Cytokines and inflammationCytokines and inflammationЦитокины и воспаление1684-7849Eco-Vector63647410.17816/CI636474ReviewsНаучные обзорыResearch ArticleA perspective on pathogenesis of post-COVID syndromeВзгляд на патогенез постковидного синдромаhttps://orcid.org/0000-0002-5243-80856093-7430KlimovNikolay A.КлимовНиколай А.
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

nklimov@mail.ruhttps://orcid.org/0000-0002-8228-42402064-7584SimbirtsevAndrey S.СимбирцевАндрей С.
Russian Federation

MD, Dr. Sci. (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences

д-р мед. наук, профессор, член-корреспондент РАН

simbas@mail.ruInstitute of Experimental MedicineИнститут экспериментальной медициныState Research Institute of Highly Pure BiopreparationsГосударственный научно-исследовательский институт особо чистых биопрепаратов040220251506202421272812509202426122024Copyright ©; 2024, Klimov N.A., Simbirtsev A.S.Copyright ©; 2024, Климов Н.А., Симбирцев А.С.2024Klimov N.A., Simbirtsev A.S.Климов Н.А., Симбирцев А.С.https://cijournal.ru/1684-7849/article/view/636474

In 2023, the World Health Organization declared the COVID-19 pandemic caused by SARS-CoV-2 officially over. The infection has now transitioned into seasonal respiratory viral infections. However, one of the major health concerns persisting beyond the pandemic is post-COVID syndrome — a condition characterized by the persistence of COVID-19 symptoms or the emergence of new symptoms three months after the initial illness. The common mechanisms underlying post-COVID syndrome include immune dysregulation, viral persistence, chronic systemic inflammation, autoimmune manifestations, thrombosis, vascular endothelial dysfunction, myocarditis, myocardial infarction, ischemic heart disease, and pulmonary fibrosis. A significant autoimmune feature of post-COVID syndrome is the high prevalence of autoantibodies, including those targeting interferons, which can neutralize the biological activity of these protective cytokines. The combined effects of these mechanisms lead to a wide range of complications affecting multiple organ systems, including neurological and neuropsychiatric disorders. The exact pathophysiological mechanisms of post-COVID syndrome and their causal relationships remain to be fully understood. This is necessary to build on accumulated experience, be fully prepared for future infectious challenges, and prevent further casualties. This review examines the clinical manifestations and pathogenesis of post-COVID syndrome.

В 2023 году пандемия новой коронавирусной инфекции, вызванной коронавирусом SARS-CoV-2, объявлена Всемирной организацией здравоохранения закончившейся. По-видимому, она перешла в разряд сезонных респираторных вирусных инфекций. Среди оставшихся после окончания пандемии проблем одно из ведущих мест занимает постковидный синдром — состояние, связанное с сохранением симптомов COVID-19 или вновь появившимися симптомами через 3 месяца после перенесённого заболевания. Наиболее общими механизмами при постковидном синдроме считаются иммунная дисрегуляция, персистенция вируса, продолжающееся генерализованное воспаление, аутоиммунные проявления, тромбозы и повреждение эндотелия сосудов, миокардиты, инфаркты миокарда, ишемическая болезнь, фиброз лёгких. Серьёзным аутоиммунным проявлением у больных с постковидным синдромом выступает высокая частота появления аутоантител, в том числе аутоантител к интерферонам, которые способны блокировать биологическую активность этих защитных цитокинов. В результате сочетанного действия данных механизмов возникает широкий спектр осложнений со стороны многих органов и систем организма, в том числе неврологических и нейропсихических осложнений. Точные патофизиологические механизмы постковидного синдрома и их причинно-следственные связи ещё предстоит установить. Это нужно для того, чтобы на основании накопленного опыта быть готовыми к новым возможным инфекционным вызовам, подойти к ним во всеоружии, избежать новых жертв. В обзоре рассмотрены вопросы симптоматики и патогенеза постковидного синдрома.

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