Abstract

Aim. In a comparative aspect, this article aimed to evaluate the effectiveness of optimized intensive care protocols for severe and extremely severe COVID-19. Methods. During the study period, 4922 patients were treated in the intensive care units of the Republican Specialized Multidisciplinary Infectious Diseases Hospital (678 in the comparison group and 4244 in the main group). The developed protocol of anticoagulant therapy was applied to all patients in the main group. Results. There was an improvement in prothrombin time (PT) from 12.0±0.4 to 13.6±0.3 sec (P < 0.05) on day 3, from 14.7±0.4 to 16.2±0.3 sec (P < 0.05) on day 10, clotting time from 3.1±0.1 to 3.3±0.1 min (P < 0.05) and from 3.7±0.1 to 4.5±0.1 min, respectively, and fibrinogen from 4.6±0.2 to 4.2±0.1 g/l (P < 0.05) and from 4.0±0.1 to 3.4±0.1 g/l (P < 0.05), a decrease in the frequency of fatal thromboembolic complications from 25.1% to 16.6% (P < 0.001). Conclusion. The introduction of optimized tactics for anticoagulant therapy in patients with severe and extremely severe COVID-19 course made it possible to accelerate the dynamics of prothrombin time, fibrinogen, and blood clotting time (BCT), which ensured a decrease in the likelihood of developing fatal thromboembolic complications in the intensive care unit.