The prevalence of West Nile virus (WNV) is increasing across Europe, with cases emerging in previously unaffected countries. Kosovo is situated in a WNV-endemic region where the seroepidemiological data on WNV in humans remains absent. To address this issue, we have conducted a seroepidemiological investigation of 453 randomly selected sera from a hospital in Kosovo, revealing a 1.55% anti-WNV IgG seroprevalence. Comparative and phylogeographic analyses of the WNV genomes obtained by sequencing archived samples from patients with West Nile fever indicate at least two recent and distinct introductions of WNV lineage 2 into Kosovo from neighboring countries. These findings confirm the eco-epidemiological status of WNV in southeast Europe, where long- and short-range dispersion of lineage 2 strains contributes to a wider circulation via central Europe. Our results suggest an increasing risk for WNV spreading in Kosovo, underscoring the need for an integrated national surveillance program targeting vectors and avian populations for early epidemic detection, as well as the screening of blood donors to gauge the impact of virus circulation on the human population.

Background: Apelin-36 may be used to identify patients with ST-segment elevation myocardial infarction (STEMI) who are at risk for the no-reflow phenomenon. Patients presenting with STEMI were evaluated and stratified according to their apelin-36 levels. Methods: In this study, 161 patients presenting with STEMI within 12 hours of symptom onset and undergoing primary percutaneous coronary intervention (pPCI) were enrolled. Biochemical parameters, including apelin-36, troponin T, creatine kinase (CK), the MB fraction of creatine kinase (CK-MB), total cholesterol, triglycerides, and other routine laboratory parameters, were measured. Blood samples for apelin-36 measurement were collected prior to PCI, centrifuged to obtain serum, and preserved at -80⁰C until being assayed. Two-dimensional echocardiography was performed in all patients. Thereafter, patients were divided into two groups according to their level of Apelin-36. Results: Among the 161 consecutive STEMI patients, 115 (71.42%) had Apelin-36 levels ≤0.58ng/mL (group 1), whereas 46 (28.57%) had Apelin-36 levels > 0.58ng/mL (group 2). In total, 51 (31.67%) STEMI patients experienced no-reflow phenomenon after PCI: 29 (18.01%) patients with apelin-36 ≤ 0.58ng/mL and 22 (13.66%) with a value > 0.58ng/mL (p < 0.001). In terms of Gensini score, the mean value in group 1 was (70.29 (±28.76), while in group 2, it was 81.95 (±23.82) (p=0.004). Overall, a positive correlation between apelin-36 and Gensini score was observed in both groups using Kendall’s correlation analysis (group 1: Figure 2, p=0.05; group 2: Figure 2, p 0.58ng/mL had troponin T levels of 132.15 (9.4-5190.0) (p < 0.012). The receiver operating characteristics (ROC) curve of apelin-36 was used to plot the true positive rate against the false positive rate at different cut-off points, with AUC=0.67 (95% CI, 0.57-0.76), and the cut-off value for apelin-36 was 0.58ng/mL, with p=0.001. Conclusions: Significant associations were observed between apelin-36 and no-reflow phenomenon in patients with STEMI. An apelin-36 cut-off value of 0.58ng/mL, measured at admission, could be used to identify patients who were at increased risk of no-reflow phenomenon/reperfusion injury.

Background: In patients with ST-segment elevation myocardial infarction (STEMI), apelin is upregulated and exerts cardioprotective effects against ischemia–reperfusion injury (IRI). The present study aimed to investigate serum apelin-36 levels in STEMI patients and their relationship with the no-reflow phenomenon. Methods: In this study, 161 patients presenting with STEMI within 12 h of symptom onset and undergoing primary percutaneous coronary intervention (pPCI) were enrolled. Biochemical parameters, including apelin-36, troponin T, creatine kinase (CK), the MB fraction of creatine kinase (CK-MB), total cholesterol, triglycerides, and other routine laboratory parameters, were measured. Two-dimensional echocardiography was performed in all patients. Thereafter, patients were divided into two groups according to their level of aaapelin-36. Results: Among the 161 consecutive STEMI patients, 115 (71.42%) had Apelin-36 levels ≤ 0.58 ng/mL (group 1), whereas 46 (28.57%) had Apelin-36 levels > 0.58 ng/mL (group 2). In total, 51 (31.67%) STEMI patients experienced no-reflow phenomenon after PCI: 29 (25.21%) of patients with apelin-36 ≤ 0.58 ng/mL and 22 (47.82%) of those with a value > 0.58 ng/mL (p < 0.001). In terms of Gensini score, the mean value in group 1 was 70.29 (±28.76), while in group 2, it was 81.95 (±23.82) (p = 0.004). Overall, a positive correlation between apelin-36 and Gensini score was observed in both groups using Kendall’s correlation analysis (group 1: p = 0.05; group 2: p < 0.0001). Binary logistic regression analysis identified apelin-36 and diabetes mellitus as significant predictors at the 5% level, with p-values of 0.045 and 0.036, respectively. Patients with apelin-36 levels ≤ 0.58 ng/mL had troponin T levels of 290.0 (8.5–9510.0), while those with a value > 0.58 ng/mL had troponin T levels of 132.15 (9.4–5190.0) (p < 0.012). The receiver operating characteristics (ROC) curve of apelin-36 was used to plot the true positive rate against the false positive rate at different cut-off points, with AUC = 0.77 (95% CI, 0.69–0.84), and the cut-off value for apelin-36 was 0.58 ng/mL, with p = 0.001. Conclusions: Significant associations were observed between apelin-36 and the no-reflow phenomenon in patients with STEMI. An apelin-36 cut-off value of 0.58 ng/mL, measured at admission, could be used to identify patients who were at increased risk of no-reflow phenomenon/reperfusion injury.

Crimean–Congo hemorrhagic fever (CCHF) is a severe tick-borne zoonotic disease associated with high case fatality rates in humans and represents a significant public health threat in endemic areas of Kosovo. However, data on viral circulation in ticks in non-endemic regions remain limited. CCHF is caused by Orthonairovirus haemorrhagiae, formerly known as the Crimean–Congo hemorrhagic fever virus (CCHFV). In the present study, 745 ticks were collected from domestic animals and the environment throughout the years 2017–2019 in seven locations of non-endemic regions in the eastern part of Kosovo, respectively Prishtina, Gjilan and Kamenica municipalities. The ticks after species identification were analyzed using RT-PCR for detection of viral RNA of CCHFV. Seven ticks (0.94%) tested positive, including six Rhipicephalus bursa ticks, three of them collected from grazing cattle and sheep in the village Hajvali (Prishtina municipality) and three others in the village Busavat (Kamenica municipality) from grazing cattle, while one positive sample was detected in a Hyalomma marginatum tick collected from a grazing dairy cow in Bresalc village (Gjilan municipality). The virus detected in Rh. bursa is considered to be consistent with the Aigia virus, formerly classified as CCHFV Clade VI/Europe 2 or the AP92-like lineage, which has generally been associated with a lower pathogenic potential and the absence of reported human cases in these areas. The first reported human CCHF case in a non-endemic area occurred in the Bresalc locality (Gjilan Municipality) in June 2018 in a dairy farmer. This occurrence coincided with the detection of Orthonairovirus haemorrhagiae RNA in one Hyalomma marginatum tick among 36 sampled ticks collected from the same farm, following clinical and laboratory confirmation of CCHF in infected patients. Consequently, this finding indicated the circulation of CCHFV in this area. These results demonstrated active circulation of CCHFV in tick populations in regions previously considered non-endemic and highlighted a potential public health risk associated with pathogenic strains. Genomic and tick surveillance, combined with targeted vector control measures and public awareness, are essential for reducing CCHFV transmission and preventing human infections.