M. O. Vitkovska’s scientific contributions

Based on a review of the scientific literature, the main data on the history of human coronavirus infections are given. Modern views on the etiology of COVID‑19, its epidemiology, pathogenesis, main clinical variants and their manifestations are described. The goal is to increase the awareness of patients, doctors and medical personnel about the epidemic of the new viral disease COVID‑19.

The results of preliminary observations indicate that the SARS-COV-2 virus can also affect the skin and affect the course of chronic diseases, including dermatoses. The cause and pathogenesis of skin manifestations have not yet been established and are under study, but they are most likely caused by infectious and allergic damage to blood vessels, as well as a high level of pro-inflammatory cytokines. The subject is to increase the effectiveness of the therapy of patients with psoriasis after suffering from the coronavirus disease by using drugs that affect the state of the endothelium of blood vessels and the blood coagulation system. Materials and methods. 69 patients with psoriasis associated with COVID-19 infection were under observation. The patients were divided into two clinical and therapeutic groups, which were representative in terms of age, sex, and severity of the disease: The first experimental group (36 patients) in complex treatment received drugs that had an effect on the normalization of endothelial dysfunction and the blood coagulation system. Patients of the II group (33 persons) received treatment according to the protocols. The control group consisted of 20 practically healthy persons, representative in terms of age and sex. Control of the treatment was carried out on the basis of clinical and laboratory data. Subjective and objective signs of the disease were evaluated, clinical and biochemical indicators were determined, including a general blood test, the state of the coagulation system using modern standardized laboratory tests. The degree of inflammatory reaction was assessed by the level of C-reactive protein and IL-6. Statistical processing of data was carried out using methods of variational statistics. Significance of differences was assessed using Student’s test for independent samples. The results. When using drugs that had an effect on the normalization of endothelial dysfunction and the blood coagulation system, in the complex treatment of patients of the 1st group, a significant improvement in the general condition was noted, a decrease in the subjective symptoms of the disease: itching, dryness, soreness in the foci of inflammation, which decreased 3–4 days earlier, than in patients from the comparison group who received traditional therapy. Clinical remission in patients of the I group occurred in (22.3 ± 2.7) days, while in patients in the II group – in (29.2 ± 3.5) days, that is, 6.9 days earlier (p < 0, 05). The use of the proposed treatment-prophylactic approach improved the parameters of the blood coagulation system in patients with psoriasis who suffered a coronavirus infection, which was manifested by the normalization of AChT, PTI, fibrinogen content and a significant decrease in D-dimer, which indicates a probable reduction in the risk of thrombotic complications. At the same time, there was a significant decrease in inflammation indicators – PSA and IL-6. Conclusions. The use of the proposed treatment-prophylactic approach contributed to an earlier onset of clinical remission: the subjective and objective signs of the disease stopped almost 7 days earlier than in patients treated only by traditional methods, normalization of indicators of the state of the coagulation system, endothelial dysfunction, which prevented development of complications from the cardiovascular system.

Psoriasis is considered a systemic disease with damage not only to the skin, but also to functional and morphological disorders of other organs and systems of the body, which significantly worsen as a result of transmission by patients of COVID‑19, therefore, the determination of assessment markers of disease severity in the post-covid period is of some interest. The purpose of the work is to determine the most informative prognostic markers of the severity of psoriasis in the blood sera of patients who have suffered from COVID‑19 in the post-epidemic period. Materials and methods. With the help of immunoenzymatic analysis and biochemical studies, the levels of IL‑6, CRP, troponin, ferritin, procalcitonin, hemostasiological indicators, as well as the functional state of the liver in the blood sera of 34 patients with psoriasis and 20 practically healthy individuals were determined. Results and discussion. Based on the results of the study, the most informative assessment markers were established in the sera of patients with psoriasis in the post-covid period. The obtained data indicate the need to take into account these indicators in the treatment of patients, especially when using immunosuppressive agents. Conclusions. When studying the functions of the hepatobiliary system in patients with psoriasis in the post-covid period, deviations from the norm of the hepatocellular type (increased levels of AlT, AsT) are observed, and in patients with psoriasis – of the mixed type (increased levels of AlT, AsT and alkaline phosphatase). When studying the state of the hemostasis system, changes in hemostasiological parameters were noted: an increase in the activated partial thromboplastin time [(30.38 ± 2.21) sec], an increase in PTI and a slight increase in fibrinogen content. It was established that the most indicative markers of the presence of an inflammatory process are the concentrations of CRP, IL 6 and D-dimer, the levels of which were higher than the normal level in all studied groups with the maximum increase in the group of patients with psoriasis in the post-epidemic period [(40.8 ± 1, 6) mg/l, against (4.8 ± 1.7) mg/l; (17.9 ± 3.4) pg/ml vs. (2.7± 1.1) pg/ml and (1321.3±634.3) ng/ml vs. (286±76.4 ng/ml), respectively, p ≤ 0.05; p ≤ 0.005], which may indicate a systemic inflammatory response.

The objective. Raise physician awareness to prevent the development of photosensitization in patients with COVID-19. Materials and methods. A review of the literature and analysis of clinical cases of photosensitization associated with SARS-CoV-2- infection and its treatment carried out. Results. Based on the literature and clinical experience, the article presents the possible causes of manifestations and exacerbations of photoallergic contact dermatitis, presents clinical cases of photosensitization associated with coronavirus infection. Conclusions. The issue of protection against ultraviolet radiation is relevant in the summer, especially during a pandemic associated with the emergence of a new coronavirus infection.

The objective. To systematize the clinical manifestations of skin lesions associated with COVID-19 and to propose the classification of these disorders. Materials and methods. The literature data describing skin lesions associated with COVID-19 and the results of observation of 31 patients with skin lesions and coronavirus infection were summarized. In the postcovid period patients with skin diseases were admitted to the hospital. They were divided into two groups: first – patients who did not suffer from skin diseases earlier; the second – patients with exacerbation of chronic dermatoses. All patients were examined by standard clinical and laboratory methods. Results. The proposed classification makes it possible to separately distinguish lesions caused precisely by COVID-19 and exacerbation of chronic dermatoses against the background of coronavirus infection, as well as as a result of the treatment of this disease (first of all, this consider to systemic corticosteroids, which are known to affect the course of psoriasis: cause the development of common forms that are resistant to other methods of therapy), which leads to their severe course. Photos of own observations are presented. This classification will improve the quality of diagnosis of COVID-19, especially in asymptomatic or low-symptomatic forms of the disease, and will also help prevent a number of complications associated with both the treatment of patients with coronavirus infection and the presence of concomitant diseases, in particular chronic dermatoses. Conclusions. The proposed classification, on the one hand, expands the possibilities of timely diagnosis of COVID-19, especially in asymptomatic or low-symptomatic forms of the disease, and also directs the doctor to the need to prevent a number of complications associated with both the treatment of patients and the presence of concomitant diseases, in particular chronic dermatoses.

The objective is to analyze skin lesions associated with coronavirus infection. Results. Based on literature data and clinical experience, the article presents the clinical and epidemiological features of skin lesions associated with coronavirus infection. Conclusions. Thus, the awareness of doctors about the skin symptoms associated with COVID-19 infection is critical to prevent misdiagnosis and timely adequate treatment.