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

Authors

  • V.V. Boyko State Institution “V.T. Zaytsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine; Kharkiv National Medical University, Kharkiv, Ukraine
  • V.M. Likhman State Institution “V.T. Zaytsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine; Kharkiv National Medical University, Kharkiv, Ukraine
  • O.M. Shevchenko State Institution “V.T. Zaytsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine; Kharkiv National Medical University, Kharkiv, Ukraine
  • O.Yu. Tkachuk State Institution “V.T. Zaytsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine; Kharkiv National Medical University, Kharkiv, Ukraine
  • A.O. Merkulov State Institution “V.T. Zaytsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine; Kharkiv National Medical University, Kharkiv, Ukraine
  • S.V. Tkach State Institution “V.T. Zaytsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine; Kharkiv National Medical University, Kharkiv, Ukraine
  • D.O. Miroshnichenko State Institution “V.T. Zaytsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine; Kharkiv National Medical University, Kharkiv, Ukraine
  • K.V. Ponomarova State Institution “V.T. Zaytsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine; Kharkiv National Medical University, Kharkiv, Ukraine

DOI:

https://doi.org/10.22141/2224-0586.18.1.2022.1461

Keywords:

surgical pathology, COVID-19, thromboembolic complications

Abstract

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 comple­xity 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.

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Published

2022-05-13

How to Cite

Boyko, V., Likhman, V., Shevchenko, O., Tkachuk, O., Merkulov, A., Tkach, S., Miroshnichenko, D., & Ponomarova, K. (2022). Assessment of the course of coagulopathies in patients with surgical pathology on the background of COVID-19. EMERGENCY MEDICINE, 18(1), 59–62. https://doi.org/10.22141/2224-0586.18.1.2022.1461

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Section

Original Researches

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