Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Curr Vasc Pharmacol. 2022;20(1):77-86. doi: 10.2174/1570161119666211014162409.
Coronavirus Disease 2019 (COVID-19) is associated with Coagulopathy (CAC) and Venous Thromboembolism (VTE). These are well-reported complications of COVID-19 infection. Earlier publications have shown that CAC and thromboembolism are predictors of mortality among COVID-19 patients with severe disease.
A prospective study was conducted in the Intensive Care Unit (ICU) where all confirmed COVID-19 patients were enrolled and followed until death or ICU discharge. CAC, VTE, along with all comorbidities, were recorded. Predictors of mortality were determined by univariate and multivariate regression.
Among 261 patients with COVID-19, 48.3% survived and 51.7% died. CAC was present in 53.2% and 76.3% of the survivors and non-survivors, respectively (p<0.001); 89 patients (31.4%) had VTE (p=0.36) and 11 patients (4.2%) had arterial thrombosis (p=0.76) among survivors and nonsurvivors. Age between 71-80 years (p=0.009), male gender (p=0.045), CAC (p<0.001), comorbidities like chronic kidney disease (CKD, p=0.013), chronic obstructive pulmonary disease (COPD, p=0.001) and asthma (p=0.046), were significant predictors of mortality.
A severe complication of COVID-19 is CAC, such as sepsis-induced coagulopathy, overt disseminated-coagulopathy and VTE. Old age, various comorbidities (e.g., COPD, CKD, or asthma), CAC, VTE (pulmonary embolism) and coagulation parameters with critical severity score (D-dimers, platelets, prothrombin time) and the SOFA (Sequential Organ Failure Assessment) score were significant predictors of mortality among COVID-19 patients.
2019 年冠状病毒病（COVID-19）与凝血功能障碍（CAC）和静脉血栓栓塞症（VTE）有关。这些都是 COVID-19 感染的常见并发症。早期的出版物表明，CAC 和血栓栓塞是 COVID-19 重症患者死亡的预测因素。
对重症监护病房（ICU）中的所有确诊 COVID-19 患者进行前瞻性研究，并对其进行随访，直至死亡或 ICU 出院。记录 CAC、VTE 以及所有合并症。通过单变量和多变量回归确定死亡率的预测因素。
在 261 例 COVID-19 患者中，48.3%存活，51.7%死亡。幸存者和非幸存者的 CAC 分别为 53.2%和 76.3%（p<0.001）；89 例（31.4%）幸存者和非幸存者中存在 VTE（p=0.36），11 例（4.2%）有动脉血栓形成（p=0.76）。71-80 岁年龄组（p=0.009）、男性（p=0.045）、CAC（p<0.001）、合并症（如慢性肾脏病[CKD]，p=0.013）、慢性阻塞性肺疾病[COPD]，p=0.001）和哮喘（p=0.046）是死亡率的显著预测因素。
COVID-19 的严重并发症是 CAC，如脓毒症引起的凝血功能障碍、明显的弥散性凝血功能障碍和 VTE。高龄、各种合并症（如 COPD、CKD 或哮喘）、CAC、VTE（肺栓塞）和凝血参数严重程度评分（D-二聚体、血小板、凝血酶原时间）和 SOFA（序贯器官衰竭评估）评分是 COVID-19 患者死亡的显著预测因素。
