ВЗАИМОСВЯЗЬ УРОВНЯ АННЕКСИНА А5 И РЕГРЕССА ПУЛЬМОНАЛЬНЫХ ОСЛОЖНЕНИЙ У БОЛЬНЫХ С ПНЕВМОНИЕЙ, АССОЦИИРОВАННОЙ С SARS-COV-2, НА АМБУЛАТОРНОМ ЭТАПЕ

Abstract

Abstract. Introduction. To date, there are still some questions regarding the novel coronavirus infection. One of them concerns the long-term post-COVID-19 effects and the regression of complications that have developed during the acute period of this disease. Apoptosis is one of the universal mechanisms for maintaining the body homeostasis. Annexin A5 (ANXA5) is a calcium-containing protein indicative of early apoptosis. Aim: To determine the relationship between the annexin A5 levels and the regression of pulmonary complications in patients with SARS-CoV-2-associated pneumonia 6 months after being treated regarding COVID-19. Materials and Methods. We examined 90 residents of the Astrakhan region, diagnosed with the coronavirus infection COVID-19 (virus identified), aged 47 [39; 57] years. Pulmonary complications were detected in 46 patients using сomputed tomography at discharge: 30 (33.3 %) with diffuse pulmonary fibrosis, 3 (3.3 %) with exudative pleuritis, and 13 (11.1 %) with the combination of the two. After 6 months of outpatient follow-up, pulmonary complications were detected in 16 (17.8 %) patients: Diffuse pulmonary fibrosis in 7 (7.8 %), pleural adhesions in 5 (5.6%), and both complications 4 (4.5 %) patients. ANXA5 level (ng/ml) in blood serum was determined by enzyme immunoassay method using immune-enzyme reaction analyzer Uniplan AIFR-01 manufactured by Picon, Russia. The distribution of numerical scores was nonparametric. To determine the statistical significance of differences in quantitative characteristics, we used the Mann-Whitney test in two independent samples and the Wilcoxon test in dependent samples. Differences in qualitative characteristics in two independent groups were analyzed using contingency tables with subsequent calculation of Pearson’s χ2 criterion, odds ratio, and 95% confidence interval. Results and Discussion. Even after 6 months of follow-up the differences remained statistically significantly higher than in the control group. Number of patients with pulmonary complications on сomputed tomography 6 months after hospitalization decreased threefold, i. e., from 51.1% down to 17.8 %. ANXA5 level after 6 months of follow-up in patients with pulmonary complications on сomputed tomography was statistically significantly higher compared to the patients of this group without pulmonary complications (p<0.001). Conclusions. Probability of pulmonary complications on сomputed tomography after 6 months of follow-up was 10 times higher in patients with the insufficient dynamics of ANXA5 levels, as compared to those with the positive dynamics of this index level (OR 10.0, 95% CI 2.7-33.3).