Prerequisites for the creation of an atlas of postcovid inflammation as a way of personalized pharmacotherapy, as well as predicting and preventing organ and systemic dysfunctions

Abstract

SARS-CoV-2 is a novel coronavirus that has been identified as the cause of the 2019 coronavirus infection (COVID-19), which originated at Wuhan city of PRC in late 2019 and widespread worldwide. As the number of patients recovering from COVID-19 continue to grow, it’s very important to understand what health issues they may keep experiencing. COVID-19 is now recognized as an infectious disease that can cause multiple organ diseases of various localization. It is against this background that a new term was introduced: post-acute post-COVID-19 syndrome characterized by several persistent symptoms inherent in the acute phase of the disease, as well as the occurrence of delayed and (or) long-term complications beyond 4 weeks from the onset of the disease. The work reflected in this article revealed a portrait of a patient with post-COVID-19 syndrome, the most common complications of this period, as well as the mechanisms of their development and the resulting metabolic, cellular, tissue disorders leading to the tissue and organ dysfunctions. A comprehensive biochemical and immunological screening was carried out using the example of three clinical cases to identify the most significant disorders in these patients and to correlate with their clinical status over time. In point of fact, such patients were diagnosed with vascular dysfunction factors (development of endothelial dysfunction), metabolic dysfunction factors (metabolic acidosis, mitochondrial dysfunction, carbohydrate metabolism disorder, insulin resistance, altered branched-chain and aromatic amino acid metabolism), neurological disorder factors (neurotoxicity of the resulting metabolites), immunological disorder factors (decreased efficiency of detoxification systems, secondary immunodeficiency, risk of secondary bacterial infection).

Neutrophil and monocyte extracellular traps in the diagnosis of post-COVID syndrome

“…The net-like structure of NET is of special physiological significance, since it is functionally active. The filaments of such net capture pathogens and dying cells of the body, and then perform retraction [8]. Monocytes/macrophages absorb and hydrolyze the net together with the pathogens and the remains of dead cells.…”

Post-covid syndrome is associated with the formation of neutrophil extracellular traps in a filamentous form

“…Больные с постковидным синдромом страдают от головных болей, астении, артромиалгий, последствий поражения внутренних органов (легких, сердца, ЖКТ), кожи и нейропсихопатологических расстройств. У больных развивается «постковидное воспаление» различной локализации, которое, как можно предположить, индуцировано формированием в крови нейтрофильных экстраклеточных ловушек (НЭЛ) [1]. Поражение внутренних органов может быть обусловлено токсическим действием продуктов ферментативной деградации волокон c ДНК, возникающих при распаде НЭЛ.…”