Dataset Information

Coagulation profile of COVID-19 patients admitted to the ICU: An exploratory study.

ABSTRACT:

Background

Coagulation abnormalities in COVID-19 patients have not been addressed in depth.

Objective

To perform a longitudinal evaluation of coagulation profile of patients admitted to the ICU with COVID-19.

Methods

Conventional coagulation tests, rotational thromboelastometry (ROTEM), platelet function, fibrinolysis, antithrombin, protein C and S were measured at days 0, 1, 3, 7 and 14. Based on median total maximum SOFA score, patients were divided in two groups: SOFA ? 10 and SOFA > 10.

Results

Thirty patients were studied. Some conventional coagulation tests, as aPTT, PT and INR remained unchanged during the study period, while alterations on others coagulation laboratory tests were detected. Fibrinogen levels were increased in both groups. ROTEM maximum clot firmness increased in both groups from Day 0 to Day 14. Moreover, ROTEM-FIBTEM maximum clot firmness was high in both groups, with a slight decrease from day 0 to day 14 in group SOFA ? 10 and a slight increase during the same period in group SOFA > 10. Fibrinolysis was low and decreased over time in all groups, with the most pronounced decrease observed in INTEM maximum lysis in group SOFA > 10. Also, D-dimer plasma levels were higher than normal reference range in both groups and free protein S plasma levels were low in both groups at baseline and increased over time, Finally, patients in group SOFA > 10 had lower plasminogen levels and Protein C ??than patients with SOFA <10, which may represent less fibrinolysis activity during a state of hypercoagulability.

Conclusion

COVID-19 patients have a pronounced hypercoagulability state, characterized by impaired endogenous anticoagulation and decreased fibrinolysis. The magnitude of coagulation abnormalities seems to correlate with the severity of organ dysfunction. The hypercoagulability state of COVID-19 patients was not only detected by ROTEM but it much more complex, where changes were observed on the fibrinolytic and endogenous anticoagulation system.

SUBMITTER: Correa TD

PROVIDER: S-EPMC7737963 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Publications

Coagulation profile of COVID-19 patients admitted to the ICU: An exploratory study.

Corrêa Thiago Domingos TD Cordioli Ricardo Luiz RL Campos Guerra João Carlos JC Caldin da Silva Bruno B Dos Reis Rodrigues Roseny R de Souza Guilherme Martins GM Midega Thais Dias TD Campos Niklas Söderberg NS Carneiro Bárbara Vieira BV Campos Flávia Nunes Dias FND Guimarães Hélio Penna HP de Matos Gustavo Faissol Janot GFJ de Aranda Valdir Fernandes VF Rolim Ferraz Leonardo José LJ

PloS one 20201215 12

<h4>Background</h4>Coagulation abnormalities in COVID-19 patients have not been addressed in depth.<h4>Objective</h4>To perform a longitudinal evaluation of coagulation profile of patients admitted to the ICU with COVID-19.<h4>Methods</h4>Conventional coagulation tests, rotational thromboelastometry (ROTEM), platelet function, fibrinolysis, antithrombin, protein C and S were measured at days 0, 1, 3, 7 and 14. Based on median total maximum SOFA score, patients were divided in two groups: SOFA ≤ ...[more]

PMID: 33320874

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Project description:Vaccines against COVID-19 show high efficacy, yet, infection is still being detected among immunized patients, although with blunted severity. The purpose of this study was to assess the severity of COVID-19 infection among immunized versus non-immunized COVID-19 patients admitted to ICU. A prospective observational cohort study, including all COVID-19 patients admitted to intensive care unit between January 1st, 2021 and June 30th, 2021 were eligible for inclusion. A comparison of severity upon hospitalization of immunized versus non-immunized patients on a 7-level ordinal scale was conducted, using ordinal logistic regression. 592 patients were enrolled, 524 (88.5%) non-immunized, 63 (10.6%) partially immunized, and 5 (0.9%) fully immunized, partially and fully immunized patients were grouped together. Majority of immunized patients (86.7%) were symptomatic before 21 days of immunization. Non-immunized group had fewer patients in the lower severity categories, while more patients in the higher severity categories compared to immunized group. At least one dose of immunization was associated with reduction of odds of moving up severity scale (OR = 0.2 [95% CI: 0.15-0.4]; p < 0.001) in a well fitted ordinal logistic regression model. At least one dose of immunization was associated with lower adjusted odds of 30 day all-cause mortality (OR = 0.45 [95% CI: 0.23-0.89]; p = 0.02). Non-immunized group had higher mortality rate (43.9% versus 29.4% [95% CI: 1.5 to 25.8]; p = 0.02). Most COVID-19 patients admitted to ICU were non-immunized, most of the partially immunized patients got infected before immunity could develop, and fully immunized patients were likely non-responders. At least one dose of immunization significantly decreases severity of the disease across all ordinal severity categories, and is significantly associated with lower 30 day all-cause mortality. Accordingly, immunization status may have to be considered when deciding on disposition of COVID-19 patients at the point of triage.

Dataset Information

Coagulation profile of COVID-19 patients admitted to the ICU: An exploratory study.

Background

Objective

Methods

Results

Conclusion

Publications

Coagulation profile of COVID-19 patients admitted to the ICU: An exploratory study.

Similar Datasets

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