akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2021.247akusherstvo-1081Research ArticleEDITORIALРЕДАКЦИОННАЯ СТАТЬЯThrombotic storm, hemostasis disorders and thromboinflammation in COVID-19Тромботический шторм, нарушения гемостаза и тромбовоспаление в условиях COVID-19https://orcid.org/0000-0001-7415-4633МакацарияА. Д.MakatsariyaA. D.

Макацария Александр Давидович – доктор медицинских наук, профессор, академик РАН, заведующий кафедрой акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4

Scopus Author ID: 57222220144

Researcher ID: M-5660-2016

 

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

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991

Scopus Author ID: 57222220144

Researcher ID: M-5660-2016

 

https://orcid.org/0000-0001-7441-2778СлуханчукЕ. В.SlukhanchukE. V.

Слуханчук Екатерина Викторовна – кандидат медицинских наук, доцент 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); врач акушер-гинеколог отделения абдоминальной хирургии и онкологии 2  ФГБНУ «Российский научный центр хирургии имени академика Б.В. Петровского»

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4;

119991 Москва, Абрикосовский пер., д. 2

Ekaterina V. Slukhanchuk – MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health; Obstetrician-Gynecologist, Department of Abdominal Surgery and Oncology 2

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991;

2 Abrikosovskiy Lane, Moscow 119991

beloborodova@rambler.ruhttps://orcid.org/0000-0001-8404-1042БицадзеВ. О.BitsadzeV. O.

Бицадзе Виктория Омаровна – доктор медицинских наук, профессор РАН, профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4

Scopus Author ID: 6506003478

Researcher ID: F-8409-2017

 

Victoria O. Bitsadze – MD, Dr Sci Med, Professor of RAS, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991

Scopus Author ID: 6506003478

Researcher ID: F-8409-2017

 

https://orcid.org/0000-0002-0725-9686ХизроеваД. Х.KhizroevaJ. Kh.

Хизроева Джамиля Хизриевна – доктор медицинских наук, профессор кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4

Scopus Author ID: 57194547147

Researcher ID: F-8384-2017

 

Jamilya Kh. Khizroeva – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991

Scopus Author ID: 57194547147

Researcher ID: F-8384-2017

 

https://orcid.org/0000-0002-3628-0804ТретьяковаМ. В.TretyakovaM. V.

Третьякова Мария Владимировна – кандидат медицинских наук, врач акушер-гинеколог отделения гинекологии

119021 Москва, ул. Тимура Фрунзе, д. 15/1

Maria V. Tretyakova – MD, PhD, Obstetrician-Gynecologist, Department of Gynecology

15/1 Timura Frunze Str., Moscow 119021

https://orcid.org/0000-0002-9783-1796ШкодаА. С.ShkodaA. S.

Шкода Андрей Сергеевич – доктор медицинских наук, профессор, главный врач

123423 Москва, ул. Саляма Адиля, д.2/44

Andrey S. Shkoda – MD, Dr Sci Med, Professor, Chief Physician

2/44 Salyama Adilya Str., Moscow 123423

https://orcid.org/0000-0002-1388-5827АкиньшинаС. В.AkinshinaS. V.

Акиньшина Светлана Владимировна – кандидат медицинских наук, врач акушер-гинеколог, гематолог

109004 Москва, ул. Земляной Вал, д. 62

Svetlana V. Akinshina – MD, PhD, Obstetrician-Gynecologist, Hematologist

62 Str. Zemlyanoi Val, Moscow 109004

https://orcid.org/0000-0002-2541-3843МакацарияН. А.MakatsariyaN. A.

Макацария Наталия Александровна – кандидат медицинских наук, доцент кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4

Researcher ID: F-8406-2017

 

Nataliya A. Makatsariya – MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children's Health

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991

Researcher ID: F-8406-2017

 

https://orcid.org/0000-0001-5888-0774ЦибизоваВ. И.TsibizovaV. I.

Цибизова Валентина Ивановна – кандидат медицинских наук, акушер-гинеколог НИЛ оперативной гинекологии Института перинатологии и педиатрии; врач отделения функциональной и ультразвуковой диагностики 

197341 Санкт-Петербург, ул. Аккуратова, д. 2

Valentina I. Tsibizova – MD, PhD, Obstetrician-Gynecologist, Research Laboratory of Operative Gynecology, Institute of Perinatology and Pediatrics; Physician, Department of Functional and Ultrasound Diagnostics

2 Akkuratova Str., Saint Petersburg 197341

https://orcid.org/0000-0002-9899-9910ГриЖ.-К.GrisJ.-C.

Гри Жан-Кристоф – доктор медицинских наук, 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 гематологии, университет Монпелье

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4;

34090 Монпелье, Rue Auguste Broussonnet, 163

Researcher ID: AAA-2923-2019

 

Jean-Christophe Gris – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health, Sechenov University

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991;

163 Rue Auguste Broussonnet, Montpellier 34090

Researcher ID: AAA-2923-2019

 

https://orcid.org/0000-0002-9576-1368ЭлаламиИ.ElalamyI.

Элалами Исмаил – доктор медицинских наук, 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 медицинского  Университета  Сорбонны; директор гематологии Центра Тромбозов, Госпиталь Тенон

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4;

75006 Париж, Улица медицинского факультета, д. 12;

75020 Париж, Китайская улица, д. 4

Scopus Author ID: 7003652413

Researcher ID: AAC-9695-2019

 

Ismail Elalamy – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health, Sechenov University; Professor, Medicine Sorbonne University, Paris, France; Director of Hematology, Department of Thrombosis Center, Hospital Tenon

163 Rue Auguste Broussonnet, Montpellier 34090;

12 Rue de l’École de Médecine, 75006 Paris;

4 Rue de la Chine, 75020 Paris

Scopus Author ID: 7003652413

Researcher ID: AAC-9695-2019

 

https://orcid.org/0000-0003-2607-9717АйЦ.AyС.

Aй Цихан – доктор медицинских наук, профессор, клиническое подразделение гематологии и гемостазиологии, медицинское  отделение  I

1010 Вена, Университетсринг, д. 1

Scopus Author ID: 55356863800

 

Cihan Ay – MD, PhD, Professor, Department of Medicine I, Clinical Division of Haematology and  Haemostaseology

Scopus Author ID: 55356863800.

1 Universitätsring, Vienna 1010, Austria

https://orcid.org/0000-0002-8980-9783ГрандонеЭ.GrandoneE.

Грандоне Эльвира – доктор медицинских наук, 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); руководитель отделения тромбозов и гемостаза исследовательского центра «Casa Sollievo della Sofferenza

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4;

Италия, 71013 Сан-Джованни-Ротондо, Viale Cappuccini, 1

Scopus Author ID: 7006391091

Researcher ID: M-1127-2019.

 

Elvira Grandone – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health, Sechenov University; Head of the Department of Thrombosis and Hemostasis, Research Center «Casa Sollievo della Sofferenza», San Giovanni Rotondo

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991;

1 Viale Cappuccini, San Giovanni Rotondo 71013

Scopus Author ID: 7006391091

Researcher ID: M-1127-2019

 

ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияSechenov UniversityRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); ФГБНУ «Российский научный центр хирургии имени академика Б.В. Петровского»РоссияSechenov University; Petrovsky National Research Centre of SurgeryRussian FederationООО «Лечебный Центр»Россия«Medical Center» LLCRussian FederationГБУЗ «Городская клиническая больница № 67 имени Л.А. Ворохобова Департамента здравоохранения города Москвы»РоссияVorokhobov City Clinical Hospital № 67, Moscow Healthcare DepartmentRussian FederationООО «Медицинский женский центр»Россия«Medical Centre for Women» LLCRussian FederationФГБУ «Национальный медицинский исследовательский центр имени В.А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research Centre, Health Ministry of Russian FederationRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); Университет МонпельеФранцияSechenov University; University of MontpellierFranceФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); Медицинский Университет Сорбонны; Госпиталь ТенонФранцияSechenov University; Medicine Sorbonne University; Hospital TenonFranceВенский университетАвстрияUniversity of ViennaAustriaФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); Исследовательский центр «Casa Sollievo della Sofferenza»ИталияSechenov University; Research Center «Casa Sollievo della Sofferenza»Italy202117092021155499514Copyright © Makatsariya A.D., Slukhanchuk E.V., Bitsadze V.O., Khizroeva J.K., Tretyakova M.V., Shkoda A.S., Akinshina S.V., Makatsariya N.A., Tsibizova V.I., Gris J., Elalamy I., Ay С., Grandone E., 20212021Макацария А.Д., Слуханчук Е.В., Бицадзе В.О., Хизроева Д.Х., Третьякова М.В., Шкода А.С., Акиньшина С.В., Макацария Н.А., Цибизова В.И., Гри Ж., Элалами И., Ай Ц., Грандоне Э.Makatsariya A.D., Slukhanchuk E.V., Bitsadze V.O., Khizroeva J.K., Tretyakova M.V., Shkoda A.S., Akinshina S.V., Makatsariya N.A., Tsibizova V.I., Gris J., Elalamy I., Ay С., Grandone E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/1081

The rate of thrombosis and disseminated intravascular coagulation (DIC) has been increasing in COVID-19 patients. Key features related to such condition include minimal or no risk of bleeding, moderate thrombocytopenia, high plasma fibrinogen as well as complement components level in the areas of thrombotic microangiopathy. The clinical picture is not typical for classic DIC. This review systematizes the pathogenetic mechanisms of hypercoagulation in sepsis and its extreme forms in patients with COVID-19. The latter consist of the thrombosis-related immune mechanisms, the complement activation, the macrophage activation syndrome, the formation of antiphospholipid antibodies, the hyperferritinemia, and the dysregulation of the renin-angiotensin system. Taking into consideration the pathogenetic mechanisms, the biomarkers had been identified related to the prognosis of the disease development. Patients with pre-existing cardiovascular disease and other risk factors, including obesity, diabetes, hypertension, and aging pose the peak risk of dying from COVID-19. We also summarize new data on platelet and endothelial dysfunction, immunothrombosis, and, as a result, thrombotic storm as essential components of COVID-19 severe features.

Число сообщений о тромбозах и диссеминированном внутрисосудистом свертывании (ДВС) у пациентов с COVID-19 растет. Ключевые особенности состояния включают отсутствие риска кровотечения, умеренную тромбоцитопению, повышенный уровень фибриногена в плазме, а также компонентов комплемента в областях тромботической микроангиопатии (ТМА). Клиническая картина не типична для классического ДВС-синдрома. В данном обзоре систематизированы патогенетические механизмы формирования гиперкоагуляции при сепсисе, а также при его крайних формах у пациентов с COVID-19. К ним относятся иммунные механизмы тромбоза, активация комплемента, синдром активации макрофагов, формирование антифосфолипидных антител, гиперферритинемия, дисрегуляция ренин-ангиотензиновой системы и другие. Учитывая патогенетические механизмы, выделены и биомаркеры, отражающие прогноз развития заболевания. Пациенты с уже существующими сердечно-сосудистыми заболеваниями и другими факторами риска, включая ожирение, сахарный диабет, гипертоническую болезнь и пожилой возраст, подвергаются наибольшей опасности смерти от COVID-19. В этом обзоре мы обобщаем новые данные, указывающие на дисфункцию тромбоцитов и эндотелия, иммунотромбоз и как результат – тромботический шторм, как на важные компоненты патологии COVID-19.

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The authors declare that there are no conflicts of interest present.