Abstract
BACKGROUND: Analysis of the effect of comorbid diseases on the concentration of biomarkers will help to deepen the understanding of the pathogenetic mechanisms of the impact of comorbid diseases on the course of COVID-19 and adjust prognostic models for its therapy.
 AIM: To study the impact of comorbid diseases on the severity and outcomes of COVID-19. In addition, an analysis of the levels of macrophage-derived chemokine, interferon-γ-induced protein 10 kD, soluble CD40 ligand, vascular endothelial growth factor has been carried out in 472 patients with COVID-19, depending on the presence of various forms of comorbid pathology.
 MATERIALS AND METHODS: To study the concentration of biomarkers an analysis has been conducted in a group of 1648 patients with confirmed COVID-19. The study assessed intergroup differences (disease outcome/severity of disease) in the general group (1648 patients) and in the group of patients without comorbidity (343 patients) — Charlson index less than 2 points. 472 medical histories of patients with COVID-19 have been analyzed, including with certain concentrations of the studied biomarkers and comorbid pathology included in the Charlson Index. For comparison, two samples have been formed: an experimental group consisting of patients with COVID-19 and the presence of a certain comorbid disease and a control group consisting of patients suffering from COVID-19 without a specified comorbid disease.
 RESULTS: For the first time, data has been obtained indicating that patients with COVID-19 have comorbid conditions with the levels of the studied biomarkers differing significantly from the indicators of the control group. Thus, in patients with arterial hypertension (I10–I15 according to the International Classification of Diseases, 10th revision), chronic heart failure (I50.0), diseases of the vascular system (I70–I79), cerebrovascular diseases (I60–I69), chronic kidney disease (N17–N19), the level of the macrophage-derived chemokine biomarker was significantly lower than in the patients without these diseases. At the same time, in the COVID-19 patients with respiratory diseases (J40–J47), the levels of interferon-γ-induced protein 10 kD and vascular endothelial growth factor were significantly lower than in the patients who did not have lung diseases.
 CONCLUSIONS: The study findings obtained have confirmed the role of signaling biomarkers in the development of severe forms and death in patients with COVID-19. Significant influence of comorbid pathology on the course of the new coronavirus infection has been shown.
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