PROLONGED IMMUNE-INFLAMMATORY REACTIONS IN PATIENTS WITH COVID-19- ASSOCIATED SURGICAL PATHOLOGY IN THE POSTCOVID PERIOD

Abstract

Summary. Introduction. The combination of pathogenetic factors of the main surgical pathology, multiple organ dysfunction, acute respiratory distress syndrome and cytokine storm against the background of SARS-Cov-2 infection justifies the relevance of this study.
 Materials and methods. We examined 13 patients with acute COVID-19 and 29 patients with SARS-Cov-2-associated urgent surgical pathology. Investigated the concentration of C-reactive protein (CRP) by latex agglutination, C3 and C4 components of the complement by immunoturbidimetry, the content of interleukins IL-6 and IL-18 by ELISA, determination of autoantibodies by luminescence microscopy.
 Results. In patients with SARS-Cov-2-associated urgent surgical pathology, certain patterns of changes in the markers under study were revealed: in all examined groups of patients, an increased concentration of C-reactive protein was observed, which indicated a systemic inflammatory response both in the acute and in the postcovid period. In the postcovid period of viral infection, the most significant are the high frequency of the maximum increase in the concentration of CRP, C3- and C4-complement components, and a significant or moderate increase in the content of interleukins IL-6 and IL-18, more pronounced than in the acute period of infection. The maximum increase in pro-inflammatory cytokines was found in patients with abdominal surgical pathology against the background of COVID-19 (postcoid period), while in the acute period of COVID-19, an increase in the concentration of IL-6 had no diagnostic value. A cytokine storm was detected in 20.5% of the examined patients with COVID-19-associated urgent surgical pathology.
 Conclusions. For COVID-19-associated surgical pathology, the formation of autoimmune conditions is characteristic, which is expressed in the presence of a wide range of autoantibodies to nuclear structures. Thus, for the prevention and complex treatment of COVID-19-associated urgent surgical pathology, it is advisable to use personified step-by-step immunotropic therapy.