Нарушения гемостаза, тромбозы, антифосфолипидные антитела у пациентов с covid-19

Abstract

The article provides an overview of main blood clotting disorders in coronavirus infection 2019 (COVID-19), which is associated with several hematological changes. Patients with COVID-19 develop typically two hemostasis disorders – an increased D-dimer levels and moderate thrombocytopenia, which occur in more than 40% of cases. Other hemostasis abnormalities, which are frequently reported in COVID-19, included prolonged prothrombin time (PT), also expressed as international normalized ratio, prolonged thrombin time, and activated partial thromboplastin time (APTT), which were typical acute phase reactions. Prolonged APTT or PT, and thrombocytopenia are common, especially in patients with severe clinical course. It has been hypothesized that increased D-dimer concentration and prolongation of PT, APTT are associated with higher mortality in patients with COVID-19. Disseminated intravascular coagulation occurs most often in severe cases of COVID-19 (about 2% of all hospitalized patients) and indicates a poor prognosis, i.e. about 90% mortality. It remains unclear whether SARS-CoV-2 can induce antiphospholipid antibodies. An increased incidence of positive lupus anticoagulants was observed in patients with COVID-19, it can be assumed that all patients with COVID-19 in whom antiphospholipid antibodies are revealed should be monitored and receive thromboprophylaxis even with no history of thromboembolism. Keywords: coronavirus infection (COVID-19), hemostasis disorder, antiphospholipid antibodies, antiphospholipid syndrome, thrombosis, anticoagulants For citation: Reshetnyak TM, Chel'dieva FA, Lila AM, Nasonov EL. Hemostasis disorders, thrombosis, antiphospholipid antibodies in patients with COVID-19. Consilium Medicum. 2021; 23 (1): 35–42. DOI: 10.26442/20751753.2021.1.200607