COVID后期间急性呼吸道病毒感染患儿免疫-内分泌平衡失调的实验室指标

L. A. Alekseeva, A. Zhirkov, T. V. Bessonova, I. Babachenko, N. Tian, G. F. Zheleznikova
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Lymphocytes predominated in the blood test in the main group at the admission to the hospital; whereas neutrophils predominated in children of the comparison group. In comparison with the controls the children of the main group had significant decrease of the level of 25 cytokines and the level of only 4 cytokines was increased (CTACK; Eotaxin; SDF-1a; PDGF-BB); the tendency of immunoglobulin M decrease was noted. The level of cortisol in the main group was 2 times lower compared with the comparison group and did not differ from the control one; the level of triidothyronine and thyroxin was reliably decreased during the whole period of observation. During acute period there was determined positive correlated relation of cortisol with the number of neutrophils; granulocytic colony-stimulating factor; macrophage inflammatory protein; and a negative relation with the number of lymphocytes; factor-stromal cells. 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引用次数: 0

摘要

研究目的是调查COVID后时期急性呼吸道病毒感染患儿的免疫-内分泌功能障碍。主要研究组包括 22 名住院前 2-6 个月轻度 COVID-19 感染后表现为急性呼吸道病毒感染的儿童;对比研究组包括 7 名病史中没有 COVID-19 的急性呼吸道病毒感染儿童;对照研究组--15 名表面健康的儿童。除标准指标外,还调查了皮质醇、甲状腺激素、三甲状腺原氨酸、甲状腺素、总免疫球蛋白和细胞因子的水平。在入院时进行的血液检测中,主要群体的儿童以淋巴细胞为主,而对比群体的儿童则以中性粒细胞为主。与对照组相比,主要组儿童的 25 种细胞因子水平明显下降,只有 4 种细胞因子水平上升(CTACK、Eotaxin、SDF-1a、PDGF-BB);免疫球蛋白 M 呈下降趋势。主要观察组的皮质醇水平比对比组低 2 倍,与对照组无差异;三甲状腺原氨酸和甲状腺素水平在整个观察期间均呈可靠的下降趋势。在急性期,皮质醇与中性粒细胞数量、粒细胞集落刺激因子、巨噬细胞炎症蛋白呈确定的正相关关系,而与淋巴细胞数量、基质细胞因子呈负相关关系。在急性期,三甲状腺原氨酸水平与血小板数量、免疫球蛋白 M 呈正相关;在恢复期,三甲状腺原氨酸和甲状腺素水平与中性粒细胞数量呈正相关;与淋巴细胞数量呈负相关。急性呼吸道病毒感染后的儿童在 COVID 后期间出现免疫内分泌功能障碍,这表明肾上腺皮质和甲状腺系统激素的合成受到抑制;大多数细胞因子的合成受到抑制;COVID-19 可能导致先天性免疫激活不足,因此有必要进行免疫纠正治疗。
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Laboratory indicators of the disorders of immune-endocrine balance in children with acute respiratory viral infection during post-COVID period
Objective of the study is to investigate immune-endocrine dysfunctions in children with acute respiratory viral infections manifested during post-COVID period.Materials and methods. The main group included 22 children with acute respiratory viral infections manifested after mild COVID-19 infection 2–6 months before their hospitalization the comparison group included 7 children with acute respiratory viral infections without COVID-19 in their medical history; and the control group – 15 apparently healthy children. The level of cortisol; thyrotrophic hormone; triidothyronine; thyroxin; total immunoglobulin; cytokines was investigated in addition to standard indicators.Results. Lymphocytes predominated in the blood test in the main group at the admission to the hospital; whereas neutrophils predominated in children of the comparison group. In comparison with the controls the children of the main group had significant decrease of the level of 25 cytokines and the level of only 4 cytokines was increased (CTACK; Eotaxin; SDF-1a; PDGF-BB); the tendency of immunoglobulin M decrease was noted. The level of cortisol in the main group was 2 times lower compared with the comparison group and did not differ from the control one; the level of triidothyronine and thyroxin was reliably decreased during the whole period of observation. During acute period there was determined positive correlated relation of cortisol with the number of neutrophils; granulocytic colony-stimulating factor; macrophage inflammatory protein; and a negative relation with the number of lymphocytes; factor-stromal cells. During acute period there were positive correlated relations between the level of triidothyronine and the number of platelets; immunoglobulin M; and during reconvalescence period the level of triidothyronine and thyroxin positively correlated with the number of neutrophils; and negatively with the number of lymphocytes.Conclusion. During post-COVID period children after acute respiratory viral infections had identified immuneendocrine dysfunctions giving evidence to inhibition of the synthesis of hormones of adrenal gland cortex and thyroid system; synthesis of most cytokines; insufficient activation of congenital immunity that is likely to occur due to COVID-19 that proves the necessity of immune-corrective therapy.
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