Association of D-dimer, inflammatory markers, cytokines abnormality, and disease severity in COVID-19 severe/critical patients in Wuhan

Objective: To analyze the association of D-dimer levels, inflammatory indicators, cytokine abnormality, and disease severity in COVID-19 severe/critical type patients. Methods: The medical records of 41 patients were collected from a single center in Wuhan from February 8, 2020 to March 25, 2020. The patients were divided into severe type group (28 patients) and critical type group (13 patients) . The levels of D-dimer, WBC, ANC, PCT, hsCRP, IL-2R, IL-6, IL-8, and TNF-α were compared among patients with different clinical types of COVID-19 infection. Moreover, the changes in the cytokines were analyzed in patients with different D-dimer levels. And, the levels of D-dimer, IL-2R, IL-6, IL-8, and TNF-α before and after anticoagulant therapy were assessed. Statistical analyses were performed using Student t test, Mann-Whitney U test, and Chi-square test. Results: Among the 41 patients, 23 were men (56.1%) and 18 were women (43.9%) ; the median patient age was 57 y. The age of the critical type patients [ (61.1±10.4) y] was higher than that of severe type patients [ (52.8±11.7) y]; the difference was significant (t=-2.264, P=0.032) . The proportion of critical type patients with chronic diseases, especially hypertension, cardiovascular disease, and cerebrovascular disease, was higher as compared to that in those with severe type patients; the differences were significant (all P<0.05) . The prevalence of dyspnea, sweats, and fatigue symptoms in the critical type patients was higher than that in those with severe type disease; the differences were significant (χ(2)=14.898, 6.972, 7.823; P<0.001, 0.008, 0.005) . The levels of D-dimer, WBC, ANC, PCT, hsCRP, and IL-8 in critical type patients were higher than those in severe type patients; the differences were significant (all P<0.05) . The levels of IL-2R, IL-8, and TNF-α in patients with abnormal D-dimer were higher as compared to those in patients with normal D-dimer levels; the differences were significant (all P<0.05) . Eight patients were treated with prophylactic anticoagulation; the levels of D-dimer, IL-2R, IL-6 and IL-8 after anticoagulant therapy were lower than those before treatment. Conclusions: COVID-19 critical type patients have more serious coagulation-immune dysfunction and dynamic monitoring of D-dimer and cytokines levels helps in identifying critical type patients as early as possible; anticoagulant therapy may improve the patient's condition by correcting coagulation-immune dysfunction.

Medienart:	E-Artikel

Erscheinungsjahr:	2020
Erschienen:	2020

Enthalten in:	Zur Gesamtaufnahme - volume:41
Enthalten in:	Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi - 41(2020), 11 vom: 14. Nov., Seite 927-931

Sprache:	Chinesisch

Beteiligte Personen:	Zhang, J [VerfasserIn] Gao, X L [VerfasserIn] Li, D J [VerfasserIn] Jiang, Y [VerfasserIn] Liu, Y [VerfasserIn] Pang, L [VerfasserIn] Xu, D [VerfasserIn] Yang, L H [VerfasserIn]

Links:	Volltext

Themen:	Biomarkers COVID-19 Coagulation Cytokines D-dimer Fibrin Fibrinogen Degradation Products Fibrin fragment D Journal Article

Anmerkungen:	Date Completed 21.12.2020 Date Revised 10.11.2023 published: Print Citation Status MEDLINE

doi:	10.3760/cma.j.issn.0253-2727.2020.11.008

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	NLM318986868