Features of the Blood Coagulation System in Patients with Coronavirus Infection

Abstract

Coronavirus infection is a powerful trigger for damage to the haemostatic system, especially in the acute phase. Diagnostically significant laboratory signs of inflammation include elevated D-dimer and pro­calcitonin levels and prolonged coagulation parameters (prothrombin time (PT) and activated partial thromboplastin time (APTT)). The most common complications of severe disease are haemostatic disor­ders, manifested by deep vein thrombosis, pulmonary embolism, thrombocytopenia and lymphopenia, as well as disseminated intravascular coagulation. When such pathological conditions arise, the choice of optimal treatment tactics and correction of the coagulation system becomes significantly more complicated. Pulmonary embolism and gastrointestinal and bronchial bleeding, the risk of which increases with anticoagulant therapy, remain the main threats of fatal complications, which makes this study relevant. Objective — to identify key risk factors for haematological complications of severe coronavirus disease and ways to prevent them. Materials and methods. We analysed 2,301 (69.8 %) medical records of individuals who sought medical attention within a week after the onset of the disease and 995 (30.2 %) medical records of individuals who were hospitalised by an emergency medical team on the eighth day. All patients underwent clinical and biochemical blood tests and a coagulogram. Results and discussion. Analysis of coagulogram indicators showed that in patients with the first manifestations of coronavirus disease, the coagulation system was activated, which resulted in microthrom­bus formation and the development of multiple organ failure syndrome.Conclusions. The inflammatory process caused by coronavirus leads to active thrombus formation, which, in older people with concomitant diseases, became a cause of death.