Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny)Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny)2070-9277Voronezh State Medical University named after N.N. Burdenko - The State Budgetary Institution of Higher Professional Education «Voronezh State Medical University named after N.N. Burdenko» of the Ministry of Public Health of the Russian1157510.18499/2070-9277-2026-29-1-124-134Study of dynamics of plasma HIF-1α and HIF-2α levels in patients with COVID-19 pneumoniaRaytsevSergei Nikolaevich<p>Postgraduate student of the Department of Biological Chemistry</p>raitsevsergei@yandex.ruZvyaginaValentina<p>Doctor of Medical Sciences, Associate Professor, Professor of the Department of Biological Chemistry</p>vizvyagina@yandex.ruKalininRoman<p>MD, Professor, Head of the Department of Cardiovascular, X-ray Endovascular Surgery, and Radiation Diagnostics</p>kalinin-re@yandex.ruBelskyEdward<p>Candidate of Medical Sciences, Associate Professor at the Department of Faculty Therapy named after Professor V.Ya. Garmash</p>ed.bels@yandex.ruTsarevaOksana Albertovna<p>Candidate of Sciences. Biol. sciences, Associate Professor of the Department of Biology</p>tsareva.oksana1966@yandex.ruRaitsevaOlga<p>student</p>olgaananyina@icloud.comRyazan State Medical University named after Academician I.P. Pavlov of the Russian Ministry of Health0704202629111912902042026Copyright © 2026, Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny)2026<p>The development of hypoxic conditions in respiratory diseases may contribute to disease progression and deterioration of patients' condition. Determination of plasma concentration of hypoxia-induced factor (HIF) may reflect the body's adaptation to hypoxia and may have prognostic significance in assessing patient survival. The aim of the study was to study the possibility of using HIF-1a HIF-2a levels in blood plasma to monitor hypoxia in patients with severe COVID-19 pneumonia. The study involved 112 patients divided into three groups: 1) 90 patients with COVID-19 pneumonia; 2) 10 patients, with acute respiratory viral infection (ARVI); 3) 12 healthy volunteers. Body mass index (BMI), Charlson comorbidity index, respiratory rate-oxygenation index (ROX), lung computed tomography (CT) data were investigated. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) index were determined. Plasma concentrations of hypoxia-induced factor 1 (HIF-1), hypoxia-induced factor 2 (HIF-2), vascular endothelial growth factor (VEGF-A), inducible nitric oxide synthase (iNOS) by competitive enzyme-linked immunosorbent assay (ELISA), and nitric oxide (NO) levels were examined. Plasma HIF-1 levels were significantly lower in healthy individuals compared with patients with COVID-19 and acute respiratory infections. Concentrations of iNOS and NO in COVID-19 exceeded control values but did not differ from the acute respiratory tract infection group. Patients who were observed in the intensive care unit had lower HIF-1a, ROX index, and saturation at admission compared with patients treated in the specialized therapeutic department. By day 7, patients from the intensive care unit showed a significant increase in HIF-1a levels, which coincided with increased respiratory support. In the group of patients who did not require intensive care, an increase in HIF-2a levels and a decrease in inflammatory markers (C-reactive protein, ferritin, PLR, NLR) were noted during the same period. The plasma levels of HIF-1, iNOS and NO reflect adaptation to hypoxia in COVID-19. The increase in HIF-1 against the background of respiratory support may indicate intermittent hypoxia. 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