Potential for infusion correction of COVID-19-associated endotheliopathy
- Authors: Simutis I.S.1,2, Ratnikov V.A.1, Scheglov A.N.3, Nikolaeva O.V.2, Boyarinov G.A.4, Sapegin A.A.1, Gaikovaya L.B.2, Evteeva D.A.2, Zamyatina K.N.2
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Affiliations:
- Sokolov North-Western District Scientific and Clinical Center
- Mechnikov North-Western State Medical University
- Central Clinical Hospital with a Polyclinic
- Privolzhsky Research Medical University
- Issue: Vol 95, No 6 (2023)
- Pages: 487-493
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/133109
- DOI: https://doi.org/10.26442/00403660.2023.6.202232
- ID: 133109
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Abstract
Aim. To evaluate the relationship between the systemic inflammatory response and the severity of COVID-19-associated endotheliopathy and the effect of succinate-containing crystalloid solution (sodium meglumine succinate) on it in patients with severe COVID-19.
Materials and methods. Clinical and laboratory parameters of 53 intensive care unit's patients with COVID-19 complicated by community-acquired bilateral multisegmental pneumonia were analyzed. Intensive therapy complex of 27 patients (study group) included daily infusion of 1.5% solution of sodium meglumine succinate (Reamberin) in the daily dose of 10 ml/kg for at least 11 days (or during the whole stay in the unit). A similar volume of Ringer's solution was present in the control group of 26 patients. The levels of endotheliocytosis, homocysteine, and systemic inflammatory response were determined at all stages of the study.
Results. The evaluation of endotheliopathy degree in the meglumine succinate group showed a significant reduction of initially elevated levels of endotheliemia and homocysteinemia at all study stages. The pattern of changes in the study group was highly correlated (r=0.90–0.96) with the dynamics of systemic inflammatory response parameters-fibrinogenemia, C-reactive protein and interleukin-6 levels. As normalization of the immune imbalance, we regarded the termination of lymphopenia in the Reamberin group.
Conclusion. Early inclusion of Reamberin infusion into intensive therapy of severe COVID-19, in comparison with Ringer's solution, leads to significant and stable correction of the severity of systemic inflammatory response, which in turn is naturally reflected in the severity of endothelial dysfunction, multiple organ failure, and also leads to a decrease in 28-day mortality.
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##article.viewOnOriginalSite##About the authors
Ionas S. Simutis
Sokolov North-Western District Scientific and Clinical Center; Mechnikov North-Western State Medical University
Author for correspondence.
Email: simutis@mail.ru
ORCID iD: 0000-0002-2537-0142
д-р мед. наук, зав. отд-нием реанимации ФГБУ «СЗОНКЦ им. Л.Г. Соколова», доц. каф. анестезиологии и реаниматологии им. В.Л. Ваневского ФГБОУ ВО «СЗГМУ им. И.И. Мечникова»
Russian Federation, Saint Petersburg; Saint PetersburgViacheslav A. Ratnikov
Sokolov North-Western District Scientific and Clinical Center
Email: simutis@mail.ru
ORCID iD: 0000-0002-9645-8408
д-р мед. наук, проф., зам ген. дир – мед. дир. ФГБУ «СЗОНКЦ им. Л.Г. Соколова»
Russian Federation, Saint PetersburgAlexey N. Scheglov
Central Clinical Hospital with a Polyclinic
Email: oper@mtd122.com
ORCID iD: 0000-0002-3783-7918
канд. мед. наук, врач отд-ния оториноларингологии ФГБУ «ЦКБ с поликлиникой» Управления делами Президента РФ
Russian Federation, MoscowOlga V. Nikolaeva
Mechnikov North-Western State Medical University
Email: simutis@mail.ru
ORCID iD: 0009-0005-4915-5286
ординатор каф. анестезиологии и реаниматологии им. В.Л. Ваневского ФГБОУ ВО «СЗГМУ им. И.И. Мечникова»
Russian Federation, Saint PetersburgGennady A. Boyarinov
Privolzhsky Research Medical University
Email: simutis@mail.ru
ORCID iD: 0000-0002-7557-0564
д-р мед. наук, проф., проф. каф. анестезиологии, реаниматологии и трансфузиологии ФГБОУ ВО ПИМУ
Russian Federation, Nizhniy NovgorodAlexander A. Sapegin
Sokolov North-Western District Scientific and Clinical Center
Email: simutis@mail.ru
ORCID iD: 0000-0002-6433-2659
канд. мед. наук, зав. клинико-диагностической лаб., врач клин. лабораторной диагностики ФГБУ «СЗОНКЦ им. Л.Г. Соколова»
Russian Federation, Saint PetersburgLarisa B. Gaikovaya
Mechnikov North-Western State Medical University
Email: simutis@mail.ru
ORCID iD: 0000-0003-1000-1114
д-р мед. наук, доц., зав. каф. биологической и общей химии им. В.В. Соколовского, зав. центральной клинико-диагностической лаб. ФГБОУ ВО «СЗГМУ им. И.И. Мечникова»
Russian Federation, Saint PetersburgDarya A. Evteeva
Mechnikov North-Western State Medical University
Email: simutis@mail.ru
ORCID iD: 0000-0001-5756-2088
заочный аспирант каф. биологической и общей химии им. В.В. Соколовского, врач клин. лабораторной диагностики центральной клинико-диагностической лаб. ФГБОУ ВО «СЗГМУ им. И.И. Мечникова»
Russian Federation, Saint PetersburgKsenia N. Zamyatina
Mechnikov North-Western State Medical University
Email: simutis@mail.ru
ORCID iD: 0000-0002-6890-6357
заочный аспирант каф. биологической и общей химии им. В.В. Соколовского, врач клин. лабораторной диагностики центральной клинико-диагностической лаб. ФГБОУ ВО «СЗГМУ им. И.И. Мечникова»
Russian Federation, Saint PetersburgReferences
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