tetano
Editor, Senior Moderator
Aging (Albany NY)
. 2020 Dec 9;12.
doi: 10.18632/aging.202223. Online ahead of print.
Coagulation dysfunction in ICU patients with coronavirus disease 2019 in Wuhan, China: A retrospective observational study of 75 fatal cases
Jiaran Shi[SUP] 1 [/SUP], Wang Zhang[SUP] 2 [/SUP], Ling Sang[SUP] 3 [/SUP], Zhaohui Qu[SUP] 4 [/SUP], Ming Zhong[SUP] 5 [/SUP], Li Jiang[SUP] 6 [/SUP], Bin Song[SUP] 7 [/SUP], Liang Kang[SUP] 4 [/SUP], Yun Zhang[SUP] 8 [/SUP], Xingxiang Wang[SUP] 1 [/SUP], Dingyu Zhang[SUP] 9 10 [/SUP], Xia Zheng[SUP] 8 [/SUP]
Affiliations
Abstract
Coagulation dysfunction in critically ill patients with coronavirus disease 2019 (COVID-19) has not been well described, and the efficacy of anticoagulant therapy is unclear. In this study, we retrospectively reviewed 75 fatal COVID-19 cases who were admitted to the intensive care unit at Jinyintan Hospital (Wuhan, China). The median age of the cases was 67 (62-74) years, and 47 (62.7%) were male. Fifty patients (66.7%) were diagnosed with disseminated intra-vascular coagulation. Approximately 90% of patients had elevated D-dimer and fibrinogen degradation products, which decreased continuously after anticoagulant treatment and was accompanied by elevated albumin (all P<0.05). The median survival time of patients treated with anticoagulant was 9.0 (6.0-14.0) days compared with 7.0 (3.0-10.0) days in patients without anticoagulant therapy (P=0.008). After anticoagulation treatment, C-reactive protein levels decreased (P=0.004), as did high-sensitivity troponin (P=0.018), lactate dehydrogenase (P<0.001), and hydroxybutyrate dehydrogenase (P<0.001). In conclusion, coagulation disorders were widespread among fatal COVID-19 cases. Anticoagulant treatment partially improved hypercoagulability, prolonged median survival time, and may have postponed inflammatory processes and cardiac injury.
Keywords: cardiac injury; coagulation dysfunction; coronavirus disease 2019; death; inflammation.
. 2020 Dec 9;12.
doi: 10.18632/aging.202223. Online ahead of print.
Coagulation dysfunction in ICU patients with coronavirus disease 2019 in Wuhan, China: A retrospective observational study of 75 fatal cases
Jiaran Shi[SUP] 1 [/SUP], Wang Zhang[SUP] 2 [/SUP], Ling Sang[SUP] 3 [/SUP], Zhaohui Qu[SUP] 4 [/SUP], Ming Zhong[SUP] 5 [/SUP], Li Jiang[SUP] 6 [/SUP], Bin Song[SUP] 7 [/SUP], Liang Kang[SUP] 4 [/SUP], Yun Zhang[SUP] 8 [/SUP], Xingxiang Wang[SUP] 1 [/SUP], Dingyu Zhang[SUP] 9 10 [/SUP], Xia Zheng[SUP] 8 [/SUP]
Affiliations
- PMID: 33318314
- DOI: 10.18632/aging.202223
Abstract
Coagulation dysfunction in critically ill patients with coronavirus disease 2019 (COVID-19) has not been well described, and the efficacy of anticoagulant therapy is unclear. In this study, we retrospectively reviewed 75 fatal COVID-19 cases who were admitted to the intensive care unit at Jinyintan Hospital (Wuhan, China). The median age of the cases was 67 (62-74) years, and 47 (62.7%) were male. Fifty patients (66.7%) were diagnosed with disseminated intra-vascular coagulation. Approximately 90% of patients had elevated D-dimer and fibrinogen degradation products, which decreased continuously after anticoagulant treatment and was accompanied by elevated albumin (all P<0.05). The median survival time of patients treated with anticoagulant was 9.0 (6.0-14.0) days compared with 7.0 (3.0-10.0) days in patients without anticoagulant therapy (P=0.008). After anticoagulation treatment, C-reactive protein levels decreased (P=0.004), as did high-sensitivity troponin (P=0.018), lactate dehydrogenase (P<0.001), and hydroxybutyrate dehydrogenase (P<0.001). In conclusion, coagulation disorders were widespread among fatal COVID-19 cases. Anticoagulant treatment partially improved hypercoagulability, prolonged median survival time, and may have postponed inflammatory processes and cardiac injury.
Keywords: cardiac injury; coagulation dysfunction; coronavirus disease 2019; death; inflammation.