tetano
Editor, Senior Moderator
Clin Immunol
. 2021 Sep 11;108852.
doi: 10.1016/j.clim.2021.108852. Online ahead of print.
Inflammation/coagulopathy/fibrinolysis: Dynamic indicators of COVID-19 progression in patients with moderate COVID-19 in Wenzhou, China
Shengwei Jin[SUP] 1 [/SUP], Hui An[SUP] 2 [/SUP], Tong Zhou[SUP] 3 [/SUP], Ting Li[SUP] 4 [/SUP], Chengshui Chen[SUP] 5 [/SUP], Binyu Ying[SUP] 6 [/SUP], Zhangye Xu[SUP] 7 [/SUP], Xiaokun Li[SUP] 8 [/SUP], Ming Li[SUP] 9 [/SUP]
Affiliations
Abstract
Background: Majority of coronavirus disease 2019 (COVID-19) non-survivors meet the criteria for disseminated intravascular coagulation (DIC). Although timely monitoring of clotting hemorrhagic development during the natural course of COVID-19 is critical for understanding pathogenesis, diagnosis, and treatment of the disease, however, limited data are available on the dynamic processes of inflammation/coagulopathy/fibrinolysis (ICF).
Methods: We monitored the dynamic progression of ICF in patients with moderate COVID-19. Out of 694 COVID-19 inpatients from 10 hospitals in Wenzhou, China, we selected 293 adult patients without comorbidities. These patients were divided into different daily cohorts according to the COVID-19 onset-time. Retrospective data were extracted from electronic medical records.
Results: The virus-induced damages to pre-hospitalization patients triggered two ICF fluctuations during the 14-day course of the disease. C-reactive protein (CRP), fibrinogen, and D-dimer levels increased and peaked at day 5 (D5) and D9 during the 1st and 2nd fluctuations, respectively. The ICF activities were higher during the 2nd fluctuation. Although twelve-day medication returned high CRP concentration to normal and blocked fibrinogen increase, the D-dimer levels remained high on 17 ± 2 and 23 ± 2 days of COVID-19 course.
Conclusion: COVID-19 is linked with chronic DIC, which could be responsible for the progression of the disease. Understanding and monitoring ICF progression during COVID-19 can help clinicians in identifying the stage of the disease quickly and accurately, and administer suitable treatment.
Keywords: C-reactive protein; Coagulopathy; Coronavirus disease 2019; D-dimer; Fibrinolysis.
. 2021 Sep 11;108852.
doi: 10.1016/j.clim.2021.108852. Online ahead of print.
Inflammation/coagulopathy/fibrinolysis: Dynamic indicators of COVID-19 progression in patients with moderate COVID-19 in Wenzhou, China
Shengwei Jin[SUP] 1 [/SUP], Hui An[SUP] 2 [/SUP], Tong Zhou[SUP] 3 [/SUP], Ting Li[SUP] 4 [/SUP], Chengshui Chen[SUP] 5 [/SUP], Binyu Ying[SUP] 6 [/SUP], Zhangye Xu[SUP] 7 [/SUP], Xiaokun Li[SUP] 8 [/SUP], Ming Li[SUP] 9 [/SUP]
Affiliations
- PMID: 34520860
- DOI: 10.1016/j.clim.2021.108852
Abstract
Background: Majority of coronavirus disease 2019 (COVID-19) non-survivors meet the criteria for disseminated intravascular coagulation (DIC). Although timely monitoring of clotting hemorrhagic development during the natural course of COVID-19 is critical for understanding pathogenesis, diagnosis, and treatment of the disease, however, limited data are available on the dynamic processes of inflammation/coagulopathy/fibrinolysis (ICF).
Methods: We monitored the dynamic progression of ICF in patients with moderate COVID-19. Out of 694 COVID-19 inpatients from 10 hospitals in Wenzhou, China, we selected 293 adult patients without comorbidities. These patients were divided into different daily cohorts according to the COVID-19 onset-time. Retrospective data were extracted from electronic medical records.
Results: The virus-induced damages to pre-hospitalization patients triggered two ICF fluctuations during the 14-day course of the disease. C-reactive protein (CRP), fibrinogen, and D-dimer levels increased and peaked at day 5 (D5) and D9 during the 1st and 2nd fluctuations, respectively. The ICF activities were higher during the 2nd fluctuation. Although twelve-day medication returned high CRP concentration to normal and blocked fibrinogen increase, the D-dimer levels remained high on 17 ± 2 and 23 ± 2 days of COVID-19 course.
Conclusion: COVID-19 is linked with chronic DIC, which could be responsible for the progression of the disease. Understanding and monitoring ICF progression during COVID-19 can help clinicians in identifying the stage of the disease quickly and accurately, and administer suitable treatment.
Keywords: C-reactive protein; Coagulopathy; Coronavirus disease 2019; D-dimer; Fibrinolysis.