ABSTRACT
Introduction: It is known that the development of COVID-19 in the human body consists of complex system of biological mechanisms underlying the complex interplay between infectious agents and the human host. This raised the question about hosts' genetic variants as predictors of clinical phenotype. The aim of our study was to analyze the effect of the NOS3 gene (VNTR intron 4 a/b), NR3C1 gene (C647G, rs41423247) and the SFTPB gene (C1580T, rs11130866) variants on the course of severe COVID-19 pneumonia in patients. Material(s) and Method(s): The study group included 20 patients (13 men and 7 women) with diagnosis "viral COVID19 pneumonia" treated at the intensive care unit. Investigation of the NOS3, NR3C1 and SFTPB genes variants was carried out by a molecular method using PCR-RFLP and allele-specific PCR, respectively. Result(s): The correlation analysis showed a significant association of the NOS3 gene variants and level of SpO2 (rS=-0.488, p=0.029;SpO2=93.1+/-2.4% for b/b and SpO2=82.0+/-1.1% for a/a genotypes). Also a significant positive correlation was between NR3C1 gene variants and duration of nasal intermittent positive pressure ventilation (nIPP) therapy (rS=0.454, p=0.044;for 647CC - 1.5+/-1.0 days and for 674GG - 3.9+/-2.5 days), presence of fever (need for antipyretics) (rS=0.525, p=0.017;647C vs 647G alleles - chi2=5.8, p=0.016). No significant correlations were found for the variants of SFTPB gene. The obtained results support a hypothesis about the combined influence of different pathways genes variants (NOS3 and NR3C1) on severity of COVID-19. However, in order to draw definite conclusions, further multifaceted research in this area are need.
ABSTRACT
ACKGROUND: Patients discharged from hospital after COVID-19-associated pneumonia often experience persistent symptoms (e.g., dyspnea, cough, fatigue), which affect their quality of life. Treatments are needed to solve these residual effects of COVID-19 and to help patients in making a full recovery. METHODS: We performed a single center open-label study to assess the impact of the oral mucolytic agent erdosteine (300 mg twice daily) for 30 days on 38 patients discharged from hospital after COVID-19-associated pneumonia who had persistent dyspnea. After discharge, all patients stopped taking all treatment for COVID-19 received during their hospital stay but continued their usual treatment for chronic diseases and they were divided into two groups: the treatment group, which received erdosteine 300 mg twice daily for 30 days and the control group, with no treatment. Patients completed St George's Respiratory Questionnaire (SGRQ) and the modified Medical Research Council (mMRC) dyspnea scale at time of discharge (Day 0) and on Day 30. The treatment group (N.=26) was compared with a control group (N.=12). RESULTS: SGRQ and mMRCscores were comparable between the treatment and control groups at hospital discharge. Both scores improved significantly in the treatment group between day 0 and day 30, whereas were not significant changes in the control group. At Day 30, significantly more patients in the treatment group than the control group had achieved clinically important changes in HRQoL and symptoms. CONCLUSIONS: In patients hospitalized for COVID-19-associated pneumonia Erdosteine treatment following hospital discharge may help their recovery, improving dyspnea and HRQoL.