Results of changes in the length of telomeres of peripheral blood lymphocytes, organs of the circulatory system, respiratory system and hemostasis in the long-term recovery period in men after severe coronavirus pneumonia
Abstract
Coronavirus pneumonia of severe course is manifested not only by damage to pulmonary parenchyma, myocardium, but also to the blood coagulation system. The purpose of the study is to evaluate the dynamics of the telomere length of peripheral blood lymphocytes, damage to the pulmonary parenchyma, myocardium and blood coagulation system in patients with severe and non-severe coronavirus pneumonia during the height of the disease, and 3 months after recovery.
Methods. We examined 72 men treated in the clinic of hospital therapy of Kirov Military Medical Academy: group I – 47 men aged 46,3±6,7 years with coronavirus pneumonia of severe course (according to NEWS scale); group II – 25 men aged 45,4±5,3 years with coronavirus pneumonia of non-severe course (according to NEWS scale). Patients received the necessary therapy according to the current valid temporary guidelines, prevention, diagnosis and treatment of new coronavirus infection (COVID-19) approved by the Ministry of Health of the Russian Federation. In 3 months after hospitalization, the patients were dynamically monitored for laboratory and instrumental parameters. Venous blood was collected from all patients and subjected to molecular genetic study to determine the telomere length of lymphocytes. Telomeres were measured in DNA isolated from peripheral blood lymphocytes using a kit (Biolabmix, Novosibirsk) according to the manufacturer's protocol.
Results. Patients with severe coronavirus pneumonia showed not only massive lung damage with decreased saturation up to 91.5% (p = 0.003), but also myocardial damage: increased troponin T up to 16.3 ng/l (p = 0.001), increased total creatine phosphokinase, aspartate aminotransferase and alanine aminotransferase compared to patients with nonsevere coronavirus pneumonia. In group I the values of general blood analysis except for platelets (175 ´ 103/l, p=0,03) did not differ from similar parameters of group II patients. There was a significant increase in C-reactive protein, D-dimer and ferritin in men of group I.
Measurement of telomere length revealed that in patients with non-serious coronavirus pneumonia in the period of disease onset this parameter amounted to 6343 (6114; 6422) nucleotide pairs (bp), and in the group of patients with severe coronavirus pneumonia – 5264 (5057; 5423) bp (p < 0,001). At the end of inpatient treatment, telomere length significantly shortened in both study groups (p < 0.001) compared to baseline values, amounting to 5654 (5406; 5769) bp in patients with coronavirus pneumonia of non-serious course and 3274 (3157; 3382) bp in patients with severe disease (p < 0.001).
When examining patients 3 months after recovery, it was revealed that the subjects of group I had significantly increased markers of respiratory and myocardial damage, as well as signs of hypercoagulability, which should be taken into account in the prolonged recovery phase in patients who had undergone coronavirus pneumonia of severe course.
Conclusion. The results of the study showed that the value of the telomere length parameter is statistically significantly associated with a number of indicators of the clinical course of coronavirus pneumonia, as well as with laboratory parameters of clinical and biochemical blood tests.
