Change of hematological parameters in COVID-19

Abstract

The new coronavirus infection, which has caused significant morbidity and mortality in most countries of the world, was first identified in December 2019 in Wuhan, China. In March 2020, the World Health Organization declared a pandemic of a new coronavirus infection, which became a challenge to humanity and the medical community. COVID-19 is a highly contagious disease caused by the SARS-CoV-2 virus. Specific prothrombotic changes in the hemostasis system in COVID-19 are associated with an increased incidence of venous thromboembolic complications. One of the most dangerous and prognostically unfavorable complications of COVID-19 is the development of coagulopathy of the type of decompensated hypercoagulation, up to disseminated intravascular coagulation. There is a close relationship between hemostatic disorders and the systemic inflammatory response to viral infection. Clinical and laboratory signs of thrombotic conditions and their severity are directly correlated with the production of inflammatory cytokines: IL-2, IL-6, IL-7, IL-10, G-CSF, IP10, MCP-1, MIP-1A and TNF-α. The relationship between inflammation and thrombosis and the ability of these two processes to exacerbate each other have been described in many pathological conditions. Physiological pro- and anticoagulants, like platelets, have pro-inflammatory properties independent of their hemostatic functions. Mutual conditioning of thrombotic complications and systemic inflammatory response is one of the main links in the pathogenesis of COVID-19. COVID-19 associated coagulopathy is accompanied by a pronounced increase in the level of D-dimer and fibrin/fibrinogen breakdown products, while the deviation of other indicators (prothrombin time, activated partial thromboplastin time, platelet count) at the onset of the disease is relatively rare. For coagulopathy associated with COVID-19, empiric anticoagulant therapy aimed at preventing venous thrombosis and thromboembolism should be carried out in all hospitalized patients, as well as standard maintenance therapy for sepsis-induced coagulopathy or disseminated intravascular coagulation syndrome. The article is a review of the literature on the diagnosis, treatment and prevention of coagulopathy and venous thromboembolic complications associated with COVID-19.

Keywords

• covid-19
• d-dimer
• fibrinogen
• covid-19 associated coagulopathy
• hemocoagulation disorders