jofinЖурнал инфектологииJournal Infectology2072-6732IPO “АIDSSPbR"10.22625/2072-6732-2021-13-4-57-65jofin-1270Research ArticleОригинальные исследованияOriginal ResearchМикробиота и кишечная проницаемость как драйверы гастроэнтерологических проявлений новой коронавирусной инфекции (COVID-19)Microbiota and intestinal permeability as drivers of gastroenterological manifestations of new coronavirus infection (COVID-19)КозловК. В.KozlovK. V.

профессор кафедры инфекционных болезней (с курсом медицинской паразитологии и тропических заболеваний), д.м.н., профессор,

Санкт-Петербург

Saint-Petersburg

kosttiak@mail.ruРатниковаА. К.RatnikovaA. K.

 младший научный сотрудник, врач-кардиолог высшей категории приемного отделения;

главный врач,

Санкт-Петербург

Saint-Petersburg

a.ratnikova@hcresort.ruГриневичВ. Б.GrinevichV. B.

заведующий 2 кафедрой (терапии усовершенствования врачей), д.м.н., профессор,

Санкт-Петербург

Saint-Petersburg

grinevich_vb@mail.ruКравчукЮ. А.KravchukYu. A.

профессор 2 кафедры (терапии усовершенствования врачей),

Санкт-Петербург

Saint-Petersburg

kravchuk2003@mail.ruМиклушП. И.MiklushP. I.

слушатель ординатуры по специальности «Инфекционные болезни»,

Санкт-Петербург

Saint-Petersburg

www.pantik.ru@mail.ruВоенно-медицинская академия имени С.М. КироваРоссияMilitary Medical Academy named after S.M. KirovRussian FederationСеверо-западный окружной научно-клинический центр им. Л.Г. Соколова; «Первая Линия», Health Care ResortРоссияNorth-Western District Scientific and Clinical Center named after L.G. Sokolov; «Pervaya Liniya», Health Care ResortRussian Federation2021261220211345765Copyright © Козлов К.В., Ратникова А.К., Гриневич В.Б., Кравчук Ю.А., Миклуш П.И., 20212021Козлов К.В., Ратникова А.К., Гриневич В.Б., Кравчук Ю.А., Миклуш П.И.Kozlov K.V., Ratnikova A.K., Grinevich V.B., Kravchuk Y.A., Miklush P.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.niidi.ru/jofin/article/view/1270

Важным направлением эффективной борьбы с пандемией COVID-19 является изучение патогенетических особенностей инфекции SARS-CoV-2, в том числе основанных на оценке состояния микробиоты и кишечной проницаемости.

Цель

Цель: изучить клинические особенности новой коронавирусной инфекции (COVID-19) у больных легкой и средней степени тяжести на этапе госпитализации, а также определить роль нарушений кишечной проницаемости, изменений качественного и количественного состава микробиоты кишечника в процессе формирования системного воспаления у больных COVID-19.

Материалы и методы

Материалы и методы. Исследование выполнено 80 пациентам с COVID-19, средний возраст которых составил 45 лет, 19 из них имели легкую и 61 – среднюю степень тяжести заболевания. Объем обследования включал традиционные клинические, клинико-лабораторные, биохимические, инструментальные и лучевые исследования, а также оригинальные методики изучения микробиоты и кишечной проницаемости.

Результаты и выводы

Результаты и выводы. Изучены клинические особенности течения COVID-19, выявлены клинико-биохимические особенности, проявления системного воспаления, изменения микробиома кишечника больных легкой и средней степени тяжести, определены уровни концентрации провоспалительных цитокинов, инсулина, фекального кальпротектина и зонулина, отражающие особенности кишечной проницаемости на фоне COVID-19. Подчеркнута роль кишечной проницаемости и микробиоты как основных драйверов развития гастроэнтерологических проявлений COVID-19, сопровождающихся более тяжелым течением заболевания. 

An important area of effective control of the COVID-19 pandemic is the study of the pathogenetic features of SARSCoV-2 infection, including those based on the assessment of the state of the microbiota and intestinal permeability.

Purpose

Purpose: To study the clinical features of the new coronavirus infection (COVID-19) in patients of mild and moderate severity at the stage of hospitalization, to determine the role of intestinal permeability disorders, changes in the qualitative and quantitative composition of the microbiota in the formation of systemic inflammation in COVID-19 patients.

Material and methods

Material and methods: The study was performed in 80 patients with COVID-19, whose average age was 45 years, 19 of them had mild and 61 had moderate severity of the disease. The scope of the examination included traditional clinical, clinical and laboratory, biochemical, instrumental and radiation studies, as well as original methods for studying microbiota and intestinal permeability.

Results and conclusions

Results and conclusions: Clinical features of the course of COVID-19 were studied, clinical and biochemical features, manifestations of systemic inflammation, changes in the intestinal microbiome of patients with mild and moderate severity were identified, concentration levels of proinflammatory cytokines, insulin, fecal calprotectin and zonulin were determined, reflecting the features of intestinal permeability against the background of COVID-19. The role of intestinal permeability and microbiota as the main drivers of the development of gastroenterological manifestations of COVID-19, accompanied by a more severe course of the disease, is emphasized. 

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