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与其他肺炎相比,急性新冠病毒肺炎存在更严重的高凝状态。

More severe hypercoagulable state in acute COVID-19 pneumonia as compared to other pneumonia.

作者信息

Spiezia Luca, Campello Elena, Cola Marco, Poletto Francesco, Cerruti Lorenzo, Poretto Anna, Simion Chiara, Cattelan Annamaria, Vettor Roberto, Simioni Paolo

机构信息

General Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padova University Hospital, Padova, Italy.

Infectious Diseases, Padova University Hospital, Padova Italy.

出版信息

Mayo Clin Proc Innov Qual Outcomes. 2021 Apr 12. doi: 10.1016/j.mayocpiqo.2020.08.014.

Abstract

OBJECTIVE

To conduct a comprehensive evaluation of coagulation profiles - via traditional and whole blood thromboelastometry tests - in COVID-19 positive vs. COVID-19 negative patients admitted to medical wards for acute pneumonia.

PATIENTS AND METHODS

We enrolled all consecutive patients admitted to Internal Medicine wards of Padova University Hospital between 7 March and 30 April 2020 for COVID-19-related pneumonia (cases) vs. non-COVID-19 pneumonia (controls). A group of healthy subjects acted as baseline for thromboelastometry parameters.

RESULTS

Fifty-six cases (mean age 64±15 yrs, M/F 37/19) and 56 controls (mean age 76±11 yrs, M/F 35/21) were enrolled. Cases and controls showed markedly hypercoagulable thromboelastometry profiles vs. healthy subjects, mainly characterized by a significantly shorter propagation phase of coagulation (Clot Formation Time, CFT) and significantly increased maximum clot firmness (MCF) (p <0.001 in all comparisons). COVID-19 patients with pneumonia had significantly shorter CFT and higher MCF (p <0.01 and <0.05, respectively in all comparisons) vs. controls.

CONCLUSION

Patients admitted to internal medicine wards for COVID-19 pneumonia presented a markedly prothrombotic state, which seems peculiar to COVID-19 rather than pneumonia itself.

摘要

目的

通过传统凝血试验和全血血栓弹力图试验,对因急性肺炎入住内科病房的新冠病毒检测阳性与阴性患者的凝血指标进行综合评估。

患者与方法

我们纳入了2020年3月7日至4月30日期间因新冠病毒相关肺炎(病例组)与非新冠病毒肺炎(对照组)入住帕多瓦大学医院内科病房的所有连续患者。一组健康受试者作为血栓弹力图参数的基线。

结果

纳入56例病例(平均年龄64±15岁,男/女37/19)和56例对照(平均年龄76±11岁,男/女35/21)。与健康受试者相比,病例组和对照组的血栓弹力图显示出明显的高凝状态,主要表现为凝血传播期显著缩短(凝血形成时间,CFT)和最大血凝块硬度(MCF)显著增加(所有比较中p<0.001)。与对照组相比,新冠病毒肺炎患者的CFT显著缩短,MCF更高(所有比较中p分别<0.01和<0.05)。

结论

因新冠病毒肺炎入住内科病房的患者呈现出明显的血栓前状态,这似乎是新冠病毒所特有的,而非肺炎本身所致。

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