RESUMEN
Experts have called attention to the possible negative impact of the coronavirus disease 2019 (COVID-19)-related cytokine storm syndrome on the progression of leprosy-related disabilities. We assessed the frequency of reactional states in patients co-infected with Mycobacterium leprae and severe acute respiratory syndrome (SARS) coronavirus (CoV) 2 (SARS-CoV-2). We consecutively included patients during the first peak of the COVID-19 epidemic in Brazil and analyzed the expressions of genes encoding interleukin (IL)-1ß, IL-6, IL-8, IL-10, IL-12A, IL-12B, and tumor necrosis factor-α in peripheral blood mononuclear cells. We included 64 leprosy patients and 50 controls. Twelve of the leprosy patients and 14 of the controls had been diagnosed with COVID-19. Co-infection was associated with increased IL-6 (P = 0.043) and IL-12B (P = 0.017) expression. The median disability grades were higher for leprosy/COVID-19 patients; however, the difference was not significant (P = 0.194). Patients co-infected with M. leprae and SARS-CoV-2 may experience a higher-grade proinflammatory state.
Asunto(s)
COVID-19/inmunología , Interleucina-12/metabolismo , Interleucina-6/metabolismo , Lepra/complicaciones , Traumatismos de los Nervios Periféricos/etiología , Adulto , COVID-19/complicaciones , COVID-19/metabolismo , Estudios Transversales , Femenino , Regulación de la Expresión Génica/inmunología , Humanos , Interleucina-12/genética , Interleucina-6/genética , Masculino , Persona de Mediana Edad , Traumatismos de los Nervios Periféricos/metabolismo , Traumatismos de los Nervios Periféricos/patologíaRESUMEN
METHODS: One hundred and sixty-one very old patients (aged ≥80 years) devoid of cognitive decline were eligible for analyses. Clinical and biochemical data along with physical and cognitive assessments encompassing dual-energy X-ray scans and hand dynamometry were adopted to investigate frailty criteria, while circulating immune mediators (IFNγ, IL-2, IL-4, IL-6, IL-10, and TNFα) were assessed using high-throughput flow cytometry. RESULTS: Preliminarily, IL-6 correlated positively with waist-to-hip ratio and C-reactive protein and negatively with glycemia. In analyses controlled for these factors, serum levels of IL-6 were comparatively augmented among the very old participants with reduced grip strength (OR = 3.299; 95% CI 1.08-6.09; p=0.032) and among those with slow walk speed (OR = 2.460; 95% CI 1.16-7.05; p=0.022). CONCLUSIONS: Our study shows a strong negative correlation of IL-6 levels with Fried's frailty components of grip strength and walk speed in very old adults, regardless of confounding factors.