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Khirurgii

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Year 2021 Vol. 29 No 4

ANESTHESIOLOGY-REANIMATOLOGY

А.V. MAROCHKOV 1, 2, A.L. LIPNITSKI 1, 2, I.A. KUPREYEVA 1, V.U. DAZORTSAVA 1

COAGULATION BALANCE AND PLATELET AGGREGATION INDICATORS IN PATIENTS WITH INFECTION COVID-19

Mogilev Regional Clinical Hospital 1, Mogilev,
Vitebsk State Order of Peoples’ Friendship Medical University 2, Vitebsk,
The Republic of Belarus

Objective. To determine changes in coagulation balance and platelet aggregation in patient during the treatment of COVID-19 infection.
Methods. A pilot non-randomized prospective clinical study of coagulation balance and platelet aggregation in patients admitted to the intensive care unit with acute respiratory distress syndrome and the diagnosis of COVID-19 (n=50) was performed. Out of 50 patients, 19 patients died, 31 patients were transferred to the therapeutic department. The study of indicators of coagulation balance and platelet aggregation was carried out once in 1-3 days starting from the patient’s admission to the hospital using coagulation analyzer ACL 10000 (Instrumentation Laboratory, USA) and platelet aggregation analyzer AP 2110 (ZAO “SOLAR”, Republic of Belarus).
Results. In 45 (90%) patients with COVID-19, there is a significant increase of von Willebrand factor activity 350 (244.5; 480) %. There were no statistically significant differences in the level of von Willebrand factor activity among the deceased and surviving patients: 450.0 (338.8; 530.5) % in deceased patients and 342.0 (188.8; 480.0) % in survivors. At von Willebrand factor activity level of up to 250%, the mortality rate was 8.3%, at a level of 250-400% – 31.3%, at a level of more than 400% – 59.1%. Significantly above the normal range in most patients were fibrinogen (above normal in 68% of patients, 4.63 (3.49; 5.87) g/L) and D-dimers (above normal in 88% of patients, 0.73 (0,31; 1.4) μg/ml). Antithrombin III was below normal in 56% of patients (82 (67.1; 97.2) %). The degree of platelet aggregation has a strong direct correlation with the von Willebrand factor level: with an ADP inducer 0.3 μg/ml (R=0.71, р=0.003); ADP 0.6 μg/ml (R=0.74, р=0.0001); ADP 1.25 μg/ml (R=0.53, р=0.01).
Conclusion. Analysis and evaluation of coagulation balance and platelet aggregation should be an integral part in the treatment of patients with COVID-19 infection.

Keywords: COVID-19, агрегация тромбоцитов, фактор Виллебранда, D-димеры, фибриноген, тромбоциты
p. 462-469 of the original issue
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Address for correspondence:
212016, Republic of Belarus,
Mogilev, Belynitskii-Biruli Str., 12,
Mogilev Regional Clinical Hospital,
the Department for Coordination of Organ
and Tissue Collection for Transplantation,
tel.: +375 222 62-75-95,
e-mail: Lipnitski.al@gmail.com,
Lipnitski Artur L.
Information about the authors:
Marochkov Alexey V., MD, Professor, Anesthesiologist of Anesthesiology and Intensive Care Unit, Mogilev Regional Clinical Hospital, the Branch of the Departments of Anesthesiology and Resuscitation with a Course of the Faculty of the Advanced Training and Retraining and Surgery of the Faculty of the Advanced Training and Retraining of Vitebsk State Medical University, Mogilev, Republic of Belarus.
https://orcid.org/0000-0001-5092-8315
Lipnitski A.L., PhD, Anesthesiologist, Head of the Department Coordination for Organ and Tissue Transplantation .Mogilev Regional Clinical Hospital, the Branch of the Departments of Anesthesiology and Resuscitation with a Course of the Faculty of the Advanced Training and Retraining and Surgery of the Faculty of the Advanced Training and Retraining of Vitebsk State Medical University, Mogilev, Republic of Belarus.
https://orcid.org/0000-0002-2556-4801
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/0000-0001-9258-4514
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