Hemostasis abnormalities in post-COVID-19 syndrome

Background : Coronavirus disease 2019 (COVID-19) causes a spectrum of disease;some patients develop a severe proinflammatory state which can be associated with a unique coagulopathy. Initially, COVID-19 infection produces a prominent elevation of fibrinogen and D-dimer/fibrin(ogen) degradation products. This is associated with systemic hypercoagulability and frequent venous thromboembolic events. The degree of D-dimer elevation positively correlates with mortality in COVID-19 patients. Here, we review the current state of knowledge of COVID-19 and hemostasis. Aims : Aim of our study was investigation of hemostasis in patients with post-COVID-19 syndrome (PCS). Methods : Materials and methods: We studied 136 patients with PCS, 78 were men, 58 -women. Average age was 49.9 ± 4.7 years. Control group included 20 healthy people. Patients were divided into 3 groups. In the 1st group were united 20 patients with chronic respiratory diseases (CRD) and chronic cardiovascular diseases (CCVD), in second group -56 patients with different CRD, in third -60 patients with CCVD. Fibrinogen concentration (F), D-dimer, activated partial thromboplastin time (APTT), and prothrombin index (P) with INR were studied in all patients and control group by standard methods. Results : For the 1 st and 3 d groups was characteristic increased level of F, d-dimer and APTT, compared with healthy persons. In the 2 d group F level was also increased comparing with control group. P and INR was similar to control group in all 3 groups, though in 1 st and 2 d groups tendency of P diminishing was revealed. F and d-dimer level was high, but different in all groups. In the 1 st group F and d-dimer level was higher on 18.8%, than in the 3 d group and higher on 14.5%, than in 2 d one. Conclusions : Hemostasis abnormalities revealed in the patients with comorbid diseases points to high risk of thromboembolic complications and underlines the necessity of monitoring coagulation tests for appropriate treatment.