Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciences0869-60472414-3545"Paediatrician" Publishers LLC133510.15690/vramn1335Research ArticleCOVID-19, septic shock and syndrome of disseminated intravascular coagulation syndrome. Part 1BitsadzeVictoria O.<p>MD, PhD, Professor</p>vikabits@mail.ruhttps://orcid.org/0000-0001-8404-1042KhizroevaJamilya Kh.<p>MD, PhD, Professor</p>jamatotu@gmail.comhttps://orcid.org/0000-0002-0725-9686MakatsariyaAlexander D.<p>MD, PhD, Professor</p>gemostasis@mail.ruhttps://orcid.org/0000-0001-7415-4633SlukhanchukEkaterina V.<p>MD, PhD, Assistant Professor</p>beloborodova@rambler.ruhttps://orcid.org/0000-0001-7441-2778TretyakovaMaria V.<p>MD, PhD, Assistant Professor</p>tretyakova777@yandex.ruhttps://orcid.org/0000-0002-3628-0804RizzoGiuseppe<p>MD, PhD, Professor</p>giuseppe.rizzo@uniroma2.ithttps://orcid.org/0000-0002-5525-4353GrisJean-Christophe Raymond<p>MD, PhD, Professor</p>jean.christophe.gris@chu-nimes.frhttps://orcid.org/0000-0002-9899-9910ElalamyIsmail<p>MD, PhD, Professor</p>ismail.elalamy@aphp.frhttps://orcid.org/0000-0002-9576-1368SerovVladimir N.<p>MD, PhD, Professor</p>v_serov@oparina4.ruhttps://orcid.org/0000-0003-2976-7128ShkodaAndrei S.<p>MD, PhD, the head </p>67gkb@mail.ruSamburovaNatalia V.<p>MD, PhD, Assistant Professor</p>nsamburova@bk.ruhttps://orcid.org/0000-0002-4564-8439I.M. Sechenov First Moscow State Medical University (Sechenov University)Petrovsky National Research Center of SurgeryMedical Center LLCUniversity of Roma Tor VergataUniversity MontpellierI.M. Sechenov Moscow State Medical University (Sechenov University)Medicine Sorbonne University, University Hospital TenonNational Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. KulakovL.A. Vorokhobov City Clinical Hospital Sixty-seven180620207521181281304202023042020Copyright © 2020, "Paediatrician" Publishers LLC2020<p>The pandemic of a new coronavirus infection (Coronavirus Disease 2019, COVID-19) caused by SARS-CoV-2 became a real challenge to humanity and the medical community in 2020 and raised a number of medical, social and even philosophical questions. An almost avalanche-like increase in the number of infected people in a short time, due to the high contagiousness of viral infection, allowed us to identify groups of patients with mild, moderate and severe forms of the disease. Doctors around the world are faced with an acute problem of treating a large number of patients in critical conditions caused by COVID-19. From the currently available information on clinical cases of COVID-19, it follows that COVID-19 patients in critical condition have a clinical picture of disseminated intravascular coagulation (DIC), septic shock with the development of multiple organ failure. The first part of the article discusses the pathogenesis of non-specific universal biological responses of the body in critical condition ― from the Sanarelli-Schwartzman phenomenon to the DIC, septic shock, systemic inflammatory response syndrome and the so-called neutrophil extracellular traps (NETs). The questions of cytokine storm in severe forms of systemic inflammatory response syndrome (SIRS), the role of inflammation in the activation of coagulation, and the relationship between inflammation and thrombosis are discussed. Modern ideas about the mechanisms of so-called NETosis, their role in the occurrence of immunothrombosis and inflammation-induced thrombosis in autoimmune diseases ― vasculitis, antiphospholipid syndrome, and systemic lupus erythematosus is highlighted. The article discusses the possibility of participation of ADAMTS-13 metalloproteinase in the pathogenesis of multiple organ failure in severe endotheliopathy in patients with viral septic shock.</p>COVID-19coronavirus infectionSARS-COV-2Sanarelli-Schwartzman phenomenonDIC-syndromeseptic shockSIRSADAMTS-13NETscytokine stormCOVID-19коронавирусная инфекцияSARS-COV-2феномен Санарелли−Шварцманасиндром диссеминированного внутрисосудистого свертывания кровисептический шоксиндром системного воспалительного ответаADAMTS-13NETsцитокиновый шторм[Shen C, Wang Z, Zhao F, et al. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. JAMA. 2020;e204783. doi: 10.1001/jama.2020.4783.][Alhazzani W, Møller MH, Arabi YM, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Med. 2020;1−34. doi: 10.1007/s00134-020-06022-5.][Макацария А.Д., Акиньшина С.В., Бицадзе В.О., и др. 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