Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya9730810.26442/00403660.2021.11.201185Research ArticlePeculiarities of blood coagulation disorders in patients with COVID-19EvtuginaNatalia G.natalja.evtugyna@gmail.comhttps://orcid.org/0000-0002-4950-3691SannikovaSvetlana S.natalja.evtugyna@gmail.comhttps://orcid.org/0000-0002-0668-1877PeshkovaAlina D.natalja.evtugyna@gmail.comhttps://orcid.org/0000-0002-8790-1818SafiullinaSvetlana I.natalja.evtugyna@gmail.comhttps://orcid.org/0000-0003-4657-0140AndrianovaIzabella A.natalja.evtugyna@gmail.comhttps://orcid.org/0000-0003-3973-3183TarasovaGulzada R.natalja.evtugyna@gmail.comhttps://orcid.org/0000-0003-3599-1599KhabirovaAlina I.natalja.evtugyna@gmail.comhttps://orcid.org/0000-0002-7243-8832RumyantsevAleksandr G.natalja.evtugyna@gmail.comhttps://orcid.org/0000-0002-1643-5960AtaullakhanovFazoil I.natalja.evtugyna@gmail.comhttps://orcid.org/0000-0002-6668-0948LitvinovRustem I.natalja.evtugyna@gmail.comhttps://orcid.org/0000-0003-0643-1496Kazan Federal UniversityCity Hospital №16Medical Center “Aibolit”Dmitry Rogachev National Medical Research Center of Pediatric HematologyDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and ImmunologyCenter for Theoretical Problems of Physico-Chemical Pharmacology151120219311125512632501202225012022Copyright © 2021, Consilium Medicum2021<p><strong>Aim. </strong>To study the relationship of hemostatic disorders with inflammation and estimate their role in the course and outcomes of COVID-19.</p>
<p><strong>Materials and methods. </strong>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.</p>
<p><strong>Results. </strong>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 <em>in vitro</em> 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.</p>
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