Laboratory monitoring of COVID-19 patients and importance of coagulopathy markers

Abstract

<jats:p>The pandemic of a new coronavirus infection COVID-19 has become a real challenge to humanity and the medical community and has raised a number of medical and social issues. From the currently available information on clinical cases of COVID-19, it follows that COVID-19 patients in critical condition have a clinical picture of disseminated intravascular coagulation (DIC), septic shock with the development of multiple organ failure, which justifies the anticoagulant therapy use in patients with COVID-19. In addition to isolating virus DNA from biological material and diagnosing SARS-CoV-2, the use of simple and easily accessible laboratory markers in the blood is necessary for the management of patients with COVID. If the activation of coagulation processes is sufficient enough, the consumption of platelets and blood clotting factors can be diagnosed by laboratory methods in the form of prolongation of routine blood clotting tests and increasing thrombocytopenia. Hyperfibrinogenemia, increased D-dimer, prolonged prothrombin time, thrombocytopenia, lymphopenia, leukocytopenia, increased interleukin 6, and ferritin are observed in most COVID-19 patients. The degree of increase in these changes correlates with the severity of the inflammatory process and is a prognostically unfavorable sign. In the article authors discuss laboratory monitoring that plays an essential role in this crisis, contributing to patient screening, diagnosis, as well as monitoring, treatment and rehabilitation.</jats:p>

COVID-19 in pregnant women after assisted reproductive technologies receiving low molecular weight heparins

“…Весь прошлый год прошел под знаком беспрецедентной пандемии новой коронавирусной инфекции, поставившей множество вопросов, начиная от диагностики и лечения и завершая управленческими решениями с целью снижения пиковой нагрузки на систему здравоохранения [1][2][3]. Спустя практически год после начала пандемии COVID-19 стало известно, что наибольшую опасность представляют беременные группы риска, у которых имеется противовоспалительный статус и хронические нарушения гемостаза.…”

COVID-19, neutrophil extracellular traps and vascular complications in obstetric practice

“…In patients with COVID-19, thrombocytopenia mechanism is probably multifactorial. It was suggested that a combination of the viral infection and an artificial ventilation leads to endothelial damage, triggering platelet activation, aggregation, and thrombosis in the lungs, in which significant platelet consumption occurs [13]. Moreover, since the lung can be a site of release of platelets from mature megakaryocytes, severe pneumonia can lead to impaired platelet defragmentation.…”

COVID-19, hemostasis disorders and risk of thrombotic complications

“…Одним из маркеров нарастания тяжести течения COVID-19 является ферритин. Функция ферритина заключается в связывании и переносе ионов железа, а также участии в иммунных и воспалительных реакциях [17]. Исследования показали, что воспалительный ответ на вирусную инфекцию (IL-18/ферритин) выступает специфическим плазменным иммунным биомаркером.…”

“…Резка мультимеров происходит при участии фермента металлопротеиназы ADAMTS-13 (a Disintegrin and Metalloprotease with Thrombospondin Type 1 Motif 13) после связывания в области А2 домена ФВ. Этот процесс активируют тромбоциты и фактор свертывания VIII [17]. ADAMTS-13 представляет собой протеазу из семейства металлопротеиназ.…”