Endothelial dysfunction and thrombotic events in patients with severe novel coronavirus infection COVID-19

Abstract

Introduction. The novel coronavirus infection COVID-19 (NCI COVID-19) caused by the COVID-19 virus, which occurs in the most severe forms, is accompanied not only by the development of respiratory failure and acute respiratory distress syndrome, but also by other equally dangerous complications such as covid-associated coagulopathy.The objective was to study the clinical and laboratory features of the development of endothelial dysfunction as the main component of covid-associated coagulopathy in the context of its most common manifestation – thrombotic events.Methods and materials. The medical records of 947 patients with confirmed novel coronavirus infection COVID-19 hospitalized at the Center for the Treatment of Patients with NCI COVID-19 of Pavlov University of the Ministry of Health of the Russian Federation during the so-called «2nd wave» of the pandemic from November 2020 to March 2021.Results. All thrombotic complications were detected only in patients with severe coronavirus infection (561 patients). Predisposing factors for the development of thrombosis in our patients were: advanced age, duration of hospitalization for more than 1 week, comorbidity in the form of coronary artery disease. Standard screening tests of the hemostasis system (platelet microscopy, coagulogram screening) do not reveal any significant features in the presence of thrombotic events, which requires the development of new studies to assess prothrombotic potential in patients with severe NCI COVID-19.Conclusion. The development of thrombotic events is one of the most formidable complications in the severe course of NCI COVID-19, which in turn leads to an increase in respiratory failure due to increased tissue hypoxia, and subsequently to death. The same patients have an increased risk of hemorrhagic events as a possible side effect of the therapy.