TNMU has Got Five Grants for the Projects on Studying Chronic Stress and Endothelial Dysfunction Caused by COVID-19
I. Horbachevsky Ternopil National Medical University has got 5 grants from the RECOOP HTS Association (President Dr. Sandor Vari) totaling $ 40,000 to study chronic stress and endothelial dysfunction caused by COVID-19.
- Endothelial dysfunction and hypercoagulation in patients with COVID-19.
- Gender differences in chronic stress in students caused by limited mobility due to the COVID-19 pandemic.
- Study of chronic stress in SARS-CoV 2 infected seropositive patients and healthcare professionals.
- Effect of COVID-19 on hypertension in patients receiving angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor antagonists (ARAII).
- Development of test kits for enzyme-linked assay on antibodies to SARS-CoV-2 in saliva.
The team involved cardiologists Prof. M.V. Hrebenyk and S.M. Masliy, vascular surgeon Prof. S.Ya. Kostiv and intern B.P Selskyi, Associate Professors O.O. Shevchuk and Ya.I. Ivankiv, TNMU graduate A. Pak and sixth-year student S. Paliy, Laboratory Assistant of the Interfaculty Research Laboratory M.M. Dziuba. At the moment, in Ternopil region blood and saliva samples are taken from the patients, who suffered from COVID-19, as well as data required for research is collected.
The aim of the project is to establish the molecular mechanisms of endothelial dysfunction, hypercoagulation and vascular thrombosis in persons who suffered from COVID-19 of varying severity, as well as in seropositive and seronegative health care workers. The study will involve people who have relapsed into COVID-19. Samples for testing will be taken 1-60 days after the last negative PCR after the disease.
The following groups of patients will be studied:
1) with a mild form of the disease, treated at home;
2) moderate, who were hospitalized;
3) with a severe course of the disease that required oxygen therapy;
4) with a critical form of the disease, who were in the intensive care unit on mechanical ventilation.
The study will also involve health care workers (of intensive care units, hospitals and primary health care centres), who interacted with COVID-19 infected patients but are seronegative, and health workers, who suffered from COVID-19 (seropositive) in the respective categories and severity groups. In the research subjects saliva and blood will be taken for gaining serum and plasma, they will also complete a questionnaire to subjective stress assessment and its impact on life quality and health. To study the mechanisms of endothelial dysfunction, the balance between production of endothelial cells of vasorelaxant and vasoconstrictor factors, the degree of damage to blood vessels walls by determining the number of circulating endothelial cells in the blood and the functional state of the endometrium by ultrasound examination of the diameter of the brachial artery in reactive hyperemia and after taking nitroglycerin will be studied in the serum of the patients. The hemostasis system in the patients who suffered from COVID will be studied in detail, as well as in health care workers by the following indicators: plasma D-dimer concentration – to assess the risk of thromboembolic complications and the presence of fibrin deposits in the bloodstream; soluble fibrin – to assess abnormal generation of thrombin in blood flow; the main anticoagulant protein, protein C – to assess the state of the anticoagulant system; functionally inactive forms of prothrombin – to assess the pathological generation of uninhibited endogenous thrombin, fibrinogen as a precursor of fibrin, as well as the aggregation function of platelets and the frequency of their hyperreactivity. The severity of oxidative stress and the state of the redox system in the serum of the studied groups of patients will be assessed; the effect of oxidative stress on the development of coagulopathy and endothelial dysfunction will be studied as well. The effect of chronic stress, determined by the level of cortisol in saliva, on the severity of endothelial dysfunction, the level of coagulopathy and the intensity of oxidative stress in the research subjects will be studied. The risks and severity of thrombosis and endothelial dysfunction development in patients with COVID-19 will be analysed depending on premorbid status and concomitant pathology presence, especially in hypertensive patients taking ACE inhibitors and AIIRA. According to the results of the research, recommendations of risk assessment and prognostic criteria as well as criteria for diagnosing the development of thrombophilia and endothelial dysfunction in patients with COVID-19 according to the severity of the disease, premorbid status and the presence of concomitant pathology will be suggested, as well as preventive recommendations for the patients who suffered from COVID-19. The results of the research will be a significant factor for development of innovative and effective treatments and reducing the number of cases with adverse clinical outcomes for patients with COVID-19.
The research is conducted in cooperation with Danylo Halytsky Lviv National Medical University and the Palladin Institute of Biochemistry. International partners are Wroclaw Technical University (Wroclaw, Poland), Comenius University in Bratislava (Bratislava, Slovakia), Josip Juraj Strossmayer University of Osijek (Osijek, Croatia), Szeged University (Szeged, Hungary).
We really appreciate the cooperation of the chief physicians of the central district hospitals and the heads of the district centres of primary health care of the region.