Endothelial injury in severe COVID-19 as a reason for infusion therapy choice

ABSTRACT

Objective. To evaluate the effect of succinate-containing crystalloid solution (sodium meglumin succinate) on the severity of endothelial dysfunction in patients with severe COVID-19. Material and methods. The study included 53 patients with severe form of COVID-19 complicated by bilateral polysegmental pneumonia. All patients are initially, by the method of envelopes, randomized into two groups. In the study group (27 patients), the intensive care complex includes daily infusion of Reamberin (1.5% solution of meglumin sodium succinate), in a daily dose of 10 ml/kg for 4 hours for up to 11 days (or time spent in the intensive care unit). Patients of the control group (26 patients) received Ringer's solution in the same volume. Endotheliocytosis, homocysteine concentration, platelet levels and coagulation tests were studied in dynamics. Results and discussion. Assessment of the severity of endothelial dysfunction showed that the study group determined a more significant (p<0.05) decrease in initially elevated levels of endothelial cytosis and homocysteine concentration at all stages of the study. Significant intergroup differences have manifested since the second day of observation. Infusion correction of the severity of endothelial dysfunction led to a decrease in the frequency of thrombotic complications, the probability of conversion to an invasive ventilator and mortality compared to the traditional approach. Conclusion. The use of a succinate-containing crystalloid solution (sodium meglumin succinate) in the complex therapy of severe forms of NCI is justified by a more significant and persistent correction of the initially pronounced endothelial dysfunction, leading to a decrease in the number of thrombotic complications, transfers to invasive ventilator and mortality. © 2022, Media Sphera Publishing Group. All rights reserved.