Особенности иммунореактивности организма в постковидном периоде у полиморбидных пациентов с хроническими очагами инфекции ЛОР-органов и полости рта

Abstract

The high level of morbidity and labor losses among the population during the epidemic of a new coronavirus infection is largely determined by the protracted course of the post-COVID syndrome, which is often complicated by the exacerbation of chronic foci of infection of the upper respiratory tract and oral cavity. Clinical manifestations of a developed immunodeficiency state require an assessment of the characteristics of the body’s immunoreactivity in patients who have undergone COVID-19 in order to develop targeted programs for their immunorehabilitation and prevent manifestations of chronic focal infection, which was the purpose of the study. Immunological examination of 37 patients aged 42 to 60 years (53 ± 3.8 years), 24 women and 13 men, in the post-COVID period with exacerbation of chronic ENT infection (nasopharyngitis, sinusitis, otitis media, laryngitis) and dental pathology (generalized inflammatory periodontal disease, apical granulomas) showed the formation of an immunological imbalance with a quantitative deficiency of T-helpers with a high level of cytotoxic T-lymphocytes and NK cells expressing the alpha chain of the CD8 antigen as well as cytokine-producing NK cells against the background of a pronounced decrease in the resources of alpha and gamma interferon and a high level of Ig E and CIC in the blood. The established immunological prerequisites for comorbid infection, allergization, autoimmunization, and chronic sequel of inflammatory response motivated approaches to the rehabilitation of patients in the post-COVID period and the prevention of activation of chronic foci of infection in the ENT organs and oral cavity through sequential detoxification and immunocorrection. The positive experience of using bioactive preparations of natural origin with a complex detoxifying, immunotropic, antioxidant, and adaptogenic action is presented.