INDICATORS OF INFLAMMATORY, MULTIORGAN IMPAIRMENT AND REDOX BIOMARKERS AND CT FINDINGS IN PATIENTS WITH COVID-19 PNEUMONIA
Abstract
COVID-19 (engl. Coronavirus disease 2019) je multisistemska bolest koju izaziva Koronavirus teškog akutnog respiratornog sindroma 2 (engl. Severe acute respiratory syndrome coronavirus 2, SARS-CoV-2). ). Od samog početka pandemije ova bolest predstavlja ogroman izazov u rasvetljavanju patofizioloških procesa koji leže u osnovi ove bolesti kako bi se mogao odrediti njen tok i preduzeti adekvatno lečenje. Glavni razlog za nastanak teže kliničke slike i mortaliteta povezanog sa SARS-CoV-2 infekcijom uključuje između ostalog citokinsku oluju, odnosno nekontrolisani sistemski inflamatorni odgovor koji dovodi do povećane produkcije proinflamatornih citokina i hemokina, a za koji je pokazano da može da indukuje i povećanu
produkciju slobodnih radikala. Prekomereno stvaranje reaktivnih vrsta kiseonika takođe može imati direktan destruktivan efekat na ćelije domaćina, a ne samo na virus. Pošto virus SARS-CoV-2 ima tropizam za respiratone ćelije, česta manifestacija bolesti je pneumonija, stoga multidetektorska kompjuterizovana tomografija (MDCT) toraksa ima veliki značaj u cilju procene zahvaćenosti plućnog parenhima inflamacijom, ali i stratifikacije težine bolesti, odluke o eventualnoj hospitalizaciji, kao i potrebi za lečenjem u jedinici intenzivne nege. Stepen oksidativnog stresa možemo da procenimo određujući nivo produkata koji nastaju kao rezultat oštećenja lipida, proteina i DNK, dok se biomarkeri inflamatornog i multiorganskog oštećenja mogu dobiti iz rutinske laboratorijske prakse. Zbog utvrđene povezanosti citokinske oluje sa olujom slobodnih radikala, može se pretpostaviti da tokom akutne faze COVID-19 pneumonije, pokazatelji oksidativnog oštećenja makromolekula mogu biti u korelaciji sa laboratorijskim parametrima inflamacije, biohemijskim markerima oštećenja pojedinih organa, kao i sa promenama na MDCT toraksa.
References
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