COVID-19 患者的凝血参数和预后分析

Filiz Koç, M. Babayiğit
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摘要

目的:影响 COVID-19 发病率和死亡率的因素很多。凝血功能障碍被认为是导致 COVID-19 死亡的重要机制之一。本研究旨在探讨凝血因子及其与 COVID-19 预后的关系:方法:对本院确诊的 COVID-19 患者进行回顾性研究。方法:对本院确诊的 COVID-19 患者进行回顾性研究,记录患者的人口统计学数据、入院时的实验室数据、重症监护入院情况以及监测情况。患者被分为两组:第一组是在诊所随访的非危重患者,第二组是需要在重症监护室接受治疗的危重患者:对 403 名 COVID-19 随访患者进行了分析。经统计,第一组患者的平均年龄明显低于第二组(第一组:45.28 ± 15.31,第二组:60.15 ± 15.72,P <0.001)。据观察,第 2 组的高血压、糖尿病、冠心病和慢性阻塞性肺病发病率在统计学上明显高于第 1 组(P <0.05)。虽然两组的 APTT 值相似,但第 2 组的 D-Dimer 值明显高于第 1 组。随着 QSOFA、SIC、DIC 和凝血标志物评分的增加,死亡患者的比例也明显增加(P <0.05)。经统计发现,年龄、高血压、慢性阻塞性肺病、PT 和高纤维蛋白原水平会增加死亡风险率(P <0.05):结论:COVID-19中决定死亡率的最重要因素是慢性阻塞性肺病和高血压。APTT和D-二聚体值并不是死亡率的预后因素。然而,PT、纤维蛋白原和年龄是不良预后因素,可用于预测需要重症监护的死亡率。
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Coagulation parameters and prognosis analysis in COVID-19 patients
Aims: There are many factors that affect morbidity and mortality in COVID-19. Coagulopathy is thought to be one of the important mechanisms in COVID-19 mortality. In this study, it was aimed to investigate coagulation factors and their relationship with prognosis in COVID-19. Methods: Patients diagnosed with COVID-19 were retrospectively reviewed in our hospital. The patients' demographic data, laboratory data on admission to the hospital, intensive care admissions, and surveillance were recorded. Patients were divided into two groups; Group 1 is non-critical patients followed up in the clinic, Group 2 is critical patients who need treatment in the intensive care unit. Results: 403 patients followed up for COVID-19 were analyzed. It was determined that the average age of the patients in Group 1 was statistically significantly lower than those in Group 2. (1: 45.28 ± 15.31 vs. 2: 60.15 ± 15.72, respectively, p <0.001). It was observed that the rates of HT, DM, CHD, and COPD in Group 2 were statistically significantly higher than Group 1 (p <0.05). While APTT values were similar in both groups, D-Dimer values were significantly higher in Group 2. As QSOFA, SIC, DIC, and coagulation marker scores increased, the percentage of patients with death increased significantly (p <0.05). Age, HT, COPD, PT, and high fibrinogen levels were found to increase the mortality risk rates statistically (p <0.05). Conclusion: It was determined that the most important factors determining mortality in COVID-19 are COPD and HT. APTT and D-dimer values were not found to be a prognostic factor in terms of mortality. However, PT, fibrinogen, and age are poor prognostic factors and can be used to predict mortality requiring intensive care.
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