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COVID-19 患者的凝血功能障碍:系统评价和荟萃分析。

Coagulopathy in patients with COVID-19: a systematic review and meta-analysis.

机构信息

Department of Geriatrics, Peking University First Hospital, Beijing 100034, China.

出版信息

Aging (Albany NY). 2020 Nov 24;12(24):24535-24551. doi: 10.18632/aging.104138.

Abstract

COVID-19 patients frequently exhibit coagulation abnormalities and thrombotic events. In this meta-analysis, we investigated the association between coagulopathy and the severity of COVID-19 illness. Using PubMed, Embase, Cochrane, WanFang Database, CNKI, and medRxiv, a systematic literature search was conducted for studies published between December 1, 2019 and May 1, 2020. We then analyzed coagulation parameters in COVID-19 patients exhibiting less severe and more severe symptoms. All statistical analyses were performed using Stata14.0 software. A total of 3,952 confirmed COVID-19 patients from 25 studies were included in the meta-analysis. Patients with severe symptoms exhibited higher levels of D-dimer, prothrombin time (PT), and fibrinogen (FIB) than patients with less severe symptoms (SMD 0.83, 95% CI: 0.70-0.97, I 56.9%; SMD 0.39, 95% CI: 0.14-0.64, I 79.4%; and SMD 0.35, 95% CI: 0.17-0.53, I 42.4%, respectively). However, platelet and activated partial thromboplastin times did not differ (SMD -0.26, 95% CI: -0.56-0.05, I 82.2%; and SMD -0.14, 95% CI: -0.45-0.18, I 75.7%, respectively). These findings demonstrate that hypercoagulable coagulopathy is associated with the severity of COVID-19 symptoms and that D-dimer, PT, and FIB values are the main parameters that should be considered when evaluating coagulopathy in COVID-19 patients.

摘要

COVID-19 患者常表现出凝血异常和血栓形成事件。在这项荟萃分析中,我们研究了凝血异常与 COVID-19 疾病严重程度之间的关系。使用 PubMed、Embase、Cochrane、万方数据库、中国知网和 medRxiv,对 2019 年 12 月 1 日至 2020 年 5 月 1 日期间发表的研究进行了系统文献检索。然后,我们分析了症状较轻和较重的 COVID-19 患者的凝血参数。所有统计分析均使用 Stata14.0 软件进行。共有 25 项研究的 3952 例确诊 COVID-19 患者纳入荟萃分析。与症状较轻的患者相比,症状较重的患者 D-二聚体、凝血酶原时间(PT)和纤维蛋白原(FIB)水平更高(SMD 0.83,95%CI:0.70-0.97,I 56.9%;SMD 0.39,95%CI:0.14-0.64,I 79.4%;SMD 0.35,95%CI:0.17-0.53,I 42.4%)。然而,血小板和活化部分凝血活酶时间没有差异(SMD -0.26,95%CI:-0.56-0.05,I 82.2%;SMD -0.14,95%CI:-0.45-0.18,I 75.7%)。这些发现表明,高凝性凝血异常与 COVID-19 症状的严重程度相关,D-二聚体、PT 和 FIB 值是评估 COVID-19 患者凝血异常时应考虑的主要参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e67a/7803569/4bf34fc51315/aging-12-104138-g001.jpg

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