Abstract
The prognostic value of telomere length and telomerase enzyme activity in patients with severe coronavirus pneumonia was assessed. In this observational prospective study, 53 patients suffering from coronavirus pneumonia were enrolled, who were divided into two groups depending on the severity of the clinical course: group 1 had a nonsevere course (n = 16) and group 2 had a severe course (n = 37). Venous blood was collected from all patients and subjected to molecular genetic testing to determine telomere length and lymphocyte telomerase activity. The prognostic value of telomere length and telomerase enzyme activity in patients with coronavirus pneumonia has been established. Patients suffering from severe coronavirus pneumonia had lower telomere length values upon admission and discharge than those suffering from a nonsevere disease course. Thus, in group 1, the telomere length upon admission was 6.343 nucleotide pairs, whereas in group 2, the telomere length was significantly (p 0.001) lower, with 5,264 nucleotide pairs. At discharge, the telomere length in both groups decreased significantly (p 0.001) compared with baseline levels, with 5.654 nucleotide pairs in patients in group 1 and 3.274 in group 2. The comparison of the number of patients in groups according to the level of telomerase activity showed a positive relationship between the severity of pneumonia and telomerase activity. Thus, a high level of telomerase activity upon hospital admission was observed in 2 (12.5%) patients in group 1 and 9 (24.3%) in group 2. The average level of telomerase activity was observed in 3 (18.8%) patients in group 1 and 15 (40.6%) in group 2. A low level of telomerase activity was detected in 11 (68.7%) patients in group 1 and in 13 (35.1%) patients in group 2, although no significant intragroup differences in this indicator were detected. At hospital discharge, no patients in group 1 had a high level of enzyme activity, but 4 (10.8%) people in group 2 had it. The average level of telomerase activity was established in 3 (18.8%) patients in group 1 and in 15 (40.6%) in group 2, without significant intragroup differences. A low level of telomerase activity was detected in 13 (81.2%) and 18 (48.7%) patients in groups 1 and 2, respectively (p = 0.028). All these findings indicate the prospect of using these indicators as factors for the prognosis and outcome of coronavirus pneumonia.