Derangement of the coagulation process using subclinical markers and viscoelastic measurements in critically ill patients with coronavirus disease 2019 pneumonia and non-coronavirus disease 2019 pneumonia
| Autor: | Andrew Horton, Lara Gianesello, Lorenzo Roberto Suardi, Vittorio Pavoni, Maddalena Pazzi |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Critical Illness 030204 cardiovascular system & hematology Fibrinogen Gastroenterology law.invention Fibrin Fibrinogen Degradation Products 03 medical and health sciences 0302 clinical medicine law Internal medicine medicine Coagulopathy Humans Blood Coagulation Blood coagulation test Aged Aged 80 and over business.industry Platelet Count SARS-CoV-2 Anticoagulant COVID-19 Hematology General Medicine Pneumonia Blood Coagulation Disorders Middle Aged medicine.disease Intensive care unit Thrombelastography Thromboelastometry Intensive Care Units Coagulation Female Blood Coagulation Tests business 030215 immunology medicine.drug |
| Zdroj: | Blood Coagulation & Fibrinolysis |
| ISSN: | 1473-5733 |
| Popis: | Systemic coagulation abnormalities including clotting activation and inhibition of anticoagulant factors have been observed in patients with pneumonia. In severe coronavirus disease 2019 (COVID-19) the alteration of coagulation parameters was associated with poor prognosis. We evaluated the difference in coagulopathy between critically ill patients with COVID-19 pneumonia (COVID group) and non-COVID-19 pneumonia (non-COVID group), using traditional coagulation markers and rotational thromboelastometry (ROTEM). Standard laboratory and ROTEM parameters were evaluated in 45 patients (20 COVID group patients and 25 non-COVID group patients) at time of admission to the Intensive Care Unit (ICU) (T0) and at 5 (T5) and 10 days (T10) later. In all evaluations times, platelet count was found higher in COVID group rather than in non-COVID group. At T0, COVID group revealed a fibrinogen value greater than non-COVID group. d-Dimer values were high in both groups and they were not statistically different. At T0 COVID group showed a significant reduction of clot formation time in INTEM and in EXTEM and a significant increase of maximum clot firmness in INTEM, EXTEM and FIBTEM respect to non-COVID group. Moreover, COVID group demonstrated a coagulability state with ROTEM profiles higher than non-COVID group at T5 and T10. Coagulation profiles showed that critically ill patients with COVID-19 pneumonia are characterized by a higher coagulable state than others; this greater procoagulative state persists over time. |
| Databáze: | OpenAIRE |
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