INVESTIGATION OF THE INTERCONNECTIONS AND DIAGNOSTIC EFFECTIVENESS OF CYTOKINESIN ASSESSING THE SEVERITY COVID-19 PATIENTS

Abstract

The nature and intensity of the reaction of the human immune system to infection with the SARS-CoV-2 virus depends on many factors. The immune response to infection includes a cellular link and a humoral link. The humoral link consists of effector-specific (antibodies) and non-specific factors (acute phase proteins, procalcitonin(PCТ), α- and β-interferons) and regulatory factors such as cytokines (interleukins (IL), γ-interferon (IFNγ)) and mediators (leukotrienes, etc.). In our work, serum levels of cytokines, namely IFNγ, IL-2, IL-6, IL-8, IL-10, IL-17A, IL-18 and the nonspecific effector factor of the immune system РСТwith varying degrees of severity of COVID-19 disease. Biomaterial (blood serum) of 91 patients aged 29-88 years (average age 53.9 years; 15 women, 76 men) was collected between May 2020 and July 2021. We divided patients into groups according to severity, depending on clinical data, oxygen demand, and hospitalization data. COVID-19 patients of «mild degree» n=9 are patients on outpatient treatment, patients of «moderate degree» n=38 are patients of the bed department of an infectious hospital, «severe degree» n=44 are patients of the infectious intensive care unit. The control group of patients n=20, blood donors without chronic diseases. As a result of the study, we identified the most important markers of the severity of the condition. Also, using ROC analysis, we calculated the thresholds for differential diagnosis of different degrees of severity according to significantly different criteria, the diagnostic effectiveness of indicators of immunity mediators in the developed logistic regression model. We have discovered and statistically confirmed the indicators that most significantly affect the severity of COVID-19 – IL-6, IL-8, IL-10, IL-18, PCT, IFNγ. We found a maximum increase in IL-17A and IFNy at a mild degree, and a decrease in the moderate and maximum severe degree of COVID-19. The factors of the poor prognosis were an increase in IL-6, IL-10, PCT, and a decrease in IFNγ. Correlations of immune response mediators (IL-8, IL-17A, IL-18, IFNγ) have been found, allowing a deeper understanding of the mechanism of development of disorders, imbalance of the immune response.

Keywords

• sars-cov-2
• ifnγ
• il-6
• il-8
• il-10
• il-17а
• il-18