Disorders of the hemostatic system in patients with COVID-19 infection of varying severity

Aim – to evaluate the individual characteristics of the hemostatic system and lungs CT-scan data in patients with a new coronavirus infection caused by the COVID-19, depending on the severity of the disease.

Material and methods. A comparative analysis included the results of clinical, epidemiological and laboratory examination of 209 COVID-19 patients divided in two groups: in-patients of the Samara State Medical University Clinics with moderate (n=106) and severe (n=103) course of the disease. The diagnosis was verified by enzyme immunoassay (ELISA) and polymerase chain reaction (PCR). The following indicators were analyzed: gender, age, body mass index (BMI), epidemiological history, clinical signs of the disease, severity, degree of lung damage according to the results of computed tomography (CT).

Results. There were no significant differences between the groups in terms of gender and age characteristics, as well as epidemiological data of COVID-19 patients. In 91% of patients with severe COVID-19, the clinical manifestations of hemorrhagic syndrome were recorded in the form of ecchymoses at injection sites, and in 75% - in the form of bleeding of various localization. The changes in the hemostatic system in patients with severe COVID-19 were characterized by high levels of platelets, INR, APTT, fibrinogen and a decrease in PI. In patients with severe COVID-19, a positive correlation was established between the level of fibrinogen, INR, APTT, PI and consolidation of lung tissue, as well as between the level of INR, APTT, PI and the presence of lung lesions in the form of "ground-glass" opacities on the CT images.