Nevra Güllü ARSLAN, Selim GÖRGÜN, Şengül AKSAKAL, İlker YILMAM

Post-COVID-19 dönemi akciğerde sekel gelişen hastalarda VEGF, IL-17 ve IgG4 düzeyleri

Giriş: COVID-19 hastalarının epidemiyolojik ve klinik özellikleri tanımlanmış olmasına rağmen; hastalığın patogenezi, uzun dönem etkiler hala belirsizdir. Pulmoner sekel bu geç sonuçlardan biridir. Bu çalışmada; COVID-19 ile enfekte olan ve farklı klinik seyir gösteren hastaların akut enfeksiyon sonrası dönemde interlökin-17 (IL-17), vasküler endotelyal büyüme faktörü (VEGF), immunglobulin G4 (IgG4) düzeylerinin pulmoner sekel gelişimine etkilerini değerlendirmek hedeflenmiştir. Materyal ve Metod: Toplam 90 hasta çalışmaya dahil edildi. Akut enfeksiyon sonrası 3-12 hafta arası kontrol amaçlı başvuran hastalardan; radyolojik olarak pulmoner sekel bulguları (traksiyon bronşektazisi, interseptal kalınlaşma, parankim yapısında bozukluklar) olan hastalar Grup I (n= 32), radyolojik olarak sekelsiz iyileşen hastalar Grup II (n= 32), COVID olmayan sağlıklı bireyler Grup III (n= 26) olarak sınıflandırıldı. Bulgular: Grup I’deki hastaların yaş ortalaması Grup II ve III’e göre anlamlı derecede yüksek saptandı (p< 0,001). Vasküler endotelyal büyüme faktörü ve IL-17 değerleri arasında, bulundukları hasta grubuna göre istatistiksel olarak anlamlı fark vardı (p< 0,05). Grup I ve III’ün VEGF değerleri Grup II’deki hastalara göre anlamlı derecede düşüktü (p< 0,001). Grup I ve II’ nin IL-17 değerleri Grup III’e göre anlamlı olarak düşük saptandı (p= 0,005). IgG4 değerleri açısından gruplar arasında istatistiksel olarak anlamlı bir ilişki yoktu. Sonuç: Çalışmamızda COVID sonrası pulmoner sekel ile iyileşen hastalarda VEGF, IL-17 ve IgG4'ün profibrotik etkilerinin baskın olmadığı; dolayısıyla bahsedilen veya henüz ortaya konmamış farklı mekanizmaların bu sonuca neden olabileceği düşünülmektedir.

VEGF, IL-17 and IgG4 levels of patients with lung sequelae in post-COVID-19 period

Introduction: Although the epidemiological and clinical characteristics of COVID-19 patients have been described; the pathogenesis of the disease and its long-term consequences are still unclear. Pulmonary fibrosis is one of these late outcomes. In this study we evaluated Interleukin-17 (IL-17), vascular endothelial growth factor (VEGF), and immunoglobulin G4 (IgG4) levels of COVID-19 infected patients with different clinical course and their effect on pulmonary fibrosis in post-COVID period. Materials and Methods: In total, 90 patients were evaluated. Among the patients who presented for a control visit between 3-12 weeks after acute infection; patients with signs of pulmonary sequelae radiologically (traction bronchiectasis, interseptal thickening, disorders in parenchyma architecture) were classified as Group I (n= 32), patients who recovered without sequelae radiologically as Group II (n= 32). The Control group included healthy individuals who did not have COVID-19, and was classified as Group III (n= 26). Results: The mean age in Group I was significantly higher than Group II and III (p< 0.001). There was a statistically significant difference between the VEGF and IL-17 values based on the patient group they are in (p< 0.05). Vascular endothelial growth factor values of Group I and III were significantly lower than the patients in Group II (p< 0.001). IL-17 values of Group I and II were found to be significantly lower than Group III (p= 0.005). There was no statistically significant relationship between groups in terms of IgG4 values. Conclusion: In our study, it was observed that the profibrotic effects of VEGF, IL-17, and IgG4 were not dominant in patients who recovered with pulmonary sequelae after COVID; therefore, it is thought that different mechanisms mentioned or not yet revealed may cause this outcome.

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