Section: 
Reviews
ReviewsPharyngeal lymphoid ring pathology in post-Covid-19 era: new challenges
S. Alekseenko (1), S. A. Artyushkin (2), A. V. Skal’nyi (3), S. V. Barashkova (4), V. V. Afanas’ev (5), A. S. Yakovlev (6), A. A. Tin’kov
(1), (2), (4) Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, Saint Petersburg, 190013, Russian Federation, (1), (2), (5) Mechnikov Northwest State Medical University, Saint Petersburg, 191015, Russian Federation, (1), (4) Raukhfus Children's Clinical Center of High Medical Technologies, Saint Petersburg, 191036, Russian Federation, (3) Peoples’ Friendship University of Russia, Moscow, 117198, Russian Federation, (3), (7) Sechenov First Moscow State Medical University, Moscow, 119992, Russian Federation, (4) National Center of Clinical Morphological Diagnostics, Saint Petersburg, 192071, Russian Federation, (6
UDK: УДК 616.322:616.98-036.11
DOI: https://doi.org/10.18692/1810-4800-2024-4-84-94
ABSTRACT
Abstract. Objective. To provide a narrative review of data on the relationship between pathology of the pharyngeal lymphoid ring and post-COVID syndrome. The results of previously published studies note a significant decrease in the severity of chronic tonsillitis and adenoiditis during the COVID-19 pandemic, which may be due to active restrictive measures that reduce the likelihood of contact with respiratory pathogens. At the same time, after the end of the COVID-19 pandemic, there has been a significant increase in the incidence of chronic inflammatory pathology of the tonsils, but the direct mechanisms of this relationship have not been sufficiently studied. The lymphoid tissue of the Pirogov-Waldeyer’s pharyngeal lymphoid ring is not only one of the first immune barriers to SARS-CoV-2 but also a site of long-term (up to six months) persistence of fragments of viral antigens and RNA after a coronavirus infection, which may determine the intensity of immunopathological reactions in this tissue. In particular, during active infection, secondary lymphoid organs are characterized by lymphocyte apoptosis due to the lymphotoxic effect of SARS-CoV-2, depletion of germinal centers and microcirculatory disorders. In addition, it is fair to assume that the systemic inflammatory response characterized by hyperproduction of proinflammatory cytokines by activated monocytes as well as lymphopenia along with the reactivation of herpesvirus and adenovirus infection in post-COVID syndrome can make a significant contribution to the progression of the pathology of the pharyngeal lymphoid ring. Thus, patients with post-COVID syndrome are characterized by an increased risk of progression of tonsillitis and adenoiditis, which necessitates the observation of these patients by an otolaryngologist.
Publication date:
09.08.2024
Keywords:
pharyngeal lymphoid ring, COVID-19 For citation:
Alekseenko S., Artyushkin S. A., Skal’nyi A. V., Barashkova S. V., Afanas’ev V. V., Yakovlev A. S., Tin’kov A. A. Pharyngeal lymphoid ring pathology in post-Covid-19 era: new challenges. Russian Otorhinolaryngology. 2024;23(4):84-94. (In Russ.) https://doi.org/10.18692/1810-4800-2024-4-84-94