Indicators of hemostasis and fibrinolysis systems, clinical blood count and C-reactive protein in patients with chronic obstructive pulmonary disease after SARS-CoV-2 infection

DOI: https://doi.org/10.29296/25877305-2024-02-02
Issue: 
2
Year: 
2024

Professor R. Abdullaev(1), MD; V. Shorokhova(1), Candidate of Medical Sciences;
N. Makaryants(1), MD; O. Komissarova(1, 2), MD
1-Central Research Institute of Tuberculosis, Moscow
2-N.I. Pirogov Russian National Research Medical University, Moscow

Objective. To study in a comparative aspect the level of markers of the state of hemostasis and fibrinolysis systems, indicators of clinical blood analysis and C-reactive protein (CRP) in patients with chronic obstructive pulmonary disease (COPD) of severe and extremely severe severity, who underwent and did not undergo infection caused by SARS-CoV-2. Material and methods. A prospective cohort study of 56 patients with severe and extremely severe COPD in the acute stage. Patients were divided into 2 groups: 1st (n=28) – patients with COPD and SARS-CoV-2 infection; 2nd (n=28) – patients with COPD without SARS-CoV-2 infection. The indicators of hemostasis and fibrinolysis systems, clinical blood analysis and CRP were evaluated. Results. It has been established that in patients with severe and extremely severe COPD who have had an infection caused by SARS-CoV-2, a hypercoagulable shift is more often observed compared to patients who have not had COVID-19. This was evidenced by the most frequent shortening of activated partial thromboplastin time, prothrombin time and an increase in fibrinogen levels. The frequency of increased D-dimer levels in the group of patients who had an infection caused by SARS-CoV-2 was twice as high compared with patients who did not have an infection caused by SARS-CoV-2. A decrease in the index of the relative width of platelet distribution was observed in both groups of patients. The indicator of systemic inflammation – CRP in the compared groups did not differ significantly. Conclusion. Patients with severe and extremely severe COPD who have had COVID-19 are more likely to have a hypercoagulable shift with manifestations of intravascular coagulation compared with COPD patients who have not had COVID-19.

Keywords: 
pulmonology
infectious diseases
chronic obstructive pulmonary disease
COVID-19
SARS-COV-2
hemostasis and fibrinolysis system
C-reactive protein
erythrocyte sedimentation rate
platelet distribution width.



References: 
  1. Абдуллаев Р.Ю., Комиссарова О.Г., Рыбка М.М. и др. Клинико-лабораторные проявления и патологоанатомическая картина тяжелого течения новой коронавирусной инфекции (COVID-19) с летальным исходом. Инфекционные болезни: новости, мнения, обучение. 2022; 11 (4): 30–7 [Abdullaev R.Yu., Komissarova O.G., Rybka M.M. et al. Clinical and laboratory manifestations and pathoanatomic picture of severe course of new coronavirus infection (COVID-19) with fatal outcome. Infectious diseases: news, opinions, training. 2022; 11 (4): 30–7 (in Russ.)]. DOI: 10.33029/2305-3496-2022-11-4-30-37
  2. Временные методические рекомендации. Профилактика, диагностика и лечение новой коронавирусной инфекции. Версия 15. 2022; с. 15–6 [Temporary methodological recommendations. Prevention, diagnosis and treatment of a new coronavirus infection. Version 15. 2022; рр. 15–6 (in Russ.)]. URL: https://minzdrav.gov.ru/ministry/med_covid19
  3. Дедов Д.В. Новая коронавирусная инфекция: клинико-патогенетические аспекты, профилактика, значение витаминов и микроэлементов. Врач. 2022; 33 (2): 47–9 [Dedov D. V. New coronavirus infection: clinical and pathogenetic aspects, prevention, the importance of vitamins and trace elements. Vrach. 2022; 33 (2): 47–9 (in Russ.)]. DOI: 10.29296/25877305-2022-02-07
  4. Хроническая обструктивная болезнь легких. Российское респираторное общество (РРО). 2018; 76 с. [Chronic obstructive pulmonary disease. Russian Respiratory Society (RRS). 2018; 76 p. (in Russ.)].
  5. Щикота А.М., Погонченкова И.В., Турова Е.А. и др. Хроническая обструктивная болезнь легких и COVID-19: актуальные вопросы. Пульмонология. 2020; 30 (5): 599–608 [Shchikota A.M., Pogonchenkova I.V., Turova E.A. et al. Genetic prevention of pulmonary tuberculosis and COVID-19: topical issues. Pulmonology. 2020; 30 (5): 599–608 (in Russ.)]. DOI: 10.18093/0869-0189-2020-30-5-599-608
  6. Chronic obstructive pulmonary disease in over 16s: diagnosis and management. National Institute for Health and Care Excellence (NICE) guideline [NG115]. 2018; 77 p. Accessed July 12, 2023. URL: https://www.nice.org.uk/guidance/ng115
  7. Fumagalli C., Zocchi C., Tassetti L. et al. Factors associated with persistence of symptoms 1 year after COVID-19: a longitudinal, prospective phone-based interview follow-up cohort study. Eur J Intern Med. 2022; 97: 36–41. DOI: 10.1016/j.ejim.2021.11.018
  8. He Y., Xie M., Zhao J. et al. Clinical Characteristics and Outcomes of Patients with Severe COVID-19 and Chronic Obstructive Pulmonary Disease (COPD). Med Sci Monit. 2020; 26: e927212. DOI: 10.12659/MSM.927212
  9. Hu W., Dong M., Xiong M. et al. Clinical Courses and Outcomes of Patients with Chronic Obstructive Pulmonary Disease During the COVID-19 Epidemic in Hubei, China. Int J Chron Obstruct Pulmon Dis. 2020; 15: 2237–48. DOI: 10.2147/COPD.S265004
  10. Huang B.Z., Chen Z., Sidell M.A. et al. Asthma disease status, COPD, and COVID-19 severity in a large multiethnic population. J Allergy Clin Immunol Pract. 2021; 9 (10): 3621–3628.e2. DOI: 10.1016/j.jaip.2021.07.030
  11. Lippi G., Henry B.M. Chronic obstructive pulmonary disease is associated with severe coronavirus disease 2019 (COVID-19). Respir Med. 2020; 167: 105941. DOI: 10.1016/j.rmed.2020.105941
  12. Liu W., Tao Z.W., Wang L. et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chin Med J (Engl.). 2020; 133 (9): 1032–8. DOI: 10.1097/CM9.0000000000000775
  13. Marron R.M., Zheng M., Fernandez Romero G et al. Impact of Chronic Obstructive Pulmonary Disease and Emphysema on Outcomes of Hospitalized Patients with Coronavirus Disease 2019 Pneumonia. Chronic Obstr Pulm Dis. 2021; 8 (2): 255–68. DOI: 10.15326/jcopdf.2020.0200
  14. Meza D., Khuder B., Bailey J.I., et al. Mortality from COVID-19 in patients with COPD: a US study in the N3C Data Enclave. Int J Chron Obstruct Pulmon Dis. 2021; 16: 2323–6. DOI: 10.2147/COPD.S318000
  15. Olloquequi J. COVID-19 Susceptibility in chronic obstructive pulmonary disease. Eur J Clin Invest. 2020; 50: e13382. DOI: 10.1111/eci.13382
  16. Parohan M., Yaghoubi S., Seraji A. et al. Risk factors for mortality in patients with Coronavirus disease 2019 (COVID19) infection: a systematic review and meta-analysis of observational studies. Aging Male. 2020; 23 (5): 1416–24. DOI: 10.1080/13685538.2020.1774748
  17. Pocket Guide to COPD. Diagnosis, management, and prevention. Global Initiative for Chronic Obstructive Lung Disease (COLD), 2021; 48 p.
  18. Safiri S., Carson-Chahhoud K., Noori M. et al. Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019. BMJ. 2022; 378: e069679. DOI: 10.1136/bmj-2021-069679
  19. Singh D., Mathioudakisa A.G., Highamaet A. Chronic obstructive pulmonary disease and COVID-19: interrelationships. Curr Opin Pulm Med. 2022; 28: 76–83. DOI:10.1097/MCP.0000000000000834
  20. Tal-Singer R., Crapo J.D. COPD at the time of COVID-19: A COPD foundation perspective. Chronic Obstr Pulm Dis. 2020; 7 (2): 73–5. DOI: 10.15326/jcopdf.7.2.2020.0149
  21. WHO. Weekly epidemiological update on COVID-19. 10 August 2023; Edition 155. Accessed July 12, 2023. URL: https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19–10-august-2023
  22. World Health Organization. Global Health Estimates. 2020. Accessed July 12, 2023. URL: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
  23. Zhao Q., Meng M., Kumar R. et al. The impact of COPD and smoking history on the severity of COVID-19: A systemic review and meta-analysis. J Med Virol. 2020; 92 (10): 1915–21. DOI: 10.1002/jmv.25889