scholarly journals Violation of hemostasis in coronavirus infection

2021 ◽  
Vol 2 (2) ◽  
pp. 6-15
Author(s):  
Yu. V. Shatohin ◽  
I. V. Snezhko ◽  
E. V. Ryabikina

Hemostatic disorders in COVID-19 play an important role in the pathogenesis and clinical implications of the disease. The ability to identify factors and risk of developing thrombotic complications, to interpret the peripheral blood and coagulation dynamics, knowledge of diagnostic criteria possible of hemostatic disorders (DIC, sepsis-induced coagulopathy, antiphospholipid, hemophagocytic, hypercoagulation syndromes, etc.) are necessary to determine the scope of the survey, differentiated prescription of adequate therapy (including anticoagulants, blood components, plasmapheresis), which determines a greater efficiency of complex treatment and prognosis of patients with COVID-19.

2020 ◽  
Vol 101 (4) ◽  
pp. 485-488
Author(s):  
S I Safiullina ◽  
R I Litvinov

The new coronavirus infection caused by the SARS-CoV-2 virus (COVID-19) is characterized by a high frequency of thrombotic complications varying from venous or, more rarely, arterial thrombosis to the development of disseminated intravascular coagulation (DIC) and/or diffuse pulmonary vascular microthrombosis, which aggravates the disease and becomes one of the leading causes of deaths. Timely and personalized anticoagulant thromboprophylaxis with low-molecular-weight heparins may prevent a severe course of the disease and improve outcomes. This applies to outpatients, hospitalized patients and patients in the early post hospital period. In the future, to develop comprehensive and evidence-based guidelines on the management of patients with COVID-19, it is necessary to conduct comprehensive systematic studies and comparative clinical trials of prophylaxis and treatment of hemostatic disorders in patients with COVID-19.


Blood ◽  
2010 ◽  
Vol 115 (26) ◽  
pp. 5322-5328 ◽  
Author(s):  
Vanesa Caruso ◽  
Augusto Di Castelnuovo ◽  
Susana Meschengieser ◽  
Maria A. Lazzari ◽  
Giovanni de Gaetano ◽  
...  

AbstractThrombotic complications in hematologic malignancies have important clinical implications. In this meta-analysis we sought to obtain accurate estimates of the thrombotic risk in lymphoma patients. Articles were searched in electronic databases and references. Eighteen articles were identified (29 cohorts, 18 018 patients and 1149 events). Pooled incidence rates (IRs) were calculated by the use of a method based on the exact maximum likelihood binomial distribution. The global IR of thrombosis was 6.4% (95% confidence interval [CI] 6.0%-6.8%). The global IRs of venous or arterial events were 5.3% (95% CI, 5.0%-5.7%) and 1.1% (95% CI, 0.9%-1.2%), respectively. The IR of thrombosis observed in subjects with non-Hodgkin lymphoma (NHL) was 6.5% (95% CI, 6.1%-6.9%), significantly greater than that observed for patients with Hodgkin lymphoma (4.7%; 95% CI, 3.9%-5.6%). Within NHL, patients with high-grade disease had a greater risk of events (IR 8.3%; 95% CI, 7.0%-9.9%) than low-grade disease (IR 6.3%; 95% CI, 4.5%-8.9%). This meta-analysis shows that the IR of thrombosis in lymphoma patients is quite high, especially in those with NHL at an advanced stage of the disease. These results may help better defining lymphoma populations at high thrombotic risk, to whom prophylactic approaches could be preferentially applied.


Author(s):  
Maksim Leonidovich Maksimov ◽  
Albina Ayratovna Zvegintseva ◽  
Lyudmila Yurievna Kulagina ◽  
Albina Zainutdinovna Nigmedzyanova ◽  
Elvina Ramisovna Kadyseva

A review article is based on current foreign sources. The level of cytokines in the peripheral blood can be increased in many diseases, but in some cases there may be an excess of their normal concentration in tens, hundreds or more times with the development of a peculiar clinical picture, which is based on a systemic inflammatory reaction. In the literature this condition has received the figurative name «cytokine storm», which highlights an extremely violent reaction of the immune system with an unknown (often unfavorable) outcome. Close attention of the scientific world and the public to the problem of extremely high levels of cytokines in the peripheral blood (hypercytokinemia) was drawn due to the high frequency of the cytokine storm in the novel coronavirus infection.


1970 ◽  
Vol 3 (1) ◽  
pp. 16-20
Author(s):  
MA Samad Talukder ◽  
ARE Mohamed ◽  
MM Madkour ◽  
Thur Y Albaage

Experiences with management of 140 (82 males and 58 females) patients of brucellosis is presented. The diagnostic criteria was based on clinical presentation (fever, joint pains) and high titre positive brucella agglutination test. Forty-four (31.4%) patients responded in 2-9 days as evidenced by high temperature coming to normal on receipt of adequate therapy by tetracycline alone or in combination with streptomycin or other drugs. Inappropriate antibiotic in inappropriate doses was given to 23 (16.4%) patients resulting in a slow response. More than half 73 (52%) were not treated as they did not attend for follow up for result of investigation or misdiagnosis. The complications were bone and joint involvement and endocarditis. To give adequate therapy and avoid complications any patient with pyrexia in Saudi Arabia should be investigated for brucellosis.DOI: http://dx.doi.org/10.3329/bjms.v3i1.8222BJMS 1996; 3(1): 16-20


2021 ◽  
pp. 405-408
Author(s):  
Sylvia Nikolaeva Genova ◽  
Nikolaeva Genova ◽  
Mina Miroslavova Pencheva ◽  
Alexander Georgiev Ivanov

The full spectrum of coronavirus disease 2019 (COVID-19) has not been fully described yet. COVID-19 is associated with a high risk of thrombotic complications such as venous thromboembolism and cerebrovascular disease. Here, we report an autopsy case of a 55-year-old woman diagnosed with severe viral pneumonia complicated by acute cerebral infarction and venous and arterial thrombosis in different organs. The patient died due to severe acute respiratory syndrome coronavirus 2. Macroscopically and histologically, in addition to viral pneumonia and diffuse hemorrhages, fibrin clots were found in arteries and venous vessels of medium and large size in the brain, lungs, and pancreas. Propagation of cerebrovascular thrombosis has led to extensive cerebral infarction. The dating of this infarction, according to the macroscopical findings and the histological changes, was between 24 and 48 h before death. This case confirms the hypothesis on the risk of generalized arterial and venous thromboses in coronavirus infection.


Author(s):  
O. Y. Mishcheniuk ◽  
O. M. Kostiukevych ◽  
L. K. Benkovska ◽  
A. N. Kravchenko

Introduction. In addition to the "Classical" Risk Factors (RF) for Arterial and Venous Thrombosis, some authors, as triggers for the development of the latter, refer to reactive changes in Peripheral Blood (PB) counts and markers of Hereditary Thrombophilia. The results of most studies indicate that the "Classical" Risk Factors (RF) for Vascular Thrombotic Episodes are strong triggers of their development, the presence of which eliminates the Pro-thrombogenic potential of carrier of the Hereditary Thrombophilia and reactive changes in Peripheral Blood (PB) (RChPB). However, to date, there is no data regarding the assessment of contribution of the Leiden Mutation in the cohort with both reactive changes in Peripheral Blood (PB) and Risk Factors (RF) for Thrombotic Complications (ThC). Results. In patients with reactive changes in the Peripheral Blood (PB), the Leiden Mutation occurs in 5,92% of cases (9 carriers). In individuals with Thrombotic Complications (ThC), the Allele G1691A of the Proaccelerin Gene is determined more often than in a cohort without them (5 out of 31 vs 4 out of 121; p=0,030). In the general cohort of individuals with reactive changes in Peripheral Blood (PB), carriage of the Leiden Mutation increased the risk of Thrombotic Complications (ThC) by 3,05 times (Relative Risk (RR) = 3,05; 95% Confidence Interval (CI) = 1,54-6,03). In patients without Risk Factors (RF) and people under 60 years of age, Thrombosis occurred more often with the Nucleotide Variant of Allele G1691A of the Gene V of Coagulation Factor than with the Allele of wild-type (3 out of 6 vs 4 out of 75; p=0,007 and 4 out of 6 vs 8 out of 107; p=0,010, respectively). The probability of developing of Thrombosis with carriage the Allele G1691A of the Proaccelerin Gene in patients with Thrombotic Complications (ThC) without Risk Factors (RF) and in younger patients was 10,57 (95% Confidence Interval (CI) = 2,60-42,87) and 16,83 times (95% Confidence Interval =3,43-82,41), respectively. The risk of Thrombotic events in people without Risk Factors (RF) younger than 60 years is 16,75 times (Relative Risk (RR) = 16,75; 95% Confidence Interval (CI) = 3,44-81,50). However, the frequency and risk of Thrombosis did not increase in individuals with Risk Factors (RF), in patients over 60 years of age or in a cohort with Risk Factors over 60 years of age. Conclusion. Carriage the Allele G1691A of the Gene V of Coagulation Factor in patients with reactive Thrombocytosis, Leukocytosis and Secondary Polycythemia increases the risk of Thrombosis primarily due to patients without Risk Factors (RF) younger than 60 years.


Author(s):  
И.Б. Симарова ◽  
С.Н. Переходов ◽  
А.Ю. Буланов

Гиперкоагуляционный характер коагулопатии, ассоциированной с новой коронавирусной инфекцией COVID-19, и высокий риск связанных с этим тромботических осложнений — хорошо известный факт на сегодняшний день. Тем не менее в литературе имеются описания и геморрагических событий у больных COVID. В обзоре приведен анализ публикаций, описывающих кровотечения при коронавирусной инфекции; общая частота их в среднем составляет 4–8%. Превалируют желудочно-кишечные кровотечения, существенную часть составляют межмышечные гематомы и кровоизлияния в кожу и слизистые. Показана предиктивная роль применения антикоагулянтов в терапевтических дозах и гипофибриногенемии. Отмечено отсутствие четкого понимания патофизиологических механизмов. Hypercoagulable character of coagulopathy associated with the novel coronavirus infection COVID-19, and the high risk of associated thrombotic complications is a well-known fact. However, there are also case reports of hemorrhagic events in COVID patients in the literature. The review summarizes the publications describing bleedings in coronavirus infection; their overall frequency is on average 4–8%. Gastrointestinal bleeding are prevalent, intermuscular hematomas and hemorrhages in the skin and mucous membranes are frequent. The predictive role of anticoagulants use in therapeutic doses and hypofibrinogenemia is shown. The absence of clear understanding of the pathophysiological mechanisms is noted.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S660-S661
Author(s):  
Jun-ichi Kawada ◽  
Yasuko Kamiya ◽  
Akihisa Sawada ◽  
Keiji Iwatsuki ◽  
Koji Izustu ◽  
...  

Abstract Background Epstein–Barr virus (EBV) is associated with T- and NK-cell lymphoproliferative disorders (EBV T/NK-LPD). For diagnosis of EBV T/NK-LPD, quantification of EBV DNA loads in peripheral blood by real-time PCR has been widely used. However, optimal blood components and cut-off values for diagnosis were not fully evaluated. Methods Fifty-nine patients with EBV T/NK-LPD including chronic active EBV infection (CAEBV), severe mosquito bite allergy, hydroa vacciniforme-like lymphoproliferative disorder (HV), and EBV- hemophagocytic lymphohistiocytosis (EBV-HLH) were enrolled. EBV DNA loads were compared among disease categories in each blood component from the same whole blood sample. The association between EBV DNA loads and disease activity were evaluated in CAEBV patients. Furthermore, the diagnostic cut-off value for EBV DNA loads in whole blood from CAEBV patients as compared with infectious mononucleosis patients was determined. Results EBV DNA loads in whole blood and peripheral blood mononuclear cells (PBMCs) were not significantly different among disease categories, whereas EBV DNA loads in plasma were significantly higher in EBV- HLH patients than in HV patients. EBV DNA loads in whole blood and PBMCs showed strong correlation (Figure 1). EBV DNA loads in plasma were significantly higher in CAEBV patients with active disease than in those with inactive disease (median: 104.5 IU/mL vs. 100.8 IU/mL, P < 0.001) (Figure 2). Diagnostic cut-off values for whole blood EBV DNA loads of CAEBV patients as compared with those of infectious mononucleosis was 104.2 ( = 15,800) IU/mL (Figure 3). Conclusion Measuring EBV DNA loads in whole blood can be considered as initial evaluation for diagnosis of EBV T/NK-LPD. EBV DNA loads in plasma are more closely related to disease activity of CAEBV than EBV DNA loads in whole blood and PBMCs. Disclosures All authors: No reported disclosures.


Sign in / Sign up

Export Citation Format

Share Document