Эндотелиальная дисфункция у пациентов с коронавирусной инфекцией COVID-19

Abstract

Endothelial dysfunction is the main cause of thrombotic complications and unfavorable disease outcome in COVID-19. The study of markers of endothelial dysfunction in patients with COVID-19 will help to determine additional directions for the treatment of hemostatic disorders. The purpose — to evaluate the diagnostic significance of endothelial dysfunction markers in moderate and severe forms of COVID-19. Material and methods. The study was carried out in 28 patients with COVID-19 hospitalized at the Republic Clinical Infectious Diseases Hospital (Kazan) from 02.16.2023 to 03.07.2023. The median age of patients was 66.5 years. The control group consisted of 20 healthy people of the same age. Results. It was found that moderate and severe forms of COVID-19 are accompanied by increased values of D-dimer and VWF in the blood, the medians of which were 2.6 and 1.9 times higher than control values, respectively. No significant differences in the values of P-selectin and thrombomodulin were detected in the compared groups. A moderate correlation was established between the level of P-selectin and the absolute number of neutrophils in the blood. It was found that the values of D-dimer and thrombomodulin were significantly higher in patients with COVID-19 who had two or more comorbid diseases. The high likelihood ratios of FFB and D-dimer positivity (LR+ = 8.4) allow considering them as reliable parameters for assessing endothelial dysfunction in patients with COVID-19. Conclusion. Endothelial dysfunction in COVID-19 disease is manifested by increased levels of D-dimer and VWF in the blood. The identified changes indicate the possibility of using medications that neutralize VWF in addition to anticoagulant drugs.