Abudouleh Esra'a, Alhamlan Fatimah, Al-Qahtani Arwa A, Bohol Marie Fe, Al Hazzani Amal, Khorfan Khadija, Alkaff Morad, Owaidah Tarek, Al-Qahtani Ahmed A
Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
Department of Infection and Immunity, Research Centre, King Faisal Specialist Hospital & Research Centre, Riyadh 11211, Saudi Arabia.
J Clin Med. 2023 Aug 10;12(16):5223. doi: 10.3390/jcm12165223.
In this study, coagulation and fibrinolysis parameters and their association with disease severity were investigated in coronavirus disease (COVID-19) patients.
COVID-19 patients ( = 446) admitted to our institute between 21 February 2021 and 17 March 2022, were recruited. Clinical data and staging were collected from all patients. Blood samples were collected and analyzed for several parameters of fibrinolysis and coagulation, including alpha-2-antiplasmin(α2AP) and plasminogen, thrombin activatable fibrinolysis inhibitor (TAFI), tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1), D-dimer, and fibrinogen levels.
The TAFI, fibrinogen, and tPA levels were significantly higher in participants who died compared to that of patients who recovered ( < 0.001). However, PAI-1, tPA, and TAFI were significantly higher in patients admitted to the ICU than those of the healthy controls ( < 0.001 for PAI-1 and tPA; = 0.0331 for TAFI). Our results showed that stage C and D COVID-19 patients had significantly higher levels of PAI-1 ( = 0.003). Furthermore, stage D COVID-19 patients had significantly higher tPA and TAFI values ( = 0.003).
Hypofibrinolysis was the most prevalent condition among patients with severe COVID-19. In this study, several coagulation markers were elevated, making them suitable prognostic markers for hypofibrinolysis.
在本研究中，我们调查了冠状病毒病（COVID-19）患者的凝血和纤溶参数及其与疾病严重程度的关联。
招募了2021年2月21日至2022年3月17日期间入住我院的COVID-19患者（n = 446）。收集了所有患者的临床数据和分期。采集血样并分析纤溶和凝血的几个参数，包括α2-抗纤溶酶（α2AP）、纤溶酶原、凝血酶激活的纤溶抑制物（TAFI）、组织纤溶酶原激活物（tPA）、纤溶酶原激活物抑制剂-1（PAI-1）、D-二聚体和纤维蛋白原水平。
与康复患者相比，死亡患者的TAFI、纤维蛋白原和tPA水平显著更高（P < 0.001）。然而，入住ICU的患者的PAI-1、tPA和TAFI显著高于健康对照组（PAI-1和tPA，P < 0.001；TAFI，P = 0.0331）。我们的结果显示，C期和D期COVID-19患者的PAI-1水平显著更高（P = 0.003）。此外，D期COVID-19患者的tPA和TAFI值显著更高（P = 0.003）。
低纤溶是重症COVID-19患者中最常见的情况。在本研究中，几种凝血标志物升高，使其成为低纤溶的合适预后标志物。
