CYTOKINE PROFILE RESPONSE IN PATIENTS WITH FRACTURES OF LONG BONES DURING COVID-19

Abstract

Introduction: The immune system swiftly responds to the onslaught of trauma and the infectious agents it triggers. However, the mechanisms of action of the COVID-19 virus remain unidentified to date. Distinctive alterations that occur in the immune system of trauma victims with COVID-19, setting them apart from changes observed in other diseases. This underscores the specificity of traumatic disease within this patient with COVID-19. The study aims to assess the response of humoral immunity markers in patients with fractures of long bones and COVID-19 and to explore their role in early diagnosing infectious complications in this particular group of patients. Materials and methods: To accomplish the study objectives, we assembled a retrospective dataset comprising 289 cases of skeletal bone fractures treated at the Kyiv City Clinical Hospital of Emergency Medical Care from March, 2020 to February, 2021, meeting the inclusion criteria for the study. The entire dataset consisted of 289 cases of skeletal bone fractures, categorized into two groups: the main group and the control group.  Results: On the first day of treatment, an increase in some pro-inflammatory cytokines (IL-6, IL-1β and IL-4) with a normal level of TNF-α, normal values of IFN-γ, IFN-α and a sharp decrease in the anti-inflammatory cytokine IL was observed among the patients of the main group -10. On the third day of the treatment, there was a significant increase in all pro-inflammatory cytokines (IL-6, IL-1β, IL-4 and TNF-α), both types of interferons, and an even sharper decrease in the anti-inflammatory cytokine IL-10. On the tenth day, the growth in the level of pro-inflammatory cytokines was noted, among which the level of TNF-α was the leader, a subnormal level of interferons and anti-inflammatory interleukin 10 was observed. Conclusions: The dynamics of pro-inflammatory cytokines in patients with long bone fractures against the background of COVID-19 tended to increase and had a maximum level on the third day of treatment. Anti-inflammatory cytokines demonstrate a tendency to depression and reache the reference value only on the 10th day of the study.