COVID-19 IN PATIENTS AT RISK OF SEVERE AND COMPLICATED COURSE
DOI:
https://doi.org/10.11603/1681-2727.2024.4.15004Keywords:
respiratory infections, risk factors, diabetes mellitus, pregnancy, endothelial dysfunction, heart failureAbstract
The problems of the course of infectious diseases against the background of concomitant pathology have been of interest to scientists and clinicians for many years. The staff of the Department of Infectious Diseases of Ivano-Frankivsk National Medical University studies both the influence of comorbid conditions on the course of the infectious process and the influence of infectious disease on the state of comorbid pathology. The founder of this idea was Doctor of Medical Sciences, Professor, Head of the Department of Infectious Diseases and Epidemiology from 1991 to 2013 Bohdan Mykolayovych Dykyi.
For many years, significant clinical, laboratory, pathogenetic and therapeutic aspects of the course of viral hepatitis, intestinal infections, leptospirosis, HIV infection, some respiratory infections, parasitosis against the background of concomitant diseases have been studied and the risks that lead to a severe (or complicated) course of both an infectious disease and destabilization of comorbid pathology have been proven.
The emergence of a new strain of coronavirus SARS-CoV-2 in 2019 was a challenge for all of humanity. Although the coronavirus disease COVID-19 has now moved into the category of seasonal respiratory diseases, it nevertheless retains significant potential to cause severe (or complicated) forms of the course, and sometimes with a fatal outcome.
In our comprehensive study, we studied the course of coronavirus disease in patients with underlying diabetes mellitus and chronic cardiovascular pathologies. We also studied some pathogenetic aspects of the course of COVID-19 in pregnant women. During the work, significant pathogenetic mechanisms of the complicated course of the disease were established: in type 2 diabetes mellitus, one of the important links of pathogenetic disorders is endothelial dysfunction and changes in the microvascular bed; factors such as chronic heart failure, reduced ejection fraction, myocardial dysfunction of various types, and pulmonary hypertension have an unfavorable prognostic value. Regarding the course of COVID-19 in pregnant women, despite increased D-dimer levels, pregnancy is not an independent risk factor for severe disease (with the exception of obesity, existing diabetes mellitus, chronic cardiovascular and other concomitant pathology in a pregnant woman).
The publication includes the results of the study, which are fragments of the comprehensive work of the Department of Infectious Diseases and Epidemiology of the Ivano-Frankivsk National Medical University “Course of Infectious Diseases Against the Background of Comorbidity, Combined Chronic Infections and Invasions, Treatment Correction”, with state funding, state registration number: 0119U100571, implementation dates: 2021-2023.
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