Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 4 de 4
Filter
1.
Research and Practice in Thrombosis and Haemostasis ; 5(SUPPL 2), 2021.
Article in English | EMBASE | ID: covidwho-1509072

ABSTRACT

Background : Activation of the coagulation system, as reflected by raised D-dimers, is prevalent in patients with COVID-19 resulting in coagulopathies as well as venous and arterial macro-and microthromboses. Laboratory tests in patients admitted with COVID-19 should include prothrombin time (PT) and D-dimers. The role of platelets in COVID-19 related immunothrombosis has not been extensively documented. Aims : Investigate platelet indices in patients with COVID-19 with raised D-dimer levels and compare the results to COVID-19 infected patients with normal D-dimer levels as well as to COVID-19 uninfected patients with raised D-dimers. Methods : This retrospective observational study was approved by the Human Research Ethics Committee of the University of the Witwatersrand (M201010). The laboratory results of patients admitted to a quaternary referral centre in Johannesburg, South Africa from June to December 2020 were reviewed. Platelet indices including platelet large cell ratio (P-LCR), mean platelet volume (MPV) and platelet distribution width (PDW) were recorded and analysed in the following 3 cohorts: 281 COVID-19 patients with raised D-dimers, 72 COVID-19 patients without raised D-dimers and 51 COVID-19 negative patients with raised D-dimers and disseminated intravascular coagulation (DIC). Results : The platelet indices P-LCR, MPV and PDW in COVID-19 positive patients were statistically different from patients without COVID-19 ( P < 0.001) (Table 1). No statistically significant difference in the platelet indices was however observed between COVID-19 patients with and without raised D-dimers. COVID-19, Corona virus disease-19;n , number of patients;SD, standard deviation;P-LCR, platelet large cell ratio;MPV, mean platelet volume;PDW, platelet distribution width. Conclusions : Platelet laboratory indices are statistically different between COVID-19 positive and COVID-19 negative patients but were not predictive of the presence of an underlying coagulopathy in COVID-19 as reflected by elevated D-dimer levels. The alterations in platelet indices in COVID-19 patients probably reflect activation of platelets and contribution to immunothrombosis.

2.
S Afr Med J ; 111(9): 841-848, 2021 07 20.
Article in English | MEDLINE | ID: covidwho-1404039

ABSTRACT

The increased use of heparin during the current COVID-19 pandemic has highlighted the risk of a rare but potentially serious complication of heparin therapy, viz. heparin-induced thrombocytopenia (HIT). This is a short review on the pharmacology of heparin and its derivatives, and the pathophysiology of HIT. Guidance on laboratory testing for and clinical management of HIT is presented in accordance with international guidelines. There are important similarities and differences between HIT and the new entity of vaccine-induced immune thrombotic thrombocytopenia, also known as thrombosis with thrombocytopenia syndrome, which clinicians need to be aware of.


Subject(s)
Anticoagulants/adverse effects , COVID-19 , Heparin/adverse effects , Thrombocytopenia/chemically induced , Anticoagulants/administration & dosage , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Heparin/administration & dosage , Humans , Thrombocytopenia/diagnosis , Thrombocytopenia/physiopathology
3.
South African Medical Journal ; 111(6):535-537, 2021.
Article in English | EMBASE | ID: covidwho-1264653

ABSTRACT

There have recently been safety concerns regarding an increased risk of vaccine-induced immune thrombotic thrombocytopenia (VITT) following administration of SARS-CoV-2 adenoviral vector vaccines. The Southern African Society of Thrombosis and Haemostasis reviewed the emerging literature on this idiosyncratic complication. A draft document was produced and revised by consensus agreement by a panel of professionals from various specialties. The recommendations were adjudicated by independent international experts to avoid local bias. We present concise, practical guidelines for the clinical management of VITT.

4.
Adv Exp Med Biol ; 1321: 173-180, 2021.
Article in English | MEDLINE | ID: covidwho-1114246

ABSTRACT

The COVID-19 pandemic, caused by the SARS-C0V-2 virus, was initially considered and managed in a similar manner to the previous SARS epidemic as they are both caused by coronaviruses. What has now become apparent is that a major cause of morbidity and mortality in COVID-19 is abnormal thrombosis. This thrombosis occurs on a macro- and microvascular level and is unique to this disease. The virus has been demonstrated in the endothelium of the pulmonary alveoli and as such is thought to contribute to the devastating respiratory complications encountered. D-dimer concentrations are frequently raised in COVID to levels not frequently seen previously. The optimal anticoagulation treatment in COVID remains to be determined, and the myriad of pathophysiologic effects caused by this virus in the human host have also yet to be fully elucidated.


Subject(s)
COVID-19 , Coronavirus , Hemostatics , Humans , Pandemics , SARS-CoV-2
SELECTION OF CITATIONS
SEARCH DETAIL