Popazu Corina, Romila Aurelia, Petrea Marius, Grosu Robert Marius, Lescai Alina-Maria, Vlad Adriana Liliana, Oprea Violeta Diana, Baltă Alexia Anastasia Ștefania
Clinical-Medical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, Str. Domnească 35, 800201 Galaţi, Romania.
Medical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, Str. Domnească 35, 800201 Galaţi, Romania.
Life (Basel). 2025 Feb 26;15(3):370. doi: 10.3390/life15030370.
Elderly patients with COVID-19 often exhibit a complex interplay between hypercoagulability and coagulopathy, key factors in determining the risk of severe complications and mortality. This study aimed to analyze coagulation and inflammatory markers to identify critical predictors of adverse outcomes in this vulnerable population. The retrospective study was conducted on a sample of 1429 elderly patients (≥60 years) diagnosed with COVID-19, hospitalized in "Sf. Ap. Andrei" St. Apostle Andrew's County Emergency Hospital in various wards between March 2020 and August 2022. Data were collected from medical records and included inflammatory markers (C-reactive protein, procalcitonin, ESR) and coagulation markers (prothrombin time, INR, fibrinogen, D-dimer). The SPSS 2.0 statistical software was used to conduct the study. : Prothrombin activity averaged 74.22%, below normal levels, indicating a heightened bleeding risk, while fibrinogen levels were significantly elevated (mean: 531.69 mg/dL), reflecting hypercoagulability. Prolonged prothrombin time (mean: 17.28 s) and elevated INR () (mean: 1.51) were associated with increased mortality, emphasizing their role in risk stratification. Elevated D-dimer levels (mean: 2.75 mg/L) further highlighted thromboembolic risks. : C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) showed marked elevations (mean CRP: 92.09 mg/L, mean ESR: 58.47 mm/h), correlating with heightened systemic inflammation and poor outcomes. : Elevated procalcitonin (mean: 1.98 ng/mL) suggested secondary bacterial infections, particularly in mechanically ventilated patients, significantly worsening prognosis. The duality of hypercoagulability and coagulopathy in elderly COVID-19 patients underscores the importance of consistently monitoring coagulation markers such as prothrombin time, INR, D-dimer, and fibrinogen. Simultaneously, elevated inflammatory markers and secondary bacterial infections require prompt therapeutic interventions. This study highlights the critical need for personalized management strategies to mitigate complications and reduce mortality in this high-risk population.
患有新冠肺炎的老年患者通常在高凝状态和凝血病之间表现出复杂的相互作用，这是决定严重并发症风险和死亡率的关键因素。本研究旨在分析凝血和炎症标志物，以确定这一脆弱人群不良结局的关键预测因素。这项回顾性研究对1429名年龄≥60岁、被诊断为新冠肺炎的老年患者进行，这些患者于2020年3月至2022年8月期间在“圣使徒安德鲁”县急救医院的各个病房住院。数据从病历中收集，包括炎症标志物（C反应蛋白、降钙素原、血沉）和凝血标志物（凝血酶原时间、国际标准化比值、纤维蛋白原、D-二聚体）。使用SPSS 2.0统计软件进行研究。：凝血酶原活性平均为74.22%，低于正常水平，表明出血风险增加，而纤维蛋白原水平显著升高（平均：531.69mg/dL），反映高凝状态。凝血酶原时间延长（平均：17.28秒）和国际标准化比值升高（平均：1.51）与死亡率增加相关，强调了它们在风险分层中的作用。D-二聚体水平升高（平均：2.75mg/L）进一步突出了血栓栓塞风险。：C反应蛋白（CRP）和红细胞沉降率（ESR）显著升高（平均CRP：92.09mg/L，平均ESR：58.47mm/h），与全身炎症加剧和不良结局相关。：降钙素原升高（平均：1.98ng/mL）提示继发细菌感染，尤其是在机械通气患者中，显著恶化预后。老年新冠肺炎患者高凝状态和凝血病的双重性强调了持续监测凝血标志物如凝血酶原时间、国际标准化比值、D-二聚体和纤维蛋白原的重要性。同时，炎症标志物升高和继发细菌感染需要及时的治疗干预。本研究强调了制定个性化管理策略以减轻并发症和降低这一高危人群死亡率的迫切需求。
