Pushkarenko O. A., Horlenko O. M., Feysa S. V., Tomey A. I.

COMORBID PATIENT WITH ACTIVE SARS-CoV-2 INFECTION AND METABOLICASSOCIATED STEATOTIC LIVER DISEASE

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About the author:

Pushkarenko O. A., Horlenko O. M., Feysa S. V., Tomey A. I.

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LITERATURE REVIEWS

Type of article:

Scientific article

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The article analyses current data from PubMed, MEDLINE, and Embase databases on the peculiarities of COVID19 in children with existing metabolic disorders. The sample of publications included sources for the period from 2019 to 2024. It has been determined that children with metabolic disorders should be considered a risk group for severe COVID-19. The analysis of the literature revealed a significant correlation between the predisposition of children and adolescents with metabolic disorders: metabolic-associated steatoid liver disease (MASLD), diabetes mellitus, obesity and high blood pressure to a burdensome course of SARS-CoV-2 infection, and prolonged post-COVID syndrome. The most probable pathological mechanisms underlying this interaction are identified: excessive immune-mediated and adipocyte-induced synthesis of proinflammatory cytokines and tumour necrosis factor. Such mechanisms are likely to increase the risk of hospitalisation of such patients due to the involvement of a larger volume of lung tissue. It has also been proven that COVID-19 is a factor with a reverse effect that negatively affects the condition of a metabolically triggered paediatric patient. As a result of layering of direct cytopathic and immune-mediated effects of the viral agent on the background dysmetabolic phenomena, the tense compensatory mechanisms for maintaining homeostasis are disrupted. As a result, dysmetabolic phenomena become pronounced, and compensated patients often become sub- and decompensated. In patients with diabetes mellitus, the need for glucose-lowering measures is likely to increase, and hepatocytes in children with diffuse liver disease are subject to a pronounced cytopathic effect: transaminases increase by more than 5 times. Even after recovery from COVID-19, it takes much longer to restore laboratory values to age-related norms than for metabolically unburdened children who have had COVID-19. One of the study's conclusions is that children with metabolic disorders should be the subject of increased attention for seasonal vaccination against COVID-19.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2024 Issue 2, 173, 137-144 pages, index UDC 616-71

DOI:

10.29254/2077-4214-2024-2-173-137-144