Meta of coagulation characteristics in COVID-19 patients

Author: Succeeder    

The 2019 novel coronavirus pneumonia (COVID-19) has spread globally. Previous studies have shown that coronavirus infection can lead to coagulation disorders, mainly manifested as prolonged activated partial thromboplastin time (APTT), thrombocytopenia, D-dimer (D-D) Elevated levels and disseminated intravascular coagulation (DIC), which are associated with higher mortality.

A recent meta-analysis of coagulation function in patients with COVID-19 (including 9 retrospective studies with a total of 1 105 patients) showed that compared with mild patients, severe COVID-19 patients had significantly higher D-D values, Prothrombin time (PT) was longer; increased D-D was a risk factor for exacerbation and a risk factor for death. However, the above-mentioned Meta-analysis included fewer studies and included fewer research subjects. Recently, more large-scale clinical studies on coagulation function in patients with COVID-19 have been published, and the coagulation characteristics of patients with COVID-19 reported in various studies are also Not exactly.

A recent study based on national data showed that 40% of COVID-19 patients are at high risk for venous thromboembolism (VTE), and 11% of high-risk patients develop without preventive measures. VTE. The results of another study also showed that 25% of severe COVID-19 patients developed VTE, and the mortality rate of patients with VTE was as high as 40%. It shows that patients with COVID-19, especially severe or critically ill patients, have a higher risk of VTE. The possible reason is that severe and critically ill patients have more underlying diseases, such as a history of cerebral infarction and malignant tumor, which are all risk factors for VTE, and severe and critically ill patients are bedridden for a long time, sedated, immobilized, and placed on various devices. Treatment measures such as tubes are also risk factors for thrombosis. Therefore, for severe and critically ill COVID-19 patients, mechanical prevention of VTE, such as elastic stockings, intermittent inflatable pump, etc., can be performed; at the same time, the patient's past medical history should be fully understood, and the patient's coagulation function should be assessed in a timely manner. of patients, prophylactic anticoagulation can be initiated if there are no contraindications

The current results suggest that coagulation disorders are more common in severe, critically ill, and dying COVID-19 patients. Platelet count, D-D and PT values ​​are correlated with disease severity and can be used as early warning indicators of disease deterioration during hospitalization.