Significance of indicators of intestinal permeability, the state of the microbiota in the development of gastroenterological manifestations in the treatment of patients with a new coronavirus infection (COVID-19)

DOI: https://doi.org/10.29296/25877305-2022-01-14
Issue: 
1
Year: 
2022

A. Ratnikova(1, 4); Professor V. Grinevich(2), MD; Professor V. Ratnikov(1, 3), MD; Professor
K. Kozlov(2), MD; V. Gorelov(1), Candidate of Medical Sciences; Professor Yu. Kravchuk(2), MD (1)L.G.
Sokolov North-West District Scientific and Clinical Center Federal Medical and Biological Agency, Saint
Petersburg (2)S.M. Kirov Military Medical Academy, Saint Petersburg (3)Saint Petersburg State University,
Saint Petersburg 4«Pervaya Liniya», Health Care Resort, Saint Petersburg

The effectiveness of combating the pandemic of a new coronavirus infection (COVID-19) is based on a detailed analysis of the pathogenetic features of the course of SARS-CoV-2 infection, including an assessment of the state of the microbiota and intestinal permeability during the treatment of COVID-19 patients. Purpose: To study the dynamics of intestinal permeability, qualitative and quantitative composition of microbiota in the treatment of COVID-19 patients. Material and methods: The study was performed in 80 patients with COVID-19, whose average age was 45 years, 19 of them had mild and 61 had moderate severity of the disease. The scope of the examination included traditional clinical, clinical and laboratory, biochemical, instrumental and radiation studies, as well as original methods for studying intestinal permeability and microbiota. Rebamipid was used as an element of complex pathogenetic therapy in the treatment of 41 patients (51.3%). Results and conclusions: The clinical, laboratory and radiation semiotics of COVID-19 were studied, the interdependence of manifestations of systemic inflammation, changes in the intestinal microbiome in patients with mild and moderate severity was revealed. The characteristic dynamics of the concentration levels of proinflammatory cytokines, insulin, fecal calprotectin and zonulin, reflecting the peculiarities of changes in intestinal permeability during COVID-19 treatment, has been established. The necessity of correction of intestinal permeability in the treatment of COVID-19 patients has been proved, the effectiveness of rebamipid when used at the inpatient stage of treatment and with further use in the process of outpatient rehabilitation has been confirmed.
Keywords: 
infectious diseases
new coronavirus infection
COVID-19
gastrointestinal tract (gastrointestinal tract)
SARS-CoV-2
rebamipid
intestinal permeability
zonulin
fecal calprotectin
microbiota
endotoxin

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