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– Korona does not choose her age, everyone is under her attack and every 10th patient requires 24-hour treatment in the intensive care unit. Infected people often have various forms of arrhythmias, fast or slow heart rate – says in an interview for “Blic” Dr. Marija Zdravković, director of KBC “Bežanijska kosa”.
The epidemic of the coronavirus virus is breaking black records day by day: more and more people are infected, dying and the number of patients with respirators is growing. And while doctors insist on respecting the measures and strengthening immunity, the capacities of hospitals are being filled and the health system faces an almost impossible challenge.
KBC “Bežanijska kosa” registers an increasing jump in the number of hospitalized day by day … Do you observe any change in the age structure of those infected or in the severity of their clinical picture compared to previous months?
– On June 23 of this year, KBC “Bežanijska kosa” was designated as the only Clinical Hospital Center that fully received and cared for Covid patients from the Belgrade territory and surrounding places. Until a month ago, when due to the jump in the incidence of Covid positive patients, the opening of other KBCs began, our institution treated Covid positive patients not only for Covid manifestations but also for other acute diseases that endangered the lives of patients corona positive – acute myocardial infarction, appendicitis, hip fracture, ruptured ulcer. Korona does not choose the years, everyone is under her attack. However, younger patients often have milder clinical pictures that do not require hospital treatment, but only regular intake of prescribed therapy and regular follow-up to assess the development of the disease. Unfortunately, a higher percentage of middle-aged and older people require hospital treatment, are dependent on oxygen, and are more prone to developing complications. In the three waves, on average, every tenth patient requires 24-hour treatment in the intensive care unit, and the average mortality is 2.5 percent, taking into account that the mortality of patients older than 70 years, as well as patients with severe chronic diseases, it is significantly higher.
You are a cardiologist by profession. How does the coronavirus affect the heart, that is, the entire cardiovascular system of patients?
– When the crown appeared, we thought it was the type of flu that causes pneumonia. Today, sadly, we know that corona is a systemic disease that attacks almost every organ in our body. The heart, as the central motor of our body’s circulation, is extremely sensitive to the slightest damage and often, corona patients have various forms of arrhythmias, fast or slow heart rate, chest pain, suffocation or the onset frequent of a special type of inflammation of the heart muscle. be very dangerous and, in the most serious cases, can end in a heart attack or sudden cardiac death.
A KBC “Bežanijska kosa” patient was discharged home after 41 days on a ventilator. Your hospital usually has a lot of the most difficult patients. How much effort does it take to save someone so in danger …?
– Reaching the respirator is the greatest fear of all Covid patients. This is the last phase of treatment, intended for the most difficult patients who can no longer breathe on their own. The appearance of complications in these patients increases with each new day on the ventilator, and our goal is for the patient to return to normal breathing as soon as possible. Every patient who is removed from the ventilator is our great victory. This patient is a reward for all the doctors and nurses who worked hard to prevent complications on the ventilator for a full six weeks. These are the great successes of medicine and the primary victory of life over death. Proof that God’s mercy is truly great, and the commitment and knowledge of our doctors and nurses is invaluable.
We have finally regained consciousness, are we calling the doctor in time?
– In the last eight months, since the crown entered Serbia, the media has done a lot to uncover the truth about this cruel disease. Journalists have been and continue to be our greatest collaborators in the fight against this still little known virus. People have understood the importance of informing the doctor on time, and there is no longer that large number of people on respirators where one of the reasons for complications is to inform the doctor late. However, when we think that everything has changed for the better and that people arrive on time, we are always surprised by someone, usually a younger patient who presents a severe form of the disease, in fact with a form prior to intubation. It always defeats us, but it also motivates us to fight for that person’s life.
Do you have a case at KBC where you have been contacted again by patients who have previously been cured of Covid 19? Does that mean we shouldn’t rely so much on antibodies after all?
– At the beginning of this disease, we thought that patients who developed antibodies were completely protected from a new corona attack. But, both in our country and in the world, there have been cases of people who had this disease twice in a short period of time with the re-development of IgM antibodies. These are actually antibodies that appear early in the disease and then disappear, giving way to a new type of antibody: IgG antibodies. IgG antibodies that develop in some other infectious diseases (for example, smallpox and smallpox) provide lifelong protection, so these diseases cannot be beaten twice. But as recent research shows, IgG antibodies in the crown do not provide 100% protection. Fortunately, there is another type of additional protection in the crown: cellular immunity, created by the mediation of special immune cells called NK (natural killer) cells. They directly kill and neutralize the virus. It is true that the immune response mediated by these cells represents the strongest protection.
Do you insist, like your colleagues, that the basic mechanism of the fight is strong immunity?
– A strong immune system is the basis for a long life. Unfortunately, the modern lifestyle is often associated with a number of factors that weaken the immune system and thus lead to the development of not only corona, but also malignant diseases, which are also diseases associated with an immune response. altered. We can do a lot ourselves to strengthen immunity, but instead of changing bad habits, most people try to “find” a supplement that improves their immunity. Unfortunately, there is no single preparation that we can achieve. Good immunity is primarily based on a balanced diet, sufficient sleep, moderate regular physical activity, and avoiding overreaction to stressful situations around us. The most important thing is that it is built in childhood, because then these are healthy pillars that we only improve later.
Together with the Kragujevac Faculty of Medicine, you are working on investigating the influence of viruses at the molecular level … Are you closer to the answer since oxidative stress affects our body and the development of the evolution of the disease …?
– Oxidative stress is a scientific term for the occurrence of a series of events in the blood that lead to an extremely strong inflammatory process in the body and accelerated aging. We investigate at the molecular level, but also at the level of cardiomagnetic resonance of the heart, which I deal with. Our goal is to show what actually happens in the blood when a corona infection breaks out and how we can quell that infection both in the blood and in the heart muscle cells themselves. In this way, we want to prevent the accelerated onset of angina pectoris, coronary myocarditis and heart failure, sometimes accompanied by fatal arrhythmias, all caused by a coronary infection. In this field, we also began to cooperate with the University Clinic in Zurich, where I was in a two-year postdoctoral training in the field of heart failure and the Mayo Clinic in the USA. Our experience in the successful treatment of coronary patients has recommended and included us in a very small number of clinics in the world with which they cooperate.
You are decorated with the third grade star of Karadjordj. How much does that recognition mean to you in such difficult months?
– That recognition is an extraordinary part for me, my family and friends, and at the same time it gives me the strength to continue fighting for the right and honorable things in my profession and in life in general. I thank the president who recognized the quality and commitment. At a crucial moment for our homeland, many of us put our lives at the service of the people and of Serbia. And we were all a team: doctors, nurses, cleaners, cooks, waitresses, drivers, and manual workers. That is why we have managed to have the best results in Europe so far in the fight against the corona virus. That’s what it promises: Serbia is a strong country that has children who love it and fight for a better life in their country. Profession and morals are the only important things to find a solution, so now it will be the same. I believe that we are close to the vaccine and that its invention will turn the wheel of history in this crown section. But until then, all that remains is to strictly follow the recommended prevention measures and inform the doctor when the first symptoms appear.
The most important thing is to inform the doctor in a timely manner
– The corona virus mainly causes severe pain in the muscles and spine, with severe headaches and fatigue, fever, shortness of breath and dry and irritating cough that are an additional burden on the patient. The most important thing is to contact the doctor in time so that the diagnosis can be made in time and the necessary therapy can be included. Unfortunately, many patients become dependent on oxygen and must be hospitalized. It is extremely important that a Covid-positive person strictly implement self-isolation measures, breaking contacts, wearing masks and avoiding the closest contact.
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