The immunocorrection of coronavirus infection patients and its effectiveness

Abstract

Objective: to analyze the immune status of coronavirus infections patients and to improve the effectiveness of their treatment by including a drug with antiviral and immunotropic action into the conventional scheme. Materials and methods. To achieve the objective, 150 patients aged 18 to 65 years with a diagnosis of acute respiratory moderate-to-severe and severe viral infection were examined at the Kyiv City Clinical Hospital № 4 Infectious Department during 2012–2015. Subsequently, the patients were included in 2 groups of patients with coronavirus infections (n=36). The first (I, research one) group (n=22) patients received the main treatment and Nuclex®: 2 capsules 3 times a day, for 7 days. The second (II, control one) group (n = 14) patients have got conventional pathogenic therapy (detoxification and symptomatic) only. Verification of the diagnosis was carried out using molecular genetic studies (multiplex polymerase chain reaction with reverse transcription in real time) of the biological material — sputum. Complex of immunological studies of the peripheral blood included determining the receptors to monoclonal antibodies CD3, CD4, CD8, CD16, CD22 on blood lymphocytes, the content of T-lymphocytes according to the data of spontaneous resetting ability of lymphocytes with sheep red blood cells by the method of M. Jondal et al. modified by K.F. Chernushenko et al. Statistical analysis of the findings was carried out by software system Windows, Word and Excel, Statistica 6.0, using the method of variation statistics with the definition of probability by means of the nonparametric Wilcoxon method for independent samples and Kruskal-Wallis analysis of variance. To compare two independent groups, we have used Mann-Whitney U-test. Results. An examination of 36 coronavirus infections patients found that these diseases are accompanied by the development of secondary cellular immune deficiency with a decrease in major subpopulations of lymphocytes (CD3, CD4, CD22), indices of NBT-test of neutrophils and increased levels of CD16 lymphocytes. The total number of T-lymphocytes and T-helper cells was reduced (P < 0.05), but the level of natural killer cells (CD16) was significantly higher: in the coronavirus infections patients — 26.34 ± 2.22 %, and in the acute respiratory infections of other origin patients — 18.45 ± 1.23 % (normal values — 16.60 ± 0.80 %) (P < 0.05). This indicates the development in coronavirus infections of secondary immunodeficiency by the relative hyperkiller type. The level of B-cells (CD22) in the coronavirus infections patients was significantly lower (P < 0.05), and 7 days after receiving ribonucleic acid in the research group patients they reached an average of 24.06±2.44%, in patients from group II average values were 19.03±2.05% (P < 0.05). Immunoregulatory index ranged from 1.2 to 2.3. Conclusions. Coronavirus infection proceeds with the development of secondary immunodeficiency caused by a significant decrease in the total number of T-lymphocytes and T-helper cells. Immune imbalance in the coronavirus patients is an important pathogenetic factor. The Nuclex® inclusion in the complex therapy the coronavirus infection patients contributes not only to reduction of the disease clinical manifestations, but also a significant correction of concomitant immune disorders, as well as provides the most favorable long-term results, allowing you to avoid various bacterial complications.