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Hard cases of a disease of COVID-19 result in need of rehabilitation of patients, it is connected with consequences of both directly artificial ventilation of the lungs, and long stay in a motionless state on a hospital bed. In particular, dysfunction of lungs, physical disadaptation and muscle weakness, delirium and other cognitive disturbances, disturbance of deglutitory and communicative function and disturbance of mental health and also the need for psychosocial support can belong to such consequences. It is obvious that the need for rehabilitation can be increased owing to the available chronic diseases and age deterioration in health.
Considering novelty and complexity of a new koronavirusny infection, the medical and scientific community needs to find in the nearest future reliable biomarkers which indicate progressing of a koronavirusny disease (COVID-19) quickly to allocate the patients entering into group of high risk. High speed of spread of an infection causes the necessity of division of patients into risk groups according to the diagnosis for optimum distribution of the available resources.
In March, 2020 the World Health Organization (WHO) declared recognition of outbreak of a new koronavirusny infection (COVID-19) caused by a coronavirus activator of a heavy acute respiratory syndrome of SARS-CoV-2 a pandemic. Messages about cases of COVID-19 arrived from all countries and territories of the region of North and South America. WHO, PAOZ and bodies of health care take measures for control of distribution of COVID-19 and mitigation of the consequences of a pandemic worldwide. While most of patients transfers COVID-19 in a moderate or uncomplicated form, approximately about 14% of cases are connected with developing of a heavy acute respiratory infection (SARI) and can demand hospitalization and oxygen support, and in 5% of cases the direction in intensive care unit and an intensive care (ORIT) is required. According to information which arrived at the initial stage of a pandemic from China, the average duration of stay of patients with COVID-19 in ORIT was about 8 days.
Refer quantity of leukocytes, lymphocytes, neutrophils, the relation of neutrophils to lymphocytes and also quantity of thrombocytes and eosinophils to hematologic markers on which distinguish risk groups from patients with COVID-19.
In addition to rather well studied hematologic, biochemical, inflammatory and coagulative markers of a new koronavirusny infection, there are some more markers which can be perspective in definition of severe forms of this disease. We will consider them in this article.
The new koronavirusny disease found in 2019 (COVID-19) which main manifestation of severe forms is the heavy acute respiratory syndrome represents serious threat for human health. Researches of upgradeable risk factors which are potentially connected with the increased susceptibility to an infection at certain groups of the population or the worst outcomes among having this disease, are concentrated on studying of cardiovascular pathology, arterial hypertension and a diabetes mellitus. Use of the angiotensin-converting enzyme inhibitors (ACEI) and the blockers of receptors of angiotensin (BRA) is of special interest because these drugs can affect ability of a coronavirus to infect cells.
Practically at once after the beginning of studying of a new koronavirusny infection it became clear that this pathology is associated with significant changes in the system of a hemostasis. There were numerous messages about higher tendency of patients with a koronavirusny infection to trombotichesky complications given about change of indicators of a hemostasis towards hypercoagulation. In this article we will consider coagulation markers as harbingers of heavier current of COVID-19.
Since December, 2019 the koronavirusny infection (COVID-19) which is caused by a virus heavy acute respiratory sindroma2 (SARS-CoV–2) extended worldwide. The arisen pandemic became serious test for the existing system of the world health care, partly it is connected with the fact that if in treatment of more earlier found heavy acute respiratory syndrome (SARS-CoV) and a coronavirus of a Middle Eastern respiratory syndrome (MERS-CoV) doctors have an experience, really effective methods of treatment COVID-19 do not exist today.
As is well-known today, one of key factors of a pathogeny of severe forms of a koronavirusny infection, development of system inflammation is. Increase in level of markers of inflammation is the critical moment which is the cornerstone of system processes of a vasculitis and pathologies of process of a blood coagulation which cause the most part of damages of a parenchyma of vitals.
The thrombophilia and hypercoagulation at COVID-19 are rather well described, and the research conducted earlier showed that system anti-coagulation by heparin can reduce mortality when carrying out IVL at patients with COVID-19. Aspirin can make similar impact thanks to the antiagregantny and antiinflammatory properties as TsOG-1 inhibitor which reduces A2 thromboxane synthesis, aggregation of thrombocytes and a thrombogenesis. At injury of lungs of advantage of aspirin as believe, consist in reduction of aggregation of thrombocytes and neutrophils in lungs, decrease in inflammation and increase in formation of a lipoksin who restores function of cells of an endothelium of lungs. This protective influence can be used at COVID-19 when the tendency to hypercoagulation is extraordinary high and often dysfunction of endothelial cells takes place.