Plasma hemostatic system in patients with the novel coronavirus disease 2019 (COVID-19)


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Abstract

Aim. To investigate plasma hemostasis in patients with different levels of COVID-19 severity. Materials and methods. The study included 46 patients with confirmed COVID-19, who were stratified into four groups based on disease severity as mild (1), moderate (2), severe (3), and critically severe (4). Laboratory investigations included APTT, Quick's prothrombin time, concentration of D-dimer, fibrinogen, ATIII, and platelet count. Results. D-dimer concentration >450 ng/ml was found in 100% of patients increasing from 973 (545-1635) ng/ml in group 1 to 13513 (7627-22512) ng/ml in group 4 (p<0.05). Patients in group 2 had the highest fibrinogen level averaging 6.1(3.9-6.4) g/L. The highest and lowest platelet counts were in groups 1 (323X109) and 4 (155x109), respectively, (p <0.05). The ATIII levels in groups 1 and 2 were within the normal range, while in groups 3 and 4, they were decreased to 76% and 64%, respectively (p <0.05). All patients enrolled in the study had normal values of APTT and Quick's prothrombin time. Unfavorable outcomes were observed at a D-dimer concentration> 3633 ng/ml (specificity 92.3%, sensitivity 100%, AUC 0.94, p <0.001, positive predictive value 99.1%, and negative predictive value 100%) and ATIII <70.8% (specificity 70%, sensitivity 82.6%, AUC 0.85, p <0.001, positive predictive value 30.5%, and negative predictive value 96.1%). Conclusion. The levels of D-dimer, fibrinogen, and ATIII were found to be associated with the severity of COVID-19.

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About the authors

Mikhail I. Markelov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: m.markelovl994@mail.ru
Clinical Pathologist, Junior Researcher at the Laboratory of Clinical Immunology

Olga S. Beznoshchenko

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: o_beznoshchenko@oparina4.ru
Clinical Pathologist, Junior Researcher at the Laboratory of Clinical Immunology

Tatiana Yu. Ivanets

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: t_ivanets@oparina4.ru
Dr. Med. Sci., Head of the Clinical Diagnostic Laboratory

Aleksey V. Pyregov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: a_pyregov@oparina4.ru
Dr. Med. Sci., Professor, Director of the Institute of Anesthesiology, Reanimatology and Transfusiology

Rosa M. Esayan

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: r_esayan@oparina4.ru
Ph.D., Endocrinologist, Head of the Department of Internal Medicine

Tatyana Yu. Gavrilova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: t_qavrilova@oparina4.ru
Dr. Med. Sci., Obstetrician-Gynecologist at the Department of Gynecology

Liubov V. Krechetova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: l_krechetova@oparina4.ru
Dr. Med. Sci., Head of the Laboratory of Clinical Immunology

References

  1. Tang N., Bai H., Chen X., Gong J., Li D., Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. Thromb. Haemost. 2020; 18(5): 1094-9. https://dx.doi.org/ 10. 1 1 11/jth.14817.
  2. Xie Y. , Wang X., Yang P., Zhang S. COVID-19 complicated by acute pulmonary embolism. Radiol. Cardiothorac. Imaging. 2020; 2(2): e200067. https://dx.doi. org/ 10.1148/ryct.2020200067.
  3. Panigada M., Bottino N., Tagliabue P., Grasselli G., Novembrino C., Chantarangkul V. et al. Hypercoagulability of COVID-19 patients in Intensive Care Unit. A Rep ort of thromboelastography findings and other parameters of hemostasis. J. Thromb. Haemost. 2020; 18(7): 1738-42. https://dx.doi.org/ 10.1111/ jth. 14 850.
  4. Schmitt F.C.F., Manolov V., Morgenstern J., Fleming T., Heitmeier S., Uhle F. et al. Acute fibrinolysis shutdown occurs early in septic shock and is associated with increased morbidity and mortality: results of an observational pilot study. Ann. Intensive Care. 2019; 9(1): 1-15. https://dx.doi.org/10.1186/s13613-019-0499 -6.
  5. Thachil J., Tang N., Gando S., Falanga A., Cattaneo M., Levi M. et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J. Thromb. Haemost. 2020; 18(5): 1 023-6. https://dx.doi.org/10.1111/ jth.14810.
  6. Klok FA, Kruip M.J.H.A., van der Meer N.J.M., Arbous M.S., Gommers D.A.M.P.J., Kant K.M. et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb. Res. 2020; 191: 145-7. https:// dx.doi.org/ 10.1016/j.thromres.2020.04.013.
  7. Llitjos J.-F., Leclerc M., Chochois C., Monsallier J.-M., Ramakers M., Auvray M. et al. High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients. J. Thromb. Haemost. 2020; 18(7): 1743-6. https://dx.doi. org/ 10.1111/jth.14869.
  8. Ranucci M., Ballotta A, Di Dedda U., Bayshnikova E., Dei Poli M., Resta M. et al. The procoagulant pattern of patients with COVID-19 acute respiratory distress syndrome. J. Thromb. Haemost. 2020; 18(7): 1747-51. https://dx.doi. org/ 10.1111/jth.14854.
  9. Временные методические рекомендации. Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19). Министерствo здравоохранения Российской Федерации. Версия 7(03.06.2020): 10-1
  10. Макацария А.Д., Григорьева К.Н., Мингалимов М.А., Бицадзе В.О., Хизроева Д.Х., Третьякова М.В., Элалами И., Шкода А.С., Немировский В.Б., Блинов Д.В., Митрюк Д.В. Коронавирусная инфекция (COVID-19) и синдром диссеминированного внутрисосудистого свертывания. Акушерство, гинекология и репродукция. 2020; 14(2): 123-31. https:// doi.org/10.17749/2313-7347.132
  11. Crawford F., Andras A., Welch K., Sheares K., Keeling D., Chappell F.M. D-dimer test for excluding the diagnosis of pulmonary embolism. Cochrane Database Syst. Rev. 2016; 2016(8): CD010864. https://dx.doi.ois/ 10.1002/14651858. CD010864.pub2.
  12. Wang D., Hu B., Hu C., Zhu F., Liu X., Zhang J. et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; 323(11): 1061-9. https://dx.doi.org/ 10.1001/ jama.2020.1585.
  13. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395 (10223): 497-506. https://dx.doi.org/10.1016/S0140-6736(20)30183-5.
  14. Wu C., Chen X., Cai Y., Xia J., Zhou X., Xu S. et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern. Med. 2020; 180(7): 1-11. https://dx.doi.org/10.1001/jamainternmed. 2020.0994.
  15. Lippi G., Plebani M., Henry B.M. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin. Chim. Acta. 2020; 506: 145-8. https://dx.doi.org/10.1016/j.cca.2020.03.022
  16. Han H., Yang L., Liu R., Liu F., Wu K.L., Li J. et al. Prominent changes in blood coagulation of patients with SARS-CoV-2 infection. Clin. Chem. Lab. Med. 2020; . 58(7): 1116-20. https://dx.doi.org/10.1515/ cclm-2020-0188
  17. Tang N., Li D., Wang X., Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J. Thromb. Haemost. 2020; 18(4): 844-7. https://dx.doi.org/10.1111/jth.14768.

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