МАРКЕРИ ЗАПАЛЕННЯ ТА ЕНДОТЕЛІАЛЬНОЇ ДИСФУНКЦІЇ У ХВОРИХ НА ЦУКРОВИЙ ДІАБЕТ 2-ГО ТИПУ З ПОСТКОВІДНИМ СИНДРОМОМ

It is well-known that a portion of patients with post-COVID syndrome develop chronic diseases such as type 2 diabetes mellitus (T2DM), autoimmune diseases, cerebrovascular and/or cardiovascular disorders (including venous thromboembolism), psychological distress, or mental illnesses. These conditions further aggravate persistent symptoms and long-term consequences following acute SARS-CoV-2 infection. The multi-organ manifestations and aftermath of COVID-19 after its acute phase are recognized as a new disease. However, the pathogenesis and prevalence of post-COVID syndrome remain insufficiently studied. Of particular importance is the investigation of type 2 diabetes mellitus progression in the context of post-COVID syndrome.The aim of the study was to examine indicators of systemic inflammation and endothelial functional status in patients with type 2 diabetes mellitus and post-COVID syndrome.Materials and methods. The study included 102 post-COVID syndrome patients divided into two groups: group I - 53 patients with T2DM but without post-COVID syndrome; group II - 49 patients with T2DM and post-COVID syndrome. Additionally, 20 practically healthy individuals (PHI) were included for comparison. Endothelial functional status was assessed through serum levels of total NO, endothelin-1 (ET-1), and sVCAM-1 using enzyme-linked immunosorbent assay (ELISA). The levels of CRP, TNF-α, TGF-β1, IL-10, and 8-isoprostane in serum were also determined using ELISA.Results. Patients with T2DM, both with and without post-COVID syndrome, exhibited intensified systemic inflammation and oxidative stress compared to PHI. The presence of post-COVID syndrome was associated with a more significant increase in CRP and pro-inflammatory cytokines, alongside a less pronounced elevation in the anti-inflammatory cytokine IL-10. Changes in endothelial functional indicators were also observed, namely, reduced total nitric oxide levels against higher concentrations of ET-1 and sVCAM-1, which were more pronounced in the presence of post-COVID syndrome.Conclusions. The study confirms that T2DM progression with post-COVID syndrome is accompanied by heightened oxidative stress, systemic inflammation, and exacerbated endothelial dysfunction.