THE CONDITION OF THE VASCULAR ENDOTHELIUM IN CHILDREN WITH COVID-19 AND BRONCHO-OBSTRUCTIVE SYNDROME
Introduction: The impact of SARS-CoV-2 infection on the human organism has proven to be more diverse than that of previously known viral infections. However, the full spectrum of the long-term consequences of the disease, especially in children, has not been thoroughly studied. One key area of concern is the development of broncho-obstructive syndrome (BOS) as a post-COVID-19 complication, which involves airway inflammation and hyperreactivity. This study investigates the relationship between endothelial dysfunction and BOS in pediatric patients following SARS-CoV-2 infection.
Objective: To explore the endothelial status in children with SARS-CoV-2 infection and its association with the development of BOS, and to assess the role of endothelial dysfunction markers—circulating endothelial cells (CECs), endothelin-1, and nitric oxide metabolites—in this context.
Methods: A retrospective study was conducted between 2020 and 2022, involving 486 children. The study included two primary groups: (1) Control: Healthy children with no history of SARS-CoV-2 infection or BOS; children with SARS-CoV-2 infection but no BOS, and (2) Main: Children with BOS but no SARS-CoV-2 infection; children with SARS-CoV-2 infection followed by the development of BOS. Endothelial function was assessed by measuring levels of CECs, endothelin-1, and nitric oxide metabolites.
Results: The study found significantly elevated CECs and endothelin-1 levels, along with decreased nitric oxide metabolites, in children who developed BOS following SARS-CoV-2 infection. The highest levels of endothelial dysfunction markers were observed in this group, suggesting a synergistic effect of SARS-CoV-2 infection and BOS on endothelial damage. Notably, 64.3% of children in this group exhibited elevated CEC levels, reflecting severe endothelial dysfunction. Endothelin-1 levels were also significantly higher in children with BOS after SARS-CoV-2 infection (0.46 ± 0.02 fmol/mL) compared to healthy controls and children with BOS without a history of SARS-CoV-2 infection. These findings highlight the critical role of endothelial dysfunction in the pathogenesis of post-COVID-19 respiratory complications.
Conclusion: SARS-CoV-2 infection contributes to significant endothelial dysfunction in children, particularly in those who develop BOS. The combination of SARS-CoV-2 infection and BOS exacerbates endothelial damage, which likely plays a critical role in the pathogenesis of post-COVID-19 respiratory complications. These findings suggest the need for further research into therapeutic strategies aimed at correcting endothelial dysfunction, potentially improving outcomes for pediatric patients suffering from long-term respiratory sequelae following COVID-19.
Toktabayeva Bakytkul Zhumagalievna – Candidate of Medical Sciences, Acting Associate Professor, Department of Propaedeutics of Children's Diseases NCJSC «Semey Medical University», 103 Abay street, Semey, 071400, Kazakhstan; Email: bakytkul.toktabayeva@smu.edu.kz; Phone number: +7(701)150-84-20. https://orcid.org/0000-0001-5899-1247
Orazalina Ainash Saparovna – Candidate of Biological Sciences, Associate Professor, Head of the Department of Molecular Biology and Medical Genetics named after Academician of the National Academy of Sciences of the Republic of Kazakhstan T.K. Raisov, Semey Medical University, 103 Abay St., Semey, Republic of Kazakhstan; https://orcid.org/0000-0003-4594-0138; e-mail: ainash.orazalina@smu.edu.kz; +7-777-235-47-72
Abylgazinova Aizhan Zhaksykeldievna – PhD, assistant, Department of Pediatrics and Medical Rehabilitation named after D.M. Tusupova NCJSC «Semey Medical University», 103 Abay street, Semey, 071400, Email: aizhan.abylgazinova@smu.edu.kz; Phone number: +7 705 318 7737 https://orcid.org/0000-0002-1894-0709.
Amrenova Kuralay Shaganovna, candidate of medical sciences, Department of Propaedeutics of Internal Diseases NCJSC «Semey Medical University», 103 Abay street, Semey, 071400, Kazakhstan; Email: kuralay.amrenova@smu.edu.kz; Phone number: +7 777 295 8521. https://orcid.org/0000-0002-4350-2698.
Kadisha Disumbekovna Abayeva - Assistant, Department of Propaedeutics of Children's Diseases NCJSC «Semey Medical University», 103 Abay street, Semey, 071400, Kazakhstan; Email: kadisha.abayeva@smu.edu.kz; Phone number: +7 777 297 5751. https://orcid.org/0000-0002-7733-0070.
Gulaiym Medetkaliyevna Zhangaliyeva - Assistant, Department of Propaedeutics of Children's Diseases NCJSC «Semey Medical University», 103 Abay street, Semey, 071400, Kazakhstan; Email: gulaiym.zhangaliyeva@smu.edu.kz; Phone number: +7 775 177 5176.
Corresponding Author:
Shakirova Aizhan Askarona – Assistant, Department of Propaedeutics of Children's Diseases NCJSC «Semey Medical University», https://orcid.org/0000-0002-5929-7588. Semey, Kazakhstan;
Post address: Kazakhstan, 071400, Semey, Abay street 103.
Email: aizhan.shakirova@smu.edu.kz
Phone number: +7 (777) 980-55-93
1. de Caestecker L., von Wissmann B. COVID-19: decision-making in public health. J R Coll Physicians Edinb. 2021 Jun;51(S1):S26-S32. doi: 10.4997/JRCPE.2021.238.
2. AlShahrani I., Hosmani J., Shankar V.G., AlShahrani A., Togoo R.A., Yassin S.M., Khan S., Patil S. COVID-19 and cardiovascular system-a comprehensive review. Rev Cardiovasc Med. 2021 Jun 30;22(2):343-351. doi: 10.31083/j.rcm2202041.
3. Kgatle M.M., Lawal I.O., Mashabela G., Boshomane T.M.G., Koatale P.C., et al. COVID-19 Is a Multi-Organ Aggressor: Epigenetic and Clinical Marks. Front Immunol. 2021 Oct 8;12:752380. doi: 10.3389/fimmu.2021.752380.
4. Suarez-Lopez J.R., Cairns M.R., Sripada K., Quiros-Alcala L., Mielke H.W., Eskenazi B., Etzel R.A., Kordas K. International Society for Children's Health and the Environment. COVID-19 and children's health in the United States: Consideration of physical and social environments during the pandemic. Environ Res. 2021 Jun;197:111160. doi: 10.1016/j.envres.2021.111160.
5. Bernard I., Limonta D., Mahal L.K., Hobman T.C. Endothelium Infection and Dysregulation by SARS-CoV-2: Evidence and Caveats in COVID-19. Viruses. 2020 Dec 26;13(1):29. doi: 10.3390/v13010029.
6. Libby P., Lüscher T. COVID-19 is, in the end, an endothelial disease. Eur Heart J. 2020 Sep 1;41(32):3038-3044. doi: 10.1093/eurheartj/ehaa623.
7. Cava E., Carbone S. Coronavirus disease 2019 pandemic and alterations of body composition. Curr Opin Clin Nutr Metab Care. 2021 May 1;24(3):229-235. doi: 10.1097/MCO.0000000000000740.
8. Nägele M.P., Haubner B., Tanner F.C., Ruschitzka F., Flammer A.J. Endothelial dysfunction in COVID-19: Current findings and therapeutic implications. Atherosclerosis. 2020 Dec;314:58-62. doi: 10.1016/j.atherosclerosis.2020.10.014.
9. Bonaventura A., Vecchié A., Dagna L., Martinod K., Dixon D.L., Van Tassell B.W. et al. Endothelial dysfunction and immunothrombosis as key pathogenic mechanisms in COVID-19. Nat Rev Immunol. 2021 May;21(5):319-329. doi: 10.1038/s41577-021-00536-9.
10. Zhang J., Tecson K.M., McCullough P.A. Endothelial dysfunction contributes to COVID-19-associated vascular inflammation and coagulopathy. Rev Cardiovasc Med. 2020 Sep 30;21(3):315-319. doi: 10.31083/j.rcm.2020.03.126.
11. Siddiqi H.K., Libby P., Ridker P.M. COVID-19 - A vascular disease. Trends Cardiovasc Med. 2021 Jan;31(1):1-5. doi: 10.1016/j.tcm.2020.10.005.
12. Amraei R., Rahimi N. COVID-19, Renin-Angiotensin System and Endothelial Dysfunction. Cells. 2020 Jul 9;9(7):1652. doi: 10.3390/cells9071652.
13. Stigal H.T. Von Willebrand Factor. Significance and Determination of Concentration in Clinical Practice (Review). Proceedings of the XIII International Scientific and Practical Conference "Modern Science: Current Issues, Achievements, and Innovations". – Perm, "Science and Education", 2020. – Vol. 1. – Pp. 217-221.
14. Godo S., Shimokawa H. Endothelial Functions. Arterioscler Thromb Vasc Biol. 2017 Sep;37(9):e108-e114. doi: 10.1161/ATVBAHA.117.309813.
15. Alexander Y., Osto E., Schmidt-Trucksäss A., Shechter M., Trifunovic D. et al. Endothelial function in cardiovascular medicine: a consensus paper of the European Society of Cardiology Working Groups on Atherosclerosis and Vascular Biology, Aorta and Peripheral Vascular Diseases, Coronary Pathophysiology and Microcirculation, and Thrombosis. Cardiovasc Res. 2021 Jan 1;117(1):29-42. doi: 10.1093/cvr/cvaa085.
16. Zuchi C., Tritto I., Carluccio E., Mattei C., Cattadori G., Ambrosio G. Role of endothelial dysfunction in heart failure. Heart Fail Rev. 2020 Jan;25(1):21-30. doi: 10.1007/s10741-019-09881-3.
17. Jourde-Chiche N., Fakhouri F., Dou L., Bellien J., Burtey S., Frimat M. et al. Endothelium structure and function in kidney health and disease. Nat Rev Nephrol. 2019 Feb;15(2):87-108. doi: 10.1038/s41581-018-0098-z.
18. Karki P., Birukova A.A. Microtubules as Major Regulators of Endothelial Function: Implication for Lung Injury. Front Physiol. 2021 Oct 28;12:758313. doi: 10.3389/fphys.2021.758313.
19. Eldridge L., Wagner E.M. Angiogenesis in the lung. J Physiol. 2019 Feb;597(4):1023-1032. doi: 10.1113/JP275860.
20. Poredos P., Poredos A.V., Gregoric I. Endothelial Dysfunction and Its Clinical Implications. Angiology. 2021 Aug;72(7):604-615. doi: 10.1177/0003319720987752.
21. Lafoz E., Ruart M., Anton A., Oncins A., Hernández-Gea V. The Endothelium as a Driver of Liver Fibrosis and Regeneration. Cells. 2020 Apr 10;9(4):929. doi: 10.3390/cells9040929.
22. Henrina J., Putra I.C.S., Lawrensia S., Marta D.S., Wijaya E., Saboe A., Cool C.J., Suciadi L.P. Cardiac manifestations, treatment characteristics, and outcomes of paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus-2: A systematic review. Prog Pediatr Cardiol. 2021 Dec;63:101365. doi: 10.1016/j.ppedcard.2021.101365.
23. Higgins V., Sohaei D., Diamandis E.P., Prassas I. COVID-19: from an acute to chronic disease? Potential long-term health consequences. Crit Rev Clin Lab Sci. 2021 Aug;58(5):297-310. doi: 10.1080/10408363.2020.1860895.
Количество просмотров: 364612
Категория статей:
Актуальная тема COVID-19
Библиографическая ссылка
Shakirova A.A., Toktabayeva B.Zh., Orazalina A.S., Abylgazinova A.Zh., Amrenova K.Sh., Abayeva K.D., Zhangaliyeva G.M. The condition of the vascular endothelium in children with COVID-19 and broncho-obstructive syndrome // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol.27 (1), pp. 137-145. doi 10.34689/SH.2025.27.1.017Похожие публикации:
THE CONDITION OF THE VASCULAR ENDOTHELIUM IN CHILDREN WITH COVID-19 AND BRONCHO-OBSTRUCTIVE SYNDROME
CONSEQUENCES OF THE CORONAVIRUS INFECTION: THE POST-COVID SYNDROME AND MENTAL MANIFESTATIONS. LITERATURE REVIEW
EFFICACY OF THE ANTIVIRAL DRUG ENISAMY IODIDE IN SEVERE ADULT ACUTE RESPIRATORY INFECTIONS IN THE COVID-19 ERA
КЛИНИЧЕСКИЕ И СОЦИАЛЬНО-ДЕМОГРАФИЧЕСКИЕ ХАРАКТЕРИСТИКИ ПАЦИЕНТОВ С ПСИХИЧЕСКИМИ И ПОВЕДЕНЧЕСКИМИ РАССТРОЙСТВАМИ В ПОСТКОВИДНОМ ПЕРИОДЕ
ИММУНОЛОГИЧЕСКИЕ ИЗМЕНЕНИЯ У ДЕТЕЙ С МУЛЬТИСИСТЕМНЫМ ВОСПАЛИТЕЛЬНЫМ СИНДРОМОМ, АССОЦИИРОВАННЫМ С SARS-COV-2