Post-COVID Sydrom: immunological sequelae after COVID-19 infection

Abstract

COVID-19 is an infectious disease primarily of the respiratory tract that resulted in more than 4 million documented deaths by the first half of 2021. About 5% of those infected progress to severe or life-threatening COVID-19 presenting severe lung damage or even multiple organ dysfunction. Sepsis and COVID-19 share many pathophysiological and clinical features such as consumptive thrombocytopenia, hemolytic anemia, vascular microthrombosis, multiple organ dysfunction syndrome, coagulopathy, septic shock, respiratory failure, fever, leukopenia, hypotension, leukocytosis, and high cytokine production. One in six patients recovered from sepsis develop the post-sepsis syndrome, which is characterized by impaired immune function, a state of chronic inflammation, similar to elderly and immunosuppressed patients with inadequate response to infections, impairment in cognitive, psychiatric, cardiovascular, renal, and decreased quality of life. Due to the great similarity between the pathophysiology of sepsis and COVID-19, it is believed that patients who developed COVID-19 and who present sequelae may also develop Post-Covid Syndrome. Based on this possibility, the objective of this study is to identify and characterize the Post-Covid Syndrome, as well as the prognostic markers of quality of life and survival of patients after hospital discharge, based on markers that have already been studied by the group in septic patients. There will be the evaluation of the metabolic, immunological and psychological status of patients after COVID-19; the metabolic state through analysis of medical records and laboratory tests; the immune status through survival and prognostic markers with microRNAs -15b-5p, -16-5p, -20a-5p, -25-3p, -27a-3p, -29a-3p, -30d-5p, - 93-5p, -146a-5p, -148a -3p, -191-5p, -195-5p, -223-3p, study of the expression of genes NLRP3, TLR2, TLR4, NF-kB, IL-1², IL- 1±, IL-10, TNF-±, IL-18, caspase 1, caspase 11, caspase 12, HSP70, HSP40 and HMGB1 from monocytes and pro and anti-inflammatory cytokines in the supernatant of the culture also from monocytes; and, also, the psychological state through the assessment of the quality of life of patients using the short-form health survey SF-36 questionnaire. (AU)