Department of Transfusion, Wuhan First Hospital, Wuhan, China.
Department of Transfusion, General Hospital of Central Theater Command of the PLA, Wuhan, China.
Int J Lab Hematol. 2020 Dec;42(6):766-772. doi: 10.1111/ijlh.13273. Epub 2020 Jun 27.
Characteristics of blood coagulation and its relation to clinical outcomes in COVID-19 patients are still rarely reported. We aimed to investigate the blood coagulation function and its influences on clinical outcomes of patients with syndrome coronavirus 2 (SARS-CoV-2) infection.
A total of 71 severe patients with confirmed SARS-CoV-2 infection who were treated in Wuhan First Hospital from February 12 to March 20, 2020, were enrolled. The blood coagulation data in these patients and in 61 healthy controls were collected. The patients with COVID-19 were divided into two groups: the aggravated group and the nonaggravated group, respectively, basing on whether the patients' conditions turned to critically ill or not after admission.
Compared with healthy controls, patients with COVID-19 had significant performances with coagulation dysfunction, including dramatically elevated values of FIB, PT, APTT, INR, FDP, and D-Dimers but markedly reduced AT value (P < .05). Importantly, more noteworthy coagulation disorders similar to the differences between patients and controls were found in the aggravated patients with conditions deterioration after admission than those in the nonaggravated patients without conditions deterioration (P < .05). Moreover, the aggravated patients possessed a longer hospital stay and a higher mortality compared with the nonaggravated patients (P < .001). The coagulation parameters of COVID-19 patients were widely and closely related to the indexes of liver function and inflammation (P < .05), indicating the coagulation dysfunction of these patients may be caused by liver injury and inflammatory storm.
Severe patients with SARS-CoV-2 infection often possess coagulation dysfunction on admission. A certain correlation exists in coagulation disorder and adverse clinical outcome among severe COVID-19 patients.
COVID-19 患者的凝血特征及其与临床结局的关系仍鲜有报道。本研究旨在探讨凝血功能及其对 2019 年冠状病毒病（SARS-CoV-2）感染患者临床结局的影响。
本研究共纳入 2020 年 2 月 12 日至 3 月 20 日在武汉市第一医院治疗的 71 例确诊 SARS-CoV-2 感染的重症患者。收集这些患者和 61 名健康对照者的凝血数据。根据患者入院后病情是否恶化至危重症，将 COVID-19 患者分为加重组和未加重组。
与健康对照组相比，COVID-19 患者表现出明显的凝血功能障碍，包括纤维蛋白原（FIB）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、国际标准化比值（INR）、纤维蛋白降解产物（FDP）和 D-二聚体（D-Dimer）显著升高，而抗凝血酶（AT）值显著降低（P<.05）。重要的是，与未恶化患者相比，入院后病情恶化的加重患者的凝血障碍与患者和对照组之间的差异更为显著（P<.05）。此外，与未恶化患者相比，加重患者的住院时间更长，死亡率更高（P<.001）。COVID-19 患者的凝血参数与肝功能和炎症指标广泛且密切相关（P<.05），表明这些患者的凝血功能障碍可能是由肝损伤和炎症风暴引起的。
SARS-CoV-2 感染的重症患者入院时常伴有凝血功能障碍。重症 COVID-19 患者的凝血障碍与不良临床结局存在一定相关性。
