Thromboembolic complications in patients with acute surgical pathology with coronavirus infection of COVID-19

Background. Coronavirus disease (COVID-19) is a highly contagious infection, the etiological factor of which is the SARS-CoV2 virus. In COVID-19, hemostasis disorders vary widely: from latent hypercoagulation, which occurs only on the basis of laboratory tests, to severe clinical manifestations in the form of cerebral, coronary arterial or venous thrombosis complicated by pulmonary embolism. The purpose was to study of clinical manifestations of hemostasis disorders according to laboratory studies. Materials and methods. The observation data of 96 patients who were treated for surgical pathology and in whom COVID-19 was detected are presented. Patients were hospitalized in the intensive care unit, thrombotic complications were detected in 37 %. Both venous (64 %) and arterial (36 %) thrombosis occurred. Results. According to a survey of patients with a confirmed diagnosis of COVID-19, pulmonary embolism was detected in 11.4 %, deep vein thrombo-sis and catheter-associated thrombosis in 1.2 %, ischemic stroke in 1.3 % of patients. The cumulative frequency of thrombosis was 28 %. Attention should be paid to the complexity of the diagnosis of thrombotic complications in patients who underwent artificial lung ventilation. possible thrombotic complications, regardless of clinical manifestations. Conclusions. Preference should be given to low molecular weight heparins in a standard prophylactic dose, an alternative to which are direct oral anticoagulants used in surgical protocols to prevent postoperative thrombosis. The duration of post-hospital thromboprophylaxis is determined individually taking into account the risk factors of thrombosis until the normalization of D-dimer and fibrinogen, but not less than 2 weeks after discharge. © 2022. The Authors. This is an open access article under the terms of the Creative Commons Attribution 4.0 International License, CC BY, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.

Assessment of the course of coagulopathies in patients with surgical pathology on the background of COVID-19

Background. Coronavirus disease (COVID-19) is a highly contagious infection, the etiological factor of which is the SARS-CoV-2. In COVID-19, hemostasis disorders vary widely: from latent hypercoagulation, which is detected only by the results of laboratory tests, to severe clinical manifestations in the form of cerebral, coronary arterial or venous thrombosis complicated by pulmonary embolism. The purpose: to study clinical manifestations of hemostasis disorders according to laboratory studies. Materials and methods. The observation data of 89 patients who were treated for surgical pathology associated with COVID-19 are presented. All individuals were hospitalized in the intensive care unit, thrombotic complications were detected in 37 % of them. Both venous (64 %) and arterial (36 %) thrombosis occurred. Hemorrhagic complications were found in 15.7 % of patients. Results. According to a survey of people with a confirmed diagnosis of COVID-19, pulmonary embolism was detected in 11.4 %, deep vein thrombosis and catheter-associated thrombosis — in 1.2 %, ischemic stroke — in 1.3 % of patients. The cumulative frequency of thrombosis was 28 %. Attention should be paid to the comple xity of the diagnosis of thrombotic complications in patients who underwent artificial lung ventilation. The overall cumulative incidence of thrombosis on days 7, 14 and 21 of hospitalization was 12, 28 and 36 %, respectively, while the frequency of thrombotic complications with clinical manifestations was only 7, 14 and 21 %, which is almost 2 times less common. This once again suggests the need to examine all patients with COVID-19 for possible thrombotic complications, regardless of clinical manifestations. Conclusions. Patients should receive continuous thromboprophylaxis after discharge from a hospital. Preference should be given to low molecular weight heparins in a standard prophylactic dose, an alternative to which are direct oral anticoagulants used in surgical protocols to prevent postoperative thrombosis. The duration of post-hospital thromboprophylaxis is determined individually taking into account the risk factors of thrombosis until the normalization of D-dimer and fibrinogen, but not less than 2 weeks after discharge. © 2022. The Authors.