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Long-term coagulation abnormalities after COVID-19

Authors: Artem’eva G.A., Kalinskaya A.I., Mal’tseva A.S., Artem’ev A.I., Rozin A.N., Lebedeva A.Yu., Vasilieva E.Yu.

Company: 1 Davydovskiy City Clinical Hospital of Moscow Department of Health, Moscow, Russian Federation
2 Department of Cardiology of Moscow State University of Medicine and Dentistry named after A.I. Evdokimov of Ministry of Health of the Russian Federation, Moscow, Russian Federation
3 InfoNet Mobil Limited Liability Company, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2021-15-3-377-388

For citation: Artem’eva G.A., Kalinskaya A.I., Mal’tseva A.S., Artem’ev A.I., Rozin A.N., Lebedeva A.Yu., Vasilieva E.Yu. Long-term coagulation abnormalities after COVID-19. Creative Cardiology. 2021; 15 (3): 377–88 (in Russ.). DOI: 10.24022/1997-3187-2021-15-3-377-388

Received / Accepted:  28.07.2021 / 25.08.2021

Keywords: COVID-19 thrombus formation fibrinolysis post-COVID-19 syndrome

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Abstract

Objective: Hypercoagulation and high incidence of thrombosis during COVID-19 is well established. However, there is a lack of data, how it changes over time. The main purpose of our study was to access different parts of hemostasis in few months after acute disease.

Material and methods. Patients discharged from our hospital were invited for follow up examination in 2,3–3,8 (group 1 – 55 pts) or 4,6–5,7 months (group 2 – 45 pts) after admission. Control group (37 healthy adults) had been collected before pandemic started. Standard coagulation tests, aggregometry, thrombodynamics and fibrinolysis results were compared between groups.

Results: D-dimer was significantly higher, and was APPT was significantly lower in group 2 compared to group 1, while fibrinogen, prothrombin levels didn’t differ. Platelet aggregation induced by ASA, ADP, TRAP, spontaneous aggregation didn’t differ significantly between groups. Thrombodynamics revealed hypocoagulation in both group 1 and group 2 compared to control: V, μm/min 27,3 (Interquartile range (IQR) 26,3; 29,4) and 28,3 (IQR 26,5; 30,1) vs. 32,6 (IQR 30,4; 35,9) respectively; all р < 0,001. Clot size and density in both group 1 and group 2 were significantly lower than in control group. Fibrinolysis appeared to be enhanced in x2 compared to control and group 1. Lysis progression, %/min was higher: 3,5 (2,5; 4,8) vs. 2,4 (1,6; 3,5) and 2,6 (2,2; 3,4) respectively, all р < 0,05. Lysis onset time in both group 1 and group 2 was significantly shorter compared to control.

Conclusion: We revealed normalization of parameters of clot formation process in 2–6 months after COVID-19, while fibrinolysis remained still enhanced. Further study is required to investigate the clinical significance of these changes.

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About Authors

  • Galina A. Artem’eva, Therapist; ORCID
  • Anna I. Kalinskaya, Associate Professor, Cand. Med. Sci., Head of Department; ORCID
  • Aleksandra S. Mal’tseva, Resident Physician; ORCID
  • Aleksandr I. Artem’ev, Leading Mathematical Analyst; ORCID
  • Aleksandr N. Rozin, Cand. Med. Sci., Head of Department; ORCID
  • Anastasiya Yu. Lebedeva, Dr. Med. Sci., Professor, Deputy Chief Physician; ORCID
  • Elena Yu. Vasilieva, Dr. Med. Sci., Professor, Head of Laboratory, Chief Physician; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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