In the article, basing on the recent ideas of the coronavirus SARS-CoV-2 mechanism of action and the multi-organ failure in COVID-19, the pathogenesis concept of the disease as a systemic process is substantiated. Pathological progression in severe COVID-19 includes an excessive unregulated response of the immune system (“cytokine storm”) leading to the internal organs immunopathological damage. Taking into consideration the inherent affinity between the inflammation and hypercoagulation it is proposed to regard the COVID-19-induced coagulopathy as an uncontrolled immunothrombotic response to the SARS-CoV-2 coronavirus infection. In accordance with the multi-organ failure pathogenesis in COVID-19, the algorithms of the anticoagulants and glucocorticoids use in patients with different severity of infection in medical wards and anaesthesiology and reanimation departments are proposed. Indications and timing of the anticoagulant and hormonal therapy are determined.

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Автор(ы): V. I. Sviatlitskaya, I. N. Kozhanova, L. N. Gavrilenko, E. I. Davidovskaya, T. A. Bich, A. M. Nerovnya, V. A. Matveev, N. A. Martusevich, I. S. Romanova, V. G. Sadouskaya