Today, Doctor Zhan Mitrev visited Ivan Ognjanovski, the patient who underwent the first heart transplant in the country.
Ivan is in good health and according to the recommendations of Doctor Mitrev he is already preparing for discharge from the hospital and further treatment and care in his home.
Ivan was looking forward to the meeting with Dr. Mitrev and therefore he got up on his feet and greeted Droctor Mitrev wishing to assure all present of his desire to recover and return to normal life as soon as possible.
Doctors from our clinic have been continually involved in his recovery from the very beginning, and together with the colleagues from the state cardiac surgery, they monitor his health condition every single minute.
The cooperation between Zan Mitrev Clinic and the state cardiac surgery team continues, especially when it comes to seriously ill patients.
Last Saturday late night, a patient in a hemorrhagic shock due to rupture of the abdominal aneurysm was admitted. Patients with such condition do not survive unless they are operated on immediately. Bleeding is resolved by replacing the abdominal aorta with a vascular prosthesis. We also took specimen for Covid-19 test.
By the end of the surgery, the result of the Covid-19 test showed that the patient was positive for Covid-19. Upon admission, he had a fever and cough, which confirmed the finding.
Since the Ministry of Health allows treating of Covid-19 patients only in the centers designated for this purpose, immediately after the surgery we tried to transfer the patient to those centers (the surgery was successful) but we did not succeed because all centers were occupied and could not accept the patient.
We had to continue the treatment and the next day we started the process of continuous blood purification with a special filter, which removes all infective mediators created by any blood infection.
We have been using this method for 8 years and with the experience we had with similar conditions of different causes, we knew that this was the only method we could use to help the patient because we do not have any experience with Covid-19 and this type of condition.
The filtration process usually lasts 48 hours continuously, but only after 12 hours, the filter was completely clogged. This was due to many infective mediators and toxins that were at the time circulating in the blood.
After this blood filtration, the patient recovered well and after two days we made another Covid-19 test, which was negative. The next three tests were also negative. So, after only six days of treatment, the patient was in a good general condition, with negative Covid-19 test and we discharged him.
“This is only one positive experience” – say from the Zan Mitrev Clinic.
This time the team of the Laboratory of Genetics and Personalized Medicine in cooperation with the company Bioengineering, led by Dr. Goran Kungulovski, was involved in another important chapter in Macedonian biomedicine.
Namely, the team sequenced the first complete genomes of the Coronavirus SARS-CoV-2, isolated from Macedonian patients in early June.
Applying the method of third generation sequencing in real time, the team of molecular biologists completely decoded all about 30 thousand letters of the genetic material of the virus in 10 Macedonian patients. Detailed genome analysis revealed the presence of the P323L mutation in the RdRP gene and the D614G mutation in the S gene, in the isolates of all 10 patients.
These mutations are particularly important because they are found in one of the two most important proteins of the Coronavirus: the S protein is the key to the virus entering the cell and infecting it, while the RdRp gene is important for the virus division in the cell.
According to the latest scientific studies, strains that have the D614G mutation have become dominant in Europe and some regions of the United States in recent months. The D614G mutation, which is absent in 97% of isolates in China and is dominant in Europe and also detected in Macedonia, is thought to increase the transmissibility and infectivity of the virus, but has no effect on the severity of symptoms.
The S protein is one of the major targets for the development of a vaccine against the virus, while the RdRp gene is one of the major targets for the development of antiviral therapy. The sequencing of multiple isolates of the virus from Macedonian patients from the very beginning of the epidemic until this day will allow for accurate monitoring of the evolution and changes of the virus in Macedonia.
