fcmedicineФундаментальная и клиническая медицинаFundamental and Clinical Medicine2500-07642542-0941КемГМУ10.23946/2500-0764-2022-7-4-45-50fcmedicine-603Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL RESEARCHОсобенности лабораторных маркеров состояния гемодинамики у пациентов средней и тяжелой степени течения COVID-19Biomarkers of hemodynamic status in patients with moderate and severe COVID-19https://orcid.org/0000-0001-6408-239XШаповаловЮ. К.ShapovalovYu. K.

Шаповалов Юрий Константинович, ассистент кафедры оториноларингологии

672000, г. Чита, ул. Горького, д. 39а

Dr. Yuri K. Shapovalov, MD, Assistant Professor, Department of Otorhinolaryngology

39a, Gor’kogo Street, Chita, 672000

yurashap95@mail.ruФГБОУ ВО «Читинская государственная медицинская академия» Министерства здравоохранения Российской ФедерацииРоссияChita State Medical AcademyRussian Federation202229122022744550Copyright © Шаповалов Ю.К., 20222022Шаповалов Ю.К.Shapovalov Y.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://fcm.kemsmu.ru/jour/article/view/603

Нарушения гемодинамики у пациентов средней и тяжелой степени течения COVID-19 − один из важных факторов повреждения органов. Однако в литературе мало работ, демонстрирующих изменения гуморальных регуляторов функционального состояния гемодинамики.

Цель

Цель. Оценить лабораторные маркеры состояния гемодинамики у среднетяжелых и тяжелых пациентов с вирусной пневмонией, ассоциированной с COVID-19.

Материалы и методы

Материалы и методы. Обследованы 2 группы пациентов: пятнадцать средней степени тяжести и шестнадцать тяжелобольных COVID-19. Контрольную группу составили 20 здоровых добровольцев. Методом ИФА определяли содержание эндотелина-1, BNP, NT-proBNP (Enzyme-Linked Immunosorbent Assay Kit; Elisa Cloud-Clone). Количество нитритов NO2 и нитратов NO3 определяли методом, основанным на ферментном превращении нитрата в нитрит. Реакция регистрировала колориметрическую концентрацию нитрита по азокрасителю, образующемуся в реакции Грисса (набор Total Nitric Oxide and Nitrate/Nitrite Parameter Assay Kit; Elisa Cloud-Clon).

Результаты

Результаты. Объективно подтверждены изменения маркеров состояния гемодинамики у пациентов COVID-19. Значения NO, NO2, эндотелина-1 оказались крайне вариабельными. При этом уровень NT-proBNP и BNP у пациентов средней степени тяжести меньше на 65% и больше на 472%, а у тяжелобольных меньше на 50% и больше на 548% относительно контроля соответственно (p<0,05). Это является признаком повышенной нагрузки левого желудочка и сердечной недостаточности.

Заключение

Заключение. При усугублении тяжести течения COVID-19 в крови прогрессивно возрастает уровень BNP и снижается NT-proBNP, изменений концентрации нитритов не отмечается.

Aim

Aim. To assess laboratory markers of hemodynamic status in patients with moderate to severe COVID-19.

Materials and Methods

Materials and Methods. Here we examined 15 patients with moderate COVID-19 and 16 critically ill COVID-19 patients. The control group consisted of 20 healthy volunteers. The levels of endothelin-1, brain natriuretic peptide (BNP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured by enzyme-linked immunosorbent assay. The amounts of nitrites (NO2) and nitrates (NO3) were measured by a Griess test (an enzymatic conversion of nitrates to nitrites) with a following colorimetric analysis.

Results

Results. Measurements of endothelin-1, nitrites, and nitrates showed high variability. The levels of NT-proBNP were reduced by 65% and 50% in patients with moderate and severe COVID-19, respectively (p < 0.05). In contrast, the levels of BNP were elevated by 472% and 548% in these patient categories (p < 0.05). These results indicated increased left ventricular load and suggested a heart failure.

Conclusion

Conclusion. Progressive increase of BNP and concurrent reduction of NT-proBNP indicate affected hemodynamics in patients with moderate and severe COVID-19.

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The authors declare that there are no conflicts of interest present.