Features of the clotting system and inflammation in patients with limb threatening ischemia after surgical reconstruction against the background of COVID-19

• Gavrilenko A.V.
• Zobov K.I.

Abstract

Background. For more than two years, the COVID-19 pandemic has remained an urgent public health problem, since the new coronavirus infection complicates the course of many chronic pathologies, in particular, atherosclerosis and, accordingly, CLTL. It is noted that in patients who have had COVID-19, there is an increase in the processes of thrombosis, up to the development of systemic thrombosis. As a result, there is a need to conduct studies for detailed understanding of changes in the blood coagulation system that occur under the influence of infection in patients after surgical treatment of CLTL.

Aim. To determine the effect of COVID-19 on the blood clotting system of patients who underwent surgical revascularization of the limb.

Material and methods. A prospective analysis of 3 groups of patients who underwent limb revascularization: those who were ill with COVID-19 (n=34), vaccinated (n=26), non-ill/unvaccinated (n=54). Thromboelastogram, aggregatogram, coagulogram, C-reactive protein and D-dimer parameters were studied in all patients before surgery and on the 5th day after.

Results. In patients who had been ill with COVID-19 and vaccinated, in comparison with the group of non-ill patients, an increase in the average values of C-reactive protein was observed, as well as a change in the parameters of the coagulation system in the direction of increased coagulation.

Conclusion. The obtained indicators demonstrate an increase in systemic inflammation in patients who have been ill and vaccinated, which persists for a long time. Changes in the coagulation system require a review of the approach to the appointment of antiplatelet agents/anticoagulants in the postoperative period, taking into account the influence of coronavirus infection.

Keywords:atherosclerosis; COVID-19; clotting system; anticoagulation therapy; chronic threatening limb ischemia

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