CLINICAL AND IMMUNOLOGICAL FEATURES OF REACTIVATION OF CHRONIC LYME BORRELIOSIS AFTER A PREVIOUS INFECTION OF COVID-19

Abstract

A clinical case of reactivation of chronic Lyme borreliosis after a COVID-19 infection has been described. The purpose of the study is to use the example of a clinical case of reactivation of chronic Lyme borreliosis to demonstrate the peculiarities of its course, and modern methods of diagnosis and treatment, as well as to confirm the potential impact of coronavirus disease on the possibility of reactivation of chronic infectious pathology, even with a mild course of the COVID-19 infection. Materials and Methods. A diagnosis of borreliosis polyarthritis and Lyme myocarditis has been established. Since the specific lesions occurred for no apparent reason, and the symptoms appeared in winter, this ruled out the possibility of re-infection with Lyme borreliosis. During the further search for a potential causative agent that led to the detected changes, the patient was tested for the detection of antibodies to Borrelia burgdorferi by immunoenzymatic analysis. Results and discussion. The obtained positive result in the detection of specific antibodies (IgM – 46.64 units/ml, IgG – 87.31 units/ml) indicated the reactivation of Lyme borreliosis. At the same time, the immunological changes were significantly deeper than during the initial episode of infection. Treatment was prescribed: doxycycline 100 mg twice a day for 28 days, anti-inflammatory therapy. After completion of the course of etiotropic therapy, there was clinical remission, as well as negative results of specific IgM after 3, 6, and 12 months. Even 3 months after achieving clinical remission, the patient had residual immunological changes. Conclusion. So, the clinical case shows the difficulties of establishing a diagnosis of reactivation of Lyme borreliosis, and the need for clinical vigilance of practical healthcare specialists regarding similar cases, even with a mild course of the COVID-19 infection, is emphasized.