kurskvestЧеловек и его здоровьеHumans and their health1998-57461998-5754Kursk State Medical University10.21626/vestnik/2023-1/01DJTQMEkurskvest-1140Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEВлияние коронавирусной инфекции на маркеры эндотелиальной дисфункции у детей при патологии почекEffects of coronavirus infection on markers of endothelial dysfunction in children with renal pathologyhttps://orcid.org/0000-0001-8126-2544ЯроваяДарья ВладимировнаYarovayaDarya V.

заочный аспирант кафедры факультетской педиатрии, Астраханский ГМУ, г. Астрахань

part-time postgraduate student at the Department of Facultative Pediatrics, ASMU, Astrakhan, Russian Federation

podkovyrova_dary@list.ruhttps://orcid.org/0000-0003-4168-4851БашкинаОльга АлександровнаBashkinaOlga A.

д-р мед. наук, профессор, зав. кафедрой факультетской педиатрии, Астраханский ГМУ, г. Астрахань

Dr. Sci. (Med.), Professor, Head of the Department of Facultative Pediatrics, ASMU, Astrakhan, Russian Federation

bashkina1@mail.ruhttps://orcid.org/0000-0003-0383-5006КрасиловаЕлена ВладимировнаKrasilovaElena V.

канд. мед. наук, зав. отделением аллергологии, ОДКБ, г. Астрахань

Cand. Sci. (Med.), Head of the Department of Allergology, RChCH, Astrakhan, Russian Federation

el25kv@mail.ruАстраханский государственный медицинский университет (Астраханский ГМУ)РоссияAstrakhan State Medical University (АSMU)Russian FederationОбластная детская клиническая больница им. Н.Н. Силищевой (ОДКБ)РоссияRegional Children's Clinical Hospital named after N.N. Silishcheva (RChCH)Russian Federation20232205202326148Copyright © Яровая Д.В., Башкина О.А., Красилова Е.В., 20232023Яровая Д.В., Башкина О.А., Красилова Е.В.Yarovaya D.V., Bashkina O.A., Krasilova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.kursk-vestnik.ru/jour/article/view/1140

Коронавирусная инфекция (COVID-19), возбудителем которой является РНК-вирус тяжелого острого респираторного синдрома 2 (SARS-CoV-2), стала глобальной проблемой в мире. Ее последствия имеют огромное значение для состояния здоровья как взрослого, так и детского населения, поскольку число летальных исходов и жизнеугрожающих осложнений достигли высоких показателей. Особое значение имеет поражение коронавирусом важных органов в детском возрасте, вследствие возможного нарушения их функций и развития в дальнейшем отдаленных осложнений. Так, формирование острого почечного повреждения (ОПП) у детей является независимым фактором риска госпитальной летальности и инвалидизации. Важное значение в развитии данного патологического состояния уделяется развитию эндотелиальной дисфункции вследствие активации ряда провоспалительных цитокинов и других биомаркеров нарушения эндотелия. Эндотелиит, повреждение эндотелия, дисфункция эндотелиальных клеток и нарушение функции микроциркуляции в различных сосудистых руслах вносят заметный вклад в опасные для жизни осложнения COVID-19, такие как венозная тромбоэмболия и полиорганное поражение. Эндотелиальная дисфункция является основной детерминантой микрососудистых нарушений за счет смещения сосудистого равновесия в сторону большей вазоконстрикции и последующей ишемии органов, воспалением с сопутствующим отеком тканей и прокоагулянтным состоянием. В целом, понимание механизмов активации и дисфункции эндотелия в ходе инфекции COVID-19 может способствовать раннему выявлению лиц, особенно детского возраста, подверженных риску тяжелых осложнений. Дальнейшее изучение эндотелиальной дисфункции в патогенезе ОПП у детей с COVID-19 является перспективным для определения персонифицированного подхода к ведению пациентов детского возраста при COVID-19.

Coronavirus infection (COVID-19), caused by severe acute respiratory syndrome 2 (SARS-CoV-2) RNA virus, has become a global problem in the world. Its consequences are of great importance for the health status of both adults and children, since the number of lethal outcomes and life-threatening complications has reached high rates. Of particular importance is coronavirus damage of important organs in childhood, due to the possible impairment of their functions and the development of later distant complications. Thus, the formation of acute kidney injury (AKI) in children is an independent risk factor for hospital mortality and disability. An important role in the development of this pathological condition is given to the development of endothelial dysfunction due to the activation of a number of pro-inflammatory cytokines and other biomarkers of endothelial disorders. Endothelitis, endothelial injury, endothelial cell dysfunction, and impaired microcirculatory function in various vascular beds all contribute markedly to life-threatening complications of COVID-19 such as venous thromboembolism and multiple organ failure. Endothelial dysfunction is the main determinant of microvascular disorders due to a shift in vascular balance towards greater vasoconstriction and subsequent organ ischemia, inflammation with concomitant tissue edema and procoagulant condition. In general, understanding the mechanisms of endothelial activation and dysfunction during COVID-19 infection can contribute to early detection of individuals, especially children, at risk of severe complications. Further study of endothelial dysfunction in the pathogenesis of AKI in children with COVID-19 is promising to determine a personalized approach to the management of pediatric patients with COVID-19.

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