USE OF INFLAMMATORY MARKERS FOR STRATIFICATION OF ORAL MUCOSA DISEASES IN PATIENTS IN THE POST-COVID PERIOD
DOI:
https://doi.org/10.35220/2078-8916-2024-54-4.1Keywords:
post-COVID-19 syndrome;. oral mucosa; recurrent herpetic stomatitis; chronic recurrent aphthous stomatitis; inflammation; biomarkers; neutrophil to lymphocyte ratio.Abstract
Current studies consider hematologic disorders as risk factors for post-COVID-19 conditions. Blood biomarkers can be valuable in assessing the intensity of oral mucosa inflammation. The aim of the study is to evaluate the clinical informativeness of NLR for the diagnosis and stratification of post-COVID-19 syndrome manifestations on the oral mucosa compared to other laboratory parameters (serum ferritin, cytokine IL-6, C-reactive protein). Materials and methods. Forty-seven patients with erosive lesions of the oral mucosa (OME) with a history of confirmed diagnosis of COVID-19 in respiratory samples by PCR were examined. The control group consisted of 19 patients without OME lesions and no COVID history. To compare the differences in laboratory markers, a panel of four parameters was used – inflammatory biomarkers: serum ferritin, cytokine IL-6, C-reactive protein, and neutrophil to lymphocyte ratio (NLR). Results and Discussion. Clinical examination, assessment of clinical and anamnesis data, and the use of additional diagnostic tests to confirm the diagnosis in patients of the main group revealed the profile of the affected population: patients with recurrent herpetic stomatitis (RHS) accounted for 29 patients (61.79%), and patients with chronic recurrent aphthous stomatitis (CRAS) – 18 patients (38.30%). Examination of the oral cavity in patients with RHS and CRAS enabled visualization of the presence of aphthae, assessment of their size, configuration and localization. The assessment of hematologic parameters revealed a significantly higher level of serum ferritin in patients with OGS, while no significant differences in its level were found in patients with CRAS. There was an increased release of the cytokine IL-6, which in patients with CRAS was 5 times higher than in healthy persons. The concentration of C-reactive protein in patients with RHS was 6 times higher than in the control group, and in patients with CRAS it was more than 30 times higher. The average NLR value in patients with CRAS was twice as high as in patients with RHS. Conclusion. The clinical value of NLR as a marker of inflammation and an indicator for recognizing post-COVID conditions in predicting the recurrence of inflammatory diseases of OME in patients with post-COVID syndrome was demonstrated.
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