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

被引：42

作者：

Correa, Thiago Domingos ^{[1
]}

Cordioli, Ricardo Luiz ^{[1
]}

Campos Guerra, Joao Carlos ^{[2
]}

da Silva, Bruno Caldin ^{[1
]}

Rodrigues, Roseny dos Reis ^{[1
]}

de Souza, Guilherme Martins ^{[1
]}

Midega, Thais Dias ^{[1
]}

Campos, Niklas Soderberg ^{[1
]}

Carneiro, Barbara Vieira ^{[1
]}

Dias Campos, Flavia Nunes ^{[1
]}

Guimaraes, Helio Penna ^{[1
]}

Janot de Matos, Gustavo Faissol ^{[1
]}

de Aranda, Valdir Fernandes ^{[2
]}

Rolim Ferraz, Leonardo Jose ^{[1
]}

机构：

[1] Hosp Israelita Albert Einstein, Dept Crit Care Med, Sao Paulo, Brazil

[2] Hosp Israelita Albert Einstein, Dept Lab Ctr, Sao Paulo, Brazil

来源：

PLOS ONE | 2020年 / 15卷 / 12期

关键词：

PROTEIN-C CONCENTRATIONS; INTENSIVE-CARE; DISEASE; SCORE;

D O I：

10.1371/journal.pone.0243604

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

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.

引用

页数：16

共 47 条

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