{"title":"重症监护病房COVID-19患者常规凝血和血栓弹性参数模式及COVID-19相关凝血病与死亡率的关系","authors":"Awale Rupali Balchandra, Tanmoy Ghatak, Sukhen Samanta, Ratender K Singh, Anupam Verma, Prabhakar Mishra, Rajendra Chaudhary, Alok Nath","doi":"10.4103/aer.aer_52_22","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Knowledge of underlying pathophysiology of coagulopathy is evolving and the pattern of coagulation parameters in coronavirus disease 2019 (COVID-19)-associated diseases is still not very clear.</p><p><strong>Aims: </strong>In the present study, we aimed to find out the pattern and distribution of conventional coagulation parameters and thromboelastographic (TEG) parameters in COVID-19-associated coagulopathy (CAC) in survivors and nonsurvivors at 28 days.</p><p><strong>Setting and design: </strong>The present prospective observational study was conducted at a tertiary care COVID-19 intensive care unit (ICU) facility from March 21, 2020, to July 15, 2021.</p><p><strong>Materials and methods: </strong>Admission clinical and laboratory data (conventional coagulation, inflammatory and TEG parameters, and disease severity parameters) of 64 COVID-19 patients admitted to the ICU were collected. Patients were divided into two groups, i.e., survivors and nonsurvivors.</p><p><strong>Statistical analysis: </strong>Data were compared between two groups, i.e., survivors versus no survivors on 28 days using Student's <i>t</i>-test/Mann-Whitney U-test or Chi-square test/Fisher's exact test.</p><p><strong>Results: </strong>Admission mean plasma fibrinogen levels (474.82 ± 167.41 mg.dL<sup>-1</sup>) and D-dimer were elevated (1.78 [0.66, 3.62] mg.mL<sup>-1</sup>) in the COVID-19 ICU patients. Overall, COVID-19 patients had mean lower normal platelet count (150 ± 50 × 10<sup>3</sup> cells.mm<sup>-3</sup>), with marginally elevated prothrombin time (16.25 ± 3.76 s) and activated partial thromboplastin time (38.22 ± 16.72 s). A 65.6% (42/64) TEG profile analysis showed a normal coagulation profile, and the rest 21.9% (14/64) and 12.5% (8/64) had hypercoagulable and hypocoagulable states, respectively. Plasma D-dimer level was markedly elevated in nonsurvivors compared to survivors (<i>P</i> < 0.05), while no other conventional coagulation parameters and TEG profile demonstrated statistically significant between the two groups.</p><p><strong>Conclusion: </strong>Markedly elevated plasma D-dimer level was observed in nonsurvivors of COVID-19 ICU patients. A large portion of COVID-19 ICU patients had a normal TEG profile. Conventional coagulation parameters and TEG profile were similar between survivors and nonsurvivors.</p>","PeriodicalId":7798,"journal":{"name":"Anesthesia, Essays and Researches","volume":"16 1","pages":"65-70"},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9558653/pdf/","citationCount":"0","resultStr":"{\"title\":\"Pattern of Conventional Coagulation and Thromboelastographic Parameters in Patients with COVID-19 Diseases and Association of COVID-Associated Coagulopathy with Mortality in Intensive Care Unit.\",\"authors\":\"Awale Rupali Balchandra, Tanmoy Ghatak, Sukhen Samanta, Ratender K Singh, Anupam Verma, Prabhakar Mishra, Rajendra Chaudhary, Alok Nath\",\"doi\":\"10.4103/aer.aer_52_22\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Knowledge of underlying pathophysiology of coagulopathy is evolving and the pattern of coagulation parameters in coronavirus disease 2019 (COVID-19)-associated diseases is still not very clear.</p><p><strong>Aims: </strong>In the present study, we aimed to find out the pattern and distribution of conventional coagulation parameters and thromboelastographic (TEG) parameters in COVID-19-associated coagulopathy (CAC) in survivors and nonsurvivors at 28 days.</p><p><strong>Setting and design: </strong>The present prospective observational study was conducted at a tertiary care COVID-19 intensive care unit (ICU) facility from March 21, 2020, to July 15, 2021.</p><p><strong>Materials and methods: </strong>Admission clinical and laboratory data (conventional coagulation, inflammatory and TEG parameters, and disease severity parameters) of 64 COVID-19 patients admitted to the ICU were collected. Patients were divided into two groups, i.e., survivors and nonsurvivors.</p><p><strong>Statistical analysis: </strong>Data were compared between two groups, i.e., survivors versus no survivors on 28 days using Student's <i>t</i>-test/Mann-Whitney U-test or Chi-square test/Fisher's exact test.</p><p><strong>Results: </strong>Admission mean plasma fibrinogen levels (474.82 ± 167.41 mg.dL<sup>-1</sup>) and D-dimer were elevated (1.78 [0.66, 3.62] mg.mL<sup>-1</sup>) in the COVID-19 ICU patients. Overall, COVID-19 patients had mean lower normal platelet count (150 ± 50 × 10<sup>3</sup> cells.mm<sup>-3</sup>), with marginally elevated prothrombin time (16.25 ± 3.76 s) and activated partial thromboplastin time (38.22 ± 16.72 s). A 65.6% (42/64) TEG profile analysis showed a normal coagulation profile, and the rest 21.9% (14/64) and 12.5% (8/64) had hypercoagulable and hypocoagulable states, respectively. Plasma D-dimer level was markedly elevated in nonsurvivors compared to survivors (<i>P</i> < 0.05), while no other conventional coagulation parameters and TEG profile demonstrated statistically significant between the two groups.</p><p><strong>Conclusion: </strong>Markedly elevated plasma D-dimer level was observed in nonsurvivors of COVID-19 ICU patients. A large portion of COVID-19 ICU patients had a normal TEG profile. Conventional coagulation parameters and TEG profile were similar between survivors and nonsurvivors.</p>\",\"PeriodicalId\":7798,\"journal\":{\"name\":\"Anesthesia, Essays and Researches\",\"volume\":\"16 1\",\"pages\":\"65-70\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9558653/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anesthesia, Essays and Researches\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/aer.aer_52_22\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/6/27 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anesthesia, Essays and Researches","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/aer.aer_52_22","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/6/27 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Pattern of Conventional Coagulation and Thromboelastographic Parameters in Patients with COVID-19 Diseases and Association of COVID-Associated Coagulopathy with Mortality in Intensive Care Unit.
Background: Knowledge of underlying pathophysiology of coagulopathy is evolving and the pattern of coagulation parameters in coronavirus disease 2019 (COVID-19)-associated diseases is still not very clear.
Aims: In the present study, we aimed to find out the pattern and distribution of conventional coagulation parameters and thromboelastographic (TEG) parameters in COVID-19-associated coagulopathy (CAC) in survivors and nonsurvivors at 28 days.
Setting and design: The present prospective observational study was conducted at a tertiary care COVID-19 intensive care unit (ICU) facility from March 21, 2020, to July 15, 2021.
Materials and methods: Admission clinical and laboratory data (conventional coagulation, inflammatory and TEG parameters, and disease severity parameters) of 64 COVID-19 patients admitted to the ICU were collected. Patients were divided into two groups, i.e., survivors and nonsurvivors.
Statistical analysis: Data were compared between two groups, i.e., survivors versus no survivors on 28 days using Student's t-test/Mann-Whitney U-test or Chi-square test/Fisher's exact test.
Results: Admission mean plasma fibrinogen levels (474.82 ± 167.41 mg.dL-1) and D-dimer were elevated (1.78 [0.66, 3.62] mg.mL-1) in the COVID-19 ICU patients. Overall, COVID-19 patients had mean lower normal platelet count (150 ± 50 × 103 cells.mm-3), with marginally elevated prothrombin time (16.25 ± 3.76 s) and activated partial thromboplastin time (38.22 ± 16.72 s). A 65.6% (42/64) TEG profile analysis showed a normal coagulation profile, and the rest 21.9% (14/64) and 12.5% (8/64) had hypercoagulable and hypocoagulable states, respectively. Plasma D-dimer level was markedly elevated in nonsurvivors compared to survivors (P < 0.05), while no other conventional coagulation parameters and TEG profile demonstrated statistically significant between the two groups.
Conclusion: Markedly elevated plasma D-dimer level was observed in nonsurvivors of COVID-19 ICU patients. A large portion of COVID-19 ICU patients had a normal TEG profile. Conventional coagulation parameters and TEG profile were similar between survivors and nonsurvivors.
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