Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC155110.15690/vramn1551INFECTIOUS DISEASES: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ ИНФЕКЦИОННЫХ БОЛЕЗНЕЙResearch ArticleThe Effect of Various Types of Anticoagulant Therapy on the Reduction of Mortality in COVID-19Влияние различных видов антикоагулянтной терапии на снижение летальности при COVID-19https://orcid.org/0000-0001-7415-46337538-2966MakatsariyaAlexander D.МакацарияАлександр Давидович
Russian Federation

MD, PhD, prof., Academician of the RAS

доктор медицинских наук, академик РАН, профессор, заведующий кафедрой акушерства и гинекологии Центра здоровья детей

gemostasis@mail.ruhttps://internist.ru/lectors/detail/makatsariya-/https://orcid.org/0000-0001-7441-27787423-8944SlukhanchukEkaterina V.СлуханчукЕкатерина Викторовна
Russian Federation

MD, PhD, Assistant Professor

кандидат медицинских наук, доцент

beloborodova@rambler.ruhttps://orcid.org/0000-0001-8404-104265060034785930-0859BitsadzeVictoria O.БицадзеВиктория Омаровна
Russian Federation

MD, PhD, Professor

доктор медицинских наук, профессор

vikabits@mail.ruhttps://orcid.org/0000-0002-0725-968657194547147F-8384-20178225-4976KhizroevaJamilya K.ХизроеваДжамиля Хизриевна
Russian Federation

MD, PhD, Professor

доктор медицинских наук, профессор кафедры акушерства и гинекологии клинического института детского здоровья имени Н.Ф. Филатова

jamatotu@gmail.comhttps://orcid.org/0000-0002-3628-08041463-0065TretyakovaMaria V.ТретьяковаМария Владимировна
Russian Federation

MD, PhD, Assistant Professor

кандидат медицинских наук, доцент кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова

tretyakova777@yandex.ruhttps://orcid.org/0000-0002-9783-1796ShkodaAndrei S.ШкодаАндрей Сергеевич
Russian Federation

MD, PhD

доктор медицинских наук

a.shkoda@67gkb.ruhttps://orcid.org/0000-0002-9576-1368ElalamyIsmailЭлаламиИсмаил
France

MD, PhD, Professor

доктор медицинских наук, профессор, заведующий кафедрой гематологии медицинского Университета Сорбонны; директор Центра Тромбозов, профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова

ismail.elalamy@aphp.frhttps://orcid.org/0000-0002-0293-6385Di RenzoGian CarloДи РенцоДжанкарло
Italy

Professor, Center for Prenatal and Reproductive Medicine

профессор, центр пренатальной и репродуктивной медицины

giancarlo.direnzo@unipg.ithttps://orcid.org/0000-0002-5525-4353RizzoGiuseppeРиццоДжузеппе
Italy

MD, PhD, Professor, Maternal Fetal Medicine Department of Ospedale

доктор медицинских наук, профессор, отделение матери и плода

giuseppe.rizzo@uniroma2.ithttps://orcid.org/0000-0003-4901-46258128-1725PyatigorskayaNatalia V.ПятигорскаяНаталья Валерьевна
Russian Federation

PhD in Pharmacology, Professor

доктор фармацевтических наук, профессор, заведующая кафедрой промышленной фармации

osipova-mma@list.ruhttps://orcid.org/0000-0002-7456-2386SolopovaAntonina G.СолоповаАнтонина Григорьевна
Russian Federation

MD, PhD, Professor

доктор медицинских наук, профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф.Филатова

antoninasolopova@yandex.ruhttps://orcid.org/0000-0002-7756-8935GrigorevaKristina N.ГригорьеваКристина Николаевна
Russian Federation

ординатор кафедры акушерства и гинекологии клинического института детского здоровья имени Н.Ф. Филатова

grigkristik96@gmail.comNakaidzeInga AlexandrovnaНакаидзеИнга Александровна
Russian Federation

PhD, Student

аспирант кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова

ingulia21@yandex.ruMitryukDiana V.МитрюкДиана Викторовна
Moldova, Republic of

Assistant

ассистент департамента акушерства и гинекологии

diana.mitriuc@gmail.comI.M. Sechenov First Moscow State Medical University (Sechenov University)Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)Petrovsky National Research Center of SurgeryРоссийский научный центр хирургии им. акад. Б.В. ПетровскогоI.M. Sechenov First Moscow State Medical University (Sechenov University)Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)L.A. Vorokhobov City Clinical Hospital № 67Городская клиническая больница № 67 им. Л.А. ВорохобоваDepartment of Thrombosis Center, Tenon University Hospital, Medicine Sorbonne UniversityМедицинский университет Сорбонна, Университетский госпиталь ТенонI.M. Sechenov First Moscow State Medical University (Sechenov University)Первый Московский государственный медицинский университет имени И.М.Сеченова (Сеченовский Университет)University of PerugiaУниверситет ПеруджиCristo Re RomaРимский Университет Тор ВергатаI.M. Sechenov First Moscow State Medical UniversityПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)State Medical and Pharmaceutical University named after Nicolae TestemitanuГосударственный медицинский и фармацевтический университет им. Николае Тестемицану030920217632682782903202116072021Copyright ©; 2021, "Paediatrician" Publishers LLCCopyright ©; 2021, Издательство "Педиатръ"2021"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/about/submissionshttps://vestnikramn.spr-journal.ru/jour/article/view/1551

Coronavirus disease 2019 (COVID-19) is a viral infection that, in severe course, leads to the development of a cytokine storm, systemic inflammatory response and coagulopathy. Unlike other sepsis-associated disseminated intravascular coagulopathy, COVID-19 induced coagulopathy is realized mainly in thrombosis. Researchers around the world are currently developing adequate diagnostic, monitoring and anticoagulant therapy approaches to safely and effectively manage patients with severe COVID-19. The need to develop laboratory monitoring is due to the fact that 20% of patients have changes in hemostasis indicators, while in patients with a severe form of the disease, they are present in 100% of cases. In case of deaths from COVID-19, there is an increase in the concentration of D-dimer and fibrinogen degradation products. Thus, the severity of hemostasis disorders has an important prognostic value. Anticoagulant therapy is included in the list of all recommendations as an effective means of reducing mortality from COVID-19. The questions of the recommended groups and doses of anticoagulant drugs are still open. The approach to the choice of an anticoagulant should be based not only on risk factors, characteristics of the course of the disease, anamnesis, but also on the wishes of the patient during long-term therapy at the post-hospital stage.

Коронавирусная инфекция 2019 (COVID-19) — вирусная инфекция, при тяжелом течении приводящая к развитию цитокинового шторма, системного воспалительного ответа, коагулопатии. В отличие от других сепсис-ассоциированных состояний диссеминированного внутрисосудистого свертывания (ДВС), ковид-ассоциированная коагулопатия реализуется преимущественно в тромбозы. Исследователи во всем мире в настоящее время разрабатывают адекватные подходы к диагностике, мониторингу и антикоагулянтной терапии для безопасного и эффективного ведения пациентов с тяжелыми формами COVID-19. Необходимость разработки лабораторного мониторинга обусловлена тем, что у 20% пациентов имеются выраженные изменения показателей гемостаза, при этом у пациентов с тяжелой формой заболевания они присутствуют в 100% случаев. При летальных исходах COVID-19 отмечается выраженное повышение концентрации D-димера и продуктов деградации фибриногена. Таким образом, степень выраженности нарушений гемостаза имеет важное прогностическое значение. Антикоагулянтная терапия внесена в перечень всех рекомендаций как эффективное средство снижения летальности от COVID-19. По-прежнему открытым остаются вопросы рекомендуемых групп и доз антикоагулянтных препаратов. Подход к выбору антикоагулянта должен быть основан не только на факторах риска, особенностях течения заболевания, анамнеза, а также на пожеланиях пациента при длительной терапии на постгоспитальном этапе.

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