EFFECT of PRO-INFLAMMATORY CYTOKINE-INTERLEUKIN 6 on the COURSE of ANKYLOSING SPONDYLITIS in PATIENTS after COVID-19

ABSTRACT

Background: Everyone knows that COVID-19 not only has a severe effect on the pulmonary system, but also triggers a whole cascade of autoimmune reactions. The study of the effect of the pro-infammatory cytokine-interleukin 6 (IL6) on the clinical course of patients with ankylosing spondylitis (AS) undergoing COVID-19 is an important problem in rheumatology. Objectives: To study the signifcance of the pro-infammatory cytokine-IL-6 on the clinical features of the course of AS in patients who have undergone COVID-19. Methods: In the period from 2020-2021, 44 patients with a diagnosis (AS) were hospitalized in the City Clinical Hospital # 3 of Tashkent city. The patients were divided into two groups Group I-20 patients with AS who underwent COVID-19 and Group II of 24 patients with no history of AS who had COVID-19 infection. The average age of patients in group I was 32 ± 4.1 years and in group II-36.5 ± 5.2 years. All patients underwent clinical and laboratory studies, including studies of serum IL-6 levels. Disease activity was assessed using the BASDAI and ASDAS scales, pain was assessed using a numerical rating scale (NRS), and peripheral joint damage was assessed by the presence of pain and swelling in 44 joints. All patients underwent PCR, as well as ELISA-IHLA tests for the presence of antibodies to COVID-19. Results: Clinical examination of the patients revealed the presence of pain in the spine, which was assessed using the numerical rating scale-(NRS) in group I it was 8.5 ± 1.2 points and 5.9 ± 2.3 points in patients of group II. Examination of peripheral joints showed an average number of painful joints (PJ) of 16.9 ± 3.2 in group I and 8.6 ± 2.7 in group II, the number of swollen joints (NSJ) 8.8 ± 2.1 in group I and 4.2 ± 1.7 in group II. group. The study of AS activity using the BASDAI scale showed an average level of 5.1 ± 1.7 points in group I and 4.4 ± 2.1 points in group II. And the study of activity on the ASDAS scale showed an average level of 4.0 ± 1.7 points in group I and 2.5 ± 0.8 points in group II, which indicates a very high activity of the pathological process in group I and medium-high activity in group II. The IL-6 level in group I was 10.2 ± pg/mL, 4.2 pg/mL in group II and 1.39 pg/mL in the control group. Conclusion: 1. The clinical course of AS in patients who have undergone COVID-19 is characterized by a more pronounced disease activity according to the BASDAI and ASDAS scales, a high intensity of pain syndrome according to a NRS, as well as a high level of IL-6. 2. A high level of IL-6 in group I indicates the impact of COVID-19 on the course, activity and severity of the autoimmune process in patients with AS, which is many times higher than in patients of group II, which allows us to consider it as a biomarker of damage to the articular and connective tissue in this infection.