Лікувально-профілактичні підходи до хворих на псоріаз після перенесеної коронавірусної інфекції

Abstract

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.