Volume 04 Issue 06-2024
70
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
06
P
AGES
:
70-77
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
The given scientific article analyses the dynamics of quantitative alterations in peripheral leukocytes and
hematopoietic elements in blood during the period of COVID-19 and recovery. We studied the effect of SARS-CoV-2
infection on the hematopoietic system, lymphocytopenia and eosinopenia during the course of the disease, control
of the recovery period from the disease by monitoring the dynamics of the number of formed elements.
KEYWORDS
COVID-19, post-COVID-19, physiology, peripheral immune cells, blood, leukocytes, lymphocytes, monocytes,
neutrophils, eosinophils.
INTRODUCTION
Research Article
ANALYSIS OF IMMUNE CELLS AND IMMUNOLOGICAL PROCESSES IN
COVID-19
Submission Date:
June 16, 2024,
Accepted Date:
June 21, 2024,
Published Date:
June 26, 2024
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume04Issue06-11
Bakridin Zaripov
National University of Uzbekistan named after Mirzo Ulugbek, Tashkent, Uzbekistan
Gulsara Akhmedova
Khajand State University named after Academician Bobojon Gafurov, Tajikistan, Uzbekistan
Bolta Kakhorov
Khajand State University named after Academician Bobojon Gafurov, Tajikistan, Uzbekistan
Behzod Shodiev
Khajand State University named after Academician Bobojon Gafurov, Tajikistan, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 04 Issue 06-2024
71
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
06
P
AGES
:
70-77
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
COVID-19 has become a global health threat.
Hematological alterations in patients with Covid-19
disease may be one of the indicators of functional
recovery, along with the immune response during
SARS-CoV-2 infection [1, 2, 16]. Therefore, quantitative
alterations in peripheral leukocytes as well as
hematopoietic elements are currently being studied to
determine whether COVID-19 is associated with fatal
outcomes as an early signal in patients [3, 4].
Analyzing the scientific literature, the most common
haematological symptoms in COVID-19 are a decrease
in the number of lymphocytes - lymphocytopenia [5, 6],
an increase in the number of neutrophils - neutrophilia
[7, 8], as well as a decrease in the number of
eosinophils
-
eosinopenia
[9]
and
mild
thrombocytopenia ( 35%) [10]. In many ways,
eosinophils have been considered antiviral cells[11].
Eosinophils contain and produce molecules with
antiviral activity and, thus, are involved in adaptive
immunity, the properties of which have been studied in
vitro and in vivo against a number of respiratory
viruses, including influenza [12]. Of note, lymphopenia
and eosinopenia were observed in 73 (52.9%) of 138
hospitalized patients with COVID-19. There is a positive
correlation
between
lymphopenia
and
thrombocytopenia in patients with severe disease (r =
0.486, P <0.001) [13]. Therefore, in this article, a
dynamic analysis of haematological indications for the
treatment of COVID-19 in the postoperative period has
been performed.
METHODS
General and biochemical analysis of blood was
conducted mainly in the 16th family clinic of the
Almazar district of Tashkent, in the multidisciplinary
clinic of the Tashkent Medical Academy. Analyzes were
performed on a biochemical analyzer BA-88A Mindray
Co.Ltd (KNR). HUMAN (GmbH) reagents (Germany)
were used. The study was conducted in a room with a
moderate temperature (26°C) [16].
The participation of study participants was voluntary
and not funded. The study was conducted in
accordance with the rules of scientific ethics, while
maintaining the anonymity of the participants [15].
Cytometric studies were carried out according to the
standards set on a BM 1800 microscope. Leukocyte
counts were performed on a BM 1800 biological
microscope using a Goryaev camera and automatic
counters. Blood was taken under sterile conditions, for
counting leukocytes 0.4 ml of a 3-5% solution of acetic
acid was added to the solution stained with methylene
blue. 20 µl of fresh blood (diluted 20 times) was taken
with a capillary pipette and leukocytes were counted.
Platelets were also counted according to the standards
set in the Goryaev chamber under a BM 1800 biological
microscope. The results were processed using the
Excel and OriginPro6.2017 programs (OriginLab
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(ISSN
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VOLUME
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ISSUE
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OCLC
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Publisher:
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Servi
Corporation, USA). The results were processed using
Fisher's test, Student's t-factor. The arithmetic mean
(M), mean deviation (±m), and statistical significance
index (р) were determined. At р≤0.05, the results were
considered 95% statistically significant.
The research participants were divided into 4
experimental and 2 control groups in the post-COVID-
19 period. For the 1st group, on the basis of voluntary
consent, individuals with a severe course of COVID-19,
under the age of 40 years, without chronic diseases
were selected (n = 25). The 2nd group, on the basis of
voluntary consent, were selected with moderate and
mild forms of COVID-19, 2-3 months after recovery, not
older than 40 years and without chronic diseases (n =
25). The second control group consisted of healthy
people aged 41-55 years who were not infected with
COVID-19 (n=12). The 3rd group, on the basis of
voluntary consent, were selected with a severe course
of COVID-19, 2-3 months after recovery, no older than
41-55 years, without chronic diseases (n=25). The 4th
group, on the basis of voluntary consent, were
selected with moderate and mild forms of COVID-19, 2-
3 months after recovery, not older than 41-55 years,
without chronic diseases (n = 25).
RESULTS AND DISCUSSION
For the study, people without concomitant chronic
diseases who recovered from COVID-19 were selected.
Functional parameters during the period of COVID-19
were obtained by retrospective analysis of case
histories. Were obtained the results presented in fig. 1.
for postoperative functional and haematological
parameters.
In the group of 30-40-year-olds, whose average
age is 36.64±2.13 years, a retrospective analysis
showed that the number of leukocytes in the disease
was
6.68±0.37*10^9cells/L
in
severe
cases,
6.47±0.41*10^9cells/L in the lungs , which is somewhat
lower than in the control norm, leukocytopenia was
observed (P<0.05). On the 4th week after the disease
it was 9.01±1.22*10^9cells/L in the first group,
8.79±0.41*10^9cells/L in the second group (P<0.05). It
was found that leukocytes increased by 26% in both
groups after recovery.
In the second large group, the average age of
the subjects was 46.1±1.87 years; as a result of
retrospective and laboratory analysis, it was found that
the number of leukocytes in the disease was 5.78±0.65
(P<0.05) in severe cases. , and in non-severe cases -
7.08 ± 0.81 (P<0.05), mild leukocytopenia was
observed somewhat less than the control norm
(P<0.05), at the 4th week after the disease - 8.75 ± 1.78
in the 3rd group, 9.15 ± 0, in the fourth group - 68
(P<0.05). Leukocytes increased by 19.2% in the first
group and by 19.7% in the second group after recovery
(Fig.1).
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Fig. 1.
Analysis of leukocytes during the recovery period (M±m) (*- Р<0,05; **-Р<0,01; ***-
Р<0,001).
The number of lymphocytes was slightly below
the norm and amounted to 0.93 ±0.11 *10^9cells/L and
1.03±0.18 (P<0.01) during the course of the disease, and
on the 4th week after the disease it was
1.50±0.19*10^9cells/L and, 2.48±0.23 (P<0.01), which
was close to the norm in dynamics. The number of
lymphocytes in the 3rd and 4th groups of the disease
was 0.97±0.16 (P<0.05) and 1.03±0.18 (P<0.01), in the
3rd group on composition 1.64±0.24 (P<0.05), in the
4th group 2.32±0.26 (P<0.01). In the 1st group, it was
established that it was 3 times smaller, and the second
group was close to the norm (Fig. 2.).
Volume 04 Issue 06-2024
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VOLUME
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Fig. 2.
Dynamics lymphocytes in the recovery period
(Note: Unit of measurement
-
10^9cells/L; *- P<0,05; **-P<0,01; ***-P<0,001)
In a number of monocytes in the first and
second groups was 0.71±0.17 (P<0.05) and 0.52±0.27
(P<0.05) during the disease, and was within the upper
limit of normal. On the 4th week after the disease, it
was 0.87±0.26 (P<0.05) in the first group and
0.72±0.09 (P<0.01) in the second group. It is
established, respectively, that it increased by 4.0 and
3.7 times. The number of monocytes in the third and
fourth groups, respectively, during the period of the
disease was 0.78±0.09 (P<0.05) and 0.58±0.01 (P<0.01)
and was within the upper limit of normal. After
diseases in the 4th week - 0.81±0.07 (P<0.05) in the 3rd
group and 0.69±0.12 (P<0.01) in the 2nd group,
respectively, it increased by 2.5 and 2.1 times from the
control. (Fig. 3.).
Fig.3.
Dynamics monocytes in the recovery period
(Note: Unit of measurement
-
10^9cells/L; *- P<0,05; **-P<0,01; ***-P<0,001)
The number of neutrophils in the disease was
5.82±0.61 (P<0.05) in the first group, 5.16±0.44 (P<0.01)
in the second group and was observed at the upper
limit of normal. After the disease, the decrease in the
number of neutrophils continued on the 4th week - in
the first group it was 5.18±0.30 (P<0.05), in the second
group - 5.81±0.62 (P<0.05) (3.15 - see figure). In the
third and fourth groups, it was 5.63±0.87 (P<0.05),
5.24±0.16 (P<0.01) and was observed at the upper limit
of normal. In the following groups after the disease,
the decrease in the number of neutrophils continued
and on the 4th week it was 5.22±0.28 (P<0.05) in the
third group, and 5.07±0.51 in the fourth group (P<0, 05)
(Fig. 4).
Volume 04 Issue 06-2024
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VOLUME
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Fig.4.
Dynamics neutrophils in the recovery period
(Note: Unit of measurement
-
10^9cells/L; *- P<0,05; **-P<0,01; ***-P<0,001)
In a number of eosinophils, weak eosinopenia
was observed, the number of which was 0.017±0.01·
(P<0.01) and 0.021±0.03· (P<0.01) in the first and
second groups, respectively. In the dynamics after the
disease, an increase in the number of eosinophils was
observed and on the 4th week it was 0.09±0.04
(P<0.05), 0.20±0.11 (P<0.05). Mild eosinopenia was
observed in patients with severe disease.
During infection with COVID-19, high levels of
chemokines are synthesized to recruit effector
inflammatory cells due to the immune response. This
inadequate immune response leads to lung infiltration
and hyperactivation of monocytes and macrophages
as a result of chemokine secretion. A large number of
inflammatory cytokines, chemokines and monocytes in
the lung tissue attract neutrophils, which causes
alveolar edema and a decrease in gas exchange [14].
This process explains the pathogenesis of changes in
the number of peripheral immune cells.
CONCLUSIONS
Thus, COVID-19 is a systemic disease that significantly
affects the haematopoietic system and haemostasis.
Since lymphocytopenia and eosinopenia are observed
during the course of the disease, dynamic control of
the number of hematopoietic elements is one of the
most important factors in recovery. As a result,
monitoring of haematological parameters, the
dynamics of the number of lymphocytes helps to
control the period of recovery from the disease and
take timely preventive measures.
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