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  • Clinical and coagulation characteristics in 7 patients with critical COVID-2019 pneumonia and acro-ischemia #MMPMID32447934
  • Zhang Y; Cao W; Xiao M; Li YJ; Yang Y; Zhao J; Zhou X; Jiang W; Zhao YQ; Zhang SY; Li TS
  • Zhonghua Xue Ye Xue Za Zhi 2020[Apr]; 41 (4): 302-307 PMID32447934show ga
  • Objective: To investigate the clinical and coagulation characteristics in patients with critical Coronavirus disease 2019 (COVID-19) and acro-ischemia. Methods: The retrospective study included 7 critical COVID-19 patients with acro-ischemia in an intensive care unit (ICU) in Wuhan, from Feb 4 to Feb 15, 2020. The clinical and laboratory data before and during the ICU stay were analyzed. Results: The median age of 7 patients was 59 years and 4 of them were men. Three patients were associated with underlying comorbidities. Fever, cough, dyspnea and diarrhea were common clinical symptoms. All patients had acro-ischemia presentations including finger/toe cyanosis, skin bulla and dry gangrene. D-dimer, fibrinogen and fibrinogen degradation product (FDP) were significantly elevated in most patients. Prothrombin time was prolonged in 4 patients. D-dimer and FDP levels progressively elevated consistent with COVID-2019 exacerbation. Four patients were diagnosed with disseminated intravascular coagulation (DIC) . Low molecular weight heparin (LMWH) was administrated in 6 patients, which reduced D-dimer and FDP rather than improved clinical symptoms. Five patients died finally and the median time from acro-ischemia to death was 12 days. Conclusions: Coagulation parameters should be monitored closely in critical COVID-2019 patients. The timing and protocol of anticoagulation therapy are still under investigation based on more clinical data.
  • |Anticoagulants/*therapeutic use[MESH]
  • |Betacoronavirus[MESH]
  • |COVID-19[MESH]
  • |China[MESH]
  • |Coronavirus Infections/*complications/drug therapy[MESH]
  • |Female[MESH]
  • |Fibrin Fibrinogen Degradation Products/analysis[MESH]
  • |Heparin, Low-Molecular-Weight/*therapeutic use[MESH]
  • |Humans[MESH]
  • |Ischemia/*drug therapy/virology[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*complications/drug therapy[MESH]
  • |Retrospective Studies[MESH]
  • |SARS-CoV-2[MESH]

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  • suck abstract from ncbi

    302 4.41 2020