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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Thromb+Thrombolysis
2020 ; 50
(3
): 580-586
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gab.com Text
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English Wikipedia
Profile of natural anticoagulant, coagulant factor and anti-phospholipid antibody
in critically ill COVID-19 patients
#MMPMID32648093
Zhang Y
; Cao W
; Jiang W
; Xiao M
; Li Y
; Tang N
; Liu Z
; Yan X
; Zhao Y
; Li T
; Zhu T
J Thromb Thrombolysis
2020[Oct]; 50
(3
): 580-586
PMID32648093
show ga
The outbreak of novel coronavirus disease 2019 (COVID-19) has now become a global
pandemic. Coagulopathy has been reported widely in critically ill COVID-19
patients and was related to high mortality. However, the comprehensive
coagulation profiles have not been examined and the underlying mechanism of the
coagulopathy in COVID-19 patients is unclear. To study the coagulation profiles
of routine hemostasis tests, natural anticoagulants, coagulant factors and
antiphospholipid antibodies in critically ill COVID-19 patients. This
single-center and cross-section study included 19 patients with COVID-19, who
were admitted to intensive care unit (ICU) at Tongji hospital in Wuhan, China,
from Feb 23 to Mar 3, 2020. Demographic data, laboratory parameters, treatments
and clinical outcomes of the patients were collected and analyzed. The final date
of follow-up was Mar 31, 2020. In this study, 12 thrombotic events occurred in 9
patients, including 4 cerebral infarctions, 7 acro-ischemia and 1 internal
jugular vein thrombosis. The common abnormalities of routine coagulation tests
included evelated D-Dimer level (100%), prolonged prothrombin time (73.7%) and
hyperfibrinogenemia (73.7%). The median activities of natural anticoagulants
including protein C, protein S and antithrombin were all below the normal range.
Factor VIII activities were significantly above normal range (median value 307%,
IQR 198-441) in all patients. Factor V and factor VII activities were
significantly lower in near-terminal stage patients. Anti-phospholipid antibodies
were present in 10 patients. Strikingly, 4 cerebral infarction events were in
patients had anti-phospholipid antibodies of multiple isotypes. Sustained
hypercoagulable status and thrombotic events were common in critically ill
patients with COVID-19. The low activities of natural anticoagulants, elevated
factor VIII level and the presence of antiphospholipid antibodies, together, may
contribute to the etiopathology of coagulopathy in COVID-19 patients.