inflammatory biomarkers are associated with ultrasound-measured cross-sectional area (CSA) of the vagus nerve in hospitalised patients with COVID-19. Methods: In this cross-sectional study, 68 hospitalised adults with PCR-confirmed SARS-CoV-2 infection underwent bilateral ultrasound assessment of vagus nerve CSA. For each nerve, CSA was calculated as the mean of three measurements. Serum levels of C-reactive protein (CRP), fibrinogen, and ferritin were recorded. CSA values and inflammatory biomarkers were classified as within or outside predefined reference ranges. Binary logistic regression was used to assess associations between inflammatory biomarkers and vagus nerve CSA classified as outside the reference range. Receiver operating characteristic (ROC) analysis was performed. As a secondary exploratory analysis, a multilayer perceptron neural network was constructed to evaluate whether the same biomarkers could classify vagus nerve CSA as within or outside the reference range. Results: Mean vagus nerve CSA was 1.32±0.30 mm2 on the right side and 1.20±0.28 mm2 on the left side. Inflammatory biomarkers were significantly associated with right vagus nerve CSA classified as outside the reference range in logistic regression, whereas no significant association was observed for the left vagus nerve. The regression model showed acceptable discriminative performance for the right vagus nerve (AUC=0.76, p=0.018). The exploratory neural network model showed similar classification performance. Conclusions: Systemic inflammatory biomarkers were associated with right vagus nerve CSA classified as outside the reference range on ultrasound, but not with left vagus nerve CSA, in hospitalised patients with COVID-19. These findings suggest a possible link between systemic inflammation and ultrasound-detectable variation in vagus nerve morphology. Larger studies are needed to confirm these findings and clarify their biological significance.