The state of the hemostasis system in patients suffering from a severe course of the coronavirus infection SARS-CoV-2 COVID-19, during hospitalization (results of a randomized clinical study)

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Objective: to assess the state of the hemostasis system and the effectiveness of a prophylactic dose of anticoagulants in patients suffering from severe COVID-19 coronavirus infection during hospitalization. Materials and methods. The study included patients diagnosed with acute community-acquired pneumonia who were admitted to the intensive care unit of the Kursk City Hospital No. 6, specialized during the pandemic in providing assistance to the adult population with coronavirus infection in the period from December 2020 to December 2021. The sample included data from 127 patients. All patients underwent CT scanning upon admission to confirm the diagnosis of bilateral pneumonia and PCR testing to confirm the diagnosis of COVID-19. A study of the blood hemostasis system was also performed for everyone within the first 24 hours after hospitalization. The diagnostic laboratory system "T2 Thrombodynamics Registrar" ("Gemacor", Moscow) was used. Results. We found statistically significant differences between laboratory parameters in surviving and deceased patients: leukocytosis level, C-reactive protein level, blood lactate. It was found that in the first sample, these parameters were significantly lower than in the second. The conducted correlation analysis showed that deceased patients had a more pronounced state of hypercoagulation of the blood coagulation system and a higher risk of developing thromboinflammatory syndrome. Conclusion. The state of the hemostasis system was assessed in patients suffering from severe coronavirus infection COVID-19 caused by SARS-CoV-2, immediately upon hospitalization. The results suggest that the use of prophylactic anticoagulant therapy in patients with a new coronavirus infection may be ineffective and even dangerous due to the relationship between hemostasis disorders and adverse outcomes. Dosing of anticoagulants such as low molecular weight or unfractionated heparins should be based on clear targets, such as thrombodynamic parameters. This approach will significantly optimize the effectiveness of anticoagulant therapy in patients with COVID-19.

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