Basanets AV, Rakhimov AZ, Ibrahimov RM, Asymbekova EU, Tugeeva EF, Buziashvili YuI. Coagulopathy in cardiac surgery in the context of the COVID-19 pandemic: A review. Consilium Medicum. 2023;25(1):58–62.
DOI: 10.26442/20751753.2023.1.202175
Коагулопатия при кардиохирургических вмешательствах в контексте пандемии COVID-19: мнение о проблеме
Басанец А.В., Рахимов А.З., Ибрагимов Р.М., Асымбекова Э.У., Тугеева Э.Ф., Бузиашвили Ю.И. Коагулопатия при кардиохирургических вмешательствах в контексте пандемии COVID-19: мнение о проблеме. Consilium Medicum. 2023;25(1):58–62. DOI: 10.26442/20751753.2023.1.202175
Basanets AV, Rakhimov AZ, Ibrahimov RM, Asymbekova EU, Tugeeva EF, Buziashvili YuI. Coagulopathy in cardiac surgery in the context of the COVID-19 pandemic: A review. Consilium Medicum. 2023;25(1):58–62.
DOI: 10.26442/20751753.2023.1.202175
Пациенты с сопутствующими сердечно-сосудистыми заболеваниями и традиционными кардиоваскулярными факторами риска (возраст, мужской пол, артериальная гипертензия, сахарный диабет и ожирение) относятся к особо уязвимой когорте, отличающейся прогрессирующим тяжелым течением COVID-19 и высокой госпитальной летальностью. Тщательные стратегии скрининга, стандартные рекомендации и протоколы на уровне центров необходимы для выявления пациентов, которые подвергаются большему риску послеоперационных осложнений и летальности. В связи с высокой актуальностью проблемы мы рассматриваем возможное влияние COVID-19 на проходимость шунтированных сосудов коронарных артерий, в основном применительно к венозным шунтам. Однако данная гипотеза нуждается в подтверждении и дальнейшем изучении в рамках клинических рандомизированных исследований.
Ключевые слова: коагулопатия, COVID-19, D-димер
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Patients with concomitant cardiovascular diseases and traditional cardiovascular risk factors (age, male gender, arterial hypertension, diabetes mellitus and obesity) belong to a particularly vulnerable cohort characterized by progressive severe COVID-19 and high hospital mortality. Thorough screening strategies, standardized guidelines, and center-level protocols are needed to identify patients who are at greater risk of postoperative complications and mortality. Therefore, in this review, we consider the possible impact of COVID-19 on the patency of bypass vessels in the coronary arteries, mainly in relation to venous shunts. However, this hypothesis needs to be confirmed and further studied in the framework of clinical randomized trials.
1. Iba T, Levy JH, Connors JM. The unique characteristics of COVID-19 coagulopathy. Crit Care. 2020;24(1):360. DOI:10.1186/s13054-020-03077-0
2. Самородов А.В., Золотухин К.Н. Профилактика COVID-19-ассоциированного нарушения гемостаза у пациента со стентированными коронарными артериями. Клинический случай. Креативная хирургия и онкология. 2020;10(2):137-42 [Samorodov AV, Zolotukhin KN. Prevention of COVID-19-associated Haemostasis Failure in Patient with Stented Coronary Arteries: a Clinical Case. Creative Surgery and Oncology. 2020;10(2):137-42 (in Russian)]. DOI:10.24060/2076-3093-2020-10-2-137-142
3. Doglietto F, Vezzoli M, Gheza F. Factors Associated with Surgical Mortality and Complications Among Patients with and Without Coronavirus Disease 2019 (COVID-19) in Italy. JAMA Surg. 2020;155(8):1-14. DOI:10.1001/jamasurg.2020.2713
4. Bansal M. Cardiovascular disease and COVID-19. Diabetes Metab Syndr. 2020;14(3):247-50. DOI:10.1016/j.dsx.2020.03.013
5. Mehra M, Desai S, Kuy S, et al. Retraction: Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19. N Engl J Med. 2020;382(26):2582. DOI:10.1056/NEJMc2021225
6. Gavriilaki E, Anyfanti P, Gavriilaki M, et al. Endothelial Dysfunction in COVID-19: Lessons Learned from Coronaviruses. Curr Hypertens Rep. 2020;22(9):63.
DOI:10.1007/s11906-020-01078-6
7. Siddiqi H, Libby P, Ridker P. COVID-19 – A vascular disease. Trends Cardiovasc Med. 2021;31(1):1-5. DOI:10.1016/j.tcm.2020.10.005
8. Pons S, Fodil S, Azoulay E, Zafrani L. The vascular endothelium: the cornerstone of organ dysfunction in severe SARS-CoV-2 infection. Crit Care. 2020;24(1):353.
DOI:10.1186/s13054-020-03062-7
9. Pourafkari L, Mirza-Aghzadeh-Attari M, Zarrintan A, Mousavi-Aghdas SA. Clinical Experience, Pathophysiology, and Considerations in the Prophylaxis and Treatment of Hypercoagulopathy of COVID-19: A Review Study. Iran J Med Sci. 2021;46(1):1-14. DOI:10.30476/ijms.2020.87233.1730
10. Ahmed S, Zimba O, Gasparyan A. Thrombosis in Coronavirus disease 2019 (COVID-19) through the prism of Virchow's triad. Clin Rheumatol. 2020;39(9):2529-43. DOI:10.1007/s10067-020-05275-1
11. Kashi M, Jacquin A, Dakhil B. Severe arterial thrombosis associated with Covid-19 infection. Thromb Res. 2020;192:75-7. DOI:10.1016/j.thromres.2020.05.025
12. Maiuolo J, Mollace R, Gliozzi M. The Contribution of Endothelial Dysfunction in Systemic Injury Subsequent to SARS-CoV-2 Infection. Int J Mol Sci. 2020;21(23):9309. DOI:10.3390/ijms21239309
13. Colling M, Kanthi Y. COVID-19-associated coagulopathy: An exploration of mechanisms. Vasc Med. 2020;25(5):471-8. DOI:10.1177/1358863X20932640
14. Zhang Y, Xiao M, Zhang S. Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19. N Engl J Med. 2020;382(17):e38. DOI:10.1056/NEJMc2007575
15. Lax S, Skok K, Zechner P. Pulmonary Arterial Thrombosis in COVID-19 With Fatal Outcome: Results from a Prospective, Single-Center, Clinicopathologic Case Series. Ann Intern Med. 2020;173(5):350-61. DOI:10.7326/M20-2566
16. Nopp S, Moik F, Jilma B, et al. Risk of venous thromboembolism in patients with COVID-19: A systematic review and meta-analysis. Res Pract Thromb Haemost. 2020;4(7):1178-91. DOI:10.1002/rth2.12439
17. Wichmann D, Sperhake J, Lütgehetmann M. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study. Ann Intern Med. 2020;173(4):268-77. DOI:10.7326/M20-2003
18. Iwasaki M, Saito J, Zhao H, et al. Inflammation Triggered by SARS-CoV-2 and ACE2 Augment Drives Multiple Organ Failure of Severe COVID-19: Molecular Mechanisms and Implications. Inflammation. 2021;44(1):13-34. DOI:10.1007/s10753-020-01337-3
19. Huertas A, Montani D, Savale L. Endothelial cell dysfunction: a major player in SARS-CoV-2 infection (COVID-19)? Eur Respir J. 2020;56(1):2001634.
DOI:10.1183/13993003.01634-2020
20. Sollini M, Ciccarelli M, Cecconi M. Vasculitis changes in COVID-19 survivors with persistent symptoms: an [18F]-FDG-PET/CT study. Eur J Nucl Med Mol Imaging. 2020;1-7. DOI:10.1007/s00259-020-05084-3
21. Fulchand S. Covid-19 and cardiovascular disease. BMJ. 2020;369:m1997. DOI:10.1136/bmj.m1997
22. Shah P, Welt F, Mahmud E. Triage Considerations for Patients Referred for Structural Heart Disease Intervention During the COVID-19 Pandemic: An ACC/SCAI Position Statement. JACC Cardiovasc Interv. 2020;13(12):1484-8. DOI:10.1016/j.jcin.2020.04.001
23. Авдеев С.Н., Адамян Л.В., Алексеева Е.И., и др. Профилактика, диагностика и лечение новой коронавирусной инфекции (2019-nCoV): Временные методические рекомендации. М., 2020. Версия 8.2020 [Avdeev SN, Adamian LV, Alekseeva EI, et al. Profilaktika, diagnostika i lecheniie novoi koronavirusnoi infektsii (2019-nCoV): Vremennyie metodicheskiie rekomendatsii. Moscow, 2020. Versiia 8.2020 (in Russian)].
24. Thachil J, Tang N, Gando S. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020;18(5):1023-6. DOI:10.1111/jth.14810
25. Topal G, Loesch A, Dashwood M. COVID-19 – Endothelial Axis and Coronary Artery Bypass Graft Patency: A Target for Therapeutic Intervention? Braz J Cardiovasc Surg. 2020;35(5):757-63. DOI:10.21470/1678-9741-2020-0303
26. Lei S, Jiang F, Su W. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine. 2020;21:100331. DOI:10.1016/j.eclinm.2020.100331
27. Jin Y, Ji W, Yang H, et al. Endothelial activation and dysfunction in COVID-19: from basic mechanisms to potential therapeutic approaches. Signal Transduct Target Ther. 2020;5(1):293. DOI:10.1038/s41392-020-00454-7
28. Liu Z, Li J, Chen D. Dynamic Interleukin-6 Level Changes as a Prognostic Indicator in Patients With COVID-19. Front Pharmacol. 2020;11:1093. DOI:10.3389/fphar.2020.01093
29. Gando S, Fujishima S, Saitoh D. The significance of disseminated intravascular coagulation on multiple organ dysfunction during the early stage of acute respiratory distress syndrome. Thromb Res. 2020;191:15-21. DOI:10.1016/j.thromres.2020.03.023
30. Li J, Liu Z, Wu G. D-Dimer as a Prognostic Indicator in Critically Ill Patients Hospitalized With COVID-19 in Leishenshan Hospital, Wuhan, China. Front Pharmacol. 2020;11:600592. DOI:10.3389/fphar.2020.600592
31. Biswas S, Thakur V, Kaur P, et al. Blood clots in COVID-19 patients: Simplifying the curious mystery. Med Hypotheses. 2021;146:110371. DOI:10.1016/j.mehy.2020.110371
32. Chen J, Wang X, Zhang S. Characteristics of Acute Pulmonary Embolism in Patients With COVID-19 Associated Pneumonia From the City of Wuhan. Clin Appl Thromb Hemost. 2020;26:1076029620936772. DOI:10.1177/1076029620936772
33. Tang N, Bai H, Chen X, et al. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18(5):1094-9. DOI:10.1111/jth.14817
34. Hayıroğlu M, Çınar T, Tekkeşin A. Fibrinogen and D-dimer variances and anticoagulation recommendations in Covid-19: current literature review. Rev Assoc Med Bras. 2020;66(6):842-8. DOI:10.1590/1806-9282.66.6.842
35. Zhou F, Yu T, Du R. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. DOI:10.1016/S0140-6736(20)30566-3
36. Ingraham N, Barakat A, Reilkoff R. Understanding the renin-angiotensin-aldosterone-SARS-CoV axis: a comprehensive review. Eur Respir J. 2020;56(1):2000912. DOI:10.1183/13993003.00912-2020
37. Varga Z, Flammer A, Steiger P. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417-8. DOI:10.1016/S0140-6736(20)30937-5
________________________________________________
1. Iba T, Levy JH, Connors JM. The unique characteristics of COVID-19 coagulopathy. Crit Care. 2020;24(1):360. DOI:10.1186/s13054-020-03077-0
2. Самородов А.В., Золотухин К.Н. Профилактика COVID-19-ассоциированного нарушения гемостаза у пациента со стентированными коронарными артериями. Клинический случай. Креативная хирургия и онкология. 2020;10(2):137-42 [Samorodov AV, Zolotukhin KN. Prevention of COVID-19-associated Haemostasis Failure in Patient with Stented Coronary Arteries: a Clinical Case. Creative Surgery and Oncology. 2020;10(2):137-42 (in Russian)]. DOI:10.24060/2076-3093-2020-10-2-137-142
3. Doglietto F, Vezzoli M, Gheza F. Factors Associated with Surgical Mortality and Complications Among Patients with and Without Coronavirus Disease 2019 (COVID-19) in Italy. JAMA Surg. 2020;155(8):1-14. DOI:10.1001/jamasurg.2020.2713
4. Bansal M. Cardiovascular disease and COVID-19. Diabetes Metab Syndr. 2020;14(3):247-50. DOI:10.1016/j.dsx.2020.03.013
5. Mehra M, Desai S, Kuy S, et al. Retraction: Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19. N Engl J Med. 2020;382(26):2582. DOI:10.1056/NEJMc2021225
6. Gavriilaki E, Anyfanti P, Gavriilaki M, et al. Endothelial Dysfunction in COVID-19: Lessons Learned from Coronaviruses. Curr Hypertens Rep. 2020;22(9):63.
DOI:10.1007/s11906-020-01078-6
7. Siddiqi H, Libby P, Ridker P. COVID-19 – A vascular disease. Trends Cardiovasc Med. 2021;31(1):1-5. DOI:10.1016/j.tcm.2020.10.005
8. Pons S, Fodil S, Azoulay E, Zafrani L. The vascular endothelium: the cornerstone of organ dysfunction in severe SARS-CoV-2 infection. Crit Care. 2020;24(1):353.
DOI:10.1186/s13054-020-03062-7
9. Pourafkari L, Mirza-Aghzadeh-Attari M, Zarrintan A, Mousavi-Aghdas SA. Clinical Experience, Pathophysiology, and Considerations in the Prophylaxis and Treatment of Hypercoagulopathy of COVID-19: A Review Study. Iran J Med Sci. 2021;46(1):1-14. DOI:10.30476/ijms.2020.87233.1730
10. Ahmed S, Zimba O, Gasparyan A. Thrombosis in Coronavirus disease 2019 (COVID-19) through the prism of Virchow's triad. Clin Rheumatol. 2020;39(9):2529-43. DOI:10.1007/s10067-020-05275-1
11. Kashi M, Jacquin A, Dakhil B. Severe arterial thrombosis associated with Covid-19 infection. Thromb Res. 2020;192:75-7. DOI:10.1016/j.thromres.2020.05.025
12. Maiuolo J, Mollace R, Gliozzi M. The Contribution of Endothelial Dysfunction in Systemic Injury Subsequent to SARS-CoV-2 Infection. Int J Mol Sci. 2020;21(23):9309. DOI:10.3390/ijms21239309
13. Colling M, Kanthi Y. COVID-19-associated coagulopathy: An exploration of mechanisms. Vasc Med. 2020;25(5):471-8. DOI:10.1177/1358863X20932640
14. Zhang Y, Xiao M, Zhang S. Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19. N Engl J Med. 2020;382(17):e38. DOI:10.1056/NEJMc2007575
15. Lax S, Skok K, Zechner P. Pulmonary Arterial Thrombosis in COVID-19 With Fatal Outcome: Results from a Prospective, Single-Center, Clinicopathologic Case Series. Ann Intern Med. 2020;173(5):350-61. DOI:10.7326/M20-2566
16. Nopp S, Moik F, Jilma B, et al. Risk of venous thromboembolism in patients with COVID-19: A systematic review and meta-analysis. Res Pract Thromb Haemost. 2020;4(7):1178-91. DOI:10.1002/rth2.12439
17. Wichmann D, Sperhake J, Lütgehetmann M. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study. Ann Intern Med. 2020;173(4):268-77. DOI:10.7326/M20-2003
18. Iwasaki M, Saito J, Zhao H, et al. Inflammation Triggered by SARS-CoV-2 and ACE2 Augment Drives Multiple Organ Failure of Severe COVID-19: Molecular Mechanisms and Implications. Inflammation. 2021;44(1):13-34. DOI:10.1007/s10753-020-01337-3
19. Huertas A, Montani D, Savale L. Endothelial cell dysfunction: a major player in SARS-CoV-2 infection (COVID-19)? Eur Respir J. 2020;56(1):2001634.
DOI:10.1183/13993003.01634-2020
20. Sollini M, Ciccarelli M, Cecconi M. Vasculitis changes in COVID-19 survivors with persistent symptoms: an [18F]-FDG-PET/CT study. Eur J Nucl Med Mol Imaging. 2020;1-7. DOI:10.1007/s00259-020-05084-3
21. Fulchand S. Covid-19 and cardiovascular disease. BMJ. 2020;369:m1997. DOI:10.1136/bmj.m1997
22. Shah P, Welt F, Mahmud E. Triage Considerations for Patients Referred for Structural Heart Disease Intervention During the COVID-19 Pandemic: An ACC/SCAI Position Statement. JACC Cardiovasc Interv. 2020;13(12):1484-8. DOI:10.1016/j.jcin.2020.04.001
23. Avdeev SN, Adamian LV, Alekseeva EI, et al. Profilaktika, diagnostika i lecheniie novoi koronavirusnoi infektsii (2019-nCoV): Vremennyie metodicheskiie rekomendatsii. Moscow, 2020. Versiia 8.2020 (in Russian).
24. Thachil J, Tang N, Gando S. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020;18(5):1023-6. DOI:10.1111/jth.14810
25. Topal G, Loesch A, Dashwood M. COVID-19 – Endothelial Axis and Coronary Artery Bypass Graft Patency: A Target for Therapeutic Intervention? Braz J Cardiovasc Surg. 2020;35(5):757-63. DOI:10.21470/1678-9741-2020-0303
26. Lei S, Jiang F, Su W. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. EClinicalMedicine. 2020;21:100331. DOI:10.1016/j.eclinm.2020.100331
27. Jin Y, Ji W, Yang H, et al. Endothelial activation and dysfunction in COVID-19: from basic mechanisms to potential therapeutic approaches. Signal Transduct Target Ther. 2020;5(1):293. DOI:10.1038/s41392-020-00454-7
28. Liu Z, Li J, Chen D. Dynamic Interleukin-6 Level Changes as a Prognostic Indicator in Patients With COVID-19. Front Pharmacol. 2020;11:1093. DOI:10.3389/fphar.2020.01093
29. Gando S, Fujishima S, Saitoh D. The significance of disseminated intravascular coagulation on multiple organ dysfunction during the early stage of acute respiratory distress syndrome. Thromb Res. 2020;191:15-21. DOI:10.1016/j.thromres.2020.03.023
30. Li J, Liu Z, Wu G. D-Dimer as a Prognostic Indicator in Critically Ill Patients Hospitalized With COVID-19 in Leishenshan Hospital, Wuhan, China. Front Pharmacol. 2020;11:600592. DOI:10.3389/fphar.2020.600592
31. Biswas S, Thakur V, Kaur P, et al. Blood clots in COVID-19 patients: Simplifying the curious mystery. Med Hypotheses. 2021;146:110371. DOI:10.1016/j.mehy.2020.110371
32. Chen J, Wang X, Zhang S. Characteristics of Acute Pulmonary Embolism in Patients With COVID-19 Associated Pneumonia From the City of Wuhan. Clin Appl Thromb Hemost. 2020;26:1076029620936772. DOI:10.1177/1076029620936772
33. Tang N, Bai H, Chen X, et al. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18(5):1094-9. DOI:10.1111/jth.14817
34. Hayıroğlu M, Çınar T, Tekkeşin A. Fibrinogen and D-dimer variances and anticoagulation recommendations in Covid-19: current literature review. Rev Assoc Med Bras. 2020;66(6):842-8. DOI:10.1590/1806-9282.66.6.842
35. Zhou F, Yu T, Du R. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. DOI:10.1016/S0140-6736(20)30566-3
36. Ingraham N, Barakat A, Reilkoff R. Understanding the renin-angiotensin-aldosterone-SARS-CoV axis: a comprehensive review. Eur Respir J. 2020;56(1):2000912. DOI:10.1183/13993003.00912-2020
37. Varga Z, Flammer A, Steiger P. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417-8. DOI:10.1016/S0140-6736(20)30937-5
ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» Минздрава России, Москва, Россия
*anna.basanets1000@gmail.com
________________________________________________
Anna V. Basanets*, Akmal Z. Rakhimov, Rustam M. Ibrahimov, Elmira U. Asymbekova, Elvina F. Tugeeva, Yuri I. Buziashvili
Bakulev National Medical Research Center of Cardiovascular Surgery, Moscow, Russia
*anna.basanets1000@gmail.com