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The procoagulant pattern of patients with COVID-19 acute respiratory distress syndrome.
- Source :
-
Journal of thrombosis and haemostasis : JTH [J Thromb Haemost] 2020 Jul; Vol. 18 (7), pp. 1747-1751. Date of Electronic Publication: 2020 May 06. - Publication Year :
- 2020
-
Abstract
- Background: Few observations exist with respect to the pro-coagulant profile of patients with COVID-19 acute respiratory distress syndrome (ARDS). Reports of thromboembolic complications are scarce but suggestive for a clinical relevance of the problem.<br />Objectives: Prospective observational study aimed to characterize the coagulation profile of COVID-19 ARDS patients with standard and viscoelastic coagulation tests and to evaluate their changes after establishment of an aggressive thromboprophylaxis.<br />Methods: Sixteen patients with COVID-19 ARDS received a complete coagulation profile at the admission in the intensive care unit. Ten patients were followed in the subsequent 7 days, after increasing the dose of low molecular weight heparin, antithrombin levels correction, and clopidogrel in selected cases.<br />Results: At baseline, the patients showed a pro-coagulant profile characterized by an increased clot strength (CS, median 55 hPa, 95% interquartile range 35-63), platelet contribution to CS (PCS, 43 hPa; interquartile range 24-45), fibrinogen contribution to CS (FCS, 12 hPa; interquartile range 6-13.5) elevated D-dimer levels (5.5 μg/mL, interquartile range 2.5-6.5), and hyperfibrinogenemia (794 mg/dL, interquartile range 583-933). Fibrinogen levels were associated (R <superscript>2</superscript>  = .506, P = .003) with interleukin-6 values. After increasing the thromboprophylaxis, there was a significant (P = .001) time-related decrease of fibrinogen levels, D-dimers (P = .017), CS (P = .013), PCS (P = .035), and FCS (P = .038).<br />Conclusion: The pro-coagulant pattern of these patients may justify the clinical reports of thromboembolic complications (pulmonary embolism) during the course of the disease. Further studies are needed to assess the best prophylaxis and treatment of this condition.<br /> (© 2020 International Society on Thrombosis and Haemostasis.)
- Subjects :
- Aged
Anticoagulants administration & dosage
Biomarkers blood
Blood Coagulation Disorders diagnosis
Blood Coagulation Disorders drug therapy
Blood Coagulation Disorders virology
Blood Coagulation Tests
COVID-19
Coronavirus Infections diagnosis
Coronavirus Infections drug therapy
Coronavirus Infections virology
Female
Fibrinolytic Agents administration & dosage
Host-Pathogen Interactions
Humans
Male
Middle Aged
Pandemics
Pneumonia, Viral diagnosis
Pneumonia, Viral drug therapy
Pneumonia, Viral virology
Prospective Studies
SARS-CoV-2
Treatment Outcome
COVID-19 Drug Treatment
Betacoronavirus pathogenicity
Blood Coagulation drug effects
Blood Coagulation Disorders blood
Coronavirus Infections blood
Pneumonia, Viral blood
Subjects
Details
- Language :
- English
- ISSN :
- 1538-7836
- Volume :
- 18
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of thrombosis and haemostasis : JTH
- Publication Type :
- Academic Journal
- Accession number :
- 32302448
- Full Text :
- https://doi.org/10.1111/jth.14854