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Dynamic changes in fibrinogen and D-dimer levels in COVID-19 patients on nafamostat mesylate.


ABSTRACT: Critical illnesses associated with coronavirus disease 2019 (COVID-19) are attributable to a hypercoagulable status. There is limited knowledge regarding the dynamic changes in coagulation factors among COVID-19 patients on nafamostat mesylate, a potential therapeutic anticoagulant for COVID-19. First, we retrospectively conducted a cluster analysis based on clinical characteristics on admission to identify latent subgroups among fifteen patients with COVID-19 on nafamostat mesylate at the University of Tokyo Hospital, Japan, between April 6 and May 31, 2020. Next, we delineated the characteristics of all patients as well as COVID-19-patient subgroups and compared dynamic changes in coagulation factors among each subgroup. The subsequent dynamic changes in fibrinogen and D-dimer levels were presented graphically. All COVID-19 patients?were classified into three subgroups: clusters A, B, and C, representing low, intermediate, and high risk of poor outcomes, respectively. All patients were alive 30 days from symptom onset. No patient in cluster A required mechanical ventilation; however, all patients in cluster C required mechanical ventilation, and half of them were treated with venovenous extracorporeal membrane oxygenation. All patients in cluster A maintained low D-dimer levels, but some critical patients in clusters B and C showed dynamic changes in fibrinogen and D-dimer levels. Although the potential of nafamostat mesylate needs to be evaluated in randomized clinical trials, admission characteristics of patients with COVID-19 could predict subsequent coagulopathy.

SUBMITTER: Osawa I 

PROVIDER: S-EPMC7486975 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Dynamic changes in fibrinogen and D-dimer levels in COVID-19 patients on nafamostat mesylate.

Osawa Itsuki I   Okamoto Koh K   Ikeda Mahoko M   Otani Amato A   Wakimoto Yuji Y   Yamashita Marie M   Shinohara Takayuki T   Kanno Yoshiaki Y   Jubishi Daisuke D   Kurano Makoto M   Harada Sohei S   Okugawa Shu S   Yatomi Yutaka Y   Moriya Kyoji K  

Journal of thrombosis and thrombolysis 20200912 3


Critical illnesses associated with coronavirus disease 2019 (COVID-19) are attributable to a hypercoagulable status. There is limited knowledge regarding the dynamic changes in coagulation factors among COVID-19 patients on nafamostat mesylate, a potential therapeutic anticoagulant for COVID-19. First, we retrospectively conducted a cluster analysis based on clinical characteristics on admission to identify latent subgroups among fifteen patients with COVID-19 on nafamostat mesylate at the Unive  ...[more]

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