Статья

Hemostasis system in covid-19 patients with heparin therapy

A. Bulanov, E. Bulanova, I. Simarova, E. Bovt, O. Eliseeva, M. Panteleev, A. Rumyantsev, F. Ataullakhanov, S. Karamzin,
2020

Blood coagulation abnormalities play an important role in the pathophysiology of COVID-19. However, the specific details of hy-per-coagulation and anticoagulant treatment require further investigations. The objective was to study the indicators of two global tests for the status of the hemostasis system assessment in patients with CO-VID-19 at the time of admission to the clinic (before the start of anticoagulant therapy) and in patients receiving heparin during treatment in the clinic. Material and methods. Global thrombodynamics (TD) and thromboelastography (TEG) tests, as well as coagulogram screening tests (APTT, PT, INR, and fibrinogen) were performed in 136 patients with COVID-19 observed in a hospital setting. All patients received low molecular weight heparins at therapeutic dosages relatively to body weight in accordance with the hospital proto-col for patients with COVID-19. Results. In patients prior to treatment, marked hypercoagulability was observed in all global tests. The main parameters of TD (clot growth rate Vi and Vs) exceeded the reference range in more than 83% and 75% of patients, respectively. Citrate native TEG parameters (R, K, angle α and MA) also showed hyper-coagulation before anticoagulant therapy initiation in 24%, 17%, 48% and 53% of patients, respectively. After the start of treatment, a significant heparin response was obtained for the Vs parameter (the most sensitive to heparin parameter of TD): in 75% of cases, TD recorded hypo-coagulation, in 15% — normocoagulation, and in 10% of measurements, TD parameters continued to be in the hyper-coagulation range. The TEG parameter most sensitive to heparin (angle α) showed a lower response to heparin: it registered hypo-coagulation only in 25% of measurements, in 60% — normoco-agulation, and in 15% the parameter was in the hyper-coagulation range. Conclusion. The significant share of hypercoagulant results (10-15%) may indicate that some patients have not achieved a suffi-cient anticoagulant effect under the therapy.

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Версии

  • 1. Version of Record от 2020-01-01

Метаданные

Об авторах
  • A. Bulanov
    Municipal Clinical Hospital No.
  • E. Bulanova
    Municipal Clinical Hospital No.
  • I. Simarova
    Municipal Clinical Hospital No.
  • E. Bovt
    Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Center of Theoretical Problems in Physico-Chemical Pharmacology RAS
  • O. Eliseeva
    Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Center of Theoretical Problems in Physico-Chemical Pharmacology RAS
  • M. Panteleev
    Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Center of Theoretical Problems in Physico-Chemical Pharmacology RAS, Lomonosov Moscow State University, Moscow Institute of Physics and Technology
  • A. Rumyantsev
    Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology
  • F. Ataullakhanov
    Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Center of Theoretical Problems in Physico-Chemical Pharmacology RAS, Lomonosov Moscow State University, Moscow Institute of Physics and Technology
  • S. Karamzin
    Center of Theoretical Problems in Physico-Chemical Pharmacology RAS
Название журнала
  • Profilakticheskaya Meditsina
Том
  • 23
Выпуск
  • 6
Страницы
  • 85-89
Номер гранта
  • undefined
Тип документа
  • journal article
Тип лицензии Creative Commons
  • CC BY
Правовой статус документа
  • Свободная лицензия
Источник
  • scopus