ABSTRACT
Background : Association between some analytical parameters and clinical evolution of patients infected by SARS-COV-2 is a controversial issue. Aims : Review the relationship between laboratory parameters and severity and/or lethality of the COVID-19. Methods : Observational, cross-sectional and retrospective study. Data obtained from electronic health record of patients over 18 years of age admitted in our hospital, between March and May 2020 with suspected SARS-COV-2 infection. After descriptive statistical study, we did an inferential analysis using Mann-Whitney U test for independent samples, in order to verify association between the results of analytical parameters and the clinical severity (defined by hospitalization in conventional ward vs. intensive care units (ICU)) and/or lethality (alive vs. death at the end of the study). Results : 668 patients were included, 345 men (52%) and 323 women (48%), with a median age of 70 years. 80% of patients had previous comorbidities, 10% were admitted to the ICU, and 17% died.Differences were found in hematimetric parameter between the different groups: leukocytes (10 3 /μl): 8.3 in ICU patients vs. 6.5 in those admitted to the ward;platelet count (10 3 /μl) of 182l in death patients vs. 223 in survivors;hemostasis parameters: D-dimer (DD) (μg/L) of 1379 and 1236 in deceased and admitted to the ICU respectively, compared to 734 and 786 in survivors and not admitted to ICU;and biochemical figures (increase in C-reactive protein (CRP), lactate dehydrogenase (LDH) or cardiac enzymes, the latter, especially, in patients who were deceased, with a median ultrasensitive troponin I (ng/L) of 34.75 vs. 7.1 in survivors. The differences were statistically significant ( P value <0.01). Conclusions : Correlation exist between severity of infection and the increase in leukocytes, neutrophils, DD, CRP and LDH, and lymphopenia, in our sample. Decrease in the platelet count and the increase in cardiac enzymes were associated with an increased risk of mortality.
ABSTRACT
Background : A first publication by Tang et in March 2020 reported a high incidence of Disseminated Intravascular Coagulation (DIC) in patients who died from SARS-COV-2 (COVID-19) infection. Since then, some studies have questioned this high incidence. Aims : To investigate the incidence of DIC in patients with confirmed diagnosis of severe COVID-19, who required admission to the ICU. Methods : Observational, descriptive, and retrospective study that includes patients older than 18 years with severe COVID-19 infection admitted to the ICU of the “Miguel Servet” University Hospital, between March to November 2020. All clinical and laboratory parameters, as well as the clinical conduct, were requested and carried out according to the usual clinical practice. Results : We included 130 patients 60% men, median age of 67 years (24-79), mortality of 40.8%, 9 cases (6.9%) of established DIC were documented, with impact in survival (Figure 1). Conclusions : Mortality in our series is similar to that reported (40%), the incidence in our series is higher than a recently published metaanalysis (6.9 VS 3%). The low incidence of DIC is interesting, because the high frequency of coagulopathy and elevation of D-dimer in the published series so, this raises the question, if there really is a classic DIC in patients with COVID-19. In our series, none of the patients with DIC presented hypofibrinogenemia. These findings support the theory that coagulopathy in COVID-19 patients is different from classic DIC and requires different management and classification.