Assessment of the inflammatory response in convalescents of a new coronavirus infection in the catamnesis

Background . The pathogenetic mechanism of the development of a prolonged systemic inflammatory process in patients who have suffered a new coronavirus infection remains an urgent problem. One of the proposed mechanisms leading to hyperinflammation in COVID-19 is the involvement of the inflammasome of NOD-like receptor protein 3 (NLRP3), gasdermin D protein (GSDMD), which are effector molecules of pyroptosis, in triggering the continuous production of an increased number of inflammatory markers due to activation by the SARS-CoV-2 virus. The aim . To evaluate the inflammatory response in convalescents of a new coronavirus infection in the catamnesis based on the dynamics of pyroptosis, interleukin response and indicators of the vascular link of hemostasis. Materials and methods . The blood of 41 patients in the recovery period was examined; one month, three and six months after the infection. The cellular composition of peripheral blood, the level of ESR, CRP, ferritin, D-dimer were determined by classical methods; and the concentration of interleukins (IL) -1β, IL-6, IL-18, NLRP3 inflammasomes, and gasdermine D (GSDMD) was determined by ELISA methods. Results . It was revealed that for all the parameters studied, there is a slow decrease in the level of values by six months. Despite the improvement in the morphological picture, altered cells are found in the peripheral blood after six months. The levels of GSDMD, platelets, IL-1β, D-dimer, ESR, IL-18, NLRP3 do not reach the values of the control group after six months, which indicates a stable hyperinflammatory response of the immune system. Conclusion . Dysregulation of the NLRP3 inflammasome and gasdermine D can lead to an inadequate immune response of the body to infection, which contributes to the maintenance of the hyperinflammatory process and long-term recovery. Further study of triggers and inducers involved in the pathophysiological processes of inflammation triggered by COVID-19 will allow us to develop an approach to personalized treatment and rehabilitation of patients.