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凝血指标在预测新型冠状病毒肺炎患者疾病严重程度中的作用

Role of Coagulation Profile in Predicting Disease Severity Among Patients of COVID-19.

作者信息

Saurabh Animesh, Dey Biswajit, Raphael Vandana, Deb Prakash, Khonglah Yookarin, Tiewsoh Iadarilang

机构信息

Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, IND.

Anesthesiology and Critical Care, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, IND.

出版信息

Cureus. 2021 Oct 29;13(10):e19124. doi: 10.7759/cureus.19124. eCollection 2021 Oct.

Abstract

Background Coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), affects the coagulation cascade. In this retrospective study, we aimed to analyze the association of different coagulation parameters including that of D-dimer, fibrinogen, prothrombin time (PT), and activated partial thromboplastin time (aPTT) with severity in COVID-19 patients. Methodology A total of 90 patients positive for SARS-CoV-2 on real-time reverse transcription-polymerase chain reaction (rRT-PCR) were included in the study. The patients were categorized as severe and non-severe, and their D-dimer, fibrinogen, PT, and aPTT values on admission were evaluated. The association of the coagulation parameters with disease severity was analyzed by independent t-test and Chi-square test. The cut-off values of these parameters were calculated to predict the disease severity by receiver operator characteristic (ROC) curve. Results Out of 90 patients admitted, 42 patients were categorized as severe and the rest 48 patients were categorized as non-severe. D-dimer, fibrinogen, and PT in the severe group were significantly higher than the non-severe group with p-values of <0.001, 0.005, and <0.001, respectively. Cut-off values of 0.99 mg/L for D-dimer,349.5 mg/dL for fibrinogen, and 13.05 seconds for PT were predictive of disease severity among COVID-19 patients. Conclusion Severe COVID-19 patients showed significantly higher levels of D-dimer and fibrinogen and prolongation of PT as compared to non-severe COVID-19 patients. Higher levels of D-dimer and fibrinogen, and prolonged PT are predictive of increased disease severity among COVID-19 patients.

摘要

背景 新型冠状病毒肺炎(COVID-19)由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起,会影响凝血级联反应。在这项回顾性研究中,我们旨在分析包括D-二聚体、纤维蛋白原、凝血酶原时间(PT)和活化部分凝血活酶时间(aPTT)在内的不同凝血参数与COVID-19患者病情严重程度之间的关联。方法 本研究共纳入90例实时逆转录聚合酶链反应(rRT-PCR)检测SARS-CoV-2呈阳性的患者。将患者分为重症组和非重症组,并评估其入院时的D-二聚体、纤维蛋白原、PT和aPTT值。通过独立样本t检验和卡方检验分析凝血参数与疾病严重程度之间的关联。通过受试者工作特征(ROC)曲线计算这些参数的临界值,以预测疾病严重程度。结果 在90例入院患者中,42例被分类为重症,其余48例被分类为非重症。重症组的D-二聚体、纤维蛋白原和PT显著高于非重症组,p值分别<0.001、0.005和<0.001。D-二聚体临界值为0.99 mg/L、纤维蛋白原为349.5 mg/dL、PT为13.05秒可预测COVID-19患者的疾病严重程度。结论 与非重症COVID-19患者相比,重症COVID-19患者的D-二聚体和纤维蛋白原水平显著更高,PT延长。较高水平的D-二聚体和纤维蛋白原以及延长的PT可预测COVID-19患者疾病严重程度增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afed/8614174/e270d8f10371/cureus-0013-00000019124-i01.jpg

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