Peculiarities of blood coagulation disorders in patients with COVID-19
- 作者: Evtugina N.1, Sannikova S.2, Peshkova A.1, Safiullina S.1,3, Andrianova I.1, Tarasova G.1, Khabirova A.1, Rumyantsev A.4, Ataullakhanov F.5,6, Litvinov R.1
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隶属关系:
- Kazan Federal University
- City Hospital №16
- Medical Center “Aibolit”
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology
- Center for Theoretical Problems of Physico-Chemical Pharmacology
- 期: 卷 93, 编号 11 (2021)
- 页面: 1255-1263
- 栏目: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/97308
- DOI: https://doi.org/10.26442/00403660.2021.11.201185
- ID: 97308
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Aim. To study the relationship of hemostatic disorders with inflammation and estimate their role in the course and outcomes of COVID-19.
Materials and methods. We examined 215 consecutive patients with moderate and severe forms of acute COVID-19. The patients were on anticoagulants and immunosuppressive drugs. Hemostasis was assessed using the thrombodynamics assay, thromboelastography, fibrinogen and D-dimer levels, prothrombin time, and soluble fibrin-monomer complexes (ethanol gelation test). The hemostatic parameters were correlated with hematological and biochemical tests, including markers of inflammation (C-reactive protein, interleukins 6 and 8), as well as with the disease severity and outcomes.
Results. Laboratory signs of coagulopathy were revealed in the vast majority of the cases. Despite the use of low-molecular-weight heparins in the prophylactic and therapeutic doses, coagulopathy in COVID-19 manifested predominantly as hypercoagulability that correlated directly with the systemic inflammation and metabolic changes due to liver and kidney dysfunction. A direct relationship was found between the grade of coagulopathy and the severity of COVID-19, including comorbidities and the mortality. The chronometric hypocoagulability observed in about 1/4 cases was associated with a high level of C-reactive protein, which may decelerate coagulation in vitro and thereby mask the true inflammatory thrombophilia. Persistent hyperfibrinogenemia and high D-dimer in the absence of consumption coagulopathy suggest the predominance of local and/or regional microthrombosis over disseminated intravascular coagulation.
Conclusion. The results obtained substantiate the need for laboratory monitoring of hemostasis and active prophylaxis and treatment of thrombotic complications in COVID-19.
作者简介
Natalia Evtugina
Kazan Federal University
Email: natalja.evtugyna@gmail.com
ORCID iD: 0000-0002-4950-3691
мл. науч. сотр.
俄罗斯联邦, KazanSvetlana Sannikova
City Hospital №16
Email: natalja.evtugyna@gmail.com
ORCID iD: 0000-0002-0668-1877
врач
俄罗斯联邦, KazanAlina Peshkova
Kazan Federal University
Email: natalja.evtugyna@gmail.com
ORCID iD: 0000-0002-8790-1818
канд. биол. наук, науч. сотр. Института фундаментальной медицины и биологии
俄罗斯联邦, KazanSvetlana Safiullina
Kazan Federal University; Medical Center “Aibolit”
Email: natalja.evtugyna@gmail.com
ORCID iD: 0000-0003-4657-0140
канд. мед. наук, ст. науч. сотр. Института фундаментальной медицины и биологии, врач-гематолог
俄罗斯联邦, KazanIzabella Andrianova
Kazan Federal University
Email: natalja.evtugyna@gmail.com
ORCID iD: 0000-0003-3973-3183
канд. биол. наук, науч. сотр. Института фундаментальной медицины и биологии
俄罗斯联邦, KazanGulzada Tarasova
Kazan Federal University
Email: natalja.evtugyna@gmail.com
ORCID iD: 0000-0003-3599-1599
врач клиники ФГАОУ ВО КФУ
俄罗斯联邦, KazanAlina Khabirova
Kazan Federal University
Email: natalja.evtugyna@gmail.com
ORCID iD: 0000-0002-7243-8832
мл. науч. сотр. Института фундаментальной медицины и биологии
俄罗斯联邦, KazanAleksandr Rumyantsev
Dmitry Rogachev National Medical Research Center of Pediatric Hematology
Email: natalja.evtugyna@gmail.com
ORCID iD: 0000-0002-1643-5960
акад. РАН, д-р мед. наук, проф., президент ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева»
俄罗斯联邦, MoscowFazoil Ataullakhanov
Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology; Center for Theoretical Problems of Physico-Chemical Pharmacology
Email: natalja.evtugyna@gmail.com
ORCID iD: 0000-0002-6668-0948
чл.-кор. РАН, д-р биол. наук, проф., науч. рук. ФГБУН ЦТП ФХФ РАН, зав. отд. биофизики и системной биологии и лабораторией биофизики ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева
俄罗斯联邦, MoscowRustem Litvinov
Kazan Federal University
编辑信件的主要联系方式.
Email: natalja.evtugyna@gmail.com
ORCID iD: 0000-0003-0643-1496
д-р мед. наук, проф., гл. науч. сотр. Института фундаментальной медицины и биологии
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