medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-4-51-65medsovet-6769Research ArticleCOVID-19Факторы, влияющие на содержание IgG-антител к S-белку SARS-CoV-2 в крови у реконвалесцентов после новой коронавирусной инфекции (COVID-19)Factors affecting the content of Ig G-antibodies to S-protein SARS-CoV-2 in the blood of reconvalescents after new coronaviral infection (COVID-19)https://orcid.org/0000-0002-8396-1936КрюковЕ. В.KryukovE. V.

Крюков Евгений Владимирович, д.м.н., член-корреспондент РАН, начальник

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Evgeniy V. Kryukov, Dr. Sci. (Med.), Corresponding Member of the Russian Academy of Sciences, Head

6, Akademik Lebedev St., St Petersburg, 194044

evgeniy.md@mail.ruhttps://orcid.org/0000-0003-1851-0941СалуховВ. В.SalukhovV. V.

Салухов Владимир Владимирович, д.м.н., начальник 1-й кафедры и клиники (терапии усовершенствования врачей)

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Vladimir V. Salukhov, Dr. Sci. (Med.), Head of the 1st Department and Clinic (Advanced Therapy for Physicians)

6, Akademik Lebedev St., St Petersburg, 194044

vlasaluk@yandex.ruhttps://orcid.org/0000-0001-7537-1218КотивБ. Н.KotivB. N.

Котив Богдан Николаевич, д.м.н., профессор, заместитель начальника по  клинической работе

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Bogdan N. Kotiv, Dr. Sci. (Med.), Professor, Deputy Head for Clinical Work

6, Akademik Lebedev St., St Petersburg, 194044

kotivbn@gmail.comhttps://orcid.org/0000-0001-8408-5301ОвчинниковД. В.OvchinnikovD. V.

Овчинников Дмитрий Валерьевич, к.м.н., начальник научного отдела

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Dmitriy V. Ovchinnikov, Cand. Sci. (Med.), Head of the Scientific Department

6, Akademik Lebedev St., St Petersburg, 194044

79112998764@yandex.ruhttps://orcid.org/0000-0003-2016-8815АндрейчукЮ. В.AndreychukYu. V.

Андрейчук Юрий Владимирович, генеральный директор лабораторной службы

194044, Санкт-Петербург, Б. Сампсониевский проспект, д. 20

Yuri V. Andreychuk, General Director of the Helix Laboratory Service

20, B. Sampsonievsky Ave., St Petersburg, 194044

https://orcid.org/0000-0002-4815-2877ДенисовД. Г.DenisovD. G.

Денисов Дмитрий Геннадьевич, медицинский директор лабораторной службы

194044, Санкт-Петербург, Б. Сампсониевский проспект, д. 20

Dmitriy G. Denisov, Medical Director of the Helix Laboratory Service

20, B. Sampsonievsky Ave., St Petersburg, 194044

ddenisov@helix.ruhttps://orcid.org/0000-0002-6110-1097БогомоловА. Б.BogomolovA. B.

Богомолов Алексей Борисович, к.м.н., старший преподаватель 1-й кафедры и клиники (терапии усовершенствования врачей)

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Alexey B. Bogomolov, Cand. Sci. (Med.), Senior Lecturer of the 1st Department and Clinic (Advanced Therapy for Physicians)

6, Akademik Lebedev St., St Petersburg, 194044

bg-ab@mail.ruhttps://orcid.org/0000-0002-6521-7986ХаритоновМ. А.KharitonovM. A.

Харитонов Михаил Анатольевич, д.м.н., профессор 1-й кафедры и клиники (терапии усовершенствования врачей)

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Mikhail A. Kharitonov, Dr. Sci. (Med.), Professor of the 1st Department and Clinic (Advanced Therapy for Physicians)

6, Akademik Lebedev St., St Petersburg, 194044

micjul11@yandex.ruhttps://orcid.org/0000-0001-7914-6173РудаковЮ. В.RudakovYu. V.

Рудаков Юрий Викторович, к.м.н., доцент 1-й кафедры и клиники (терапии усовершенствования врачей)

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Yuri V. Rudakov, Cand. Sci. (Med.), Associate Professor of the 1st Department and Clinic (Advanced Therapy for Physicians)

6, Akademik Lebedev St., St Petersburg, 194044

rudakov_yura@mail.ruhttps://orcid.org/0000-0002-6022-5709СадовниковП. С.SadovnikovP. S.

Садовников Павел Сергеевич, руководитель проектов, технологический департамент лабораторной службы

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Pavel S. Sadovnikov, Project Manager, Technological Department of the Helix Laboratory Service

6, Akademik Lebedev St., St Petersburg, 194044

sadovnikov.p@helix.ruhttps://orcid.org/0000-0002-2532-6133ЧугуновА. А.ChugunovA. A.

Чугунов Александр Алексеевич, адъюнкт 1-й кафедры (терапии усовершенствования врачей)

194044, Россия, Санкт-Петербург, ул. Академика Лебедева, д. 6

Alexandr A. Chugunov, Adjunct of the 1st Department and Clinic (Advanced Therapy for Physicians)

6, Akademik Lebedev St., St Petersburg, 194044

alexandrchugun@yandex.ruВоенно-медицинская академии имени С.М. КироваРоссияMilitary Medical Academy named after S.M. KirovRussian FederationНаучно-производственная фирма «Хеликс»РоссияHelix Research and Production CompanyRussian Federation202206042022045165Copyright © Крюков Е.В., Салухов В.В., Котив Б.Н., Овчинников Д.В., Андрейчук Ю.В., Денисов Д.Г., Богомолов А.Б., Харитонов М.А., Рудаков Ю.В., Садовников П.С., Чугунов А.А., 20222022Крюков Е.В., Салухов В.В., Котив Б.Н., Овчинников Д.В., Андрейчук Ю.В., Денисов Д.Г., Богомолов А.Б., Харитонов М.А., Рудаков Ю.В., Садовников П.С., Чугунов А.А.Kryukov E.V., Salukhov V.V., Kotiv B.N., Ovchinnikov D.V., Andreychuk Y.V., Denisov D.G., Bogomolov A.B., Kharitonov M.A., Rudakov Y.V., Sadovnikov P.S., Chugunov A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6769Введение

Введение. Заболеваемость и  летальность COVID-19 актуализируют выявление групп с  наибольшим риском первичного и повторного инфицирования, лиц, нуждающихся в первоочередной вакцинации либо ревакцинации.

Цель – изучить факторы, влияющие на содержание IgG-антител к S-белку SARS-CoV-2 у реконвалесцентов после перенесенного COVID-19 в течение полугода.

Материалы и методы

Материалы и методы. Исследование Военно-медицинской академии имени С.М. Кирова и лабораторной службы «Хеликс» проводилось с 01.06.2020 по 01.08.2021 на базе Военно-медицинской академии и центров «Хеликс». В исследование включен 1421 чел. обоих полов в возрасте от 18 до 70 лет: 1205 с бессимптомной и легкой формой заболевания (амбулаторная группа), 216 со среднетяжелой или тяжелой формой (стационарная группа). Амбулаторной группе выполнялось количественное определение IgG к спайковому (S) белку SARS-CoV-2 методом иммунохемилюминесцентного анализа на 30, 45, 60, 90, 180-е сутки от установления диагноза. Диагноз верифицировался положительным результатом ОТ-ПЦР. Стационарной группе производилось идентичное исследование на 1, 14, 45, 60, 90 и 180-е сутки от момента поступления в стационар. Диагноз верифицировался аналогично.

Результаты

Результаты. У реконвалесцентов формируется постинфекционный иммунитет с 30-х суток. Пожилой возраст ассоциировался с  более выраженной продукцией IgG к  S-белку SARS-CoV-2, преимущественно это отмечено у  пожилых женщин. Среднетяжелое и тяжелое течение характеризуется более высокими концентрациями IgG к S-белку SARS-CoV-2. Высокий уровень IgG к S-белку SARS-CoV-2 сохраняется на протяжении до 90 суток с последующим снижением к 180-м суткам. Масса тела, дни оксигенотерапии, гипертермии, объем поражения легочной ткани и  уровень С-реактивного белка коррелируют с концентрацией IgG к S-белку SARS-CoV-2. Применение глюкокортикоидов (ГКС) характеризуется наличием более высокой концентрации IgG к S-белку SARS-CoV-2 до 6 мес. Имеется дозозависимый эффект применения ГКС.

Выводы

Выводы. Формирование и сохранение уровня нейтрализующих антител на протяжении 6 мес. зависят от тяжести заболевания, пола и возраста пациентов, факта применения ГКС. Это необходимо учитывать при проведении лечебных и профилактических мероприятий, планировании вакцинации.

Introduction

Introduction. Morbidity and mortality of COVID-19 actualizes the identification of groups with the greatest risk of primary and re-infection, persons in need of priority vaccination or revaccination.

Objective

Objective. To study the factors affecting the content of IgG antibodies to the S-protein SARS-CoV-2 in convalescents after suffering COVID-19 for 6 months.

Materials and methods

Materials and methods. The study of  the Military Medical Academy and the  Helix Laboratory Service was carried out from 06/01/2020 to 08/01/2021 on the basis of the Military Medical Academy and the Helix centers. The study included 1421 people – both sexes from 18 to 70 years old. 1205 with asymptomatic and mild disease (outpatient group). 216 with moderate or severe form (inpatient group). The outpatient group underwent a quantitative determination of IgG to the spike (S) protein SARS-CoV-2 by immunochemiluminescence analysis at 30, 45, 60, 90, 180 days from diagnosis. The diagnosis was verified by a positive RT-PCR result. The inpatient group underwent an identical study on the 1st, 14th, 45th, 60th, 90th and 180th days from the moment of admission to the hospital. The diagnosis was verified in the same way.

Results

Results. In convalescents, post-infectious immunity is formed from 30 days. Older age was associated with a more pronounced production of IgG to the S-protein SARS-CoV-2, mainly in older women. Moderate and severe course is characterized by higher concentrations of IgG to the SARS-CoV-2 S protein. A high level of IgG to the S-protein SARS-CoV-2 persists for up to 90 days, with a subsequent decrease by 180 days. Body weight, days of oxygen therapy, hyperthermia, the volume of lung tissue lesions and the level of C-reactive protein correlate with the concentration of IgG to the S-protein SARS-CoV-2. The use of glucocorticoids (GCS) is characterized by the presence of a higher concentration of IgG to the S-protein SARS-CoV-2 up to 6 months. There is a dose-dependent effect of using GCS.

Conclusion

Conclusion. The formation and maintenance of the level of neutralizing antibodies for 6 months depends on the severity of the disease, the gender and age of the patients, and the fact of using GCS. This must be taken into account when carrying out therapeutic and preventive measures, planning vaccination.

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The authors declare that there are no conflicts of interest present.