Trimethylamin N-oxide (TMAO), IL-1 beta, ilstaeyin-6 and than-alfacychlicocolus extract of IL-1 beta, ilstaeyin-6 and than-alphachicoleri investigation of relationship with

Inflammation is a reaction that occurs in everyone and is formed by the immune system to protect the body against various diseases or injuries. Although there are various factors that cause inflammation, the most important factor is microorganisms. Like bacteria, viruses, rickettsia, fungi, protozoa and helminths, COVID-19 is also a factor. Recent studies have shown that the role of microbiota and dysbiosis is important in inflammation and sepsis, as in many diseases. Microbiota is another factor thought to be effective on the course of the disease, morbidity and mortality. Serum trimethylamine N-oxide (TMAO) level varies depending on age, gender, habits, comorbidities and microbiota. Revealed in the inflammation pathway; Inflammatory molecules such as Interleukin-1β (IL-1β), Interleukin 6 (IL-6), Interleukin-10 (IL-10), Tumor necrosis factor alpha (TNF-alpha), lipopolysaccharide (LPS) play a regulatory role in starting and stopping this process. they receive. Disruption of this regulation causes inflammation to progress to sepsis and septic shock. Our aim is to investigate whether microbiota and TMAO can be biomarkers for inflammation, COVID-19, sepsis and septic shock based on all these assumptions. Whether TMAO levels are of diagnostic importance in patients with COVID-19 infected without septic disease, in patients with septic shock infected with COVID-19, and in patients with septic shock who are not infected with COVID-19, whether they can be used as a test in the early diagnosis of the disease, and whether the deterioration in microflora We examined the intestinal endotoxemia, which is a reflection of the disease, and the levels of TMAO in these diseases. We also examined IL-6, IL-10, IL-1beta, TNF-alpha and LPS levels in patient groups other than TMAO and the relationship between these parameters. A total of 160 cases were included in the study, including 40 patients infected with COVID-19 without septic disease, 40 patients with COVID-19 positive septic shock, 40 patients with COVID-19 negative septic shock, and 40 healthy controls. In our study; TNF-α and IL-1β levels were found to be significantly lower (p<0.001) in the patient groups, and significantly higher (p<0.001) for IL-6 and IL-10. IL-1β showed an even more significant decrease, especially in the groups infected with COVID-19. IL-6 was further increased in groups infected with COVID-19. LPS level was found to be extremely high in the sepsis group infected with COVID-19 compared to the other groups. The TMAO level was measured at significantly higher values (p<0.001) in the sepsis group than in the other groups. These results show us that there is a need for new multicenter studies with a larger population in order to use TMAO as a biomarker in sepsis and septic shock. Keywords: Sepsis, Septic shock, SARS-CoV-2, COVID-19, TMAO