Consequences of coronavirus infection: Hemorheological disorders and possibilities for correction

Aim. To study intravascular changes in hemostasis and changes in electrical, viscoelastic parameters of erythrocytes in COVID-19 convalescents and to evaluate the effectiveness of the pharmacological composition of nicotinamide, cocarboxylase, trifosadenine, cyanocobalamin for intramuscular administ...

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Main Authors: Margarita V. Kruchinina, Andrei A. Gromov, Irina I. Logvinenko, Elina V. Kruchinina
Format: Article
Language:Russian
Published: ZAO "Consilium Medicum" 2024-12-01
Series:Consilium Medicum
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Online Access:https://consilium.orscience.ru/2075-1753/article/viewFile/642883/158853
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author Margarita V. Kruchinina
Andrei A. Gromov
Irina I. Logvinenko
Elina V. Kruchinina
author_facet Margarita V. Kruchinina
Andrei A. Gromov
Irina I. Logvinenko
Elina V. Kruchinina
author_sort Margarita V. Kruchinina
collection DOAJ
description Aim. To study intravascular changes in hemostasis and changes in electrical, viscoelastic parameters of erythrocytes in COVID-19 convalescents and to evaluate the effectiveness of the pharmacological composition of nicotinamide, cocarboxylase, trifosadenine, cyanocobalamin for intramuscular administration (Cocarnit® drug) and cytidine diphosphocholine (citicoline, Ronocit® drug) to eliminate hemorheological disorders. Materials and methods. Examined 308 patients (154 men and 154 women), average age 53.1±13.8 years, COVID-19 convalescents, within 2 to 14 months after the disease, 50 people of comparable age and gender who had not suffered COVID-19. 42 patients from the main group who had suffered coronavirus infection received complex therapy (taking the drugs Ronocit® and Cocarnit® (World Medicine Ilac San. Ve Tic. A.S., Turkey), and were re-examined after 8 weeks. The electrical, viscoelastic parameters of erythrocytes were studied by dielectrophoresis using an electro-optical cell detection system; hemostasis parameters were studied by standard methods. Results. COVID-19 convalescents revealed a marked decrease in the surface charge of erythrocytes with an increased tendency to aggregate formation, a decrease in the ability to deform against the background of high summarized viscosity and rigidity, the predominance of immature cells with reduced polarizability, high readiness for hemolysis, with a significantly altered structure of erythrocyte membranes associated with their thickening and increased ability to conduct electric current (p=0.05–0.00001). Changes in the cellular link, endothelium and leukocytes proved to be dominant in the activation of hemostasis and indicated the course of endotheliitis (p=0.00001). Combined therapy with Ronocit® and Cocarnit® drugs for 8 weeks led to an increase in the diameter of erythrocytes, the proportion of discocytes, a decrease in the proportion of deformed cells and spherocytes (p=0.00007–0.003), an increase in the amplitude of deformation of erythrocytes at high electric field frequencies (106, 5×105 Hz), membrane capacity and a decrease of summarized rigidity and viscosity (p=0.0003–0.04), a decrease in the electrical conductivity of cell membranes, an increase in the speed of movement of red blood cells to the electrodes, the magnitude of the dipole moment; there was a mixing of the crossover frequency into the low frequency range (p=0.0001–0.052). A decrease in the degree of hemolysis was revealed, to a greater extent at low frequencies of the electric field (p=0.0004–0.05), an increase in polarizability at frequencies 5×105, 105, and 5×104 Hz (p=0.005–0.05) and relative polarizability (p=0.001). The normalization of the Willebrand factor level (p=0.0001) was noted, reflecting the restoration of the integrity and function of the endothelium. Intravascular coagulation indices, estimated by the level of soluble fibrin-monomer complexes, decreased (p=0.018). Normalization of bleeding duration (p=0.012), prolongation of clotting time (p=0.001) against the background of complex therapy were established. Conclusion. The use of complex therapy with Cocarnit® and Ronocit® drugs made it possible to improve the electrical, viscoelastic parameters of erythrocytes, normalize intravascular disorders and eliminate endotheliitis in COVID-19 convalescents, creating the basis for further development of pathogenetic therapy for postcovid syndrome.
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spelling doaj-art-ed3d4a5c193049a88b835c7149b407012025-08-20T02:34:35ZrusZAO "Consilium Medicum"Consilium Medicum2075-17532542-21702024-12-01261171973210.26442/20751753.2024.11.2029654893Consequences of coronavirus infection: Hemorheological disorders and possibilities for correctionMargarita V. Kruchinina0https://orcid.org/0000-0003-0077-3823Andrei A. Gromov1https://orcid.org/0000-0001-9254-4192Irina I. Logvinenko2https://orcid.org/0000-0003-1348-0253Elina V. Kruchinina3Institute of Cytology and GeneticsInstitute of Cytology and GeneticsInstitute of Cytology and GeneticsNovosibirsk State Medical UniversityAim. To study intravascular changes in hemostasis and changes in electrical, viscoelastic parameters of erythrocytes in COVID-19 convalescents and to evaluate the effectiveness of the pharmacological composition of nicotinamide, cocarboxylase, trifosadenine, cyanocobalamin for intramuscular administration (Cocarnit® drug) and cytidine diphosphocholine (citicoline, Ronocit® drug) to eliminate hemorheological disorders. Materials and methods. Examined 308 patients (154 men and 154 women), average age 53.1±13.8 years, COVID-19 convalescents, within 2 to 14 months after the disease, 50 people of comparable age and gender who had not suffered COVID-19. 42 patients from the main group who had suffered coronavirus infection received complex therapy (taking the drugs Ronocit® and Cocarnit® (World Medicine Ilac San. Ve Tic. A.S., Turkey), and were re-examined after 8 weeks. The electrical, viscoelastic parameters of erythrocytes were studied by dielectrophoresis using an electro-optical cell detection system; hemostasis parameters were studied by standard methods. Results. COVID-19 convalescents revealed a marked decrease in the surface charge of erythrocytes with an increased tendency to aggregate formation, a decrease in the ability to deform against the background of high summarized viscosity and rigidity, the predominance of immature cells with reduced polarizability, high readiness for hemolysis, with a significantly altered structure of erythrocyte membranes associated with their thickening and increased ability to conduct electric current (p=0.05–0.00001). Changes in the cellular link, endothelium and leukocytes proved to be dominant in the activation of hemostasis and indicated the course of endotheliitis (p=0.00001). Combined therapy with Ronocit® and Cocarnit® drugs for 8 weeks led to an increase in the diameter of erythrocytes, the proportion of discocytes, a decrease in the proportion of deformed cells and spherocytes (p=0.00007–0.003), an increase in the amplitude of deformation of erythrocytes at high electric field frequencies (106, 5×105 Hz), membrane capacity and a decrease of summarized rigidity and viscosity (p=0.0003–0.04), a decrease in the electrical conductivity of cell membranes, an increase in the speed of movement of red blood cells to the electrodes, the magnitude of the dipole moment; there was a mixing of the crossover frequency into the low frequency range (p=0.0001–0.052). A decrease in the degree of hemolysis was revealed, to a greater extent at low frequencies of the electric field (p=0.0004–0.05), an increase in polarizability at frequencies 5×105, 105, and 5×104 Hz (p=0.005–0.05) and relative polarizability (p=0.001). The normalization of the Willebrand factor level (p=0.0001) was noted, reflecting the restoration of the integrity and function of the endothelium. Intravascular coagulation indices, estimated by the level of soluble fibrin-monomer complexes, decreased (p=0.018). Normalization of bleeding duration (p=0.012), prolongation of clotting time (p=0.001) against the background of complex therapy were established. Conclusion. The use of complex therapy with Cocarnit® and Ronocit® drugs made it possible to improve the electrical, viscoelastic parameters of erythrocytes, normalize intravascular disorders and eliminate endotheliitis in COVID-19 convalescents, creating the basis for further development of pathogenetic therapy for postcovid syndrome.https://consilium.orscience.ru/2075-1753/article/viewFile/642883/158853covid-19 convalescentselectricalviscoelastic parameterserythrocyteshemostasiscorrectionciticolinepharmacological composition of nicotinamidecocarboxylasetrifosadeninecyanocobalamin
spellingShingle Margarita V. Kruchinina
Andrei A. Gromov
Irina I. Logvinenko
Elina V. Kruchinina
Consequences of coronavirus infection: Hemorheological disorders and possibilities for correction
Consilium Medicum
covid-19 convalescents
electrical
viscoelastic parameters
erythrocytes
hemostasis
correction
citicoline
pharmacological composition of nicotinamide
cocarboxylase
trifosadenine
cyanocobalamin
title Consequences of coronavirus infection: Hemorheological disorders and possibilities for correction
title_full Consequences of coronavirus infection: Hemorheological disorders and possibilities for correction
title_fullStr Consequences of coronavirus infection: Hemorheological disorders and possibilities for correction
title_full_unstemmed Consequences of coronavirus infection: Hemorheological disorders and possibilities for correction
title_short Consequences of coronavirus infection: Hemorheological disorders and possibilities for correction
title_sort consequences of coronavirus infection hemorheological disorders and possibilities for correction
topic covid-19 convalescents
electrical
viscoelastic parameters
erythrocytes
hemostasis
correction
citicoline
pharmacological composition of nicotinamide
cocarboxylase
trifosadenine
cyanocobalamin
url https://consilium.orscience.ru/2075-1753/article/viewFile/642883/158853
work_keys_str_mv AT margaritavkruchinina consequencesofcoronavirusinfectionhemorheologicaldisordersandpossibilitiesforcorrection
AT andreiagromov consequencesofcoronavirusinfectionhemorheologicaldisordersandpossibilitiesforcorrection
AT irinailogvinenko consequencesofcoronavirusinfectionhemorheologicaldisordersandpossibilitiesforcorrection
AT elinavkruchinina consequencesofcoronavirusinfectionhemorheologicaldisordersandpossibilitiesforcorrection