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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">akusherstvo</journal-id><journal-title-group><journal-title xml:lang="en">Obstetrics, Gynecology and Reproduction</journal-title><trans-title-group xml:lang="ru"><trans-title>Акушерство, Гинекология и Репродукция</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2313-7347</issn><issn pub-type="epub">2500-3194</issn><publisher><publisher-name>IRBIS LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17749/2313-7347/ob.gyn.rep.2021.217</article-id><article-id custom-type="elpub" pub-id-type="custom">akusherstvo-1011</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW ARTICLES</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>НАУЧНЫЕ ОБЗОРЫ</subject></subj-group></article-categories><title-group><article-title>Macrophage activation syndrome in COVID-19</article-title><trans-title-group xml:lang="ru"><trans-title>Синдром активации макрофагов при COVID-19</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7756-8935</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Григорьева</surname><given-names>К. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Grigorieva</surname><given-names>K. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Григорьева Кристина Николаевна – ординатор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н. Ф. Филатова</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p></bio><bio xml:lang="en"><p>Kristina N. Grigoreva – MD, Medical Resident, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p></bio><email xlink:type="simple">grigkristik96@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8404-1042</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бицадзе</surname><given-names>В. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Bitsadze</surname><given-names>V. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бицадзе Виктория Омаровна – д.м.н., профессор РАН, профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н. Ф. Филатова</p><p>Scopus Author ID: 6506003478; Researcher ID: F-8409-2017</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p></bio><bio xml:lang="en"><p>Victoria O. Bitsadze – MD, Dr Sci Med, Professor of RAS, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health</p><p>Scopus Author ID: 6506003478; Researcher ID: F-8409-2017</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0725-9686</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хизроева</surname><given-names>Д. Х.</given-names></name><name name-style="western" xml:lang="en"><surname>Khizroeva</surname><given-names>J. Kh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хизроева Джамиля Хизриевна – д.м.н., профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н. Ф. Филатова</p><p>Scopus Author ID: 57194547147; Researcher ID: F-8384-2017</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p></bio><bio xml:lang="en"><p>Jamilya Kh. Khizroeva – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health</p><p>Scopus Author ID: 57194547147; Researcher ID: F-8384-2017</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3628-0804</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Третьякова</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Tretyakova</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Третьякова Мария Владимировна – к.м.н., врач акушер-гинеколог отделения гинекологии</p><p>119021 Москва, ул. Тимура Фрунзе, д. 15/1</p></bio><bio xml:lang="en"><p>Maria V. Tretyakova – MD, PhD, Obstetrician-Gynecologist, Department of Gynecology</p><p>15/1 Timura Frunze Str., Moscow 119021</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3367-9844</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Блинов</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Blinov</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Блинов Дмитрий Владиславович – к.м.н., руководитель по медицинским и научным вопросам, Институт Превентивной и Социальной Медицины; врач-невролог, Клинический Госпиталь Лапино, ГК «Мать и Дитя»</p><p>Scopus Author ID: 6701744871; Researcher ID: E-8906-2017; RSCI: 9779-8290</p><p>127006 Москва, ул. Садовая-Триумфальная, д. 4–10</p><p>143081 Московская область, Одинцовский район, Лапино, 1-е Успенское шоссе, д. 111</p></bio><bio xml:lang="en"><p>Dmitry V. Blinov – MD, PhD, MBA, Head of Medical and Scientific Affairs, Institute for Preventive and Social Medicine; Neurologist, Lapino Clinical Hospital, MD Medical Group</p><p>Scopus Author ID: 6701744871; Researcher ID: E-8906-2017; RSCI: 9779-8290</p><p>4–10 Sadovaya-Triumfalnaya Str., Moscow 127006</p><p>1st Uspenskoye Highway, 111, Moscow Region, Odintsovo District, Lapino 143081</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5888-0774</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цибизова</surname><given-names>В. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsibizova</surname><given-names>V. 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A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Пономарев Дмитрий Анатольевич – зав. филиалом № 1 – Родильный дом № 4</p><p>123423 Москва, ул. Саляма Адиля, д.2/44</p></bio><bio xml:lang="en"><p>Dmitry A. Ponomarev – Head of Maternity Hospital № 4 – Branch of Vinogradov City Clinical Hospital</p><p>2/44 Salyama Adilya Str., Moscow 123423</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9783-1796</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шкода</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Shkoda</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шкода Андрей Сергеевич – д.м.н., профессор, главный врач</p><p>123423 Москва, ул. Саляма Адиля, д.2/44</p></bio><bio xml:lang="en"><p>Andrey S. Shkoda – MD, Dr Sci Med, Professor, Chief Physician</p><p>2/44 Salyama Adilya Str., Moscow 123423</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Оруджова</surname><given-names>Э. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Orudzhova</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Оруджова Эсмира Афлатуновна – зав. центром амбулаторной медицинской помощи женской консультации, Родильный дом № 1 – филиал ГБУЗ «Городская клиническая больница № 67 имени Л. А. Ворохобова Департамента здравоохранения города Москвы»</p><p>123423 Москва, ул. Саляма Адиля, д.2/44</p></bio><bio xml:lang="en"><p>Esmira A. Orudzhova – MD, Head of Antenatal Outpatient Care Center, Maternity Hospital № 1 – Branch of Vorokhobov City Clinical Hospital № 67</p><p>2/44 Salyama Adilya Str., Moscow 123423</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8980-9783</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Грандоне</surname><given-names>Э.</given-names></name><name name-style="western" xml:lang="en"><surname>Grandone</surname><given-names>E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Грандоне Эльвира – д.м.н., профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н. Ф. Филатова ФГАОУ ВО Первый Московский государственный медицинский университет имени И. М. Сеченова Министерства здравоохранения Российской Федерации, (Сеченовский университет); профессор, руководитель отделения тромбозов и гемостаза научно-исследовательского центра «Casa Sollievo della Sofferenza»</p><p>Scopus Author ID: 7006391091; Researcher ID: M-1127-2019</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p><p>1 Viale Cappuccini, Сан-Джованни-Ротондо, Италия</p></bio><bio xml:lang="en"><p>Elvira Grandone – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health, Sechenov University; Professor, Thrombosis and Haemostasis Research Unit, Department of Medical Genetics, Ospedale "Casa Sollievo della Sofferenza", San Giovanni Rotondo (Rome, Italy)</p><p>Scopus Author ID: 7006391091; Researcher ID: M-1127-2019</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p><p> </p></bio><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5525-4353</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Риццо</surname><given-names>Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Rizzo</surname><given-names>G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Риццо Джузеппе – д.м.н., профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н. Ф. Филатова ФГАОУ ВО Первый Московский государственный медицинский университет имени И. М. Сеченова Министерства здравоохранения Российской Федерации, (Сеченовский университет); профессор, директор департамента перинатологии, Римский университет Тор Вергата, Рим, Италия</p><p>Scopus Author ID: 7102724281; Researcher ID: G-8234-2018</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p></bio><bio xml:lang="en"><p>Giuseppe Rizzo – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health, Sechenov University; Professor, Director, Division of Maternal and Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata (Rome, Italy)</p><p>Scopus Author ID: 7102724281; Researcher ID: G-8234-2018</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7415-4633</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макацария</surname><given-names>А. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Makatsariya</surname><given-names>A. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Макацария Александр Давидович – д.м.н., профессор, академик РАН, зав. кафедрой акушерства и гинекологии Клинического института детского здоровья имени Н. Ф. Филатова</p><p>Scopus Author ID: 57222220144; Researcher ID: M-5660-2016</p><p>119991 Москва, ул. Большая Пироговская, д. 2, стр. 4</p></bio><bio xml:lang="en"><p>Alexander D. Makatsariya – MD, Dr Sci Med, Academician of RAS, Professor, Head of the Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health</p><p>Scopus Author ID: 57222220144; Researcher ID: M-5660-2016</p><p>2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991</p></bio><xref ref-type="aff" rid="aff-8"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И. М. Сеченова  Министерства здравоохранения Российской Федерации (Сеченовский университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Sechenov University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ООО «Лечебный Центр»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>«Medical Center» LLC</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Институт Превентивной и Социальной Медицины; Клинический Госпиталь Лапино, ГК «Мать и Дитя»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute for Preventive and Social Medicine; Lapino Clinic Hospital, MD Medical Group</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Almazov National Medical Research Centre, Health Ministry of Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ГБУЗ «Городская клиническая больница № 67 имени Л. А. Ворохобова Департамента здравоохранения города Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Vorokhobov City Clinical Hospital № 67, Moscow Healthcare Department</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И. М. Сеченова  Министерства здравоохранения Российской Федерации (Сеченовский университет); Научно-исследовательский центр «Casa Sollievo della Sofferenza»</institution><country>Италия</country></aff><aff xml:lang="en"><institution>Sechenov University; Tor Vergata University of Rome</institution><country>Italy</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И. М. Сеченова  Министерства здравоохранения Российской Федерации (Сеченовский университет); Римский университет Тор Вергата</institution><country>Италия</country></aff><aff xml:lang="en"><institution>Sechenov University; Tor Vergata University of Rome</institution><country>Italy</country></aff></aff-alternatives><aff-alternatives id="aff-8"><aff xml:lang="ru"><institution>ФГАОУ ВО Первый Московский государственный медицинский университет имени И. М. Сеченова  Министерства здравоохранения Российской Федерации (Сеченовский университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Sechenov University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>09</day><month>07</month><year>2021</year></pub-date><volume>15</volume><issue>3</issue><fpage>313</fpage><lpage>320</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Grigorieva K.N., Bitsadze V.O., Khizroeva J.K., Tretyakova M.V., Blinov D.V., Tsibizova V.I., Ponomarev D.A., Shkoda A.S., Orudzhova E.A., Grandone E., Rizzo G., Makatsariya A.D., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Григорьева К.Н., Бицадзе В.О., Хизроева Д.Х., Третьякова М.В., Блинов Д.В., Цибизова В.И., Пономарев Д.А., Шкода А.С., Оруджова Э.А., Грандоне Э., Риццо Д., Макацария А.Д.</copyright-holder><copyright-holder xml:lang="en">Grigorieva K.N., Bitsadze V.O., Khizroeva J.K., Tretyakova M.V., Blinov D.V., Tsibizova V.I., Ponomarev D.A., Shkoda A.S., Orudzhova E.A., Grandone E., Rizzo G., Makatsariya A.D.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.gynecology.su/jour/article/view/1011">https://www.gynecology.su/jour/article/view/1011</self-uri><abstract><p>The novel coronavirus epidemic is characterized by high rates of morbidity and relatively high mortality. Laboratory test results in patients include leukopenia, an increase in liver function tests and ferritin levels reaching hundreds, and sometimes thousands of units. These data remind us about the macrophage activation syndrome (MAC). Secondary hemophagocytic lymphohistiocytosis syndrome, MAC, which pathogenesis is based on a defect in the mechanisms of T-cell cytotoxicity and decreased level of natural killer cells associated with the defect in the perforin-encoding gene as well as hyperproduction of a number of cytokines – interleukin (IL)-1â, tumor necrosis factor-á, etc. by T-lymphocytes and histiocytes, indirectly leading to the activation of macrophages and production of proinflammatory cytokines, in particular IL-6 hyperproduction. MAC is one of "hyperferritinemic syndromes". These disorders have similar clinical and laboratory manifestations, and they also respond to similar treatments, suggesting that hyperferritinemia may be involved in the overall pathogenesis and is characterized by elevated ferritin level and cytokine storm. Despite the fact that data on the immune and inflammatory status in patients with COVID-19 have only started to appear, it is already clear that hyperinflammation and coagulopathy affect the disease severity and increase the risk of death in patients infected with SARS-CoV-2. Hence, understanding the pathogenesis of the novel coronavirus infection can help in its early diagnostics and treatment.</p></abstract><trans-abstract xml:lang="ru"><p>COVID-19 – инфекционное заболевание, вызываемое бета-коронавирусом SARS-CoV-2, которое получило распространение по всему миру в 2020 г. Эпидемия нового коронавируса характеризуется высокими показателями заболеваемости и относительно высокой смертностью. В большинстве тяжелых случаев клиническая картина характеризуется не только лихорадкой, кашлем и другими конституциональными симптомами, но также гиперцитокинемией, дыхательной недостаточностью и в конечном итоге может привести к смерти. Среди лабораторных данных можно выделить лейкопению, повышение функциональных проб печени и уровень ферритина, достигающий сотен, а иногда и тысяч единиц. Совокупность этих данных напоминает нам о синдроме активации макрофагов (САМ). Синдром вторичного гемофагоцитарного лимфогистиоцитоза, САМ – это состояние, которое развивается у пациентов с инфекционными и ревматологическими заболеваниями, а также у пациентов со злокачественными новообразованиями. Основу патогенеза составляет дефект механизмов Т-клеточной цитотоксичности и снижение уровня естественных киллеров, сопряженных с дефектом в гене, кодирующем перфорин, а также гиперпродукция Т-лимфоцитами и гистиоцитами ряда цитокинов – интерлейкина (IL)-1â, фактора некроза опухоли aльфа и др., опосредованно ведущих к активации макрофагов и продукции провоспалительных цитокинов, в частности гиперпродукции IL-6. САМ входит в комплекс «гиперферритинемических синдромов», также как катастрофический антифосфолипидный синдром, болезнь Стилла и септический шок. Эти расстройства имеют сходные клинические и лабораторные проявления, и они также отвечают на аналогичные методы лечения, предполагая, что гиперферритинемия может быть вовлечена в общий патогенез. Все вышеперечисленные состояния характеризуются повышенным уровнем ферритина и цитокиновым штормом.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>синдром активации макрофагов</kwd><kwd>САМ</kwd><kwd>гиперферритинемический синдром</kwd><kwd>SARS-CoV-2</kwd></kwd-group><kwd-group xml:lang="en"><kwd>macrophage activation syndrome</kwd><kwd>MAC</kwd><kwd>hyperferritinemic syndrome</kwd><kwd>SARS-CoV-2</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Обзор выполнен при финансовой поддержке РФФИ в рамках научного проекта номер 20-24-70001 (№ ЦИТИСАААА-А-20-120091790046-5).</funding-statement><funding-statement xml:lang="en">The review was funded by RFBR project number 20-24-70001 (№ ЦИТИСАААА-А-20-120091790046-5).</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">WHO. Novel Coronavirus (2019-nCoV): situation report, 7. WHO, 2020. 5 p. 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