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Marochkov А.V.1,2, Lipnitski A.L.1,2, Starovoitov A.G.3, Dazortsava V.U.1, Livinskaya V.A.4
Selection and determination of the optimal concentration of the platelet aggregation inducer in intensive therapy of patients with COVID-19 infection
1Mogilev Regional Clinical Hospital, Mogilev, Republic of Belarus
2Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
3Mogilev Regional Blood Transfusion Station, Mogilev, Republic of Belarus
4Belarusian-Russian University, Mogilev, Republic of Belarus

Vestnik VGMU. 2021;20(3):16-24.

The change in platelet function that occurs in patients during treatment for a new coronavirus infection can be determined using the platelet aggregation method.
Objectives. To determine optimal inducer of platelet aggregation and to assess its prognostic significance in intensive therapy of patients with COVID-19 infection.
Material and methods. 34 patients with new coronavirus infection were included in group 1, and 30 healthy women were included in group 2. The study of platelet aggregation was carried out by the turbidimetric method with AP2110 analyzer (SOLAR, Minsk, Republic of Belarus).
Results. The area under the aggregation curve was statistically significantly greater in patients in group 1 when using an ADP inducer at a dose of 0.3 μg/ml (69.1 (27.3; 164.4) unit in comparison with 55.3 (31.5; 68.2) units in group 2, p<0.001). When using an ADP inducer in high concentrations of 1.25 and 2.5 μg/ml and an adrenaline inducer in concentrations of 2.5 and 5 μM, the area under the curve in patients with COVID-19 infection was statistically significantly lower compared to group 2. The area under the aggregation curve according to the Hosmer-Lemeshov criterion has been found to be an independent predictor of death in the intensive care unit (Chi-square=5.074, p=0.06 for ADP 0.3 μg/ml and Chi square=15.121, p=0.057 for ADP 0.6 μg/ml).
Conclusions. A comparative analysis of platelet aggregation using inducers of ADP, adrenaline and collagen has shown that in patients with new coronavirus infection, the degree of coagulation imbalance should be determined according to the indications obtained with an ADP inducer at a dose of 0.3 and 0.6 μg/ml.
Key words: platelet aggregation, platelets, coagulation balance, hypercoagulation, new coronavirus infection, COVID-19.


1. Levin GIa, Popovicheva AN, Sosnina LN, Sheremetev IuA. Platelet aggregation and platelet size in pediatric burn disease. Gematologiia Transfuziologiia. 2019;64(4):462-70. (In Russ.)
2. Zubovskaia ET. Vilchuk KU, Kurlovich IV, Dvornikov SS, Komiak DI. Platelet aggregometry in clinical practice: posobie dlia vrachei. Minsk, RB: ProniaPlius; 2018. 69 р. (In Russ.)
3. Mirzaev KB, Andreev DA, Sychev DA. Assessment of platelet aggregation in clinical practice. Ratsion Farmakoterapiia Krdiologii. 2015;11(1):85-91. (In Russ.)
4. Escher R, Breakey N, Lämmle B. Severe COVID-19 infection associated with endothelial activation. Thromb Res. 2020 Jun;190:62. doi:
5. Iba T, Levy JH, Connors JM, Warkentin TE, Thachil J, Levi M. The unique characteristics of COVID-19 coagulopathy. Crit Care. 2020 Jun;24(1):360. doi:
6. Panigada M, Bottino N, Tagliabue P, Grasselli G, Novembrino C, Chantarangkul V, et al. Hypercoagulability of COVID-19 patients in intensive care unit: A report of thromboelastography findings and other parameters of hemostasis. J Thromb Haemost. 2020 Jul;18(7):1738-1742. doi:
7. Carsana L, Sonzogni A, Nasr A, Rossi RS, Pellegrinelli A, Zerbi P, et al. Pulmonary post-mortem findings in a series of COVID-19 cases from northern Italy: a two-centre descriptive study. Lancet Infect Dis. 2020 Oct;20(10):1135-40. doi:10.1016/S1473-3099(20)30434-5
8. Yang X, Yang Q, Wang Y, Wu Y, Xu J, Yu Y, Shang Y. Thrombocytopenia and its association with mortality in patients with COVID-19. J Thromb Haemost. 2020 Jun;18(6):1469-1472. doi:
9. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020 Apr;18(4):844-847. doi:  
10. National Institutes of Health. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19). Treatment Guidelines. Available from: [Accessed 25th May 2021].
11. M-vo zdravookhraneniia Rossiiskoi Federatsii. Provisional Methodological Recommendations for Prevention, Diagnosis and Treatment of New Coronavirus Infection (COVID-19). Version 10 (08.02.2021). Available from: [Accessed 25th May 2021]. (In Russ.)
12. Marini JJ, Gattinoni L. Management of COVID-19 respiratory distress. JAMA. 2020 Jun;323(22):2329-2330. doi:
13. Marochkov AV, Lipnitckii AL, Tcopov DS, Kupreeva IA, Dozortceva OV. Peculiarities of platelet aggregation in patients with COVID-19 infection. Preliminary results. Novosti Khirurgii. 2020;28(5):558-64. (In Russ.)
14. Gonchar IA, Shishlo LM, Bonchkovskaia TIu. Platelet impedance aggregometry and functional outcome of acute cerebral infarction. Voen Meditsina. 2015;(2):23-5. (In Russ.)

Information about authors:
Marochkov A.V. – Doctor of Medical Sciences, professor, anesthesiologist-resuscitator of the anesthesiology and resuscitation department, Mogilev Regional Clinical Hospital; professor of the affiliated branch of the Chairs of Anesthesiology and Resuscitation with the course of the Faculty for Advanced Training & Retraining and Hospital Surgery of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University,
Lipnitski A.L. – Candidate of Medical Sciences, anesthesiologist-resuscitator, head of the department for taking organs and tissues for transplantation, Mogilev Regional Clinical Hospital; lecturer of the affiliated branch of the Chairs of Anesthesiology and Resuscitation with the course of the Faculty for Advanced Training & Retraining and Hospital Surgery of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University,
Starovoitov A.G. – valeologist, Mogilev Regional Blood Transfusion Station,
Dazortsava V.U. – doctor of laboratory diagnostics of the Centralized Laboratory of Clinical Biochemistry, Mogilev Regional Clinical Hospital,
Livinskaya V.A. – Candidate of Physical and Mathematical Sciences, associate professor of the Chair «Finance & Accounting», Belarusian – Russian University,

Correspondence address: Republic of Belarus, 212016, Mogilev, 12 Belynitsky-Birula str., Mogilev Regional Clinical Hospital, the department for taking organs and tissues for transplantation. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Artur L. Lipnitski.

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