Коронавирусная инфекция (COVID-19) и синдром диссеминированного внутрисосудистого свертывания

COVID-19 – инфекционное заболевание, вызываемое бета-коронавирусом SARS-CoV-2, которое получило распространение по всему миру в 2020 г. У большинства тяжелых пациентов клиническая картина начинается с дыхательной недостаточности, в последующем прогрессирующей вплоть до полиорганной недостаточности. Самым неблагоприятным прогностическим признаком является развитие коагулопатии. На основании анализа доступных на сегодняшний день клинических данных, у 71,4 % погибших и у 0,6 % выживших имелись признаки явного ДВС-синдрома. Мониторинг содержания Д-димера, протромбинового времени, количества тромбоцитов и уровня фибриногена важен для определения показаний к назначению лечения и госпитализации у пациентов с COVID-19. При ухудшении этих параметров должна проводиться более «агрессивная» реанимационная помощь. Низкомолекулярный гепарин (НМГ) следует назначать всем пациентам с диагностированной инфекцией COVID-19 (включая некритических больных), которым требуется госпитализация, при отсутствии у данных больных противопоказаний к НМГ.

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