Abstract：
The universal proteinase inhibitor α2-macroglobulin (α₂-MG) exhibiting antiviral and immunomodulatory activities, is considered as an important participant in the infectious process. The activity of α₂-MG in the new coronavirus infection and post-covid syndrome (long COVID) has not been studied yet. We examined 85 patients diagnosed with community-acquired bilateral polysegmental pneumonia developed under conditions of a new coronavirus infection SARS-CoV-2. For assessment of the post-COVID period, 60 patients were examined 5.0±3.6 months after the coronavirus infection. Among these patients, 40 people had complications, manifested in the form of neurological, cardiological, gastroenterological, dermatological, bronchopulmonary symptoms. The control group included 30 conditionally healthy individuals with a negative PCR result for SARS-CoV-2 RNA and lack of antibodies to the SARS-CoV-2 virus. The α₂-MG activity in serum samples of patients with coronavirus infection dramatically decreased, up to 2.5% of the physiological level. This was accompanied by an increase in the activity of the α₁-proteinase inhibitor, elastase- and trypsin-like proteinases by 2.0-, 4.4- and 2.6-fold respectively as compared with these parameters in conditionally healthy individuals of the control. In the post-COVID period, despite the trend towards normalization of the activity of inhibitors, the activity of elastase-like and especially trypsin-like proteinases in serum remained elevated. In overweight individuals, the increase in the activity of trypsin-like proteinases was most pronounced and correlated with an increase in the antibody titer to the SARS-CoV-2 virus. In the post-COVID period, the α₂-MG activity not only normalized, but also exceeded the control level, especially in patients with dermatological and neurological symptoms. In patients with neurological symptoms or with dermatological symptoms, the α₂-MG activity was 1.3 times and 2.1 times higher than in asymptomatic persons. Low α₂-MG activity in the post-COVID period persisted in overweight individuals. The results obtained can be used to monitor the course of the post-COVID period and identify risk groups for complications.
摘要：
具有抗病毒和免疫调节活性的通用蛋白酶抑制剂α2-巨球蛋白（α2-MG），被认为是感染过程的重要参与者。尚未研究新冠状病毒感染和后covid综合征（长COVID）中α2-MG的活性。我们检查了在新的冠状病毒感染SARS-CoV-2的条件下诊断为社区获得性双侧多节肺炎的85例患者。对于后COVID时期的评估，60例患者在冠状病毒感染后5.0±3.6个月进行了检查。在这些患者中,40人出现并发症,表现为神经学的形式，心脏病学,胃肠病学,皮肤病学,支气管肺症状。对照组包括30名条件健康的个体，其SARS-CoV-2RNA的PCR结果为阴性，并且缺乏针对SARS-CoV-2病毒的抗体。冠状病毒感染患者血清样本中的α2-MG活性急剧下降，高达2.5%的生理水平。这伴随着α1蛋白酶抑制剂活性的增加，弹性蛋白酶和胰蛋白酶样蛋白酶由2.0-，与对照的条件健康个体中的这些参数相比,分别为4.4和2.6倍。在后COVID时期，尽管抑制剂活性趋于正常化的趋势，血清中弹性蛋白酶样，尤其是胰蛋白酶样蛋白酶的活性仍然升高。在超重的个体中，胰蛋白酶样蛋白酶活性的增加最为明显，并且与SARS-CoV-2病毒抗体滴度的增加相关。在后COVID时期，α2-MG活动不仅正常化，但也超出了控制水平，尤其是有皮肤病和神经系统症状的患者。在有神经症状或皮肤症状的患者中，α2-MG活性分别是无症状人群的1.3倍和2.1倍。超重个体在COVID后时期持续存在低α2-MG活性。获得的结果可用于监测COVID后时期的过程，并确定并发症的风险组。
