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The Long Term Residual Effects of COVID-Associated Coagulopathy

During the acute phase of COVID-19, many patients experience a complex coagulopathy characterized by a procoagulant pattern. The present study investigates the persistence of hemostatic changes in post-COVID patients at a long-term follow up, and the link with the persistence of physical and neurops...

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Autores principales: Ranucci, Marco, Baryshnikova, Ekaterina, Anguissola, Martina, Pugliese, Sara, Falco, Mara, Menicanti, Lorenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10049638/
https://www.ncbi.nlm.nih.gov/pubmed/36982589
http://dx.doi.org/10.3390/ijms24065514
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author Ranucci, Marco
Baryshnikova, Ekaterina
Anguissola, Martina
Pugliese, Sara
Falco, Mara
Menicanti, Lorenzo
author_facet Ranucci, Marco
Baryshnikova, Ekaterina
Anguissola, Martina
Pugliese, Sara
Falco, Mara
Menicanti, Lorenzo
author_sort Ranucci, Marco
collection PubMed
description During the acute phase of COVID-19, many patients experience a complex coagulopathy characterized by a procoagulant pattern. The present study investigates the persistence of hemostatic changes in post-COVID patients at a long-term follow up, and the link with the persistence of physical and neuropsychological symptoms. We completed a prospective cohort study on 102 post-COVID patients. Standard coagulation and viscoelastic tests were performed, along with an assessment of persistent symptoms and recording of acute phase details. A procoagulant state was adjudicated in the presence of fibrinogen > 400 mg/dL, or D-dimer > 500 ng/mL, or platelet count > 450,000 cells/µL, or a maxim clot lysis at viscoelastic test < 2%. A procoagulant state was identified in 75% of the patients at 3 months follow up, 50% at 6 months, and 30% at 12–18 months. Factors associated with the persistence of a procoagulant state were age, severity of the acute phase, and persistence of symptoms. Patients with major physical symptoms carry a procoagulant state relative risk of 2.8 (95% confidence interval 1.17–6.7, p = 0.019). The association between persistent symptoms and a procoagulant state raises the hypothesis that an ongoing process of thrombi formation and/or persistent microthrombosis may be responsible for the main physical symptoms in long-COVID patients.
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spelling pubmed-100496382023-03-29 The Long Term Residual Effects of COVID-Associated Coagulopathy Ranucci, Marco Baryshnikova, Ekaterina Anguissola, Martina Pugliese, Sara Falco, Mara Menicanti, Lorenzo Int J Mol Sci Article During the acute phase of COVID-19, many patients experience a complex coagulopathy characterized by a procoagulant pattern. The present study investigates the persistence of hemostatic changes in post-COVID patients at a long-term follow up, and the link with the persistence of physical and neuropsychological symptoms. We completed a prospective cohort study on 102 post-COVID patients. Standard coagulation and viscoelastic tests were performed, along with an assessment of persistent symptoms and recording of acute phase details. A procoagulant state was adjudicated in the presence of fibrinogen > 400 mg/dL, or D-dimer > 500 ng/mL, or platelet count > 450,000 cells/µL, or a maxim clot lysis at viscoelastic test < 2%. A procoagulant state was identified in 75% of the patients at 3 months follow up, 50% at 6 months, and 30% at 12–18 months. Factors associated with the persistence of a procoagulant state were age, severity of the acute phase, and persistence of symptoms. Patients with major physical symptoms carry a procoagulant state relative risk of 2.8 (95% confidence interval 1.17–6.7, p = 0.019). The association between persistent symptoms and a procoagulant state raises the hypothesis that an ongoing process of thrombi formation and/or persistent microthrombosis may be responsible for the main physical symptoms in long-COVID patients. MDPI 2023-03-14 /pmc/articles/PMC10049638/ /pubmed/36982589 http://dx.doi.org/10.3390/ijms24065514 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ranucci, Marco
Baryshnikova, Ekaterina
Anguissola, Martina
Pugliese, Sara
Falco, Mara
Menicanti, Lorenzo
The Long Term Residual Effects of COVID-Associated Coagulopathy
title The Long Term Residual Effects of COVID-Associated Coagulopathy
title_full The Long Term Residual Effects of COVID-Associated Coagulopathy
title_fullStr The Long Term Residual Effects of COVID-Associated Coagulopathy
title_full_unstemmed The Long Term Residual Effects of COVID-Associated Coagulopathy
title_short The Long Term Residual Effects of COVID-Associated Coagulopathy
title_sort long term residual effects of covid-associated coagulopathy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10049638/
https://www.ncbi.nlm.nih.gov/pubmed/36982589
http://dx.doi.org/10.3390/ijms24065514
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