Experimental Hematology & Oncology (Feb 2021)

COVID-19-associated coagulopathy: thromboembolism prophylaxis and poor prognosis in ICU

  • Runhui Zheng,
  • Jing Zhou,
  • Bin Song,
  • Xia Zheng,
  • Ming Zhong,
  • Li Jiang,
  • Chun Pan,
  • Wei Zhang,
  • Jiaan Xia,
  • Nanshan Chen,
  • Wenjuan Wu,
  • Dingyu Zhang,
  • Yin Xi,
  • Zhimin Lin,
  • Ying Pan,
  • Xiaoqing Liu,
  • Shiyue Li,
  • Yuanda Xu,
  • Yimin Li,
  • Huo Tan,
  • Nanshan Zhong,
  • Xiaodan Luo,
  • Ling Sang

DOI
https://doi.org/10.1186/s40164-021-00202-9
Journal volume & issue
Vol. 10, no. 1
pp. 1 – 11

Abstract

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Abstract Background Coronavirus disease 2019 (COVID-19) is associated with coagulation abnormalities which are indicators of higher mortality especially in severe cases. Methods We studied patients with proven COVID-19 disease in the intensive care unit of Jinyintan Hospital, Wuhan, China from 30 to 2019 to 31 March 2020. Results Of 180 patients, 89 (49.44 %) had died, 85 (47.22 %) had been discharged alive, and 6 (3.33 %) were still hospitalised by the end of data collection. A D-dimer concentration of > 0.5 mg/L on admission was significantly associated with 30 day mortality, and a D-dimer concentration of > 5 mg/L was found in a much higher proportion of non-survivors than survivors. Sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC) scoring systems were dichotomised as 2 than 0.5 mg/L on admission is a risk factor for severe disease. A SIC score of > 4 and DIC score of > 5 may be used to predict mortality. Thromboembolic prophylaxis can reduce mortality only in patients with a D-dimer concentration of > 2 mg/L or DIC score of ≥ 5.

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