Moya-Salazar Jeel, Cóndor Liliana Y, Zuñiga Nahomi, Jaime-Quispe Alexis, Moya-Salazar Belén, Chicoma-Flores Karina, Cañari Betsy, Contreras-Pulache Hans
South America Center for Education and Research in Public Health Universidad Norbert Wiener Lima Peru.
Pathology Deparment Hospital Nacional Docente Madre Niño San Bartolomé Lima Peru.
Health Sci Rep. 2023 Mar 15;6(3):e1105. doi: 10.1002/hsr2.1105. eCollection 2023 Mar.
COVID-19 is a pandemic disease that can lead to altered lung function, systemic inflammatory events, and altered coagulation. During severe stages of the disease, changes in coagulation homeostasis increase, leading to thrombosis, and increased risk of death. In this cross-sectional study, we aimed to assess coagulation markers by COVID-19 severity in Peruvian adults.
During the second wave of infections, we included 186 adults diagnosed with COVID-19 (mean age 53.3 ± 16.3 years). Patients were divided into mild, moderate, and severe stages of COVID-19, and coagulation markers included prothrombin time (PT), activated partial prothrombin time (aPTT), fibrinogen, d-dimer, and platelet count.
Of the total, 120 (64.5%) were males and 39 (21%) were in the intensive care unit. We determine 104 (55.9%), 43 (24.7%), and 36 (19.4%) patients in mild, moderate, and severe stages of COVID-19, respectively. In the severe stage of COVID-19, patients had an average concentration of PT, aPTT, fibrinogen, d-dimer, and platelets of 13.2 ± 0.9 s, 28.9 ± 4.3 s, 679.4 ± 185.1 mg/dL, 1.9 ± 3.1 µg/mL, and 272.8 ± 88.9 cel/10 mm, respectively. We found no differences in the concentration of each marker according to severity ( < 0.05). Patients with severe COVID-19 had altered the aPTT, fibrinogen, d-dimer, and PT in 31 (57.4%), 48 (88.9%), 37 (68.5%), and 15 (27.8%) cases, respectively.
Our results showed that although there is an alteration in coagulation markers, mainly fibrinogen and d-fiber, there are no differences in concentration according to the severity of COVID-19.
新型冠状病毒肺炎（COVID-19）是一种大流行病，可导致肺功能改变、全身炎症反应以及凝血功能改变。在疾病的严重阶段，凝血稳态变化加剧，导致血栓形成，死亡风险增加。在这项横断面研究中，我们旨在评估秘鲁成年人中COVID-19严重程度与凝血标志物之间的关系。
在第二波感染期间，我们纳入了186例确诊为COVID-19的成年人（平均年龄53.3±16.3岁）。患者被分为COVID-19的轻度、中度和重度阶段，凝血标志物包括凝血酶原时间（PT）、活化部分凝血活酶时间（aPTT）、纤维蛋白原、D-二聚体和血小板计数。
总计120例（64.5%）为男性，39例（21%）入住重症监护病房。我们分别确定了104例（55.9%）、43例（24.7%）和36例（19.4%）处于COVID-轻度、中度和重度阶段的患者。在COVID-19的重度阶段，患者的PT、aPTT、纤维蛋白原、D-二聚体和血小板平均浓度分别为13.2±0.9秒、28.9±4.3秒、679.4±185.1mg/dL、1.9±3.1μg/mL和272.8±88.9个/10mm³。根据严重程度，我们未发现各标志物浓度存在差异（P<0.05）。重度COVID-19患者的aPTT、纤维蛋白原、D-二聚体和PT改变的病例分别为31例（57.4%）、48例（88.9%）、37例（68.5%）和15例（27.8%）。
我们的结果表明，尽管凝血标志物存在改变，主要是纤维蛋白原和D-二聚体，但根据COVID-19的严重程度，其浓度并无差异。
