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2.
Research and Practice in Thrombosis and Haemostasis ; 5(SUPPL 2), 2021.
Article in English | EMBASE | ID: covidwho-1509096

ABSTRACT

Background : COVID-19 frequently associated thrombotic complication that could determine severe evolution. Inflammation was proved as important pathogenic mechanism of thrombosis. Aims : The main objective was to evaluate the role of inflammation in increased risk of thrombosis in COVID 19 patients. Methods : Our study was prospective and included all patients diagnosed with COVID 19 between April-September 2020 in Hematology, Pneumology and Intensive Care Unit from Colentina Clinical Hospital (285 patients). The diagnosis was established using molecular test for SARS-Cov2. Results : Thrombotic complication was presented in 56 COVID-19 patients (19, 65%), The higher incidence of thrombosis was observed in severe form of COVID-19: stage 3 (66%) and stage 2 (26.3%), Comorbidities: diabetes mellitus, obesity and arterial hypertension were presented in majority of COVID 19 patients with thrombosis. Acute thrombosis (stroke, myocardial infarction or pulmonary embolism) was diagnosed in 14 patients;all of them were admitted in Intensive care unit due severe form of COVID-19. Inflammatory markers including C reactive protein (CRP), procalcitonin, ferritin are significantly increased in COVID-19 group with acute thrombosis compared with COVID -19 patients with thrombosis in medical history CRP 148.86 mg/L (2.96-386.5) vs. 58.24 mg/L (min 0.25, max 212.98) P = 0.005;procalcitonin 0.93 ng/ml (0.04-784) vs 0.18 (min 0.02, max 14.1) P = 0.02;ferritin 702 ng/ml (min 102, max 4070) vs. 1195 ng/ml (min 358, max 12800) P = 0.03. There is no significant difference between haematological parameters in COVID-19 patients with acute thrombosis or in their medical history. D Dimers are significant increased in patients with acute thrombosis 4.79 ug/ml (0.51-20) vs patients with medical history of thrombosis 2.12 (0.31-20), P = 0.02. The level of protein C, protein S and antitrombine III, antiphospholipid antibodies are not significant modified in the both groups. Conclusions : The assessment of inflammation parameters are very important in COVID-19 patients especially those with a history of thrombosis or who have significant comorbidities (diabetes mellitus, arterial hypertension or obesity).

3.
HemaSphere ; 5(SUPPL 2):383, 2021.
Article in English | EMBASE | ID: covidwho-1393444

ABSTRACT

Background: The severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) was first reported in Wuhan, China in December2019 and represented the pathogen agent that induced COVID-19. The onset and evolution of COVID -19 is severe when is associated with another comorbidities. Patients with acute leukemia present high risk for severe form of COVID-19 Aims: The main objective was to evaluate the particularities of COVID-19 in patients with acute leukemia. Methods: Our study was prospective and included 49 patients with acute leukemia (27 male median age 64 and22 female median age 54,5) who also were SARS CoV2 positive between April2020- February2021 admitted in Hematology and Intensive Care Unit Departments of Colentina Clinical Hospital Bucharest. The diagnosis was established using molecular test for SARS-Cov2 Results: In the group was included 32 patients diagnosed with acute myeloid leukemia (AML), 9 patients with acute lymphoid leukemia (ALL), 6 patients with acut promyelocytic leukemia and2 patients with acute bifenotypic leukemia. Severe form of COVID-19 with ICU addmission was diagnosed in16 patients (32,17%), almost all of them (15 patients) had unfavourable evolution compared with non-ICU patients group with only1 deceased patient, p<0.0001. The recent chemotherapy followed by severe aplasia was the main negative factor that impacted patient evolution (rho=0.508, p=0.0002),13 patients admitted in ICU Department and12 patients in non-ICU. Severe pneumonia (more than 30% lung field) was diagnosed in17 patients with recent chemotherapy and 4 untreated patients. The type of leukemia or refractory status have not any impact of patient evolution. Antiviral therapy - Remdesivir rapidly introduced in patient's therapy was followed by favourable evolution. Summary/Conclusion: Patients with acute leukemia are negatively impacted by intensive chemotherapy during COVID-19 evolution. The key for good prognosis of these patients during COVID-19 are rapid diagnosis and antiviral therapy at the onset of the disease.

5.
Clinical Lymphoma, Myeloma and Leukemia ; 20:S228, 2020.
Article in English | EMBASE | ID: covidwho-989493

ABSTRACT

Context: Coronavirus disease 2019 (COVID-19) is a highly infectious disease. A small proportion of COVID patients are positive for SARS-CoV-2 for long time. We report a COVID-19 patient with prolonged presence of SARS-CoV-2 RNA. Objective: In this study we evaluate the unexpected evolution of patients with CLL diagnosed with COVID-19. Design and Setting: We have a prospective study that included all CLL patients admitted in the Hematology Department of Colentina Clinical Hospital, during April-June 2020. Patients or other participants: The study group included 3 CLL patients. All patients were SARS-CoV-2 positive by molecular test. Results: 1st patient: A 53-year-old male diagnosed with COVID on 25th March, 2020, at the onset presented fever, headache, and associated anal abscess. The patient had a history of diabetes mellitus and CLL (starting 2014). The CLL patient was monitored as a “watch and wait” patient until 2019 when started on Ibrutinib (was stopped on 16th March, 2020). He received antiviral+hydroxychloroquine associated with antibiotics Piperacilin/Tazobactam and Linezolid with favourable evolution and resolution of anal abscess. During surgical monitoring (week 3), patient presented fever, chills, cough and dyspnea. CT scan revealed bilateral COVID pneumonia and associated Klebsiella pneumonie infection in sputum by Biofire exam. Antibiotics treatment (Vancomycin, Colimicin, and Meropenem), antifungal treatment (Caspofungin), and Tocilizumab 640 mg was started with favourable evolution but patient is still SARS-CoV-2-positive (50 days). The long-time of positive SARS-CoV-2 status although the patient received COVID treatment including Tocilizumab is not an usual evolution for COVID patient 2nd and 3rd patients watch and wait CLL patients with positive SARS-CoV-2 test and ongoing evolution during 2 weeks. Compared with the rest of patients, including AML or MPN patients (negativity of SARS-CoV-2 test was obtained in maximum 2 weeks), CLL patients had long evolution. Conclusions: These cases suggest that a small proportion of COVID patients like CLL patients may have prolonged positivity for SARS-CoV-2 RNA although the evolution is not severe.

6.
Clinical Lymphoma, Myeloma and Leukemia ; 20:S217, 2020.
Article in English | EMBASE | ID: covidwho-989492

ABSTRACT

Context: Coronavirus disease 2019 (COVID-19) is a highly infectious disease. Severity of this disease is associated with comorbidities present (hypertension, obesity, pulmonary disease) or with age. Objective: In this study, we evaluate haematological and biochemistry parameters in order to obtain indications for unfavourable evolution of the patient. Design and Setting: We performed a prospective study that included all patients admitted in our hospital in Hematology, Pneumology, and ICU at Department Colentina Clinical Hospital during April and May 2020. Patients or other participants: The study group included 80 patients that was split into ICU and non-ICU patients. All patients were SARS-CoV-2-positive by molecular test. The distribution according to gender was: 47 male with median age: 73 (min 35, max 88) and 33 female with median age: 50 (min 17, max 84). Results: Age is an important risk factor for the severity, as the median age of patients admitted in ICU was 73 (min 43, max 88) compared with non-ICU patients 41 (min 17, max 64), p=0.00004. Comorbidities associated were important but were present in both groups. In ICU patients, we obtained lower level of lymphocytes compared with non ICU group median: 0.87× 103/L (min 0.09 × 103/L max 7.04 × 103/L) vs 2.17 × 103/L (min 0.19 × 103/L max 3.28 × 103/L), p=0.01. There are no significant differences between groups for the rest of haematological parameters. The biochemistry markers ferritin, AST, ALT, LDH, and D Dimers are important in evaluation of COVID-19 patients;there are statistical differences between ICU and non ICU patients (median value: LDH 405.5 UI/l vs 215 U/l, p=0.001;ferritin 1275 ng/ml vs. 161 ng/ml, p=0.002;D Dimers 2.61 mg/ml FEU vs 0.39 mg/ml FEU, p=0.002;AST 70.9 U/l vs. 19.9 U/l, p=0.0003;ALT 50.05 U/l vs. 18.5 U/l, p=0.009). The ICU patients with unfavourable evolution had a higher level of D-Dimers at the admission in hospital compared with ICU patients who was discharged from the hospital (3.42 mg/ml FEU vs 1.09 mg/ml FEU, p=0.01). We did not obtain statistical significance between ICU groups for all haematological and biochemistry parameters. Conclusions: We conclude that lymphocyte count, LDH, AST, ALT, and ferritin at the time of hospital admission is important to evaluate in COVID-19 patient in order to expect a severe evolution of the disease. D-Dimer should be an important parameter to evaluate for all COVID-19 patients. Anti-thrombotic therapy is important to be introduced in COVID-19 patients.

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