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Clinical and laboratory features of hypercoagulability in COVID-19 and other respiratory viral infections amongst predominantly younger adults with few comorbidities.
Tan, Chuen Wen; Tan, Jing Yuan; Wong, Wan Hui; Cheong, May Anne; Ng, Ian Matthias; Conceicao, Edwin Philip; Low, Jenny Guek Hong; Ng, Heng Joo; Lee, Lai Heng.
  • Tan CW; Department of Haematology, Singapore General Hospital, 20 College Road, Singapore, 169856, Singapore. tan.chuen.wen@singhealth.com.sg.
  • Tan JY; SingHealth Internal Medicine Residency, Singapore General Hospital, Singapore, Singapore.
  • Wong WH; Department of Haematology, Singapore General Hospital, 20 College Road, Singapore, 169856, Singapore.
  • Cheong MA; Department of Haematology, Singapore General Hospital, 20 College Road, Singapore, 169856, Singapore.
  • Ng IM; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore, Singapore.
  • Conceicao EP; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore, Singapore.
  • Low JGH; Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore.
  • Ng HJ; Programme in Emerging Infectious Diseases, Duke NUS Medical School, Singapore, Singapore.
  • Lee LH; Department of Haematology, Singapore General Hospital, 20 College Road, Singapore, 169856, Singapore.
Sci Rep ; 11(1): 1793, 2021 01 19.
Article in English | MEDLINE | ID: covidwho-1065942
Semantic information from SemMedBD (by NLM)
1. Comorbidity PROCESS_OF Young Adult
Subject
Comorbidity
Predicate
PROCESS_OF
Object
Young Adult
2. Thrombophilia COEXISTS_WITH COVID-19
Subject
Thrombophilia
Predicate
COEXISTS_WITH
Object
COVID-19
3. Complication COEXISTS_WITH Infection
Subject
Complication
Predicate
COEXISTS_WITH
Object
Infection
4. 2019 novel coronavirus CAUSES COVID-19
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
COVID-19
5. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
6. Comorbidity PROCESS_OF Young Adult
Subject
Comorbidity
Predicate
PROCESS_OF
Object
Young Adult
7. Thrombophilia COEXISTS_WITH COVID-19
Subject
Thrombophilia
Predicate
COEXISTS_WITH
Object
COVID-19
8. Complication COEXISTS_WITH Infection
Subject
Complication
Predicate
COEXISTS_WITH
Object
Infection
9. 2019 novel coronavirus CAUSES COVID-19
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
COVID-19
10. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
ABSTRACT
COVID-19 caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and other respiratory viral (non-CoV-2-RV) infections are associated with thrombotic complications. The differences in prothrombotic potential between SARS-CoV-2 and non-CoV-2-RV have not been well characterised. We compared the thrombotic rates between these two groups of patients directly and further delved into their coagulation profiles. In this single-center, retrospective cohort study, all consecutive COVID-19 and non-CoV-2-RV patients admitted between January 15th and April 10th 2020 were included. Coagulation parameters studied were prothrombin time and activated partial thromboplastin time and its associated clot waveform analysis (CWA) parameter, min1, min2 and max2. In the COVID-19 (n = 181) group there were two (1.0 event/1000-hospital-days) myocardial infarction events while one (1.8 event/1000-hospital-day) was reported in the non-CoV-2-RV (n = 165) group. These events occurred in patients who were severely ill. There were no venous thrombotic events. Coagulation parameters did not differ throughout the course of mild COVID-19. However, CWA parameters were significantly higher in severe COVID-19 compared with mild disease, suggesting hypercoagulability (min1 6.48%/s vs 5.05%/s, P < 0.001; min2 0.92%/s2 vs 0.74%/s2, P = 0.033). In conclusion, the thrombotic rates were low and did not differ between COVID-19 and non-CoV-2-RV patients. The hypercoagulability in COVID-19 is a highly dynamic process with the highest risk occurring when patients were most severely ill. Such changes in haemostasis could be detected by CWA. In our population, a more individualized thromboprophylaxis approach, considering clinical and laboratory factors, is preferred over universal pharmacological thromboprophylaxis for all hospitalized COVID-19 patients and such personalized approach warrants further research.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Virus Diseases / Thrombophilia / COVID-19 Type of study: Diagnostic study / Etiology study / Observational study / Randomized controlled trials / Risk factors Limits: Adult / Female / Humans / Male Language: English Journal: Sci Rep Year: 2021 Document Type: Article Affiliation country: S41598-021-81166-y

Full text: Available Collection: International databases Database: MEDLINE Main subject: Virus Diseases / Thrombophilia / COVID-19 Type of study: Diagnostic study / Etiology study / Observational study / Randomized controlled trials / Risk factors Limits: Adult / Female / Humans / Male Language: English Journal: Sci Rep Year: 2021 Document Type: Article Affiliation country: S41598-021-81166-y