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Pattern of Conventional Coagulation and Thromboelastographic Parameters in Patients with COVID-19 Diseases and Association of COVID-Associated Coagulopathy with Mortality in Intensive Care Unit
BACKGROUND: Knowledge of underlying pathophysiology of coagulopathy is evolving and the pattern of coagulation parameters in coronavirus disease 2019 (COVID-19)–associated diseases is still not very clear. AIMS: In the present study, we aimed to find out the pattern and distribution of conventional...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9558653/ https://www.ncbi.nlm.nih.gov/pubmed/36249158 http://dx.doi.org/10.4103/aer.aer_52_22 |
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author | Balchandra, Awale Rupali Ghatak, Tanmoy Samanta, Sukhen Singh, Ratender K. Verma, Anupam Mishra, Prabhakar Chaudhary, Rajendra Nath, Alok |
author_facet | Balchandra, Awale Rupali Ghatak, Tanmoy Samanta, Sukhen Singh, Ratender K. Verma, Anupam Mishra, Prabhakar Chaudhary, Rajendra Nath, Alok |
author_sort | Balchandra, Awale Rupali |
collection | PubMed |
description | BACKGROUND: Knowledge of underlying pathophysiology of coagulopathy is evolving and the pattern of coagulation parameters in coronavirus disease 2019 (COVID-19)–associated diseases is still not very clear. AIMS: In the present study, we aimed to find out the pattern and distribution of conventional coagulation parameters and thromboelastographic (TEG) parameters in COVID-19–associated coagulopathy (CAC) in survivors and nonsurvivors at 28 days. SETTING AND DESIGN: The present prospective observational study was conducted at a tertiary care COVID-19 intensive care unit (ICU) facility from March 21, 2020, to July 15, 2021. MATERIALS AND METHODS: Admission clinical and laboratory data (conventional coagulation, inflammatory and TEG parameters, and disease severity parameters) of 64 COVID-19 patients admitted to the ICU were collected. Patients were divided into two groups, i.e., survivors and nonsurvivors. STATISTICAL ANALYSIS: Data were compared between two groups, i.e., survivors versus no survivors on 28 days using Student's t-test/Mann–Whitney U-test or Chi-square test/Fisher's exact test. RESULTS: Admission mean plasma fibrinogen levels (474.82 ± 167.41 mg.dL(−1)) and D-dimer were elevated (1.78 [0.66, 3.62] mg.mL(−1)) in the COVID-19 ICU patients. Overall, COVID-19 patients had mean lower normal platelet count (150 ± 50 × 10(3) cells.mm(−3)), with marginally elevated prothrombin time (16.25 ± 3.76 s) and activated partial thromboplastin time (38.22 ± 16.72 s). A 65.6% (42/64) TEG profile analysis showed a normal coagulation profile, and the rest 21.9% (14/64) and 12.5% (8/64) had hypercoagulable and hypocoagulable states, respectively. Plasma D-dimer level was markedly elevated in nonsurvivors compared to survivors (P < 0.05), while no other conventional coagulation parameters and TEG profile demonstrated statistically significant between the two groups. CONCLUSION: Markedly elevated plasma D-dimer level was observed in nonsurvivors of COVID-19 ICU patients. A large portion of COVID-19 ICU patients had a normal TEG profile. Conventional coagulation parameters and TEG profile were similar between survivors and nonsurvivors. |
format | Online Article Text |
id | pubmed-9558653 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-95586532022-10-14 Pattern of Conventional Coagulation and Thromboelastographic Parameters in Patients with COVID-19 Diseases and Association of COVID-Associated Coagulopathy with Mortality in Intensive Care Unit Balchandra, Awale Rupali Ghatak, Tanmoy Samanta, Sukhen Singh, Ratender K. Verma, Anupam Mishra, Prabhakar Chaudhary, Rajendra Nath, Alok Anesth Essays Res Original Article BACKGROUND: Knowledge of underlying pathophysiology of coagulopathy is evolving and the pattern of coagulation parameters in coronavirus disease 2019 (COVID-19)–associated diseases is still not very clear. AIMS: In the present study, we aimed to find out the pattern and distribution of conventional coagulation parameters and thromboelastographic (TEG) parameters in COVID-19–associated coagulopathy (CAC) in survivors and nonsurvivors at 28 days. SETTING AND DESIGN: The present prospective observational study was conducted at a tertiary care COVID-19 intensive care unit (ICU) facility from March 21, 2020, to July 15, 2021. MATERIALS AND METHODS: Admission clinical and laboratory data (conventional coagulation, inflammatory and TEG parameters, and disease severity parameters) of 64 COVID-19 patients admitted to the ICU were collected. Patients were divided into two groups, i.e., survivors and nonsurvivors. STATISTICAL ANALYSIS: Data were compared between two groups, i.e., survivors versus no survivors on 28 days using Student's t-test/Mann–Whitney U-test or Chi-square test/Fisher's exact test. RESULTS: Admission mean plasma fibrinogen levels (474.82 ± 167.41 mg.dL(−1)) and D-dimer were elevated (1.78 [0.66, 3.62] mg.mL(−1)) in the COVID-19 ICU patients. Overall, COVID-19 patients had mean lower normal platelet count (150 ± 50 × 10(3) cells.mm(−3)), with marginally elevated prothrombin time (16.25 ± 3.76 s) and activated partial thromboplastin time (38.22 ± 16.72 s). A 65.6% (42/64) TEG profile analysis showed a normal coagulation profile, and the rest 21.9% (14/64) and 12.5% (8/64) had hypercoagulable and hypocoagulable states, respectively. Plasma D-dimer level was markedly elevated in nonsurvivors compared to survivors (P < 0.05), while no other conventional coagulation parameters and TEG profile demonstrated statistically significant between the two groups. CONCLUSION: Markedly elevated plasma D-dimer level was observed in nonsurvivors of COVID-19 ICU patients. A large portion of COVID-19 ICU patients had a normal TEG profile. Conventional coagulation parameters and TEG profile were similar between survivors and nonsurvivors. Wolters Kluwer - Medknow 2022 2022-06-27 /pmc/articles/PMC9558653/ /pubmed/36249158 http://dx.doi.org/10.4103/aer.aer_52_22 Text en Copyright: © 2022 Anesthesia: Essays and Researches https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Balchandra, Awale Rupali Ghatak, Tanmoy Samanta, Sukhen Singh, Ratender K. Verma, Anupam Mishra, Prabhakar Chaudhary, Rajendra Nath, Alok Pattern of Conventional Coagulation and Thromboelastographic Parameters in Patients with COVID-19 Diseases and Association of COVID-Associated Coagulopathy with Mortality in Intensive Care Unit |
title | Pattern of Conventional Coagulation and Thromboelastographic Parameters in Patients with COVID-19 Diseases and Association of COVID-Associated Coagulopathy with Mortality in Intensive Care Unit |
title_full | Pattern of Conventional Coagulation and Thromboelastographic Parameters in Patients with COVID-19 Diseases and Association of COVID-Associated Coagulopathy with Mortality in Intensive Care Unit |
title_fullStr | Pattern of Conventional Coagulation and Thromboelastographic Parameters in Patients with COVID-19 Diseases and Association of COVID-Associated Coagulopathy with Mortality in Intensive Care Unit |
title_full_unstemmed | Pattern of Conventional Coagulation and Thromboelastographic Parameters in Patients with COVID-19 Diseases and Association of COVID-Associated Coagulopathy with Mortality in Intensive Care Unit |
title_short | Pattern of Conventional Coagulation and Thromboelastographic Parameters in Patients with COVID-19 Diseases and Association of COVID-Associated Coagulopathy with Mortality in Intensive Care Unit |
title_sort | pattern of conventional coagulation and thromboelastographic parameters in patients with covid-19 diseases and association of covid-associated coagulopathy with mortality in intensive care unit |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9558653/ https://www.ncbi.nlm.nih.gov/pubmed/36249158 http://dx.doi.org/10.4103/aer.aer_52_22 |
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