Hypoxia and novel coronavirus infection: Hypoxia-inducible factor 1-alpha as marker of disease severity and new therapeutic target

BACKGROUND: Hypoxia has been identified as a crucial factor in the pathogenesis of the novel coronavirus infection, with studies demonstrating its role in inflammatory processes and complications. Hypoxia-inducible factor 1-alpha plays a critical role in regulating the body’s adaptation to oxygen deficiency. A comprehensive investigation of variations in hypoxia-inducible factor 1-alpha in patients with new coronavirus infection allows for elucidating the pathogenetic mechanisms of the disease and identifying promising therapeutic targets. AIM: The work aimed to evaluate the role of hypoxia-inducible factor 1-alpha in the compensation and adaptation of the body to hypoxic stress during novel coronavirus infection. METHODS: From January 2020 to March 2022, 295 patients were assessed at the Naval Therapy Clinic of the Kirov Military Medical Academy, with 272 of them diagnosed with the novel coronavirus infection. The patients were divided into three age groups based on the World Health Organization’s classification: group 1, young age (207 patients); group 2, middle age, (56 patients); and group 3, elderly age (32 patients). Serum hypoxia-inducible factor 1-alpha was measured using an enzyme immunoassay. Statistical data were processed using GraphPad Prism 8 and IBM SPSS Statistics. Statistical significance was set at p 0.05. RESULTS: Hypoxia-inducible factor 1-alpha correlated with both age and novel coronavirus infection severity, peaking among elderly patients with severe forms of the disease. Hypoxia-inducible factor 1-alpha decreased during recovery, indicating the adaptive response to hypoxic stress termination. In the group of elderly patients, higher hypoxia-inducible factor 1-alpha values were associated with mild novel coronavirus infection, which was related to existing comorbidities. CONCLUSION: The findings corroborate the hypothesis that hypoxia-inducible factor 1-alpha is a valuable prognostic marker for hypoxic complication severity in patients with the novel coronavirus infection and confirm its potential as a therapeutic target. Further studies are needed to elucidate the molecular mechanisms of its regulation and develop pharmacological treatment strategies for hypoxic disorders.