cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2020.5.n1132cardio-1132Research ArticleРЕДАКЦИОННАЯ СТАТЬЯEDITORIALСогласованная позиция экспертов Евразийской ассоциации терапевтов по некоторым новым механизмам патогенеза COVID-19: фокус на гемостаз, вопросы гемотрансфузии и систему транспорта газов кровиThe Agreed Experts’ Position of the Eurasian Association of Therapists on Some new Mechanisms of COVID-19 Pathways: Focus on Hemostasis, Hemotransfusion Issues and Blood gas ExchangeАрутюновГ. П.ArutyunovG. P.

д.м.н., член-корреспондент РАН, заведующий кафедрой внутренних болезней и общей физиотерапии ФГАОУ ВО РНИМУ им. Н.И. Пирогова,  Москва

MD, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Internal Medicine and General Physiotherapy, Federal State Autonomous Educational Institution of Higher Education N.I. Pirogova, Moscow

arut@ossn.ruКозиоловаН. А.KoziolovaN. A.

д.м.н., профессор,  заведующий кафедрой внутренних болезней ФГБОУ ВО Пермского ГМУ им. ак. Е.А. Вагнера, Пермь

MD, professor, head of the Department of Internal Diseases, Federal State Budgetary Educational Establishment of Higher Education Perm Medical University named after Acad. E.A. Wagner, Perm

nakoziolova@mail.ruhttps://orcid.org/0000-0002-9659-7010ТарловскаяЕ. И.TarlovskayaE. I.

MD, professor, head of the Department of Therapy and Cardiology, FSBEI HE PIMU, Nizhny Novgorod

etarlovskaya@mail.ruАрутюновА. Г.ArutyunovA. G.

д.м.н., доцент,   профессор кафедры внутренних болезней и общей физиотерапии ФГАОУ ВО РНИМУ им. Н.И. Пирогова,  Москва

MD, associate professor, professor of the Department of Internal Medicine and General Physiotherapy, Federal State Autonomous Educational Establishment of Higher Educational Institution named after N.I. Pirogova, Moscow

agarutyunov@mail.ruГригорьеваН. Ю.GrigorjevaN. Yu.

д.м.н., доцент,  заведующий  кафедрой факультетской и поликлинической терапии ФГБОУ ВО ПИМУ Минздрава России,   Нижний Новгород

MD, Associate Professor, Head of the Department of Faculty and Outpatient Therapy, FSBEI HE PIMU of the Ministry of Health of Russia, Nizhny Novgorod

grigoreva28@mail.ruhttps://orcid.org/0000-0001-7452-5625ДжунусбековаГ. А.DzhunusbekovaG. A.

MD, Professor, Head of the Department of Cardiology of the Kazakh Medical University of Postgraduate Education, Almaty, Republic of Kazakhstan

gulnara_1010@mail.ruМальчиковаС. В.MalchikovaS. V.

MD, Associate Professor, Professor, Department of Hospital Therapy, FSBEI HE Kirov State Medical University, Kirov

malchikova@list.ruhttps://orcid.org/0000-0002-9088-721XМитьковскаяН. П.MitkovskayaN. P.

MD, Professor, Head of the Department of Cardiology and Internal Medicine of the Belarusian State Medical University, Minsk, Republic of Belarus

mitkovskaya1@mail.ruОрловаЯ. А.OrlovaYa. A.

д.м.н., профессор, заведующий кафедрой терапии факультета фундаментальной медицины ФГБОУ ВО МГУ имени М. В.Ломоносова, Москва.

Md,l Sciences, Professor, Head of the Department of Therapy, Faculty of Fundamental Medicine, Moscow State University Lomonosov Moscow

5163002@bk.ruПетроваМ. М.PetrovaM. M.

MD, professor, head of the department of outpatient therapy, family medicine and healthy lifestyle with a course in Krasnoyarsk State Medical University named after professors V.F. War-Yasenetsky, Krasnoyarsk

stk99@yandex.ruРебровА. П.RebrovA. P.

д.м.н., профессор, заведующий кафедрой госпитальной терапии ФГБОУ ВО Саратовского ГМУ им. В.И. Разумовского, Саратов.

MD, Professor, Head of the Department of Hospital Therapy, Saratov State Medical University named after IN AND. Razumovsky, Saratov

aprebrov@yandex.ruhttps://orcid.org/0000-0003-2986-0525СисакянА. С.SisakyanA. S.

MD, Professor, Head of the Department of Cardiology, Faculty of General Medicine, Yerevan State Medical University, Yerevan, Republic of Armenia

hsisakian@gmail.comСкибицкийВ. В.SkibitskyV. V.

д.м.н., профессор заведующий кафедрой госпитальной терапии ФГБОУ ВО Кубанского государственного медицинского университета, Краснодар

MD, professor Head of the Department of Hospital Therapy, Federal State Budgetary Educational Institution of Higher Education Kuban State Medical University, Krasnodar

vvsdoctor@mail.ruСугралиевА. Б.SugralievA. B.

к.м.н., доцент, заведующий кафедрой внутренних болезней №1 Казахского национального медицинского университета имени С.Д. Асфендиярова, Алма-Аты, республика Казахстан

Phd, associate professor, head of the department of internal diseases No. 1 of the Kazakh National Medical University named after S.D. Asfendiyarova, Almaty, Republic of Kazakhstan

asugraliyev@gmail.comФоминИ. В.FominI. V.

д.м.н., доцент, заведующий кафедрой госпитальной терапии ФГБОУ ВО ПИМУ, Нижний Новгород

MD, Associate Professor, Head of the Department of Hospital Therapy, FSBEI HE PIMU, Nizhny Novgorod

fomin-i@yandex.ruЧесниковаА. И.ChesnikovaA. I.

д.м.н., профессор,   профессор кафедры внутренних болезней №1 ФГБОУ ВО РостГМУ,  Ростов-на-Дону

MD, professor, professor of the Department of Internal Medicine No. 1 of FSBEI HE Rostov State Medical University, Rostov-on-Don

rostov-ossn@yandex.ruШапошникИ. И.ShaposhnikI. I.

д.м.н., профессор,  заведующий  кафедрой пропедевтики внутренних болезней ФГБОУ ВО Южно-Уральский государственный медицинский университет,  Челябинск

MD, Professor, Head of the Department of Propaedeutics of Internal Diseases FSBEI HE South Ural State Medical University, Chelyabinsk

 

shaposhnik@yandex.ruФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава России, Москва, РоссияРоссияN. I. Pirogov Russian National Research Medical University, Moscow, RussiaRussian FederationФГБОУ ВО «Пермский государственный медицинский университет им. акад. Е. А. Вагнера» Минздрава России, Пермь, РоссияРоссияAcademician E. A. Vagner Perm State Medical University, Perm, RussiaRussian FederationФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава России, Нижний Новгород, РоссияРоссияPrivolzhsky Research Medical University, Nizhniy Novgorod, RussiaRussian FederationКазахский медицинский университет последипломного образования, Алма-Аты, Республика КазахстанКазахстанKazakh Medical University of Postgraduate Education, Almaty, Republic of KazakhstanKazakhstanФГБОУ ВО «Кировский государственный медицинский университет» Минздрава России, Киров, РоссияРоссияKirov State Medical University, Kirov, RussiaRussian FederationБелорусский государственный медицинский университет, Минск, Республика БеларусьБеларусьBelorussian State Medical University, Minsk, Republic of BelarusBelarusФГБОУ ВО «Московский государственный университет им. М. В. Ломоносова», Москва, РоссияРоссияM. V. Lomonosov Moscow State University, Moscow, RussiaRussian FederationФГБОУ ВО «Красноярский государственный медицинский университет им. проф. В. Ф. Войно-Ясенецкого» Минздрава России, Красноярск, РоссияРоссияV. F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, RussiaRussian FederationФГБОУ ВО «Саратовский государственный медицинский университет им. В. И. Разумовского» Минздрава России, Саратов, РоссияРоссияV. I. Razumovsky Saratov State Medical University, Saratov, RussiaRussian FederationЕреванский Государственный медицинский университет им. М. Гераци, Ереван, АрменияАрменияM. Geratsi Erevan State Medical University, Erevan, ArmeniaArmeniaФГБОУ ВО «Кубанский государственный медицинский университет», Краснодар, РоссияРоссияKuban State Medical University, Krasnodar, RussiaRussian FederationКазахский национальный медицинский университет им. С. Д. Асфендиярова, Алма-Аты, Республика КазахстанКазахстанS. D. Asfendiyarov Kazakh National Medical University, Almaty, Republic of KazakhstanKazakhstanФГБОУ ВО «Ростовский государственный медицинский университет» Минздрава России, Ростов-на-Дону, РоссияРоссияRostov State Medical University, Rostov-on-Don, RussiaRussian FederationФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава России, Челябинск, РоссияРоссияSouth Ural State Medical University, Chelyabinsk, RussiaRussian Federation202004052020605919Copyright © Kardiomag, 20202020KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/1132

В статье обсуждаются вопросы патогенеза и лечения COVID-19. Представлены современные данные о нарушениях системы гемостаза у пациентов с COVID-19 и клинические рекомендации по профилактике тромбозов и эмболий у пациентов, инфицированных SARS-CoV-2. Подробно обсуждено предположение, выдвинутое китайскими врачами, о новом звене в патогенезе COVID-19, а именно, о влиянии вируса SARS-CoV-2 на бета-цепь гемоглобина и формирование комплекса с порфирином, что приводит к вытеснению иона железа. Тем самым гемоглобин лишается возможности осуществлять транспорт кислорода, что усугубляет гипоксию и ухудшает прогноз. В статье представлены данные о правилах безопасности гемотрансфузий на фоне пандемии COVID-19.

The article discusses pathogenesis and treatment of COVID-19. The authors presented state-of-the-art insight into hemostatic disorders in patients with COVID-19 and clinical recommendations on prevention of thrombosis and thromboembolism in patients infected with SARS-CoV-2. The article discussed in detail a new hypothesis proposed by Chinese physicians about a new component in the pathogenesis of COVID-19, namely, about the effect of SARS-CoV-2 virus on the hemoglobin beta-chain and the formation of a complex with porphyrin, which results in displacement of the iron ion. Thus, hemoglobin loses the capability for transporting oxygen, which aggravates hypoxia and worsens the prognosis. The article stated rules of hemotransfusion safety in the conditions of COVID-19 pandemic.

 

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