Тромбоз, гемостаз и реология

Tromboz, Gemostaz I Reologiya
scientific and practical journal

ISSN 2078–1008 (Print); ISSN 2687-1483 (online)
2022, Original papers
2022

Acute stroke associated with novel coronavirus infection COVID‐19: 616.8-092

Original papers
Published 2023-02-22
Ekaterina N. Kabaeva
People’s Friendship University of Russia; 6 Miklukho-Maklaya Str., Moscow 117198, Russia;
ФГАОУ ВО «Российский университет дружбы народов»; Россия, 117198 Москва, ул. Миклухо-Маклая, 6;
https://orcid.org/0000-0002-7941-2010 (unauthenticated)
Petr F. Litvitskiy
Sechenov University; 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991, Russia;
ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет);Россия, 119991 Москва, ул. Большая Пироговская, 2, стр. 4;
https://orcid.org/0000-0003-0151-9114 (unauthenticated)
Oleg P. Artyukov
People’s Friendship University of Russia; 6 Miklukho-Maklaya Str., Moscow 117198, Russia; Vinogradov City Clinical Hospital, Department of Moscow Healthcare Department; 61 Vavilova Str., Moscow 117292, Russia;
ФГАОУ ВО «Российский университет дружбы народов»; Россия, 117198 Москва, ул. Миклухо-Маклая, 6; ГБУЗ «Городская клиническая больница имени В.В. Виноградова Департамента здравоохранения города Москвы»; Россия, 117292 Москва, ул. Вавилова, 61;
https://orcid.org/0000-0001-7758-4006 (unauthenticated)
Kristina A. Tushova
People’s Friendship University of Russia; 6 Miklukho-Maklaya Str., Moscow 117198, Russia;
ФГАОУ ВО «Российский университет дружбы народов»; Россия, 117198 Москва, ул. Миклухо-Маклая, 6;
https://orcid.org/0000-0002-4563-5718 (unauthenticated)
Natalia V. Nozdryukhina
People’s Friendship University of Russia; 6 Miklukho-Maklaya Str., Moscow 117198, Russia;
ФГАОУ ВО «Российский университет дружбы народов»; Россия, 117198 Москва, ул. Миклухо-Маклая, 6;
https://orcid.org/0000-0003-3032-6768 (unauthenticated)
Anton V. Ershov
Sechenov University; 2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991, Russia; Negovsky Research Institute of General Reanimatology, Federal Scientific and Clinical Center of Intensive Care Medicine and Rehabilitology; 25 bldg. 2, Petrovka Str., Moscow 107031, Russia
ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет);Россия, 119991 Москва, ул. Большая Пироговская, 2, стр. 4; Научно-исследовательский институт общей реаниматологии имени В.А. Неговского, ФГБНУ «Федеральный научно-клинический центр реаниматологии и реабилитологии»; Россия, 107031 Москва, ул. Петровка, 25, стр. 2
https://orcid.org/0000-0001-5758-8552 (unauthenticated)

Keywords

acute stroke
novel coronavirus infection COVID‐19
risk factors
  Full Text

Abstract

Summary. Background. COVID-19 is a widespread, important, and frequently fatal disease, considered a risk factor for the deve- lopment and progression of other pathologies. One of the most common associated conditions is stroke. Objective: to identify the patterns of occurrence and mechanisms of ischemic stroke (IS) development under novel coronavirus infection COVID-19. Patients/Methods. The prospective study included 80 individuals: 20 COVID-19 patients with subsequent IS development (main group); 40 COVID-19 patients without cerebrovascular accident (comparison group); 20 healthy volunteers (control group). Concen- trations of fibrinogen, antithrombin III, D-dimer, von Willebrand factor (vWF), C-reactive protein (CRP), matrix metalloproteinase-2 (MMP-2), cytokines (interleukin, IL) — IL-6, IL-8, IL-10, tumor necrosis factor-alpha (tumor necrosis factor-alpha, TNF-α) were accessed in peripheral blood. The study was carried out from November 2020 to February 2021. The primary endpoint of the study was IS development in COVID-19 patients. Results. In 70% patients of the main group a stroke developed by the end of the second week from the infection onset. The main risk factor in 12 (57%) COVID-19 patients with an unfavorable stroke course and subsequent devel- opment of multiple organ failure syndrome (MOFS) was a high comorbidity with various forms of circulatory system pathology. All 12 patients with IS and MOFS (100%) showed a statistically significant changes in many clinical and laboratory parameters by the end of the first day after admission to the hospital: they had arterial hypertension (100%), tachycardia (80%), significant increased blood levels of D-dimer (83%), vWF (75%), IL-10 (92%), TNF-α (92%), CRP (100%), MMP-2 (100%). Conclusions. COVID-19 and high comorbidity with various forms of circulatory system pathology are 2 significant risk factors for both the occurrence and adverse course of stroke and its outcomes. Arterial hypertension, increased blood levels of D-dimer, vWF, IL-10, TNF-α, CRP and MMP-2 are the early predictors of acute MOFS development in more than 75% of COVID-19 patients with stroke.

For citation: Kabaeva E.N., Litvitskiy P.F., Artyukov O.P., Tushova K.A., Nozdryukhina N.V., Ershov A.V. Acute stroke associated with novel coronavirus infection COVID-19. Tromboz, gemostaz i reologiya. 2022;(4):41–53. (In Russ.).

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