Diagnosis and correction of hemostasis disorders in the postcovid period

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Abstract

Objective. Optimization of diagnosis and treatment of hemostasis disorders in the post-COVID period.

Materials and methods. The study included 100 patients aged 50.5 ± 0.84 years discharged from a COVID hospital 9 months ago. The state of the hemostatic system was assessed after 6 and 9 months after discharge using coagulogram and thrombodynamics test. Depending on the results of the thrombodynamics test in the post-COVID period, patients were divided into 3 groups (A, B, C). Patients in group A (n = 35), with severe hypercoagulation, received rivaroxaban 10 mg per day or apixaban 5 mg per day, patients in group B (n = 45) with moderate hypercoagulation – sulodexide 250 LU 2 times a day, patients of group C (n = 20), with minor changes in hemostasis, did not receive medications. The control group, examined at outpatient settings, included 20 apparently healthy individuals who had not had coronavirus infection (clinically and serologically) and had not been vaccinated against COVID-19. Statistical analysis of the results was carried out in the Statistica version 10 program (StatSoft Inc., USA), using multivariate ANOVA, Kruskal–Wallis test and Spearman correlation analysis.

Results. A hypercoagulable state in the post-COVID period was recorded in 86% of patients. After 3 months in group A, the number of patients with severe hypercoagulation decreased by 2.08 times (from 73 to 35%). Sulodexide was effective in situations with moderate hypercoagulation; in group B, after taking the drug, normocoagulation was observed in 16% of cases.

Conclusion. The data obtained indicate a long-term (more than 9 months) and persistent impairment of hemostasis in the post-COVID period and allows to determine tactics for diagnosing and correcting the prothrombotic state.

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About the authors

Ivan I. Chuprov

Kuban State Medical University, Ministry of Health of Russia

Author for correspondence.
Email: chupanya95@mail.ru
ORCID iD: 0000-0001-6164-9995

Full-Time Postgraduate Student, Department of Infectious Diseases and Epidemiology

Russian Federation, Krasnodar

Vladimir N. Gorodin

Kuban State Medical University, Ministry of Health of Russia

Email: vgorodin@mail.ru
ORCID iD: 0000-0003-3062-7595

MD, Pofessor, Head, Department of Infectious Diseases and Epidemiology

Russian Federation, Krasnodar

Diana L. Moysova

Kuban State Medical University, Ministry of Health of Russia

Email: moisova.di@yandex.ru
ORCID iD: 0000-0003-3920-5997

MD, Associated Professor, Department of Infectious Diseases and Epidemiology

Russian Federation, Krasnodar

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Supplementary files

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2. Fig. 1. Frequency of patient complains 6 months after discharge from the COVID hospital

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3. Fig. 2. Simple linear correlation between TD and biochemical coagulogram parameters а - INR and D; b - fibrinogen and D; с - АРТТ and V; d - D-dimer and V.

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4. Fig. 3. Comparative analysis of TD parameters in patients а - V (DOAC); b - Tsp (DOAC); с - Vi (DOAC); d - V (sulodexide); е - CS (sulodexide); f - Tsp (sulodexide); g - V (without therapy); h - Tsp (without therapy); i - Tlag (without therapy).

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