The level of melatonin and serotonin neurohormones in blood serum in patients with non-alcoholic fatty liver disease and kidney lesions infected with COVID-19 virus

Abstract

Background. Research aimed at determining the possible mechanisms of progression in the damage to various organs and systems against the background of COVID-19 infection is an urgent, not thoroughly studied issue in contemporary clinical medicine. The purpose was to determine the peculiarities of changes in serum melatonin (МТ) and serotonin (ST) neurohormone levels in patients with non-alcoholic fatty liver disease (NAFLD) and kidney damage infected with the COVID-19 virus. Materials and methods. 84 patients with NAFLD (steatohepatitis) combined with increased body mass index were examined. NAFLD patients were divided into two groups depending on the presence or absence of type 2 diabetes mellitus (DM), and namely: Group 1 included 34 NAFLD and insulin resistance (IR) patients; Group 2 comprised 38 patients with NAFLD and type 2 DM. All examined patients were tested for MT and ST levels in blood serum. Results. There was a significant decrease in serum MT level in both examined groups — by 2.2 and 3.2 times respectively in group 1 and 2 patients at the time of admission to the hospital. The same trend was identified in the indicators of serum MT level in both groups of patients on day 1 of inpatient treatment (IT) — and namely, its decrease by 1.5 and 2.3 times. Revealed a correlation between the progression of liver damage and the decrease of MT and ST levels in blood serum, which is probably a consequence of its toxic damage against the background of the conducted treatment of patients infected with COVID-19. The decreased serum neurohormone levels also correlate with the insulin level and IR index. There is also a strong correlation between renal damage occurring at the IT stage in NAFLD patients and impaired carbohydrate metabolism during COVID-19 infection and decreased levels of MT and ST in the blood, according to glomerular filtration rate MDRD MDRD (r = 0,88; р < 0,01 and r = 0,94; р < 0,01 accordance). Conclusions. COVID-19 infection and its treatment in NAFLD patients with impaired carbohydrate metabolism lead to impaired renal functional status. In patients with NAFLD and carbohydrate metabolism disorders, a decrease in serum levels of the neurohormones MT and ST was found, which progressively decreased against the background of COVID-19 infection and kidney damage in these patients.