Covid-19: Consumption coagulopathy with increased severity and mortality - A retrospective study

Kunal Gaur, S. Natarajan, M. Gupta
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Abstract

To compare quantitative values of parameters of coagulation pathway like Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), International Normalized Ratio (INR) and D-Dimer (DD) on date of admission versus date of patient's mortality. A total of 50 patients who were tested positive for COVID-19 in our hospital between April 21, 2021 and May 30, 2021, were taken into this study. The changes in PT, APTT, INR and DD were compared at day of admission and day of patient's mortality. The study involved 50 patients (36 male and 14 female). D-dimer at the day of admission (mean 1540.79 ng/ml; IQR 231-8776) was found with an elevation of 250% at the day of mortality (mean 5379.04ng/ml; IQR 434-10000). PT at the day of admission (mean 13.602; IQR 11.6-14.8) was found elevated (Normal range-10.5-13.5sec) in 19/50 patients which increased to 43/50 patients at the day of mortality, an increase of 126%. According to the study done, the number of patients with increased levels of PT, APTT, INR and DD were substantially greater at the time of mortality compared to the same patients at their time of admission, suggesting a dynamic coagulation process in COVID-19 patients. This likely suggested that the patients were in progression from a hypercoagulating state that transforms into a fibrinolytic state as a result of the extensive use of coagulation factors.
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Covid-19:严重程度和死亡率增加的消耗性凝血功能障碍——一项回顾性研究
比较两组患者入院当日与死亡当日凝血酶原时间(PT)、活化部分凝血活素时间(APTT)、国际标准化比值(INR)、d -二聚体(DD)等凝血途径参数的定量值。本研究选取了2021年4月21日至2021年5月30日在我院新冠肺炎检测呈阳性的患者50例。比较患者入院当日和死亡当日PT、APTT、INR、DD的变化。该研究涉及50例患者(男性36例,女性14例)。入院当天d -二聚体(平均1540.79 ng/ml;IQR 231-8776)在死亡当天升高250%(平均5379.04ng/ml;差434 - 10000)。入院当日PT(平均13.602;19/50例患者IQR值升高(正常范围10.5-13.5sec),死亡当日IQR值升高至43/50例,升高126%。根据已完成的研究,与入院时相比,死亡时PT、APTT、INR和DD水平升高的患者数量显著增加,表明COVID-19患者的凝血过程是动态的。这可能表明,由于广泛使用凝血因子,患者正处于从高凝状态转变为纤溶状态的进展中。
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