Abstract:
The coming era of COVID-19 introduces critical challenges for researchers - what will happen
to the patients who have suffered from long COVID-19? What diseases threaten them? What
happens to the patients’ immunity after the action of antigen SARS-CoV-2? To what extent do
the changes caused by it contribute to or, on the contrary, prevent from the development of
long-term protective immunity? And how effective will COVID-19 vaccine be in these
patients?
We tried to answer some of these questions in our research. The study was conducted in 49
patients with ophthalmic pathologies who had previously undergone COVID-19. On the one
hand, ocular pathologies are important because they allow in a non-traumatic way to obtain
lifetime visualization of the state of blood vessels and capillaries, as well as to assess the effect
of the virus on the central nervous system. On the other hand, immunological studies made it
possible to draw a conclusion about the state of antiviral immunity, immune status and its correlation with the severity of inflammatory processes in the eye structure, the central nervous
system including the vascular endothelium.
The novelty of the study is that we have established a causal relationship between SARS-CoV-
2 infecting, formed dysfunction of immune parameters that caused the manifestation of chronic
inflammatory diseases. As a result, light adaptation was impaired by 2.3 times, due to the
damage to blood circulation owing to the neurotoxic effect of SARS-CoV-2 and hypoxemia.
The corrective effect of drug Mercureid was fixed in 73.4 % of patients.
The most dramatic cases were observed in the group of patients with damage to the retinal
vascular system: the phenomenon of re-thrombosis of both the central retinal vein and its
branches, as well as circulatory disorders in the optic nerve trunk - ischemic optic neuropathy
with a sharp deterioration in vision. In these patients, the combination of vascular drugs and
drug Mercureid allowed stabilizing the patients’ state, achieve remission and in some cases
reach high visual functions in 50.0% of cases.
Mercureid made venotonic and angioprotective effect. It reduced vein elasticity and capillary
permeability. Also it improved venous outflow and microcirculation that allowed in some cases
to restore lymphatic drainage.
According to the results of the immune study, the targeted effect of the new drug Mercureid,
aimed at modulating the activity of several critical target proteins, such as CD3, CD4, CD8,
CD25, CD38, CD54, CD95 was revealed. The therapeutic efficacy of Mercureid was 75.1%.
The second research finding is that in patients with manifestation of chronic inflammatory
diseases who have previously been infected with SARS-CoV-2, the production of specific
protective antibodies is likely to be impaired (as these patients often have pathologically low
levels of CD4, CD8, CD25 and overexpression of CD38, ICAM-1, CD95 that causes apoptosis
of immune cells, lymphopenia and also forms the phenotype of exhausted T-cells with
activation of the expression of inhibitory receptors) and vaccination may be ineffective for
them, due to the presence of a compromised immune system. Accordingly, the provision of
corrective multitarget immunotherapy aimed at several target proteins, which are critical for
the formation of long-term effective post-viral immunity to SARS-CoV-2, is an extremely
important therapeutic need. This immunotherapy can be carried out both before and after
vaccination in order to achieve the maximum protective effect from the vaccine. But the
definite answer to this research question will require another type of study design, which we
plan to conduct in the future.
