[Peculiarities of hemostasis in patients with COVID-19].

Autor:	Kalinskaya AI; Davydovsky City Clinical Hospital.; Yevdokimov Moscow State University of Medicine and Dentistry., Dukhin OA; Davydovsky City Clinical Hospital.; Yevdokimov Moscow State University of Medicine and Dentistry., Molodtsov IA; Davydovsky City Clinical Hospital., Anisimova AS; Yevdokimov Moscow State University of Medicine and Dentistry., Sokorev DA; Davydovsky City Clinical Hospital., Elizarova AK; Davydovsky City Clinical Hospital.; Yevdokimov Moscow State University of Medicine and Dentistry., Sapozhnikova OA; Davydovsky City Clinical Hospital., Glebova KA; Davydovsky City Clinical Hospital., Shakhidzhanov SS; Center for Theoretical Problems of Physicochemical Pharmacology., Spiridonov IS; Center for Theoretical Problems of Physicochemical Pharmacology., Ataullakhanov FI; Center for Theoretical Problems of Physicochemical Pharmacology.; University of Pennsylvania., Shpektor AV; Yevdokimov Moscow State University of Medicine and Dentistry., Vasilieva EY; Davydovsky City Clinical Hospital.; Yevdokimov Moscow State University of Medicine and Dentistry.
Jazyk:	ruština
Zdroj:	Terapevticheskii arkhiv [Ter Arkh] 2022 Aug 12; Vol. 94 (7), pp. 876-883. Date of Electronic Publication: 2022 Aug 12.
DOI:	10.26442/00403660.2022.07.201754
Abstrakt:	Aim: Analysis of the dynamics of different stages of clot formation and its lysis in patients with different COVID-19 severity. Materials and Methods: We prospectively included 58 patients with COVID-19 (39 patients with moderate disease severity and 18 patients with severe disease) and 47 healthy volunteers as a control group. All participants underwent the assessment of flow-mediated dilation (FMD) of brachial artery, impedance aggregometry, rotational thromboelastometry and thrombodynamics. Von Willebrand factor antigen (vWF:Ag) quantification was also performed in patients with COVID-19. Measurements were repeated on the 3rd and 9th day of hospitalization. Results: Compared to the control group, patients with COVID-19 showed reduced values of platelet aggregation and greater values of the clot growth rate, as well as its size and density. On the first day of hospitalization, we found no differences in the activity of plasma hemostasis and endogenous fibrinolysis between subgroups of patients. With the progression of the disease, the growth rate and size of the clot were higher in the severe subgroup, even despite higher doses of anticoagulants in this subgroup. An increase in platelet aggregation was noted during the progression of the disease, especially in the severe subgroup. There were no differences in the results of the FMD test by subgroups of patients. The vWF:Ag level was significantly higher in the severe subgroup. Conclusion: Thus, plasma hemostasis followed by secondary platelet activation correlates with the severity of COVID-19. Patients with moderate to severe coronavirus infection have predominantly local rather than generalized endothelial dysfunction.
Databáze:	MEDLINE
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