The Role of Vascular-Platelet Hemostasis Disturbances in the Genesis of Respiratory Failure in Patients with COVID-19
The objective: to study the relationship between markers of imbalance in the platelet-vascular hemostasis system and lung damage and disease outcome in patients with COVID-19.Subjects and Methods: the study included 225 patients with the confirmed diagnosis of moderate, severe and extremely severe C...
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| Format: | Article |
| Language: | Russian |
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New Terra Publishing House
2022-07-01
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| Series: | Вестник анестезиологии и реаниматологии |
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| Online Access: | https://www.vair-journal.com/jour/article/view/669 |
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| author | M. I. Neymark D. P. Epp M. G. Nikolaeva A. P. Momot S. N. Proskurin A. N. Karkavina V. V. Kontseba C. V. Mekshun |
| author_facet | M. I. Neymark D. P. Epp M. G. Nikolaeva A. P. Momot S. N. Proskurin A. N. Karkavina V. V. Kontseba C. V. Mekshun |
| author_sort | M. I. Neymark |
| collection | DOAJ |
| description | The objective: to study the relationship between markers of imbalance in the platelet-vascular hemostasis system and lung damage and disease outcome in patients with COVID-19.Subjects and Methods: the study included 225 patients with the confirmed diagnosis of moderate, severe and extremely severe COVID-19. In all patients, lung damage was confirmed using computed and X-ray diagnostic methods. We studied the concentration of von Willebrand factor (vWF), activity of metalloproteinase ADAMTS-13, concentration of homocysteine, endothelin-1, thrombomodulin and the number of platelets and changes in these parameters on the 1st, 3–5th and 7–10th days from the admission to the intensive care unit (ICU). In deceased patients (n = 106), lung specimens were collected to assess the nature of morphological changes.Results. It was determined that by the 7–10th days with a lethal outcome of the disease, there was a statistically significant increase in the concentration of vWF by 22.2% (p = 0.0225), the vWF/ADAMTS-13 ratio by 2 times (p = 0.0408) and decrease in the platelet count by 52% (p = 0.0008) versus the initial stage of the study. In all the deceased, the morphological picture of lung tissue damage was characterized by destruction of alveolocytes, proliferation of connective tissue, cellular infiltration, plethora of capillaries, parietal erythrocyte thrombi in the lumen of capillaries, arterioles and venules, and obstructive erythrocyte thrombi in the lumen of vessels of lung microcirculation.Conclusion. The study showed that a possible cause of thrombosis in the lumen of vessels of lung microcirculation in the case of a lethal outcome of COVID-19 might be a primary imbalance in the vascular-platelet hemostasis characterized by a significant increase in the concentration of the vWF factor, the vWF/ADAMTS-13 ratio and a decrease in the number (consumption) of platelets by the 7–10th day of the disease versus the initial stage of the study. |
| format | Article |
| id | doaj-art-b2f7c76795d147d2bd29240a53fceab7 |
| institution | Kabale University |
| issn | 2078-5658 2541-8653 |
| language | Russian |
| publishDate | 2022-07-01 |
| publisher | New Terra Publishing House |
| record_format | Article |
| series | Вестник анестезиологии и реаниматологии |
| spelling | doaj-art-b2f7c76795d147d2bd29240a53fceab72025-08-20T03:42:56ZrusNew Terra Publishing HouseВестник анестезиологии и реаниматологии2078-56582541-86532022-07-01193152410.21292/2078-5658-2022-19-3-15-24522The Role of Vascular-Platelet Hemostasis Disturbances in the Genesis of Respiratory Failure in Patients with COVID-19M. I. Neymark0D. P. Epp1M. G. Nikolaeva2A. P. Momot3S. N. Proskurin4A. N. Karkavina5V. V. Kontseba6C. V. Mekshun7Altai State Medical UniversityAltai State Medical UniversityAltai State Medical UniversityAltai Branch of National Research Medical Center of HematologyN. P. Gull City Hospital no. 4N. P. Gull City Hospital no. 4City Hospital no. 5, BarnaulCity Hospital no. 5, BarnaulThe objective: to study the relationship between markers of imbalance in the platelet-vascular hemostasis system and lung damage and disease outcome in patients with COVID-19.Subjects and Methods: the study included 225 patients with the confirmed diagnosis of moderate, severe and extremely severe COVID-19. In all patients, lung damage was confirmed using computed and X-ray diagnostic methods. We studied the concentration of von Willebrand factor (vWF), activity of metalloproteinase ADAMTS-13, concentration of homocysteine, endothelin-1, thrombomodulin and the number of platelets and changes in these parameters on the 1st, 3–5th and 7–10th days from the admission to the intensive care unit (ICU). In deceased patients (n = 106), lung specimens were collected to assess the nature of morphological changes.Results. It was determined that by the 7–10th days with a lethal outcome of the disease, there was a statistically significant increase in the concentration of vWF by 22.2% (p = 0.0225), the vWF/ADAMTS-13 ratio by 2 times (p = 0.0408) and decrease in the platelet count by 52% (p = 0.0008) versus the initial stage of the study. In all the deceased, the morphological picture of lung tissue damage was characterized by destruction of alveolocytes, proliferation of connective tissue, cellular infiltration, plethora of capillaries, parietal erythrocyte thrombi in the lumen of capillaries, arterioles and venules, and obstructive erythrocyte thrombi in the lumen of vessels of lung microcirculation.Conclusion. The study showed that a possible cause of thrombosis in the lumen of vessels of lung microcirculation in the case of a lethal outcome of COVID-19 might be a primary imbalance in the vascular-platelet hemostasis characterized by a significant increase in the concentration of the vWF factor, the vWF/ADAMTS-13 ratio and a decrease in the number (consumption) of platelets by the 7–10th day of the disease versus the initial stage of the study.https://www.vair-journal.com/jour/article/view/669covid-19hemostasismorphologyadamts-13resuscitationacute respiratory failure |
| spellingShingle | M. I. Neymark D. P. Epp M. G. Nikolaeva A. P. Momot S. N. Proskurin A. N. Karkavina V. V. Kontseba C. V. Mekshun The Role of Vascular-Platelet Hemostasis Disturbances in the Genesis of Respiratory Failure in Patients with COVID-19 Вестник анестезиологии и реаниматологии covid-19 hemostasis morphology adamts-13 resuscitation acute respiratory failure |
| title | The Role of Vascular-Platelet Hemostasis Disturbances in the Genesis of Respiratory Failure in Patients with COVID-19 |
| title_full | The Role of Vascular-Platelet Hemostasis Disturbances in the Genesis of Respiratory Failure in Patients with COVID-19 |
| title_fullStr | The Role of Vascular-Platelet Hemostasis Disturbances in the Genesis of Respiratory Failure in Patients with COVID-19 |
| title_full_unstemmed | The Role of Vascular-Platelet Hemostasis Disturbances in the Genesis of Respiratory Failure in Patients with COVID-19 |
| title_short | The Role of Vascular-Platelet Hemostasis Disturbances in the Genesis of Respiratory Failure in Patients with COVID-19 |
| title_sort | role of vascular platelet hemostasis disturbances in the genesis of respiratory failure in patients with covid 19 |
| topic | covid-19 hemostasis morphology adamts-13 resuscitation acute respiratory failure |
| url | https://www.vair-journal.com/jour/article/view/669 |
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