The world faced the global pandemic COVID-19 more than a year ago [8, 10, 15]. The high level of morbidity and mortality, huge socio-economic losses require the development of algorithms for effective diagnosis, therapy and prevention of COVID-19 [8, 10]. Despite the achievements of modern science and practical medicine, the issues of aetiology, pathogenesis, peculiarities of the clinical evidence, the choice of diagnostic methods and treatment tactics remain without any answers [8, 12, 15].
Data on complications from various organs and systems associated with COVID-19 are constantly updated [12, 13, 15]. Among all forms of complications, the leading position belongs to coronavirus pneumonia. Recently, more and more data appear on the defeat of the nervous system [9, 10, 13]. One of the most severe forms of the nervous system pathology in COVID-19 is cerebrovascular accidents [9, 13].
Stroke is one of the main medical and social problems with a high level of morbidity, disability and mortality [1, 2, 3]. The key elements of the pathogenesis in COVID-19 with the development of cytokine imbalance («storm»), endotoxicosis, various types of hypoxia, disorders in the hemostasis system aggravate the severity of disorders of homeostasis of the body as a whole and create a favourable background for the development of cerebral forms of pathology [11]. Progressive deadaptation and loss of central nervous function in terms of regulatory and trophic effects on the somatic sphere in stroke patients associated with COVID-19 leads to a generalization of metabolic disorders, which contributes to the aggravation of both cerebral and systemic hypoxia [9, 13]. There is decompensation of chronic forms of pathology already in the patient associated with the background of the new coronavirus infection. At the same time, changes in the circulatory system dominate [10, 12]. According to the latest data, patients with high vascular comorbidity, i.e. a combination of two or more diseases of the circulatory system, are at increased risk for COVID-19. There is a high incidence of severe forms of the disease and deaths in these patients, [9, 13, 14]. Over 50 % of patients with stroke suffer from more than 2–3 diseases of the circulatory system [1, 4, 6]. Stroke progression in this group of patients is primarily due to the already existing disorder of the vascular wall associated with severe forms of endothelial dysfunction, which is observed in patients with systemic atherosclerosis, severe forms of hypertension and decompensated type 2 diabetes [6, 8]. Such patients are characterized by a disorder of the hemostasis system with an increase in the coagulant potential, as a result of which they have severe forms of chronic DIC even before the development of a stroke [5, 6]. The initiating role of the SARSCoV-2 virus in the progression of disorders of the hemostatic system has been proven [11].