Dynamics of immune status parameters in patients with COVID-19, receiving therapy with inclusion of an IL-6 receptor antagonist

ABSTRACT

Introduction. Timely prescribing of proactive cytokine storm therapy in patients with COVID-19 using targeted therapy is an important component of success in the treatment of this disease. However, the blockade of receptors to proinflammatory cytokines, in particular to IL-6, leads to shifts in immunoregulatory processes, the nature of which can determine the effectiveness of the therapy and the course of the postCOVID period of rehabilitation of the patient. The aim of the study - to study the dynamics of the parameters of innate and adaptive immunity in a patient with COVID-19 using an IL-6 receptor anatagonist. Material and methods. 30 hospitalized patients were examined with the diagnosis COVID-19 coronavirus infection (confirmed), moderate form;complication bilateral polysegmental pneumonia. The comparison group consisted of practically healthy donors (30 people). The dynamics of laboratory parameters (general clinical, biochemical and immunological) were evaluated against the background of therapy with IL-6 blockers. Results. The presence of lymphopenia in the patient, an increase in the level of CRP, LTK, fibrinogen, lactate, IL-6 require the use of proactive anti-cytokine therapy. The timely administration of these drugs (in particular, the IL-6 receptor inhibitor) has a positive effect on the course of the disease and the recovery of patients. In the immune system, after the introduction of monoclonal antibodies to IL-6 receptors, 2 weeks after administration, there is an increase in the maturation of T-lymphocytes, documented by an increase in the content of T-lymphocytes with helper function with a simultaneous decrease in the number of natural killers, B-lymphocytes and disimmunoglobulinemia of IgA, IgM and IgG classes. Conclusion. The use of monoclonal antibodies to IL-6 receptors in patients with a moderate form of COVID-19 leads to dysregulatory processes in the immune system with their gradual normalization by 2 weeks after administration.