COVID-19, septic shock and syndrome of disseminated intravascular coagulation syndrome. Part 2

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The article discusses the issues of hemostatic system disorders in patients with COVID-19. Strengthening the coagulopathy characteristic of DIC-syndrome, is a key sign of deterioration and an unfavorable prognosis in COVID-19 patients. Data obtained by Chinese colleagues demonstrates that a significantly increased level of D-dimer is one of the predictors of death. The article also highlights the preliminary recommendations of the International society of Thrombosis and Hemostasis (ISTH, 2020) to identify markers such as D-dimer, prothrombin time and platelet count as significant predictive markers in severe COVID-19 patients. The necessity of anticoagulant therapy in hospitalized patients is justified. The article discusses the features of sepsis in pregnant women. Data from a meta-analysis of 19 studies evaluating pregnancy complications and outcomes in patients with various coronavirus infections are presented. Despite the complicated course of pregnancy, there were no cases of vertical transmission of viral infection. In the pathogenesis of severe COVID-19 complications with the formation of severe acute respiratory distress syndrome, multi-organ dysfunction, super inflammation and cytokine storm play a leading role. In connection with viral sepsis, the article discusses the role of hemophagocytic lymphohistiocytosis as a hyperinflammatory syndrome characterized by fulminant and fatal hypercytokinemia with multiple organ failure, the role of hyperferritinemia in predicting the outcomes of severe sepsis. Groups of patients at high risk of death are discussed, as well as the need for anticoagulant and anti-cytokine therapy in patients with COVID-19.

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About the authors

Victoria O. Bitsadze

The First I.M. Sechenov Moscow State Medical University (Sechenov University)

Author for correspondence.
ORCID iD: 0000-0001-8404-1042
SPIN-code: 5930-0859

Russian Federation, Trubetskaya str. 8-2, 119991 Moscow

MD, PhD, Professor

Jamilya Kh. Khizroeva

The First I.M. Sechenov Moscow State Medical University (Sechenov University)

ORCID iD: 0000-0002-0725-9686
SPIN-code: 8225-4976

Russian Federation, Moscow

MD, PhD, Professor

Alexander D. Makatsariya

The First I.M. Sechenov Moscow State Medical University (Sechenov University)

ORCID iD: 0000-0001-7415-4633
SPIN-code: 7538-2966

Russian Federation, Moscow

MD, PhD, Professor

Ekaterina V. Slukhanchuk

Petrovsky National Research Center of Surgery

ORCID iD: 0000-0001-7441-2778
SPIN-code: 7423-8944

Russian Federation, Moscow

MD, PhD, Assistant Professor

Maria V. Tretyakova

Medical Center LLC

ORCID iD: 0000-0002-3628-0804

Russian Federation, Moscow

MD, PhD, Assistant Professor

Giuseppe Rizzo

The First I.M. Sechenov Moscow State Medical University (Sechenov University); University of Roma Tor Vergata

ORCID iD: 0000-0002-5525-4353

Russian Federation, Moscow; Rome

MD, PhD, Professor

Jean-Christophe Gris

The First I.M. Sechenov Moscow State Medical University (Sechenov University); University Montpellier

ORCID iD: 0000-0002-9899-9910

France, Moscow; Montpellier

MD, PhD, Professor

Ismail Elalamy

The First I.M. Sechenov Moscow State Medical University (Sechenov University); Medicine Sorbonne University, University Hospital Tenon

ORCID iD: 0000-0002-9576-1368

France, Moscow; Paris

MD, PhD, Professor

Vladimir N. Serov

National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov

ORCID iD: 0000-0003-2976-7128

Russian Federation, Moscow

MD, PhD, Professor

Andrei S. Shkoda

LA Vorokhobov City Clinical Hospital 67

ORCID iD: 0000-0002-9783-1796

Russian Federation, Moscow


Natalia V. Samburova

The First I.M. Sechenov Moscow State Medical University (Sechenov University)

ORCID iD: 0000-0002-4564-8439
SPIN-code: 9084-7676

Russian Federation, Moscow

MD, PhD, Assistant Professor


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