Assessing the influence of psychoemotional, neuroendocrine, metabolic and immunological changes on the clinical course of acne after COVID-19

Objective — to determine the pathogenetic role of some metabolic, immunological disorders and vitamin D deficiency, as well as their consequences in the development of acne in women after COVID-19. Materials and methods. We examined 134 women with acne aged 18—45. All patients underwent lab tests to determine the level of cortisol and prolactin, vitamin D, pro-inflammatory and anti-inflammatory interleukins and phagocytic indices in blood serum, index of insulin resistance and anxiety. Results and discussion. In women with acne, the cortisol level was increased by 19.98 % (p < 0.01), and in women with acne who had suffered from COVID-19, it was reduced by 17.36 % (p < 0.01) compared to the indicator in persons of the control group. The prolactin level was increased by 8.21 % in women with acne compared to the control group (p > 0.05) and by 32.91 % (p < 0.001) in acne patients who had had COVID-19. In women with acne after COVID-19, the level of total vitamin D (25OH) (D2 + D3) in blood serum was more than three times (p < 0.001) higher than in the control group and almost twice as high (p < 0.01) in women with acne who did not have COVID-19. The НОМА index was increased by 11.89 % (p > 0.05) in patients with acne and by 52.87 % (p < 0.05) in women with acne who had suffered from COVID-19. IL-1 (b) levels elevated almost twofold in women who had not had COVID-19 and by 2.86 times in women who had suffered from COVID-19; IL-8 levels elevated by 2.96 and 1.54 times (p < 0.05), respectively; IL-4 levels elevated only by 1.9 and 1.57 times, respectively; IL-10 levels elevated by 1.88 and 1.59 times, respectively. Significant changes in phagocytosis indicators were also found both at the initial and final stages in all examined women with acne, with more substantial deviations observed in patients after COVID-19. Conclusions. Changes in certain immunological (decreased amount of pro-inflammatory and anti-inflammatory interleukins and phagocytic indices both at early and final stages) neuroendocrine and metabolic indices (serum cortisol, prolactin, vitamin D and insulin resistance index), the presence of significant reactive and personal anxiety were observed in women with acne. A strong and moderate correlation between the nature of changes in the abovementioned indices and COVID-19 in anamnesis was detected. This substantiates the necessity to search for new comprehensive treatment of patients with acne, taking into account the neuroendocrine, metabolic and immunological changes and consequences of COVID-19.