Biomarcadores sanguíneos da covid-19 em populações brasileiras

Abstract

SARS-CoV-2 is a β-coronavirus capable of causing COVID-19 and responsible for the most recent major pandemic of severe acute respiratory syndrome (SARS). Since the first reported cases of the disease, it was noted that the elderly was more susceptible to more severe cases of the disease and death, even when compared to other groups with inflammatory comorbidities such as cardiovascular disease and obesity. Aging is accompanied by a chronic, systemic, and low-grade inflammation that is called inflammaging. This inflammatory state is related to several inflammatory and degenerative diseases in frail elderly people. Some regions of Brazil are still characterized as an endemic zone for many infectious diseases. Our group has shown that, in these areas, high and continuous exposure to infectious stimuli accelerates the aging of individuals who live there, leading to unexplored consequences in terms of senescence. Therefore, the hypothesis of this study is that the inflammaging in the elderly, as well as the inflammatory profile of adult individuals may be a determining factor in the severe clinical outcome of COVID-19. Our objective was to evaluate the clinical, laboratory and inflammatory profile of adults (18 to 59 years old) and elderly people (over 60 years old) with COVID-19 in Belo Horizonte, MG, Governador Valadares, MG (endemic region for several diseases) and São Paulo. Paul, SP. For this, 309 individuals with symptoms between 1 and 7 days were recruited, tested for SARS-CoV-2 infection using the RT PCR technique and divided into different clinical groups: a group with flu symptoms who were negative for SARS-CoV-2, groups with COVID-19 and classified as mild, moderate or severe. All subjects had their blood plasma analyzed by Luminex assay (using BioRad's Bio-Plex® Pro Human Cytokine Standard Kit) for 27 pro- and anti-inflammatory cytokines and chemokines. The results confirm our hypothesis. Mediators such as CXCL8, CXCL10, CCL2, IFN-γ, IL-12p70 IL-6, IL-10 and IL-1Ra, which are hightened in the inflammation of COVID-19, and some also present in the inflammaging, were increased in individuals with severe COVID-19 when compared to individuals with mild disease or negative controls. A unique profile of inflammation was also found in the elderly. Significant differences were observed in the plasma of adult individuals when compared with the elderly and when different clinical groups were compared. Our conclusion is that the inflammatory profile at the initial stage of COVID-19 appears to be associated with worsening the disease. However, further analyzes are needed to complete the inflammatory panel and confirm these data.