ASPECTOS CLÍNICOS E IMUNOLÓGICOS DE PACIENTES ASSINTOMÁTICOS OU COM FORMA LEVE DE COVID-19 QUE APRESENTARAM SINTOMAS PROLONGADOS

Abstract

Covid-19 is an infection caused by the SARS-CoV-2 coronavirus, whose infected patients can present varied respiratory and systemic manifestations. The evolution to the most severe form is associated with an exacerbated inflammatory process, known as “cytokine storm”. Although most patients have mild forms of the disease, prolonged symptoms have been observed, including weakness, myalgia, headache, and changes in taste and smell. In this context, the literature has few data on the inflammatory response of these patients. Aiming to better understand the inflammatory mechanisms involved in the absence and persistence of these symptoms, the present prospective cohort study determined the profile of serum inflammatory cytokines in a cohort of patients with a positive molecular test for SARS-CoV-2, asymptomatic or with the mild form of Covid. -19. The included patients underwent four visits, the first (V1) in a home environment (up to 10 days of symptoms) and the others with 30 (V2), 60 (V3) and 120 (V4) days from the onset of symptoms at the Hospital's outpatient clinic. “Professor Esterina Corsini” Day (HUMAP/UFMS. During outpatient visits, patients underwent collection of clinical and demographic data, clinical evaluation, peripheral blood collection for laboratory tests and quantification of inflammatory mediators IL-6, IL -10, IL-12, IL-1β, TNF-α, GM-CSF and G-CSF using high sensitivity kits. All patients were also referred for spirometry and chest computed tomography tests. that 59.7% of patients had prolonged symptoms after 30 days, 53.3% after 60 days and 56% after 120 days. The main prolonged symptoms were: cough (V1=28%; V2=16%; V3=9 %; V4=13%), headache (V1=25%; V2=19%; V3=9%; V4= 25%), anosmia (V1=19%; V2=16%; V3=6%; V4=13%) and adynamia (V1=13%; V2=34%; V3=28%; V4=16%). No significant changes in lung function were observed. Chest tomographic findings revealed lesions compatible with Covid-19 in 50% of patients at 30 days and only 4% at 120 days. The evaluated patients had higher serum IL-6 levels compared to the control group, whose concentrations were associated with a body mass index above 25. Thus, the presence of post-Covid-19 symptoms in individuals who presented the mild form is associated the presence of low-grade inflammation, possibly related to overweight.