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Cross-talk between the Inflammatory Response and Coagulopathy: Single-center Report
Research and Practice in Thrombosis and Haemostasis ; 5(SUPPL 2), 2021.
Article in English | EMBASE | ID: covidwho-1509134
ABSTRACT

Background:

Covid-19 appeared quaint with evolving hyperinflammation phase, vasculoendothelial dysfunction, and a distinct coagulopathy.

Aims:

We present our experience regarding coagulopathy predictive factors in hospitalized Covid-19 patients just after pandemic declaration.

Methods:

The data were obtained retrospectively by screening the institution's electronic data system between March and May 2020. The treatment protocol based on Health Ministry guidelines, includes hydroxychloroquine, azithromycin, favipiravir, low-molecular-weight heparin, dipyridamole, and anti-cytokine agents on the hyperinflammation phase. We stratified 3 groups, patients with proven coagulopathy, highly suspected coagulopathy, and patients without coagulopathy. Highly suspected coagulopathy encompasses clinical deterioration with sudden and inconsistent D-dimer elevation.

Results:

A total of 511 patients were screened. Forty-nine of them were excluded due to accompanying conditions resulting in high D-dimer levels. The median age of the remaining patients was 56 years with a male/female ratio of 284/178. Proven coagulopathy as documented thrombosis developed in 3.2% with a male predominance (60%). Highly suspected coagulopathy was decided in 10.1% of patients. Among predictive factors for coagulopathy, the risk factors at admission were being over 65-year-old, having coronary artery disease, dyspnea, severe lymphopenia (<500/μl), monocytopenia (<300/ μl), and elevated LDH. For highly suspected coagulopathy, in addition to these having more than 3 comorbidities, high initial ferritin (>1000 ng/ml) and d-dimer levels as greater than 3600 U/ml were also predictive. The clinical pictures in the proven coagulopathy group included 5 myocardial infarctions, 4 disseminated intravascular coagulation (DIC), 2 deep vein thrombosis, 1 catheter-related venous thrombosis, 1 catheter-related venous thrombosis, and pulmonary embolism, 1 lower extremity arterial thrombosis, 1 stroke. All DIC cases had gram-negative bacterial sepsis.

Conclusions:

Our data suggest coagulopathy is not directly correlated with inflammation severity but patients in hyperinflamation phase should be pursued for possible proven coagulopathy.

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Randomized controlled trials Language: English Journal: Research and Practice in Thrombosis and Haemostasis Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Randomized controlled trials Language: English Journal: Research and Practice in Thrombosis and Haemostasis Year: 2021 Document Type: Article