[Rehabilitation of patients with post-COVID syndrome depending on C(159)T polymorphism of SD-14 gene].

Abstract

Researchers are interested in studying the genes that regulate immunocompetent molecules. Genetic polymorphism has an impact on morbidity, mortality and the reserves of the body's recovery in communicable diseases.

Objective: To study the possibilities of rehabilitation of patients with post-COVID syndrome (PCS) in the conditions of a sanatorium-resort organization depending on the genetic polymorphism of the CD-14 monocytes receptor gene.

Material and methods: The study included 97 patients with COVID-19 past history and PCS diagnosis, who underwent rehabilitation in the Department of Pulmonology of the I.M. Sechenov Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation (Yalta). Comprehensive clinical, laboratory and functional examinations of patients were performed. Questionnaires for assessment of dyspnea, psychological state and quality of life were additionally used. Determination of genotype variants was done using sets of the «Lytech» company (Russia) according to the manufacturer's instructions. The detection of amplification products for C(159)T polymorphism of the SD-14 gene was performed by means of horizontal electrophoresis in 3% agarose gel. Patients received comprehensive rehabilitation including: climatotherapy, physical therapy, massage, aromatherapy, respiratory therapy and pharmaceutical treatments as medically indicated. The treatment course was 21 days. Evaluation of the efficacy of therapy was carried out on the basis of studying the dynamics of the investigational indicators before and after the rehabilitation course.

Results: Patients were divided into 3 groups according to the data of performed analysis: with variants of homozygous distribution of CC alleles - 30 (30.9%) patients and TT - 22 (22.7%) patients, as well as with heterozygous variant of CT - 45 (46.4%) patients. It has been established that the most pronounced respiratory symptoms, degree of dyspnea, low grade by questionnaires of dyspnea, low value of the indicators of pulmonary function tests, laboratory abnormalities, as well as more significant reduction of life quality, development of anxiety, low assessment of the level of one's own health are characteristic for CC genotype. Patients with this genotype's variant were more likely to have obesity and dyslipidemia, which exacerbated respiratory symptoms. The heterozygous CT variant of genotype, in which more indicators had a significant positive dynamics during rehabilitation, proved to be more sensitive to rehabilitative exposure.

Conclusion: The state of PCS depending on the genotypes of the SD-14 gene was studied. The most pronounced symptoms were revealed in CC159 genotype. The best dynamics during the rehabilitation period in the sanatorium-resort organization has been noted in the heterozygous variant of CT159 genotype of the SD-14 gene, slightly lower - in the group with CC genotype, in the TT group the dynamics has been significant not for all indicators. The genotype determination in patients with PCS will allow to personalize rehabilitation programs and increase their efficacy for the full recovery of physical and mental state of the patients who suffered from COVID-19.