Systemic inflammation and intestinal microbiocenosis in patients with COVID-19: a role of macrophage inflammatory proteins in the disease pathogenesis

Background: dysregulation of immune response plays a key role in pathogenesis of an infection caused by the novel coronavirus SARS-CoV-2 (COVID-19). Its relationship with intestinal microbiota is of particular interest as an important link in regulation of systemic inflammation. Aim: to determine a role of macrophage inflammatory proteins in disruption of microbiocenosis of the large intestine in patients with moderate COVID-19 Materials and Methods: in 2022-2023, 100 patients of both sexes (age: 18–75 years) with moderate COVID-19 were examined in an inpatient department. Microbiocenosis was tested by a culture method. Along with this, macrophage inflammatory proteins (MIP-1α and MIP-1β) and soluble CD14 (sCD14) were assayed by an enzyme immunoassay. These parameters were tested on the day of admission (i.e., an acute phase) and before a hospital discharge (i. e., an early convalescence phase). Results: increased levels of MIP-1α and MIP-1β were reported in 100% of patients with acute COVID-19 upon admission while elevated sCD14 level was observed in 86.1% of them. Upon discharge, MIP-1α and MIP-1β levels were still increased in 86.1% and 97.2% of patients, respectively. As for sCD14 level, an increase was reported in 47.2% of patients. Most patients demonstrated a decreased number of symbionts, as well as growth of opportunistic pathogenic bacteria. Correlations were found between MIP-1α and MIP-1β levels at an acute phase upon admission and Lactobacillus spp. (r=0.450, p=0.011), Enterococcus faecalis (r=0.482, p=0.006) upon discharge. Conclusion: increased MIP-1α and MIP-1β levels were reported in all patients with the acute disease. Moreover, they significantly exceeded the reference values in most patients at an early convalescence phase suggesting persistent systemic inflammation after clinical improvement. The results demonstrate persistent systemic inflammation and pronounced abnormalities in composition of the intestinal microbiota in patients with moderate COVID-19 at both phases of the disease. KEYWORDS: COVID-19, microbiocenosis, MIP-1α, MIP-1β, sCD14, immune response, dysbiosis. FOR CITATION: Martynova N.S., Ponezheva Zh.B., Kulikova N.G., Bityumina L.A., Lazareva E.N., Usenko D.V., Vdovina E.T. Systemic inflammation and intestinal microbiocenosis in patients with COVID-19: a role of macrophage inflammatory proteins in the disease pathogenesis. Russian Medical Inquiry. 2025;9(5):259–265 (in Russ.). DOI: 10.32364/2587-6821-2025-9-5-1