tetano
Editor, Senior Moderator
Zhonghua Xue Ye Xue Za Zhi. 2020 Mar 28;41(0):E006. doi: 10.3760/cma.j.issn.0253-2727.2020.0006. [Epub ahead of print]
[Clinical and coagulation characteristics of 7 patients with critical COVID-2019 pneumonia and acro-ischemia].
[Article in Chinese; Abstract available in Chinese from the publisher]
Zhang Y[SUP]1[/SUP], Cao W[SUP]2[/SUP], Xiao M[SUP]3[/SUP], Li YJ[SUP]4[/SUP], Yang Y[SUP]5[/SUP], Zhao J[SUP]6[/SUP], Zhou X[SUP]7[/SUP], Jiang W[SUP]8[/SUP], Zhao YQ[SUP]1[/SUP], Zhang SY[SUP]9[/SUP], Li TS[SUP]2[/SUP].
Author information
Abstract
in English, Chinese
Objective: To investigate the clinical and coagulation characteristics of the critical Coronavirus disease 2019 (COVID-19) patients with acro-ischemia in the intensive care unit (ICU). Methods: The retrospective study included 7 critical COVID-19 patients with acro-ischemia in a single center in Wuhan, from Feb 4 to Feb 15, 2020. The clinical and laboratory data before and during the ICU stay were analyzed. Results: The median age of 7 patients was 59 years and 4 of them were men. 3 of them were associated with underlying comorbidities. Fever, cough, dyspnea and diarrhea were common clinical symptoms. All patients had acro-ischemia presentations including finger/toe cyanosis, skin bulla and dry gangrene. D-dimer, fibrinogen and fibrinogen degradation product (FDP) were significantly elevated in most patients. Prothrombin time (PT) were prolonged in 4 patients. D-dimer and FDP levels increased progressively when COVID-2019 exacerbated, and 4 patients were diagnosed with definite disseminated intravascular coagulation (DIC). 6 patients received low molecular weight heparin (LMWH) treatment, after which their D-dimer and FDP decreased, but there was no significant improvement in clinical symptoms. 5 patients died finally and the median time from acro-ischemia to death was 12 days. Conclusions: The existence of hypercoagulation status in critical COVID-2019 patients should be monitored closely, and anticoagulation therapy can be considered in selected patients. More clinical data is needed to investigate the role of anticoagulation in COVID-2019 treatment.
KEYWORDS:
Anticoagulation therapy; Critical, COVID-2019, hypercoagulation status
PMID:32220276DOI:10.3760/cma.j.issn.0253-2727.2020.0006
[Clinical and coagulation characteristics of 7 patients with critical COVID-2019 pneumonia and acro-ischemia].
[Article in Chinese; Abstract available in Chinese from the publisher]
Zhang Y[SUP]1[/SUP], Cao W[SUP]2[/SUP], Xiao M[SUP]3[/SUP], Li YJ[SUP]4[/SUP], Yang Y[SUP]5[/SUP], Zhao J[SUP]6[/SUP], Zhou X[SUP]7[/SUP], Jiang W[SUP]8[/SUP], Zhao YQ[SUP]1[/SUP], Zhang SY[SUP]9[/SUP], Li TS[SUP]2[/SUP].
Author information
Abstract
in English, Chinese
Objective: To investigate the clinical and coagulation characteristics of the critical Coronavirus disease 2019 (COVID-19) patients with acro-ischemia in the intensive care unit (ICU). Methods: The retrospective study included 7 critical COVID-19 patients with acro-ischemia in a single center in Wuhan, from Feb 4 to Feb 15, 2020. The clinical and laboratory data before and during the ICU stay were analyzed. Results: The median age of 7 patients was 59 years and 4 of them were men. 3 of them were associated with underlying comorbidities. Fever, cough, dyspnea and diarrhea were common clinical symptoms. All patients had acro-ischemia presentations including finger/toe cyanosis, skin bulla and dry gangrene. D-dimer, fibrinogen and fibrinogen degradation product (FDP) were significantly elevated in most patients. Prothrombin time (PT) were prolonged in 4 patients. D-dimer and FDP levels increased progressively when COVID-2019 exacerbated, and 4 patients were diagnosed with definite disseminated intravascular coagulation (DIC). 6 patients received low molecular weight heparin (LMWH) treatment, after which their D-dimer and FDP decreased, but there was no significant improvement in clinical symptoms. 5 patients died finally and the median time from acro-ischemia to death was 12 days. Conclusions: The existence of hypercoagulation status in critical COVID-2019 patients should be monitored closely, and anticoagulation therapy can be considered in selected patients. More clinical data is needed to investigate the role of anticoagulation in COVID-2019 treatment.
KEYWORDS:
Anticoagulation therapy; Critical, COVID-2019, hypercoagulation status
PMID:32220276DOI:10.3760/cma.j.issn.0253-2727.2020.0006