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Study of Coagulopathies in Covid 19 Positive Patients & Their Correlation with Outcome of Disease

INTRODUCTION COVID-19 started in November 2019 as an infection with a new strain of Corona virus and spread across all geographic regions. It has been observed that various coagulation abnormalities are not infrequent in COVID-19. Bleeding and coagulation abnormalities have surfaced as one of the me...

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Autores principales: Khunger, Jitender, Diwan, Sahil, Kohli, Santvana, Malhotra, Monica, Agarwal, Mohan, Sachdeva, Harish, Saluja, Sumita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society of Hematology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8330235/
http://dx.doi.org/10.1182/blood-2020-138679
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author Khunger, Jitender
Diwan, Sahil
Kohli, Santvana
Malhotra, Monica
Agarwal, Mohan
Sachdeva, Harish
Saluja, Sumita
author_facet Khunger, Jitender
Diwan, Sahil
Kohli, Santvana
Malhotra, Monica
Agarwal, Mohan
Sachdeva, Harish
Saluja, Sumita
author_sort Khunger, Jitender
collection PubMed
description INTRODUCTION COVID-19 started in November 2019 as an infection with a new strain of Corona virus and spread across all geographic regions. It has been observed that various coagulation abnormalities are not infrequent in COVID-19. Bleeding and coagulation abnormalities have surfaced as one of the mechanisms that could be related to increased mortality associated with it. Through our work, we look forward to discovering more on this association & we believe our study could provide new insight that could save additional lives. AIMS & OBJECTIVES - To study coagulation abnormalities in Covid-19 Positive patients. - To correlate these coagulation abnormalities with severity of disease and outcome of Covid-19 Positive patients. Material & Methods:This is a prospective study being carried out on the Intensive Care Unit (ICU) admitted Covid 19 positive patients, in a tertiary care hospital. Fifty cases have been studied so far, to look for coagulation abnormalities. Covid 19 positive patients by RNA detection by RT PCR method, admitted in ICU of hospital have been investigated for Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Thrombin Time (TT), Fibrinogen levels and D-Dimer levels.The results of these investigations were correlated with clinical condition of these ICU patients, to assess the prognosisand outcome, of Covid-19 Positive patients. Results: Fifty COVID positive patients admitted in ICU have been studied & out of these 19 patients eventually expired (Non-survivors group) and 31 recovered from their illness (Survivors group). These fifty patients were investigated,at the time of presentation in ICU. Prothrombin time (PT)was prolonged in Covid 19 positive patients. Prothrombin time (PT) values in theSurvivors group ranged from 13.47 to 15.36 seconds(Mean 14.42 seconds). Prothrombin time (PT) values in theNon-survivors group ranged from 13.63 to 15.43 seconds (Mean 14.53 seconds).Normal control of Prothrombin time (PT) was 13 seconds. Prothrombin time (PT) values in the Survivors group were compared with Non-survivors group with ap value = 0.865(statistically not significant). Activated partial thromboplastin time (APTT)values in theSurvivors group ranged from 33.44 to 36.38 seconds(Mean 34.91 seconds). Activated partial thromboplastin time (APTT) values in theNon-survivors group ranged from 33.68 to 38.32 seconds(Mean 36.00 seconds). Normal control of activated partial thromboplastin time (APTT) was 34 seconds. Activated partial thromboplastin time (APTT) values in the Survivors group were compared with Non-survivors group with ap value = 0.397(statistically not significant). Thrombin time (TT)values in theSurvivors group ranged from 17.61 to 19.81 seconds(Mean 18.71 seconds). Thrombin time (TT) values in theNon-survivors group ranged from 18.68 to 22.32 seconds(Mean 20.50 seconds). Normal control of thrombin time (TT) was 18 seconds. Thrombin time (TT) values in the Survivors group were compared with Non-survivors group with ap value = 0.072(statistically not significant). Fibrinogen levelsin theSurvivors group ranged from 378 mgm/dl to 441mgm/dl(Mean 410mgm/dl). Fibrinogen levels in theNon-survivors group ranged from 331 mgm/dl to 419mgm/dl(Mean 375mgm/dl). Normal values for fibrinogen levels were 150 to 450 mgm/dl. Fibrinogen levels in the Survivors group were compared with Non-survivors group with ap value = 0.184(statistically not significant). D-Dimer levelswere increased in Covid 19 positive patients. D-Dimer levels in theSurvivors group ranged from 854 ngm/ml to 1847ngm/ml(Mean 1401ngm/ml). D-Dimer levels in theNon-survivors group ranged from 1308 ngm/ml to 2858 ngm/ml(Mean 2083ngm/ml). Normal values for D-Dimer levels were 135 to 250 ngm/ml. D-Dimer levels in the Survivors group were compared with Non-survivors group with ap value = 0.130(statistically not significant). Conclusion Ours is a small single centre study, however, shows coagulopathies in Covid 19 positive patients. Although, there is a difference between coagulation abnormalities in survivor & non-survivor group of ICU patients but this difference is statistically not significant. DISCLOSURES: No relevant conflicts of interest to declare.
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spelling pubmed-83302352021-08-03 Study of Coagulopathies in Covid 19 Positive Patients & Their Correlation with Outcome of Disease Khunger, Jitender Diwan, Sahil Kohli, Santvana Malhotra, Monica Agarwal, Mohan Sachdeva, Harish Saluja, Sumita Blood 322.Disorders of Coagulation or Fibrinolysis INTRODUCTION COVID-19 started in November 2019 as an infection with a new strain of Corona virus and spread across all geographic regions. It has been observed that various coagulation abnormalities are not infrequent in COVID-19. Bleeding and coagulation abnormalities have surfaced as one of the mechanisms that could be related to increased mortality associated with it. Through our work, we look forward to discovering more on this association & we believe our study could provide new insight that could save additional lives. AIMS & OBJECTIVES - To study coagulation abnormalities in Covid-19 Positive patients. - To correlate these coagulation abnormalities with severity of disease and outcome of Covid-19 Positive patients. Material & Methods:This is a prospective study being carried out on the Intensive Care Unit (ICU) admitted Covid 19 positive patients, in a tertiary care hospital. Fifty cases have been studied so far, to look for coagulation abnormalities. Covid 19 positive patients by RNA detection by RT PCR method, admitted in ICU of hospital have been investigated for Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Thrombin Time (TT), Fibrinogen levels and D-Dimer levels.The results of these investigations were correlated with clinical condition of these ICU patients, to assess the prognosisand outcome, of Covid-19 Positive patients. Results: Fifty COVID positive patients admitted in ICU have been studied & out of these 19 patients eventually expired (Non-survivors group) and 31 recovered from their illness (Survivors group). These fifty patients were investigated,at the time of presentation in ICU. Prothrombin time (PT)was prolonged in Covid 19 positive patients. Prothrombin time (PT) values in theSurvivors group ranged from 13.47 to 15.36 seconds(Mean 14.42 seconds). Prothrombin time (PT) values in theNon-survivors group ranged from 13.63 to 15.43 seconds (Mean 14.53 seconds).Normal control of Prothrombin time (PT) was 13 seconds. Prothrombin time (PT) values in the Survivors group were compared with Non-survivors group with ap value = 0.865(statistically not significant). Activated partial thromboplastin time (APTT)values in theSurvivors group ranged from 33.44 to 36.38 seconds(Mean 34.91 seconds). Activated partial thromboplastin time (APTT) values in theNon-survivors group ranged from 33.68 to 38.32 seconds(Mean 36.00 seconds). Normal control of activated partial thromboplastin time (APTT) was 34 seconds. Activated partial thromboplastin time (APTT) values in the Survivors group were compared with Non-survivors group with ap value = 0.397(statistically not significant). Thrombin time (TT)values in theSurvivors group ranged from 17.61 to 19.81 seconds(Mean 18.71 seconds). Thrombin time (TT) values in theNon-survivors group ranged from 18.68 to 22.32 seconds(Mean 20.50 seconds). Normal control of thrombin time (TT) was 18 seconds. Thrombin time (TT) values in the Survivors group were compared with Non-survivors group with ap value = 0.072(statistically not significant). Fibrinogen levelsin theSurvivors group ranged from 378 mgm/dl to 441mgm/dl(Mean 410mgm/dl). Fibrinogen levels in theNon-survivors group ranged from 331 mgm/dl to 419mgm/dl(Mean 375mgm/dl). Normal values for fibrinogen levels were 150 to 450 mgm/dl. Fibrinogen levels in the Survivors group were compared with Non-survivors group with ap value = 0.184(statistically not significant). D-Dimer levelswere increased in Covid 19 positive patients. D-Dimer levels in theSurvivors group ranged from 854 ngm/ml to 1847ngm/ml(Mean 1401ngm/ml). D-Dimer levels in theNon-survivors group ranged from 1308 ngm/ml to 2858 ngm/ml(Mean 2083ngm/ml). Normal values for D-Dimer levels were 135 to 250 ngm/ml. D-Dimer levels in the Survivors group were compared with Non-survivors group with ap value = 0.130(statistically not significant). Conclusion Ours is a small single centre study, however, shows coagulopathies in Covid 19 positive patients. Although, there is a difference between coagulation abnormalities in survivor & non-survivor group of ICU patients but this difference is statistically not significant. DISCLOSURES: No relevant conflicts of interest to declare. American Society of Hematology 2020-11-05 2021-08-03 /pmc/articles/PMC8330235/ http://dx.doi.org/10.1182/blood-2020-138679 Text en Copyright © 2020 American Society of Hematology. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle 322.Disorders of Coagulation or Fibrinolysis
Khunger, Jitender
Diwan, Sahil
Kohli, Santvana
Malhotra, Monica
Agarwal, Mohan
Sachdeva, Harish
Saluja, Sumita
Study of Coagulopathies in Covid 19 Positive Patients & Their Correlation with Outcome of Disease
title Study of Coagulopathies in Covid 19 Positive Patients & Their Correlation with Outcome of Disease
title_full Study of Coagulopathies in Covid 19 Positive Patients & Their Correlation with Outcome of Disease
title_fullStr Study of Coagulopathies in Covid 19 Positive Patients & Their Correlation with Outcome of Disease
title_full_unstemmed Study of Coagulopathies in Covid 19 Positive Patients & Their Correlation with Outcome of Disease
title_short Study of Coagulopathies in Covid 19 Positive Patients & Their Correlation with Outcome of Disease
title_sort study of coagulopathies in covid 19 positive patients & their correlation with outcome of disease
topic 322.Disorders of Coagulation or Fibrinolysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8330235/
http://dx.doi.org/10.1182/blood-2020-138679
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