Post-COVID Syndrome: immunological sequels 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 through the first half of 2021. About 5% of those infected progress to severe or life-threatening COVID-19, presenting with lung damage severe 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 develops post-sepsis syndrome, which is characterized by impaired immune function, a state of chronic inflammation, similar to elderly and immunosuppressed patients with an inadequate response to infections, impaired cognitive, psychiatric, cardiovascular, renal and decrease in 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 patients septic. The metabolic, immunological and psychological status of patients after COVID-19 will be evaluated. Metabolic status through analysis of medical records and laboratory tests. The immune status through the 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 of monocytes and pro and anti-inflammatory cytokines in the culture supernatant also of monocytes. And the psychological state through the evaluation of the patients' quality of life using the short-form health survey SF-36 questionnaire. (AU)