COVID-19-associated coagulopathy : thromboembolism prophylaxis and poor prognosis in ICU
BACKGROUND: Coronavirus disease 2019 (COVID-19) is associated with coagulation abnormalities which are indicators of higher mortality especially in severe cases.
METHODS: We studied patients with proven COVID-19 disease in the intensive care unit of Jinyintan Hospital, Wuhan, China from 30 to 2019 to 31 March 2020.
RESULTS: Of 180 patients, 89 (49.44 %) had died, 85 (47.22 %) had been discharged alive, and 6 (3.33 %) were still hospitalised by the end of data collection. A D-dimer concentration of > 0.5 mg/L on admission was significantly associated with 30 day mortality, and a D-dimer concentration of > 5 mg/L was found in a much higher proportion of non-survivors than survivors. Sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC) scoring systems were dichotomised as < 4 or ≥ 4 and < 5 or ≥ 5, respectively, and the mortality rate was significantly different between the two stratifications in both scoring systems. Enoxaparin was administered to 68 (37.78 %) patients for thromboembolic prophylaxis, and stratification by the D-dimer concentration and DIC score confirmed lower mortality in patients who received enoxaparin when the D-dimer concentration was > 2 than < 2 mg/L or DIC score was ≥ 5 than < 5. A low platelet count and low serum calcium concentration were also related to mortality.
CONCLUSIONS: A D-dimer concentration of > 0.5 mg/L on admission is a risk factor for severe disease. A SIC score of > 4 and DIC score of > 5 may be used to predict mortality. Thromboembolic prophylaxis can reduce mortality only in patients with a D-dimer concentration of > 2 mg/L or DIC score of ≥ 5.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
|---|---|
| Enthalten in: |
Experimental hematology & oncology - 10(2021), 1 vom: 01. Feb., Seite 6 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zheng, Runhui [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Revised 06.02.2021 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1186/s40164-021-00202-9 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM320841049 |
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| 100 | 1 | |a Zheng, Runhui |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a COVID-19-associated coagulopathy |b thromboembolism prophylaxis and poor prognosis in ICU |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Revised 06.02.2021 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a BACKGROUND: Coronavirus disease 2019 (COVID-19) is associated with coagulation abnormalities which are indicators of higher mortality especially in severe cases | ||
| 520 | |a METHODS: We studied patients with proven COVID-19 disease in the intensive care unit of Jinyintan Hospital, Wuhan, China from 30 to 2019 to 31 March 2020 | ||
| 520 | |a RESULTS: Of 180 patients, 89 (49.44 %) had died, 85 (47.22 %) had been discharged alive, and 6 (3.33 %) were still hospitalised by the end of data collection. A D-dimer concentration of > 0.5 mg/L on admission was significantly associated with 30 day mortality, and a D-dimer concentration of > 5 mg/L was found in a much higher proportion of non-survivors than survivors. Sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC) scoring systems were dichotomised as < 4 or ≥ 4 and < 5 or ≥ 5, respectively, and the mortality rate was significantly different between the two stratifications in both scoring systems. Enoxaparin was administered to 68 (37.78 %) patients for thromboembolic prophylaxis, and stratification by the D-dimer concentration and DIC score confirmed lower mortality in patients who received enoxaparin when the D-dimer concentration was > 2 than < 2 mg/L or DIC score was ≥ 5 than < 5. A low platelet count and low serum calcium concentration were also related to mortality | ||
| 520 | |a CONCLUSIONS: A D-dimer concentration of > 0.5 mg/L on admission is a risk factor for severe disease. A SIC score of > 4 and DIC score of > 5 may be used to predict mortality. Thromboembolic prophylaxis can reduce mortality only in patients with a D-dimer concentration of > 2 mg/L or DIC score of ≥ 5 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Coagulation parameters | |
| 650 | 4 | |a D-dimer | |
| 650 | 4 | |a Disseminated intravascular coagulation | |
| 650 | 4 | |a Sepsis‐induced coagulopathy | |
| 700 | 1 | |a Zhou, Jing |e verfasserin |4 aut | |
| 700 | 1 | |a Song, Bin |e verfasserin |4 aut | |
| 700 | 1 | |a Zheng, Xia |e verfasserin |4 aut | |
| 700 | 1 | |a Zhong, Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Jiang, Li |e verfasserin |4 aut | |
| 700 | 1 | |a Pan, Chun |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Xia, Jiaan |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Nanshan |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Wenjuan |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Dingyu |e verfasserin |4 aut | |
| 700 | 1 | |a Xi, Yin |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Zhimin |e verfasserin |4 aut | |
| 700 | 1 | |a Pan, Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Xiaoqing |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Shiyue |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Yuanda |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Yimin |e verfasserin |4 aut | |
| 700 | 1 | |a Tan, Huo |e verfasserin |4 aut | |
| 700 | 1 | |a Zhong, Nanshan |e verfasserin |4 aut | |
| 700 | 1 | |a Luo, Xiaodan |e verfasserin |4 aut | |
| 700 | 1 | |a Sang, Ling |e verfasserin |4 aut | |
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