Hemostasis in the post-COVID period

Abstract

This review shows the current literature data on the delayed consequences of COVID-19 for the hemostasis. The pathogenesis, epidemiology, clinical manifestations, diagnostics, and possibilities of correction of hemostasis disorders are presented. In the context of declining mortality from COVID-19, the long-term multisystem consequences of the disease, which significantly affect the life quality oof convalescents are gradually becoming the main health problem of all states. The main mechanism for the occurrence of post-COVID syndrome is persistent inflammation, which is an important part of endotheliopathy. Most of the modern studies indicate a low incidence of VTE (0.8–1.6%) and arterial thrombosis (0.75%) in the post-COVID period. Laboratory data in the post-COVID period confirm endothelial dysfunction and the persisting prothrombotic phenotype of hemostasis disorder. The strategy of selective prolonged thromboprophylaxis of COVID-19 convalescents discharged from the hospital is justified, but the duration and criteria for the sufficiency of thromboprophylaxis are unknown. The tactics of endothelial protection are recognized as pathogenetically significant, but there is no reliable evidence base for the use of sulodexide in the post-COVID period. Key words: post-COVID syndrome, hemostasis, thrombosis, anticoagulants, sulodexide