Analysis of key parameters of the hemostatic system in patients with osteoarthritis after COVID-19

BACKGROUND: Osteoarthritis (OA) is a leading cause of disability worldwide, and its impact is exacerbated by the long-term effects of COVID-19, which can lead to structural and functional disorders in various organ systems, including hemostasis. This retrospective observational study aimed to evaluate changes in the hemostasis system’s procoagulant, anticoagulant, and fibrinolytic links in patients with OA following recovery from COVID-19.METHODS: The study involved patients aged 45 to 68 with knee OA, divided into three groups: Control (healthy donors), OA (stage II or III knee OA patients), and OA+Covid-19 (OA patients who had COVID-19). The concentrations of рrоthrombin, protein C, thrombomodulin (TM), plasminogen, tissue plasminogen activator (tPA), and plasminogen activator inhibitor-1 (PAI-1) in blood plasma were measured by enzyme-linked immunosorbent assay. The activity of prothrombin, antithrombin III (AT III), plasminogen, alpha-2-antiplasmin (α2-AP) and tPA was assessed using chromogenic substrates. Soluble fibrin monomer complexes were evaluated with o-phenanthroline test, and the activity of α1-antitrypsin (α1-AT) and α2-macroglobulin (α2-MG) was measured spectrophotometrically.RESULTS: In analyzing hemostasis system indicators in patients with OA and those who had experienced COVID-19, a decrease in prothrombin content and activity was established, alongside an increase in SFMC concentration. There was inhibition of the protein C, AT III, and TM. The fibrinolysis system was impaired, as evidenced by decreases in the concentration of plasminogen, its tissue activator, the PAI-1 inhibitor, and α2-AP activity. Abnormal levels of the proteinase inhibitors α1-AT and α2-MG were also detected.CONCLUSIONS: The findings indicate that the thrombotic risk in patients with OA remains high even months after the acute COVID-19 phase. This is attributed to suppressed anticoagulant activity and reduced fibrinolytic potential in plasma.