Analysis Study of Visual and Physiological Functions, Expression of Various CD Markers of the Immune System, Clinical Course and Treatment of Complications in Patients with COVID-19 When Using Drug Mercureid

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.