DIAGNOSTIC ASPECTS OF THE CYTOKINE SPECTRUM IN RENAL COMPLICATIONS IN CHILDREN DURING THE COVID-19 PANDEMIC
Keywords:
COVID-19, acute pyelonephritis, urine cytokine profileAbstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging global health problem that potentially affects all organs, including the kidneys. The aim of the study was to determine and evaluate the features of the cytokine profile in the serum and urine of children with acute pyelonephritis that developed against the background of COVID-19. Methods. Participants were selected for the groups before the start of treatment based on the presence of COVID-19 in the anamnesis. Two groups were formed: group 1 included 30 children with AP without a history of COVID-19, and group 2 included 35 patients with AP against the background of COVID-19. The cytokine profile of the serum and urine was studied based on the study of the cytokines IL-4, IL-6, TNF-α and INF-y. Results. The active process was combined with a significantly increased concentration of IL-4, TNF-α and INF-y in the urine. In patients of the 1st group, TNF-α levels were exceeded four times, and INF-y levels were exceeded eleven times compared to the control group, while in children of the 2nd group, these levels were exceeded 7 and 15 times and amounted to 83.49 ± 2.66 and 205.26 ± 3.32 pg / ml (p ≤ 0.001), respectively. Discussion. The results of the analysis indicate a significant role of IL-6 as an aggressive factor in the development of tubulointerstitial damage, its level in urine was increased 31.2 times in children of subgroup 1 and 38.5 times in patients of subgroup 2 compared to these levels in healthy children (control group). Conclusion. In order to monitor the course of latent tubular damage (screening study) in patients who have had COVID-19, it is necessary to study the level of cytokines (IL-6, INF-y, TNF-α, IL-4) in the blood serum and urine, on the basis of which it is possible to determine the degree of proliferative changes in the tubulointerstitial tissue of the kidneys and form risk groups of patients according to the chronicity of the process.
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