Russian Journal of Infection and ImmunityRussian Journal of Infection and ImmunityИнфекция и иммунитет2220-76192313-7398SPb RAACI192510.15789/2220-7619-ABS-1925ORIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИResearch ArticleAssociations between serum levels of C3, C4, and total classical complement activity in COVID-19 patients at the time of admission and clinical outcomeСвязь уровня сывороточных С3, С4 и общей активности классического пути активации комплемента у пациентов с COVID-19 при госпитализации с клиническим исходомRaziA.РазиА.
Iran, Islamic Republic of

PhD, MD (Medicine), Assistant Professor

д.м.н., доцент, преподаватель кафедры урологии

raknv@mail.ruAzimianA.АзимианА.

PhD, MD (Medicine), Associate Professor, Faculty Member, Department of Pathobiology and Laboratory Sciences

д.м.н., доцент, преподаватель кафедры патобиологии и лабораторных наук

raknv@mail.ruArezumandR.АрезумандР.
Iran, Islamic Republic of

PhD, MD (Medicine), Assistant Professor, Faculty Member, Department of Pathobiology and Laboratory Sciences

д.м.н., ассистент, преподаватель кафедры патобиологии и лабораторных наук

raknv@mail.ruSolatiA.СолатиА.
Iran, Islamic Republic of

PhD, MD (Philosophy), Associate Professor, Faculty Member, Department of English Language

д.ф.н., доцент, преподаватель кафедры английского языка медицинского факультета

raknv@mail.ruAhmadabadH. N.АхмадабадХ. Н.
Iran, Islamic Republic of

PhD, MD (Medicine), Associate Professor, Faculty Member, Department of Pathobiology and Laboratory Sciences

д.м.н., доцент, преподаватель кафедры патобиологии и лабораторных наук

namdar360@gmail.comNorth Khorasan University of Medical SciencesСеверо-Хорасанский университет медицинских наукNorth Khorasan University of Medical SciencesСеверо-Хорасанский университета медицинских наук08072022161120221258698740804202227062022Copyright ©; 2023, Razi A., Azimian A., Arezumand R., Solati A., Ahmadabad H.N.Copyright ©; 2023, Рази А., Азимиан А., Арезуманд Р., Солати А., Ахмадабад Х.Н.2023Razi A., Azimian A., Arezumand R., Solati A., Ahmadabad H.N.Рази А., Азимиан А., Арезуманд Р., Солати А., Ахмадабад Х.Н.https://creativecommons.org/licenses/by/4.0https://iimmun.ru/iimm/article/view/1925

In the present study, we investigated the association between complement system status at the time of admission and clinical outcomes in COVID-19 patients. This single-center study was carried out with sixty-one adult patients with COVID-19 who were hospitalized at Imam Hassan Hospital of North Khorasan University of Medical Sciences (Bojnurd, Iran) with less than three days passage since onset of COVID-19 symptoms. Twenty-three healthy volunteers with demographic features similar to the patient group (matched by age and gender) were included in the study as a control group. Patient information including demographic information, demographic data, clinical characteristics, and clinical outcomes were obtained from electronic medical records. Of 61 hospitalized patients with COVID-19, 28 (47.54%) were female, and the average age was 48.7±8.8 years. The healthy control group included 23 cases (11 (47.8%) female, 12 (52.1%) males, mean age 46.4±4.4 years). Twenty-one of the 61 patients (34.4%) were admitted to the ICU, and sixteen of them (26.2%) died. Thirty-three (54.10%) patients with COVID-19 were hospitalized for less than 7 days, and 28 (45.90%) of them were hospitalized for ≥ 7 days. Our results show that length of hospital stay in the no-ICU group was significantly lower than the ICU admission or death groups (6.49±0.24 vs. 8.85±1.59 and 10.53±1.80, p = 0.0002). The levels of C3, C4, and CH50 were determined through the immunoturbidimetric method and single-radial-haemolysis plates, respectively, on serum samples obtained from patients at the time of admission or those in the control group. Our results indicate that C3, C4 and CH50 levels were markedly lower in COVID-19 patients than in the control group. We also found that complement parameter levels in COVID-19 patients who died or were admitted to ICU were significantly lower than in non-ICU COVID-19 patients. In general, it seems that serum level of C3, C4, and CH50 at admission may predict disease progression or adverse clinical outcome in COVID-19 patients.

В статье представлены результаты оценки зависимости клинического исхода у пациентов с COVID-19 от состояния системы комплемента на момент госпитализациии. В одноцентровое исследование были включены госпитализированные в больницу имама Хасана Северо-Хорасанского университета медицинских наук (Боджнурд, Иран) взрослые пациенты с COVID-19 (n = 61), у которых с момента появления симптомов COVID-19 прошло менее трех дней. Контрольную группу составили 23 здоровых добровольца, сходных по возрасту и полу с основной группой. Информация о пациентах, включая данные о возрасте, половой принадлежности, особенностях клинического течения и исходах заболевания, была получены из электронных медицинских карт. Из числа госпитализированных с COVID-19 пациентов 47,54% составляли женщины (28 из 61), средний возраст пациентов — 48,7±8,8 года. В контрольную группу вошли 23 человека (11 (47,8%) женщин и 12 (52,1%) мужчин), средний возраст — 46,4±4,4 года. Двадцать один из 61 пациента (34,4%) был направлен в отделение интенсивной терапии (ОИТ), из них шестнадцать (26,2%) умерли. Продолжительность госпитализации 33 (54,1%) пациентов с COVID-19 составила < 7 дней, 28 (45,9%) пациентов находились в стационаре ≥ 7 дней. Показано, что продолжительность пребывания в стационаре в группе пациентов, не нуждавшихся в оказании медицинской помощи в ОИТ, была значительно ниже, чем в группах пациентов, помещенных в ОИТ, или умерших (6,49±0,24 против 8,85±1,59 и 10,53±1,8 соответственно, p = 0,0002). Уровни С3, С4 определяли иммунотурбидиметрическим методом, уровень СН50 — одномерным радиальным гемолизом. Материалом для исследований служили образцы сыворотки, полученные от пациентов при поступлении в стационар и от лиц контрольной группы. Установлено, что у пациентов с COVID-19 уровни C3, C4 и CH50 были существенно ниже, чем у лиц контрольной группы, а у пациентов ОИТ и умерших — ниже, чем у пациентов с COVID-19, не нуждавшихся в терапии в условиях ОИТ. Таким образом, возможно, что уровень сывороточных C3, C4 и CH50 при поступлении может являться прогностическим фактором дальнейшего течения заболевания и развития неблагоприятных клинических исходов у пациентов с COVID-19.

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