3 research outputs found
Π ΠΏΡΠΈΠ½ΡΠΈΠΏΠ°Ρ ΡΠ°Π±ΠΎΡΡ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ° Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΠΈ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ°
The rapid spread of COVID-19 and the large number of cases put a significant burden on the health systems of any developed country. Specialists in natural disasters and military medicine should be involved in the provision of medical care and observance of anti-epidemic measures. In some countries, including Italy, they were involved only after the situation was dramatically worsening with many clinical units and hospitals overloaded by infected patients. To curb the spread of COVID-19, most countries declared a state of emergency, and unprecedented measures have been taken to strengthen quarantine in suspected or positive symptomatic subjects. Nevertheless, the crisis associated with the unexpectedly global scale and tragedy of the pandemic and the inconsistency of actions of both society and individuals and specialized medical services, lead to insufficient effectiveness of the measures taken in a number of regions. In the present day, it is vital for every person to change its mindset β relying on personal responsibility to comply with all recommendations of quarantine and anti-epidemic measures, and to reorganize departments and resources of medical institutions at all levels in order to withstand the spread of infection and at the same time provide all those in need with the necessary and appropriate medical care. Particular attention should be paid to the obstetric care service, given that even in normal times, the obstetric hospital is an area of increased responsibility for the life and health of mother and child and future mankind. Fulfillment of existing orders, instructions of national and regional committees, international and national protocols and clinical protocols should undoubtedly lead to a positive result, but this requires additional training of medical personnel at all levels. The purpose of this review is to propose quick key strategies for reassessing the maternity and neonatal wards/ hospitals based on the experience of health systems and organizations which faced the spread of this new coronavirus; this advice may be applied along with binding tight instructions in obstetric hospitals in order to proactively respond to a likely wave of growth in COVID-19.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. ΠΡΡΡΡΠΎΠ΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΠ΅ COVID-19 ΠΈ Π±ΠΎΠ»ΡΡΠΎΠ΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ Π·Π°Π±ΠΎΠ»Π΅Π²ΡΠΈΡ
Π½Π°ΠΊΠ»Π°Π΄ΡΠ²Π°Π΅Ρ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΡΡ Π½Π°Π³ΡΡΠ·ΠΊΡ Π½Π° ΡΠΈΡΡΠ΅ΠΌΡ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ ΡΠ°Π·Π²ΠΈΡΡΡ
Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ². Π ΡΡΠ΄Π΅ ΡΡΡΠ°Π½ ΠΊ ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΈ ΡΠΎΠ±Π»ΡΠ΄Π΅Π½ΠΈΡ ΠΏΡΠΎΡΠΈΠ²ΠΎΡΠΏΠΈΠ΄Π΅ΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΠΉ ΠΏΡΠΈΠ²Π»Π΅ΠΊΠ°ΡΡΡΡ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΡ ΠΏΠΎ ΡΡΠΈΡ
ΠΈΠΉΠ½ΡΠΌ Π±Π΅Π΄ΡΡΠ²ΠΈΡΠΌ ΠΈ Π²ΠΎΠ΅Π½Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½Π΅, ΠΎΠ΄Π½Π°ΠΊΠΎ Π² Π½Π΅ΠΊΠΎΡΠΎΡΡΡ
ΡΡΡΠ°Π½Π°Ρ
, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ Π² ΠΡΠ°Π»ΠΈΠΈ, ΠΎΠ½ΠΈ Π±ΡΠ»ΠΈ Π·Π°Π΄Π΅ΠΉΡΡΠ²ΠΎΠ²Π°Π½Ρ ΠΏΠΎΡΠ»Π΅ ΡΠΎΠ³ΠΎ, ΠΊΠ°ΠΊ ΠΌΠ½ΠΎΠ³ΠΈΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΠΎΠ΄ΡΠ°Π·Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΈ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΡ Π±ΡΠ»ΠΈ ΠΏΠ΅ΡΠ΅Π³ΡΡΠΆΠ΅Π½Ρ. ΠΠ»Ρ ΡΠ΄Π΅ΡΠΆΠΈΠ²Π°Π½ΠΈΡ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΡ COVID-19 Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²ΠΎ ΡΡΡΠ°Π½ ΠΎΠ±ΡΡΠ²ΠΈΠ»ΠΈ ΡΡΠ΅Π·Π²ΡΡΠ°ΠΉΠ½ΠΎΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠ΅, Π±ΡΠ»ΠΈ ΠΏΡΠΈΠ½ΡΡΡ Π±Π΅ΡΠΏΡΠ΅ΡΠ΅Π΄Π΅Π½ΡΠ½ΡΠ΅ ΠΌΠ΅ΡΡ ΠΏΠΎ ΡΡΠΈΠ»Π΅Π½ΠΈΡ ΠΊΠ°ΡΠ°Π½ΡΠΈΠ½Π½ΡΡ
ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΠΉ. Π’Π΅ΠΌ Π½Π΅ ΠΌΠ΅Π½Π΅Π΅ ΠΊΡΠΈΠ·ΠΈΡ, ΡΠ²ΡΠ·Π°Π½Π½ΡΠΉ Ρ Π½Π΅ΠΎΠΆΠΈΠ΄Π°Π½Π½ΠΎ Π³Π»ΠΎΠ±Π°Π»ΡΠ½ΡΠΌ ΠΌΠ°ΡΡΡΠ°Π±ΠΎΠΌ ΠΈ ΡΡΠ°Π³ΠΈΡΠ½ΠΎΡΡΡΡ ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΠΈ, ΠΈ Π½Π΅ΡΠΎΠ³Π»Π°ΡΠΎΠ²Π°Π½Π½ΠΎΡΡΡ Π΄Π΅ΠΉΡΡΠ²ΠΈΠΉ ΠΊΠ°ΠΊ ΠΎΠ±ΡΠ΅ΡΡΠ²Π° ΠΈ ΠΎΡΠ΄Π΅Π»ΡΠ½ΡΡ
Π³ΡΠ°ΠΆΠ΄Π°Π½, ΡΠ°ΠΊ ΠΈ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΡΠ»ΡΠΆΠ± ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡ ΠΊ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΠΉ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠΌΡΡ
ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΠΉ Π² ΡΡΠ΄Π΅ ΡΠ΅Π³ΠΈΠΎΠ½ΠΎΠ². ΠΡΠΎΠ±ΠΎΠ΅ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ ΡΠ»Π΅Π΄ΡΠ΅Ρ ΡΠ΄Π΅Π»ΠΈΡΡ ΡΠ»ΡΠΆΠ±Π΅ ΡΠΎΠ΄ΠΎΠ²ΡΠΏΠΎΠΌΠΎΠΆΠ΅Π½ΠΈΡ, ΡΡΠΈΡΡΠ²Π°Ρ, ΡΡΠΎ ΠΈ Π² ΡΠΏΠΎΠΊΠΎΠΉΠ½ΠΎΠ΅ Π²ΡΠ΅ΠΌΡ Π°ΠΊΡΡΠ΅ΡΡΠΊΠΈΠΉ ΡΡΠ°ΡΠΈΠΎΠ½Π°Ρ ΡΠ²Π»ΡΠ΅ΡΡΡ Π·ΠΎΠ½ΠΎΠΉ ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΠΎΠΉ ΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎΡΡΠΈ Π·Π° ΠΆΠΈΠ·Π½Ρ ΠΈ Π·Π΄ΠΎΡΠΎΠ²ΡΠ΅ ΠΌΠ°ΡΠ΅ΡΠΈ ΠΈ ΡΠ΅Π±Π΅Π½ΠΊΠ°. ΠΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΠ΅ Π΄Π΅ΠΉΡΡΠ²ΡΡΡΠΈΡ
ΠΏΡΠΈΠΊΠ°Π·ΠΎΠ², ΡΠΊΠ°Π·Π°Π½ΠΈΠΉ Π½Π°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΡ
ΠΈ ΡΠ΅Π³ΠΈΠΎΠ½Π°Π»ΡΠ½ΡΡ
ΠΊΠΎΠΌΠΈΡΠ΅ΡΠΎΠ², ΠΌΠ΅ΠΆΠ΄ΡΠ½Π°ΡΠΎΠ΄Π½ΡΡ
/Π½Π°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΡ
ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΡΠΎΠΊΠΎΠ»ΠΎΠ², Π½Π΅ΡΠΎΠΌΠ½Π΅Π½Π½ΠΎ, ΠΏΡΠΈΠ²Π΅Π΄Π΅Ρ ΠΊ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΠΌΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ, Π½ΠΎ ΡΡΠ΅Π±ΡΠ΅Ρ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ ΠΈ ΡΡΠ΅Π½ΠΈΡΠΎΠ²ΠΊΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠ³ΠΎ ΠΏΠ΅ΡΡΠΎΠ½Π°Π»Π° Π²ΡΠ΅Ρ
ΡΡΠΎΠ²Π½Π΅ΠΉ.
Π¦Π΅Π»Ρ ΠΎΠ±Π·ΠΎΡΠ° β ΠΏΡΠ΅Π΄Π»ΠΎΠΆΠΈΡΡ ΠΊΠ»ΡΡΠ΅Π²ΡΠ΅ ΡΡΡΠ°ΡΠ΅Π³ΠΈΠΈ, ΠΎΡΠ½ΠΎΠ²ΡΠ²Π°ΡΡΡ Π½Π° ΠΎΠΏΡΡΠ΅ ΡΠ΅Π³ΠΈΠΎΠ½ΠΎΠ², ΡΠ°Π½Π΅Π΅ ΡΡΠΎΠ»ΠΊΠ½ΡΠ²ΡΠΈΡ
ΡΡ Ρ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΠ΅ΠΌ Π½ΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ°, ΠΊΠΎΡΠΎΡΡΠ΅ ΠΌΠΎΠ³ΡΡ Π±ΡΡΡ Π±ΡΡΡΡΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½Ρ Π½Π°ΡΡΠ΄Ρ Ρ ΠΎΠ±ΡΠ·Π°ΡΠ΅Π»ΡΠ½ΡΠΌΠΈ ΠΊ ΠΈΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ Π΄Π΅ΠΉΡΡΠ²ΡΡΡΠΈΠΌΠΈ ΠΏΡΠΈΠΊΠ°Π·Π°ΠΌΠΈ ΠΈ ΡΠ°ΡΠΏΠΎΡΡΠΆΠ΅Π½ΠΈΡΠΌΠΈ Π² Π°ΠΊΡΡΠ΅ΡΡΠΊΠΈΡ
ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°Ρ
, ΡΡΠΎΠ±Ρ ΠΏΡΠ΅Π²Π΅Π½ΡΠΈΠ²Π½ΠΎ ΠΎΡΡΠ΅Π°Π³ΠΈΡΠΎΠ²Π°ΡΡ Π½Π° Π²Π΅ΡΠΎΡΡΠ½ΡΡ Π²ΠΎΠ»Π½Ρ ΡΠΎΡΡΠ° Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΈ Π½ΠΎΡΠΈΡΠ΅Π»ΡΡΡΠ²Π° COVID-19
COVID-19, Π½Π°ΡΡΡΠ΅Π½ΠΈΡ Π³Π΅ΠΌΠΎΡΡΠ°Π·Π° ΠΈ ΡΠΈΡΠΊ ΡΡΠΎΠΌΠ±ΠΎΡΠΈΡΠ΅ΡΠΊΠΈΡ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ
The spread of a new coronavirus infection worldwide since the end of 2019 has becomes a pandemic. Thrombotic complications are the leading cause of death in this disease. After entering the human body, the virus starts a cascade of reactions leading to the development of a cytokine storm, activation of all parts of the hemostasis and complement systems and other changes that result in disturbances in the circulation system with the development of multiple organ failures. Numerous studies have shown that a predictor of a severe course of COVID-19 is a sharp increase of D-dimer concentration in the blood and rise of some other markers of hemostasis activation. Based on the pathogenesis, the developed schemes for the prevention and treatment of COVID-19 severe complications include low molecular weight heparins (LMWH) which are also recommended for an outpatient COVID-19 patient. The prescription of low molecular weight heparin, the duration of their use and doses should be decided on the basis of a risk assessment of factors for each individual patient in combination with laboratory monitoring.Π Π°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΠ΅ Π½ΠΎΠ²ΠΎΠΉ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ ΠΏΠΎ Π²ΡΠ΅ΠΌΡ ΠΌΠΈΡΡ Ρ ΠΊΠΎΠ½ΡΠ° 2019 Π³. ΠΏΡΠ΅Π²ΡΠ°ΡΠΈΠ»ΠΎΡΡ Π² ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΡ. Π’ΡΠΎΠΌΠ±ΠΎΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡ ΡΠ²Π»ΡΡΡΡΡ Π²Π΅Π΄ΡΡΠ΅ΠΉ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΡΠΌΠ΅ΡΡΠΈ ΠΏΡΠΈ ΡΡΠΎΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΈ. ΠΠΎΡΠ»Π΅ ΠΏΠΎΠΏΠ°Π΄Π°Π½ΠΈΡ Π² ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ° Π²ΠΈΡΡΡ Π·Π°ΠΏΡΡΠΊΠ°Π΅Ρ ΠΊΠ°ΡΠΊΠ°Π΄ ΡΠ΅Π°ΠΊΡΠΈΠΉ, ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡΠΈΡ
ΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ²ΠΎΠ³ΠΎ ΡΡΠΎΡΠΌΠ°, Π°ΠΊΡΠΈΠ²Π°ΡΠΈΠΈ Π²ΡΠ΅Ρ
Π·Π²Π΅Π½ΡΠ΅Π² ΡΠΈΡΡΠ΅ΠΌΡ Π³Π΅ΠΌΠΎΡΡΠ°Π·Π° ΠΈ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΌΠ΅Π½ΡΠ°, Π΄ΡΡΠ³ΠΈΠΌ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡΠΌ, ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡΠΈΠΌ ΠΊ Π½Π°ΡΡΡΠ΅Π½ΠΈΡΠΌ Π² ΡΠΈΡΡΠ΅ΠΌΠ΅ ΠΊΡΠΎΠ²ΠΎΠΎΠ±ΡΠ°ΡΠ΅Π½ΠΈΡ Ρ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ΠΌ ΠΏΠΎΠ»ΠΈΠΎΡΠ³Π°Π½Π½ΡΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ. ΠΠ½ΠΎΠ³ΠΎΡΠΈΡΠ»Π΅Π½Π½ΡΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ, ΡΡΠΎ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠΎΠΌ ΡΡΠΆΠ΅Π»ΠΎΠ³ΠΎ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ΅Π·ΠΊΠΎΠ΅ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ D-Π΄ΠΈΠΌΠ΅ΡΠ° Π² ΠΊΡΠΎΠ²ΠΈ ΠΈ Π½Π΅ΠΊΠΎΡΠΎΡΡΡ
Π΄ΡΡΠ³ΠΈΡ
ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² Π°ΠΊΡΠΈΠ²Π°ΡΠΈΠΈ Π³Π΅ΠΌΠΎΡΡΠ°Π·Π°. ΠΡΡ
ΠΎΠ΄Ρ ΠΈΠ· ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Π°, ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π½ΡΠ΅ ΡΡ
Π΅ΠΌΡ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΡΠΆΠ΅Π»ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ COVID-19 Π²ΠΊΠ»ΡΡΠ°ΡΡ Π½ΠΈΠ·ΠΊΠΎΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΡΠ΅ Π³Π΅ΠΏΠ°ΡΠΈΠ½Ρ, ΠΊΠΎΡΠΎΡΡΠ΅ ΡΠ°ΠΊΠΆΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄ΡΡΡ Π΄Π»Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π² Π°ΠΌΠ±ΡΠ»Π°ΡΠΎΡΠ½ΡΡ
ΡΡΠ»ΠΎΠ²ΠΈΡΡ
. ΠΠ°Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ Π½ΠΈΠ·ΠΊΠΎΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΡΡ
Π³Π΅ΠΏΠ°ΡΠΈΠ½ΠΎΠ², Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΈΡ
ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΈ Π΄ΠΎΠ·Ρ Π΄ΠΎΠ»ΠΆΠ½Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡΡΡ Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° Π΄Π»Ρ ΠΊΠ°ΠΆΠ΄ΠΎΠ³ΠΎ ΠΎΡΠ΄Π΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Ρ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΠΌ ΠΌΠΎΠ½ΠΈΡΠΎΡΠΈΠ½Π³ΠΎΠΌ
COVID-19 and thrombotic microangiopathy [COVID-19 ΠΈ ΡΡΠΎΠΌΠ±ΠΎΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΌΠΈΠΊΡΠΎΠ°Π½Π³ΠΈΠΎΠΏΠ°ΡΠΈΡ]
As shown by numerous studies conducted during the pandemic, the severe course of COVID-19 is accompanied by multiple organ failure. Cytokine storm, hypercoagulation, complement hyperactivation and other arms comprise the overall picture of the pathogenesis of the severe disease course. The frequent diagnosis of multiple microvascular thrombosis in lung, heart, and kidneys, as well as the presence of platelet-fibrin thrombi there and signs of terminal organ damage, suggest a possible involvement of thrombotic microangiopathy (TMA) in the development of multiple organ failure. In this regard, it is especially important to timely diagnose TMA and start pathogenetic therapy. These measures can significantly reduce mortality due to the novel disease. Heparins and direct oral anticoagulants are the mainstay for prevention and treatment of venous thromboembolism in patients with COVID-19, but their effectiveness in the presence of TMA is questionable. It has been proven that anticoagulants use in critically ill patients with COVID-19 for prevention of large vessel thrombosis is effective, but their role in the prevention of microthrombosis is not clear. Here we review the currently available information on thrombotic microangiopathy, as well as a review of literature data describing TMA-like conditions in COVID-19, discuss potential pathophysiology of the condition development and proposed therapeutic approaches. Β© Obstetrics, Gynecology and Reproduction 2021