INFLAMMATION AND HEMOSTASIS IN PATIENTS WITH SEVERE CORONAVIRUS INFECTION COVID-19

The objective of the research. To assess the prognostic value of the severity of the inflammatory response and the level of key coagulogram markers in patients with severe COVID-19.

Material of the research. We analyzed 110 case histories of patients aged 20 to 95 years with a severe form of coronavirus infection. The patients were divided into 2 groups: the first group consisted of 56 patients who recovered, the second group consisted of 54 patients whose disease had lethal outcome. The severity of inflammatory reaction was assessed by the number of leukocytes, peripheral blood neutrophils, C-reactive protein (CRP) and ferritin. Hemostasis system was assessed by blood platelet count, D-dimer level, prothrombin time and activated partial thromboplastin time (APTT). Analysis of the studied parameters was performed on the day of hospitalization and before the disease outcome.

Results. It was found that on the day of hospitalization in the group of deceased patients the number of neutrophils in the blood was significantly higher than in the group of survivors. There were no statistically significant differences in the values of CRP and ferritin. Prothrombin time and D-dimer values differed on the day of hospitalization: median D-dimer, in particular, in the deceased group was 3 times higher than in the comparison group.
Analysis of inflammatory markers at the end of the disease showed that median values of the key inflammatory markers - leukocytes, neutrophils and CRP - in the group of deceased patients were significantly higher than in the comparison group. The most notable difference was in the level of CRP, the median of which was 16.7 times higher among the deceased compared to the survivors. The mean values of hemostasis indices in the group of the deceased were the highest. The most significant difference was demonstrated by D-dimer, the median of which was 7.8 times higher in the deceased than in the comparison group (p<0.001). D-dimer level above 1000 ng/ml is associated with a high risk of mortality (p<0.05).

Conclusions. The studies showed that in the group of deceased patients a pronounced inflammatory activity of the blood remained throughout the disease, which created conditions for long-term endothelial dysfunction and implementation of the prothrombotic potential.

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