ХАРАКТЕР ИЗМЕНЕНИЙ ГЕМОСТАЗИОЛОГИЧЕСКИХ ПОКАЗАТЕЛЕЙ У БЕРЕМЕННЫХ С БЕССИМПТОМНЫМ И ЛЕГКИМ ТЕЧЕНИЕМ COVID-19

Abstract

Background. Coronavirus infection (COVID-19) is characterized by various abnormalities including pulmonary inflammation and activation of the hemostatic system, termed COVID-19-associated coagulopathy. Objective. To study the nature and direction of changes in the hemostatic system in pregnant women with COVID-19. Material and methods. A total of 132 pregnant women in the third trimester of gestation were examined: 91 patients diagnosed with SARS-CoV-2 virus infection constituted the main group and 41 pregnant women without coronavirus infection constituted the control group. Haemostasiological, biochemical and haematological investigations were performed. Results. An asymptomatic course of COVID-19 infection was registered in 84.6% of pregnant women in the experimental group. In pregnant women with signs of viral infection, the disease course was mild. There were no statistically significant differences in D-dimer between the experimental and control groups, but there was an increase in its level in 29.1% of pregnant women with coronavirus infection (815-8307 ng/ml) and in 27.3% of pregnant women in the control group (703-1175 ng/ml). In pregnant women with a confirmed diagnosis of COVID-19, as compared to controls, a shortening of the aPTT was significantly more likely to be observed (p=0.032), and these changes, along with a decrease in R-aPTT, were more common in those with clinical manifestations of coronavirus infection (p=0.0025). Pregnant women with elevated D-dimers had a higher level of CRP (p=0.043), a lower prothrombin level (p=0.05) and a higher INR (p=0.003); there was also a decrease in erythrocyte count (p=0.031), higher monocyte count (p=0.0067) and a lower proportion of segmented neutrophils (p=0.0024). Conclusions. The revealed abnormalities may indicate the presence of disturbances in the blood coagulation system in pregnant women with asymptomatic or mild course of COVID-19 directed towards hypercoagulable processes, and these changes are statistically significantly more common in individuals with clinical manifestations of coronavirus infection.