Broncho-obstructive syndrome and the enzymes of cellular energy metabolism after coronavirus infection

N. Kosyakova, M. V. Akulenko
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Abstract

Broncho-obstructive syndrome (BOS) after coronavirus infection is characterized by long-term, dry and painful cough which is hard for treatment, significantly reducing the quality of life of the patients. The goal of the study: to investigate the specific features of clinical manifestations of BOS diagnosed for the first time in patients belonging to different age groups in post-COVID-19 period and to estimate the degree of mitochondrial dysfunction by the imbalance of the enzymes of cellular energy metabolism. Materials and methods. 298 patients with BOS (age 18–78) were observed continuously for 2 years. Standard clinical, biochemical and functional examination was carried out, Saint George`s Respiratory Questionnaire (SGRQ) was used. Mitochondrial dysfunction was determined by the ratio of levels of two enzymes, lactate dehydrogenase (LDH) and succinate dehydrogenase (SDH), in peripheral blood lymphocytes. Statistical data processing was performed in STATISTICA 10.1 program package. Results. The duration and severity of BOS manifestations increased with age, they were the most prominent in the age group older than 60 y/o. Bronchial asthma was diagnosed for the first time in 85 patients, most of them belonging to the group 18–25 y/o. In all the patients with BOS, the SGRQ coeffitient was above 50, and comorbidity was established in 82.4% of the patients. The longest duration of BOS (49.4±3.5 days) was established in the group older than 60 y/o (n = 86). LDH/SDH ratio decreased from 6 to 4.8–5.2 a.u. in all the age groups. Such changes should be taken into account in the patients from young age groups. Conclusion. The revealed low values of LDH/SDH ratio have not been shown in the available literature earlier. These values demonstrate the development of secondary mitochondrial dysfunction in post-COVID-19 period in both younger and older age groups, particularly, in patients with more severe progression of BOS. Estimation of this parameter would allow to revealthe personified characteristics for each patients, which is important for quantifying the efficacy and duration of the required antioxidant therapy.
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冠状病毒感染后的支气管阻塞综合征和细胞能量代谢酶
冠状病毒感染后的支气管阻塞综合征(BOS)以长期干咳和疼痛为特征,难以治疗,大大降低了患者的生活质量。本研究的目的是:调查冠状病毒感染后-19 期间不同年龄组患者首次确诊的支气管阻塞综合征临床表现的具体特征,并通过细胞能量代谢酶的失衡估计线粒体功能障碍的程度。材料和方法对 298 名 BOS 患者(18-78 岁)进行了为期两年的连续观察。进行了标准的临床、生化和功能检查,并使用了圣乔治呼吸问卷(SGRQ)。线粒体功能障碍通过外周血淋巴细胞中乳酸脱氢酶(LDH)和琥珀酸脱氢酶(SDH)两种酶的水平比值来确定。统计数据处理由 STATISTICA 10.1 程序包完成。结果随着年龄的增长,支气管哮喘的持续时间和严重程度也在增加,60 岁以上年龄组的表现最为突出。85名患者首次被诊断为支气管哮喘,其中大部分属于18-25岁年龄组。所有支气管哮喘患者的 SGRQ 系数均高于 50,82.4% 的患者有合并症。60 岁以上组(86 人)的 BOS 持续时间最长(49.4±3.5 天)。所有年龄组的 LDH/SDH 比值均从 6 a.u. 降至 4.8-5.2 a.u.。年轻组患者应考虑到这些变化。结论所发现的 LDH/SDH 比值较低的情况在之前的文献中没有出现过。这些数值表明,COVID-19 后的年轻和老年患者,尤其是 BOS 进展更为严重的患者,都出现了继发性线粒体功能障碍。估算这一参数可以揭示每位患者的个性化特征,这对于量化所需抗氧化疗法的疗效和持续时间非常重要。
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