Inspiration
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome, Coronavirus 2 (SARS-CoV-2). The death toll for COVID-19 is on the rise. ALI/ARDS , fulminant myocarditis are the major causes of mortality in these patients . We have a desire to clarify the pathogenesis of Covid-19 , to detect correlation between complication of Coronavirus (Covid -19 ) and vitamin D deficiency , ARB/ACEI influence over Ace2 expression , tissue distribution of ACE2 effect on SARS-CoV-2 pathogenesis , understanding RAAS and immune system response on coronavirus infection . RAAS The role of the renin -aldosterone system (RAAS) in many cardiovascular disorders is well established. These include hypertension, cardiac hypertrophy, and atherosclerosis. ACE and ACE2 and their peptides have a regulatory role in RAAS.
It is also well known that the RAAS components have a big influence on the inflammatory response . The ACE axis promotes inflammation while it is counter regulated by Ace2 axis ( Ace /Ang , AngII/AT1R axis and ACE2/ANG-(1-7) Mas R axis ).
- The main question is that the use of ARBs/ACEI lead to increased ACE2 expression - does this change viral entry? Therefore hypertension and ACE2 is a big dilemma for today in connection with Covid-19. It needs to confirm or refuse ACEI/ARB value in preventing and treating the effects of Coronavirus SARS-CoV-2 , the cause of infection called Covid-19.
Vitamin D and RAAS
- On the other hand there is interesting interaction between Vitamin D and RAAS components . Lower plasma Vitamin D level is associated with significantly higher circulating Ang II concentrations by the way increased Ang II concentration is in correlation with Pulmonary hypertension and ARDS.
- Vitamin D deficiency has a role in the regulation of inflammatory response . Hyper inflammation response ( cytokine storm ) is one associated mortality cause in Covid-19 patients.
What it does
Our team is expected to advance our knowledge about Covid-19 pathopisiology , contributing an efficient patient management and public health preparedness and response to current and future outbreaks of coronavirus infection . The overall scope of this topic is to provide patients with new tools including clinical data patterns , laboratory tests profile patterns and imaging analysis for a better control of ARDS in Covid- 19 patients. In particular , the topic aims the following specific objectives :
To enable doctors , healthcare workers to make early diagnosis of vitamin D insufficiency
To identify early patient at risk of progression to ARDS to enable earlier interventions and possibly prevent fatal outcomes
To find correlation between Covid-19 and hypertension
To establish the correlation between antihypertensive drugs and Covid-19
Determining the causes and hazards will be prerequisite of developing rational treatment strategy with optimized outcomes in Covid-19 patients and reduce the disease complication
To control Vitamin D concentration effect on hyper inflammation and cytokin storm
To control D vitamin concentration with the aim of reducing Angiotensin II production to an efficient ARDS
How I built it
We started 2 weeks ago by establishing the collaboration between Cardionet Pineo clinic , First University Clinic , Clinical laboratory Vistamed and National control desease center in Georgia .Now we will biuld on this at the hackathon . We have new team members through this hackathon , they will support us to keep growing the amounts of data , its quality and usefulness.
Challenges I ran into
Since identifying the possible route of infection has major implications for understanding the pathogenesis and future treatment strategies for SARS
To establish vitamin D deficiency is a risk factor for and/or driver of the exaggerated and persistent inflammation that is hallmark of ARDS.
To find correlation between Covid-19 and hypertension
To detect benefit or damage ARB/ACEI use in coronavirus complications
To reduce hospitalization time in the ICU departments for the intubated patients to decrease total expenses
To construct project website to promote the project and its findings during the period of the trial
To sum up outcomes and publish the abstract.
Accomplishments that I'm proud of
I am proud of creating great team in a short time .Our team include cardiologists , internists , epidemiologists, radiologists, Critical Care Medicine Specialists and Infectious Disease Specialists. Consortium partners have project excellent skills in a particular scientific field .Their multifaceted knowledge and experience will facilitate the research process and the achievement of results. We are also proud that in our research will equally participate as professors and scholars, also resident physicians. We have volunteer students who are willing to participate in this project . Therefore, this will make it easier for the team leaders to divide functions and responsibilities, that will lead to successful completion of the research and to achieve the final result contribution to public health preparedness and response in the context of the ongoing epidemic of COVID-19 and future outbreaks of pan-coronaviruses. We also trust our laboratory . experience and quality
What I learned
It is hard work but we often get encouragement when we help patients . I learned you have to be very hardworking , persistent , confident , to keep balance under high pressure and stress and be able to surround great people.
What's next for Cardionet
On the basis of the proposed activity, we will describe how the outputs of the project will contribute to the following impacts and include wherever possible targets . The outcome of this research is potentially practice-changing as it may define a new and improved standard for the treatment of Covid-19 complications.
Identification the connection of level of Vitamin D to Covid -19 complications such as Ali/ARDS and fulminant myocarditis The patients data from the study will allow better understanding of Vitamin D dose-volume relationships for lung tissue complications, enabling refined selection of patients for D vitamin therapy in the future. Key component in the management of these patients to shorten the length of hospital and ICU (In particular on mechanical ventilation) stay.
Vitamin D deficiency can be a potential referable contributor to morbidity and mortality among patients complicated Covid-19 .The analysis of broad spectrum of patients with HTN treated or not with ARB/ACE inhibitor can help to support or refuse the statement about the harmful or beneficial effect of ACE/ARB . The results should allow health authorities and healthcare providers to improve the quality of care through better evidence of benefits and patient outcomes and support reimbursement decisions.
The outcomes of the study decrease expenses of the Health care .The patients data from the study will allow better understanding of Vitamin D dose-volume relationships for lung tissue complications, enabling refined selection of patients for D vitamin therapy in the future.
Built With
- elsevier-sciencedirect
- pubmed
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