Mazzaccaro Daniela, Giacomazzi Francesca, Giannetta Matteo, Varriale Alberto, Scaramuzzo Rosa, Modafferi Alfredo, Malacrida Giovanni, Righini Paolo, Marrocco-Trischitta Massimiliano M, Nano Giovanni
Operative Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, 20026 Milan, Italy.
Cardiovascular Department, IRCCS Policlinico San Donato, San Donato Milanese, 20026 Milan, Italy.
J Clin Med. 2020 Jun 8;9(6):1781. doi: 10.3390/jcm9061781.
Aim of the study is to assess the occurrence of early stage coagulopathy and disseminated intravascular coagulation (DIC) in patients with mild to moderate respiratory distress secondary to SARS-CoV-2 infection.
Data of patients hospitalized from 18 March 2020 to 20 April 2020 were retrospectively reviewed. Two scores for the screening of coagulopathy (SIC and non-overt DIC scores) were calculated. The occurrence of thrombotic complication, death, and worsening respiratory function requiring non-invasive ventilation (NIV) or admission to ICU were recorded, and these outcomes were correlated with the results of each score. Chi-square test, receiver-operating characteristic curve, and logistic regression analysis were used as appropriate. Values < 0.05 were considered statistically significant.
Data of 32 patients were analyzed. Overt-DIC was diagnosed in two patients (6.2%), while 26 (81.2%) met the criteria for non-overt DIC. Non-overt DIC score values ≥4 significantly correlated with the need of NIV/ICU ( = 0.02) and with the occurrence of thrombotic complications ( = 0.04). A score ≥4 was the optimal cut-off value, performing better than SIC score ( = 0.0018). Values ≥4 in patients with thrombotic complications were predictive of death ( = 0.03).
Overt DIC occurred in 6.2% of non-ICU patients hospitalized for a mild to moderate COVID-19 respiratory distress, while 81.2% fulfilled the criteria for non-overt DIC. The non-overt DIC score performed better than the SIC score in predicting the need of NIV/ICU and the occurrence of thrombotic complications, as well as in predicting mortality in patients with thrombotic complications, with a score ≥4 being detected as the optimal cut-off.
本研究的目的是评估新型冠状病毒肺炎（SARS-CoV-2）感染继发轻至中度呼吸窘迫患者早期凝血功能障碍和弥散性血管内凝血（DIC）的发生情况。
回顾性分析2020年3月18日至2020年4月20日住院患者的数据。计算了两种用于筛查凝血功能障碍的评分（SIC和非显性DIC评分）。记录血栓并发症、死亡以及需要无创通气（NIV）或入住重症监护病房（ICU）的呼吸功能恶化情况，并将这些结果与各评分结果相关联。酌情使用卡方检验、受试者工作特征曲线和逻辑回归分析。P值<0.05被认为具有统计学意义。
分析了32例患者的数据。2例患者（6.2%）被诊断为显性DIC，而26例（81.2%）符合非显性DIC标准。非显性DIC评分≥4与需要NIV/ICU（P = 0.02）以及血栓并发症的发生（P = 0.04）显著相关。评分≥4是最佳临界值，其表现优于SIC评分（P = 0.0018）。血栓并发症患者中评分≥4可预测死亡（P = 0.03）。
因轻至中度新型冠状病毒肺炎呼吸窘迫住院的非ICU患者中，6.2%发生显性DIC，而81.2%符合非显性DIC标准。在预测NIV/ICU需求、血栓并发症的发生以及血栓并发症患者的死亡率方面，非显性DIC评分优于SIC评分，评分≥4被确定为最佳临界值。
