Факторы риска, иммунологические механизмы и биологические маркеры тяжелого течения COVID-19 (обзор исследований)

Abstract

The article presents the conducted analysis of risk factors, immunological mechanisms and biological markers of the severe COVID-19 course. Official statistical data and scientific publications on the problem of assessing the risk of severe COVID-19 course were used in this analysis. It was found that elderly age, male gender, the presence of comorbidity (diabetes mellitus, cardiovascular, respiratory, renal and autoimmune diseases, and immunodeficiency conditions) increase the risk of an adverse outcome in COVID-19. The following immunological mechanisms of the disease manifestation and prognostic significance of different biological markers were determined: elevated levels of SAA, C-reactive protein, procalcitonin, IL-6, urea, creatinine, direct bilirubin, LDH, D-dimer and serum cholinesterase. Lymphopenia (abnormally low level of lymphocytes) and neutrophil-to-lymphocyte ratio (NLR) are the most common described prognostic markers in COVID-19. Thrombocytopenia and elevated D-dimer levels may indicate coagulopathies in patients with COVID-19 and predict morbidity and mortality even at the onset. Thus, the determination of risk factors and levels of inflammatory markers (commonly found in severe cases of COVID-19) should be used to choose the right treatment tactics to improve the clinical outcome. KEYWORDS: COVID-19, risk factors, immunological mechanisms, comorbidity, biological markers. FOR CITATION: Bilichenko T.N. Risk factors, immunological mechanisms and biological markers of severe COVID-19 course (study overview). Russian Medical Inquiry. 2021;5(5):237–244 (in Russ.). DOI: 10.32364/2587-6821-2021-5-5-237-244.