Известия высших учебных заведений. Поволжский регион: Медицинские науки (Dec 2023)

The features of hemostasis disorders in acute pancreatitis in patients with coronavirus infection (COVID-19)

  • A.P. Vlasov,
  • Sh.S. Al-Kubaysi,
  • K.I. Levkin,
  • N.A. Myshkina,
  • M.Yu. Khachaturov

DOI
https://doi.org/10.21685/2072-3032-2023-3-4
Journal volume & issue
no. 3

Abstract

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Background. Until now, the frequency of total mortality in Russia in acute pancreatitis (AP) remains high, amounting to 2-5 % in mild forms, and 12-75% in destructive forms. One of the reasons for this is insufficient knowledge of the pathogenetic mechanisms of OP, including in friendly diseases. The purpose of the study is to determine the features of homeostasis disorders in patients with acute pancreatitis with coronavirus infection. Material and methods. The work is based on studies of 50 patients with AP: in the first group (n = 25) – without COVID-19; the second (n = 25) – with COVID-19. Endogenous intoxication, lipid peroxidation, phospholipase activity, microcirculation and hemostasis system were evaluated. Results. In the early phase, patients with AP have significant microcirculation disorders and homeostatic changes: endogenous intoxication, oxidative stress, activation of phospholipase systems, hemostatic disorders in the form of hypercoagulemia. The presence of coronavirus infection in AP is a significant factor in the modification of these changes. An increase in endotoxemia, intensification of lipid peroxidation and phospholipase, hypocoagulemia, hypofibrinolysis have been recorded. In patients of the first group, the number of estimated severity scores on the ARASNE II scale decreased in dynamics and by the 7th day was 4.6 ± 0.3, while in the second group it remained high was 7.8 ± 0.4 points (p < 0.05). The presence of coronavirus infection is also the cause of complications (higher by 28.5 %). Conclusion. In patients with AP and coronavirus infection, the phenomena of endotoxemia, oxidative stress, phospholipase activity, microcirculatory disorders, changes in the homeostasis system are more pronounced. Undoubtedly, this is the most important factor in maintaining the severity of the disease and the development of complications.

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