ACTIVATION OF THE IMMUNE-INFLAMMATORY RESPONSE AMONG PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA ASSOCIATED WITH CORONAVIRUS INFECTION

Abstract

The aim of the study is to determine the levels of markers of the immune-inflammatory response in patients with community-acquired pneumonia associated with coronavirus infection. Materials and methods. An open, prospective, observational study was conducted to achieve the goal and address the specified issues. From January, 2021 to February, 2022, 256 patients aged 40 to 65 years with community-acquired pneumonia were examined at the outpatient clinic of the Kherson City Clinical Hospital named after A. Tropin and O. Tropin. Among them, 177 patients had community-aquired pneumonia associated with SARS-CoV-2, and 79 were tested negative for coronavirus infection. Additionally, 35 healthy volunteers were examined on an outpatient basis. The assessment of interleukin-6, interleukin-10, and hsCRP was performed in blood plasma using enzyme-linked immunosorbent assay with standard kits: "HF CRP-ELISA-Best," "IL-6-ELISA-Best," "IL-10-ELISA-Best," following the provided instructions. Results. The level of high-sensitivity C-reactive protein between the groups of patients was significantly higher by 27.5% in the group of patients with community-acquired pneumonia and COVID-19 than in patients with community-acquired pneumonia without COVID-19. Interleukin-6 was the highest in the group of patients with community-acquired pneumonia and COVID and was significantly higher by 9.5% compared with the group of patients with community-acquired pneumonia without COVID and 3.8 times higher compared with the value in healthy volunteers. There was no significant difference in interleukin-10 levels between the group of patients with community-acquired pneumonia with COVID-19 and the group of patients with community-acquired pneumonia without COVID. The level of this indicator in the group of practically healthy volunteers was significantly higher by 14.3% and 13.9% compared to the group of patients with community-acquired pneumonia with COVID-19 and the group of patients with community-acquired pneumonia without COVID-19, respectively. Correlation analysis revealed the following relationships between the parameters: a direct relationship between interleukin-6 and high-sensitivity C-reactive protein (R = +0.43, p < 0.05) and a direct relationship between IL-6/IL-10 and high-sensitivity C-reactive protein (R = +0.35, p < 0.05). There was no significant correlation between interleukin-10 and high-sensitivity C-reactive protein levels. Conclusion. Assessment of proinflammatory cytokines can be used for predicting the severity of community-acquired pneumonia associated with coronavirus infection. The possible association between the level of proinflammatory cytokines and the severity of community-acquired pneumonia in the pre-hospital stage is important for assessing possible complications of the disease and developing a preventive action plan.