RESISTANCE TO GLUCOCORTICOSTEROID THERAPY IN PATIENTS WITH SARS-COV-2 INFECTION WITH ELEVATED MARKERS OF ENDOTOXEMIA

Abstract

<h3>Introduction</h3> One of the most important factors potentiating the effect of SARS-CoV-2 virus influencing the results of anti-inflammatory therapy may be lipopolysaccharides of gram negative flora, which are strong activators of innate immune system mechanisms. <h3>Methods</h3> 104 patients with PCR-positive SARS-CoV-2 age 44-70 years who were hospitalized were examined. Patients were divided into 2 groups: Group 1 (n = 51) – patients with a positive response to glucocorticosteroid therapy; and Group 2 (n = 53) – patients with no response to glucocorticosteroid therapy. For the control 20 healthy people were selected. The patients were examined for the levels of lipopolysaccharide-binding protein (LBP), sCD14-ST, ferritin and C-reactive protein (CRP) in peripheral blood. <h3>Results</h3> In the Group 1 patients with new PCR-positive SARS-CoV-2 infection who responded positively to glucocorticosteroid therapy, significantly higher levels of LBP, 60.1 μg/mL [36.3; 73.5], sCD14-ST – 3181 pg/mL [2799; 3420], ferritin 276.00 µg/L [184.00;463.00], and CRP 74.3 mg/L [34.9;108.0] were noted compared with the control group (p<0.01). In the Group 2 patients with a negative response to glucocorticosteroid anti-inflammatory therapy, significantly higher levels of LBP, sCD14-ST, ferritin, and CRP were seen compared with Group 1. <h3>Conclusion</h3> Elevated levels of endotoxemia markers may play a role in the response to glucocorticosteroid therapy in patients with SARS-CoV-2.