Evaluation of hemostasis clinical and laboratory indicators of patients with stroke and coronavirus infection (COVID-19) on the basis of a multidisciplinary hospital in the period of its conversion to an infectious diseases hospital

Abstract

Introduction. The COVID-19 impact on hemostasis of stroke survivors with community-acquired pneumonia is an urgent problem. The aim of the study is to analyze the features of clinical and laboratory parameters in cerebral stroke combined with community-acquired pneumonia caused by the SARS-Co-V-2 virus. Materials and methods. The instrumental and laboratory examination results of 88 patients aged 73.0 (12.3) years in the acute period of stroke with community-acquired viral pneumonia symptoms were analyzed. The present study included 39.8 % (n=53) male and 60.2 % female (n=35) with duration of diagnosed infectious disease less than 7 days. The symptoms of cerebral stroke were compared with the results of laboratory testing of the hemostasis system, lipid metabolism, and the activity of the systemic inflammatory response. The severity of lung tissue damage and the outcomes of the diagnosed changes were assessed. Results. All patients had mild or moderate COVID-19. In 87.5 % (n=77) cases unspecified (40.2 %, n=31), cardioembolic (36.4 %, n=28), lacunar (3.9 %, n=3) and atherothrombotic (19.5 %, n=15) ischemic stroke subtype was diagnosed. Focal ischemia lesion in the left middle cerebral artery (LMCA) territory was detected in 45.6 % (n=35), in the right middle cerebral artery (RMCA) territory in 41.6 % (n=32). Manifestations of hemorrhagic stroke were noted in 12.5 % (n=11) with signs of parenchymal hemorrhage in 54.5 % (n=6), ventricular hemorrhage in 27.3 % (n=3), subarachnoid hemorrhages were noted in 18.2 % (n=2). The indicators of the coagulation system in terms of the number of platelets corresponded to 251.3 (90.7); the APTT value was in the range of 29.2 (26.7 33.0) (s); the INR parameter was 1.16 (1.05 1.25); the value of prothrombin ( %) corresponded to the value of 85.9(23.4). Conclusion. We do not observe the great disorders of haemostasis in the most acute period of the stroke. When combined with COVID-19 the most common stroke is ischemic stroke. The stroke survivors with the community-acquired pneumonia caused by SARS-CoV-2 laboratory tests show that increase of inflammatory markers are above the reference range.