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Altered platelet and coagulation function in moderate-to-severe COVID-19
To reveal if coagulopathies relate to the course of COVID-19, we examined 255 patients with moderate and severe COVID-19, receiving anticoagulants and immunosuppressive drugs. Coagulopathy manifested predominantly as hypercoagulability that correlated directly with systemic inflammation, disease sev...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8357814/ https://www.ncbi.nlm.nih.gov/pubmed/34381066 http://dx.doi.org/10.1038/s41598-021-95397-6 |
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author | Litvinov, Rustem I. Evtugina, Natalia G. Peshkova, Alina D. Safiullina, Svetlana I. Andrianova, Izabella A. Khabirova, Alina I. Nagaswami, Chandrasekaran Khismatullin, Rafael R. Sannikova, Svetlana S. Weisel, John W. |
author_facet | Litvinov, Rustem I. Evtugina, Natalia G. Peshkova, Alina D. Safiullina, Svetlana I. Andrianova, Izabella A. Khabirova, Alina I. Nagaswami, Chandrasekaran Khismatullin, Rafael R. Sannikova, Svetlana S. Weisel, John W. |
author_sort | Litvinov, Rustem I. |
collection | PubMed |
description | To reveal if coagulopathies relate to the course of COVID-19, we examined 255 patients with moderate and severe COVID-19, receiving anticoagulants and immunosuppressive drugs. Coagulopathy manifested predominantly as hypercoagulability that correlated directly with systemic inflammation, disease severity, comorbidities, and mortality risk. The prolonged clotting tests in about ¼ of cases were associated with high levels of C-reactive protein and antiphospholipid antibodies, which impeded coagulation in vitro. Contraction of blood clots was hindered in about ½ of patients, especially in severe and fatal cases, and correlated directly with prothrombotic parameters. A decrease in platelet contractility was due to moderate thrombocytopenia in combination with platelet dysfunction. Clots with impaired contraction were porous, had a low content of compressed polyhedral erythrocytes (polyhedrocytes) and an even distribution of fibrin, suggesting that the uncompacted intravital clots are more obstructive but patients could also be prone to bleeding. The absence of consumption coagulopathy suggests the predominance of local and/or regional microthrombosis rather than disseminated intravascular coagulation. The results obtained (i) confirm the importance of hemostatic disorders in COVID-19 and their relation to systemic inflammation; (ii) justify monitoring of hemostasis, including the kinetics of blood clot contraction; (iii) substantiate the active prophylaxis of thrombotic complications in COVID-19. |
format | Online Article Text |
id | pubmed-8357814 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-83578142021-08-13 Altered platelet and coagulation function in moderate-to-severe COVID-19 Litvinov, Rustem I. Evtugina, Natalia G. Peshkova, Alina D. Safiullina, Svetlana I. Andrianova, Izabella A. Khabirova, Alina I. Nagaswami, Chandrasekaran Khismatullin, Rafael R. Sannikova, Svetlana S. Weisel, John W. Sci Rep Article To reveal if coagulopathies relate to the course of COVID-19, we examined 255 patients with moderate and severe COVID-19, receiving anticoagulants and immunosuppressive drugs. Coagulopathy manifested predominantly as hypercoagulability that correlated directly with systemic inflammation, disease severity, comorbidities, and mortality risk. The prolonged clotting tests in about ¼ of cases were associated with high levels of C-reactive protein and antiphospholipid antibodies, which impeded coagulation in vitro. Contraction of blood clots was hindered in about ½ of patients, especially in severe and fatal cases, and correlated directly with prothrombotic parameters. A decrease in platelet contractility was due to moderate thrombocytopenia in combination with platelet dysfunction. Clots with impaired contraction were porous, had a low content of compressed polyhedral erythrocytes (polyhedrocytes) and an even distribution of fibrin, suggesting that the uncompacted intravital clots are more obstructive but patients could also be prone to bleeding. The absence of consumption coagulopathy suggests the predominance of local and/or regional microthrombosis rather than disseminated intravascular coagulation. The results obtained (i) confirm the importance of hemostatic disorders in COVID-19 and their relation to systemic inflammation; (ii) justify monitoring of hemostasis, including the kinetics of blood clot contraction; (iii) substantiate the active prophylaxis of thrombotic complications in COVID-19. Nature Publishing Group UK 2021-08-11 /pmc/articles/PMC8357814/ /pubmed/34381066 http://dx.doi.org/10.1038/s41598-021-95397-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Litvinov, Rustem I. Evtugina, Natalia G. Peshkova, Alina D. Safiullina, Svetlana I. Andrianova, Izabella A. Khabirova, Alina I. Nagaswami, Chandrasekaran Khismatullin, Rafael R. Sannikova, Svetlana S. Weisel, John W. Altered platelet and coagulation function in moderate-to-severe COVID-19 |
title | Altered platelet and coagulation function in moderate-to-severe COVID-19 |
title_full | Altered platelet and coagulation function in moderate-to-severe COVID-19 |
title_fullStr | Altered platelet and coagulation function in moderate-to-severe COVID-19 |
title_full_unstemmed | Altered platelet and coagulation function in moderate-to-severe COVID-19 |
title_short | Altered platelet and coagulation function in moderate-to-severe COVID-19 |
title_sort | altered platelet and coagulation function in moderate-to-severe covid-19 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8357814/ https://www.ncbi.nlm.nih.gov/pubmed/34381066 http://dx.doi.org/10.1038/s41598-021-95397-6 |
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