Year 2020 Vol. 28 No 5

ANESTHESIOLOGY-REANIMATOLOGY

À.V.MAROCHKOV 1, 3, A.L. LIPNITSKI 1, 3, D.S. TSOPAU 2, I.A. KUPREYEVA 1, V.U. DAZORTSAVA 1

FEATURES OF PLATELET AGGREGATION IN PATIENTS WITH COVID-19 INFECTION. PRELIMINARY RESULTS

Mogilev Regional Clinical Hospital 1,
Mogilev Hospital No1 2, Mogilev,
Vitebsk State Medical University 3, Vitebsk ,
The Republic of Belarus

Objectives. To determine changes in platelet aggregation during intensive care of critically ill patients with COVID-19 infection.
Methods. A pilot non-randomized prospective clinical study of platelet aggregation in patients admitted to the intensive care unit with acute respiratory distress syndrome with the diagnosis of COVID-19 (group 1, n=15) was carried out. A control group (group 2, n=15) included healthy people who have ambulatory study of platelet aggregation. In the 1st-3d days of hospitalization at the intensive care blood sampling was carried out in the group 1. The study was performed on a platelet aggregation analyzer AR 2110 (ZAO «SOLAR», Republic of Belarus).
Results. When platelet aggregation was induced by high doses of ADP (1.25 and 2.5 μg/ml), a lower degree of aggregation was observed in patients with COVID-19 (58.7 (34.2; 63.2)% and 66.5 (59.6; 70.9)% vs 67.2 (64.1; 70.3)% and 77.5 (71.8; 80.3)% in group 2, respectively, (p<0.05)), which occurred significantly faster (161.5 (103; 214) s and 197 (127; 309) s compared to 413 (325; 465) s and 362.5 (296.5; 422) s in group 2, respectively, (p<0.05)). With the inducer adrenaline at doses of 2.5 and 5 μM the degree of aggregation was also significantly lower in patients with COVID-19 (40.8 (26.1; 63.9)% and 38.7 (29.4; 66.8 )%, respectively). Single-phase irreversible platelet aggregation with an aggregation degree of 75.2 (71.9; 83.2) % was observed with a collagen inducer in patients with COVID-19 infection.
Conclusion. The degree of platelet aggregation with ADP and adrenaline was significantly reduced in patients with COVID-19 infection due to receiving anticoagulant and antiplatelet therapy (by main and concomitant pathologies).

Keywords: platelet aggregation, Covid-19, SARS-CoV-2, platelets, platelet aggregation, hypercoagulation, coagulation balance
p. 558-564 of the original issue
References
  1. Solovei NV, Karpov IA, Gorbich IuL. COVID-19 infektsiia: sovremennye vozmozhnosti i perspektivy protivovirusnogo lecheniia. Retsept. Spetsvyp: COVID-19: chto dolzhen znat’ kazhdyi vrach. 2020;23(2):163-71. (In Russ.)
  2. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19). Treatment Guidelines [Electronic resource]. National Institutes of Health; 2020 [äàòà îáðàùåíèÿ: 2020 Èþëü 23]. Available from: https://www.covid19treatmentguidelines.nih.gov/
  3. Escher R, Breakey N, Lämmle B. Severe COVID-19 infection associated with endothelial activation. Thromb Res. 2020 Jun;190:62. doi: 10.1016/j.thromres.2020.04.014
  4. Panigada M, Bottino N, Tagliabue P, Grasselli G, Novembrino C, Chantarangkul V, Pesenti A, Peyvandi F, Tripodi A. Hypercoagulability of COVID-19 patients in intensive care unit: a report of thromboelastography findings and other parameters of hemostasis. J Thromb Haemost. 2020 Jul;18(7):1738-42. doi: 10.1111/jth.14850
  5. Carsana L, Sonzogni A, Nasr A, Rossi RS, Pellegrinelli A, Zerbi P, Rech R, Colombo R, Antinori S, Corbellino M, Galli M, Catena E, Tosoni A, Gianatti A, Nebuloni M. Pulmonary post-mortem findings in a large series of COVID-19 cases from northern Italy [Internet]. Published online 2020 Apr 22. doi: 10.1101/2020.04.19.20054262
  6. Schaller T, Hirschbühl K, Burkhardt K, Braun G, Trepel M, Märkl B, Claus R. Postmortem examination of patients with COVID-19. JAMA. 2020 Jun 23;323(24):2518-20. doi: 10.1001/jama.2020.8907
  7. Koupenova M. Potential role of platelets in COVID-19: Implications for thrombosis. Res Pract Thromb Haemost. 2020 Jul;4(5):737-40. Published online 2020 Jun 21. doi: 10.1002/rth2.12397
  8. Yang X, Yang Q, Wang Y, Wu Y, Xu J, Yu Y, Shang Y. Thrombocytopenia and its association with mortality in patients with COVID-19. J Thromb Haemost. 2020 Jun;18(6):1469-72. doi: 10.1111/jth.14848
  9. Iba T, Levy JH, Connors JM, Warkentin TE, Thachil J, Levi M. The unique characteristics of COVID-19 coagulopathy. Crit Care. 2020 Jun 18;24(1):360. doi: 10.1186/s13054-020-03077-0
  10. Iba T, Levy JH, Levi M, Thachil J. Coagulopathy in COVID-19. J Thromb Haemost. 2020;18:2103-09. doi: 10.1111/jth.14975
  11. Zubovskaia ET, Iurkevich TIu, Mitroshenko IV, Demidova RN. Trombotsitarnaia agregatometriia v klinicheskoi praktike: posobie dlia vrachei. Minsk, RB: ProniaPlius; 2018. 67 p.(In Russ.)
  12. Marini JJ, Gattinoni L. Management of COVID-19 respiratory distress. JAMA. 2020;323(22):2329-30. doi: 10.1001/jama.2020.6825
Address for correspondence:
212016, Republic of Belarus,
Mogilev, Belynickij-Biruli str., 12,
Mogilev Regional Clinical Hospital,
the Department for Coordinating
the Collection of Organs and Tissues
for Transplantation,
tel.: +375 222 62-75-95,
e-mail:Lipnitski.al@gmail.com,
Lipnitski Artur Leonidovich
Information about the authors:
Marochkov Alexey V., MD, Professor, Anesthesiologist-Resuscitator, the Intensive Care Unit, Mogilev Regional Clinical Hospital, the Affiliate of the Department of Anesthesiology and Reanimatology with the Course of the Faculty of Advanced Training and Retraining of Specialists and the Surgery Department of the Faculty of Advanced Training and Retraining of Specialists, Vitebsk State Medical University, Mogilev, Republic of Belarus.
https://orcid.org/0000-0001-5092-8315
Lipnitski Artur L., PhD, Anesthesiologist-Resuscitator, Head of the Department for Coordinating the Collection of Organs and Tissues intended for Transplantation, Mogilev Regional Clinical Hospital, the Affiliate of the Department of Anesthesiology and Reanimatology, with the Course of the Faculty of Advanced Training and Retraining of Specialists and the Surgery Department of the Faculty of Advanced Training and Retraining of Specialists, Vitebsk State Medical University, Mogilev, Republic of Belarus.
https://orcid.org/0000-0002-2556-4801
Tsopau Dmitry S., Anesthesiologist-Resuscitator, the Intensive Care Unit, Mogilev Hospital No1, Mogilev, Republic of Belarus.
https://orcid.org/0000-0001-8286-0036;
Kupreyeva Irina A., Head of the Centralized Laboratory of Clinical Biochemistry, Mogilev Regional Clinical Hospital, Mogilev, Republic of Belarus.
https://orcid.org/0000-0002-5745-1203
Dazortsava Olga V., Physician of Laboratory Diagnostics of the Centralized Laboratory of Clinical Biochemistry, Mogilev Regional Clinical Hospital, Mogilev, Republic of Belarus.
https://orcid.org/0000-0002-4059-8321
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