Coagulopathy in SARS-CoV-2 Infected Patients: Implication for the Management of COVID-19

Getu, Sisay; Tiruneh, Tegenaw; Henok, Andualem; Hailemichael, Wasihun; Kiros, Teklehayimanot; Belay, Demeke Mesfin; Kiros, Mulugeta

doi:10.2147/jbm.s304783

Cited by 11 publications

(12 citation statements)

References 83 publications

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“…Several studies establish that COVID-19 is predominantly a respiratory illness that affects the lungs, is highly associated with coagulopathy [ 3 , 4 ], and may increase the risk of thrombosis [ 5 ]. Dysfunction of the coagulation pathway is related to poor prognosis.…”

Section: Introductionmentioning

confidence: 99%

Implications of COVID-19 on Thrombotic Profile of Severely Affected Patients

et al. 2022

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Introduction: Coronavirus disease 2019 (COVID-19) is a novel viral disease that spread as a global pandemic in 2020 by infecting millions of people across the world. Its clinical prognosis is dependent on various coagulatory parameters since thrombotic events are frequently associated with infection severity. Methods: A total of 383 COVID-19 patients enrolled in Rajiv Gandhi Super Specialty Hospital, Delhi, India, were included in the present retrospective study. Patients were divided into three categories, severe (n = 141), moderate (n = 138), and mild (n = 104) based on infection severity. Various thrombotic parameters and anticoagulant levels were measured in 70 patients and further analyzed. Results: Coagulopathy is seen in COVID-19 patients (n = 70) with a significant increase in fibrinogen, D-dimer levels, and prothrombin time in patients with severe and moderate disease compared to patients with a mild infection. Approximately, 70% of patients with severe and moderate disease demonstrated fibrinogen levels higher than the standard reference range. 60.41% of patients with severe disease showed significantly higher D-dimer levels. Thrombotic parameters were notably elevated in the nonsurvivors group compared to COVID-19 survivors. Nearly, 91% of patients with severe infection had anticoagulant protein S levels below the reference range. Conclusion: COVID-19 infection severely impacts the blood coagulation cascade, which might lead to the manifestation of severe symptoms and increased mortality in patients.

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Section: Introductionmentioning

confidence: 99%

Implications of COVID-19 on Thrombotic Profile of Severely Affected Patients

et al. 2022

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“…Patients with COVID-19 may have a hypercoagulable state and an increased rate of thromboembolic events, such as occlusion in the spinal artery. 10 In this case report, we presented a typical ischemic pattern of spinal cord stroke after COVID-19 infection, with an acute onset, a complete neurological problem at the 12th thoracic level, and a hypercoagulable state confirmed by elevated D-dimer levels and hyperfibrinogenemia. Intravascular thrombosis pathways leading to microvascular and macrovascular thrombosis complications occur after intravascular thrombosis pathways are activated because of systemic cytokine production.…”

Section: Discussionmentioning

confidence: 91%

“…This reaction facilitates coagulation activation and thrombin formation, which induces occlusion in the vascular system. 10 Furthermore, local apoptosis and potent inflammatory cytokines are induced by inflammation in pericytes and infection in endothelial cells, and intravascular coagulopathy is activated following the inflammatory process in the pulmonary alveoli. Patients with COVID-19 may have a hypercoagulable state and an increased rate of thromboembolic events, such as occlusion in the spinal artery.…”

Section: Discussionmentioning

confidence: 99%

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Hypercoagulable State Induced Spinal Cord Stroke After Coronavirus Disease 19 Infection

Amalia¹

2021

JBM

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Background Spinal cord stroke after coronavirus disease 19 (COVID-19) infection is rare, and limited cases have been reported. Spinal cord ischemia after COVID-19 infection is related to increased coagulopathy with thromboembolic consequences. Patients with COVID-19 may have a hypercoagulable state and an increased rate of thromboembolic events, such as occlusion in the spinal artery. Case Presentation We report a male case with confirmed COVID-19 infection, aged 60 years, with flaccid paraplegia, hyporeflexia, loss of sensation below the 12th thoracic level, loss of autonomic function, bilateral positive Babinski sign 14 days after the onset of flu-like symptoms, and elevated serum D-dimer and fibrinogen levels. There was stenosis of the spinal artery at the 12th thoracic level in magnetic resonance imaging and magnetic resonance angiography. He showed improvement in motor strength of the lower limb (walking with assistance), numbness and pain, and urine and fecal retention after receiving a subcutaneous anticoagulant. Conclusion COVID-19 can damage endothelial cells and activate thrombotic pathways, which can lead to clinical thromboembolic complications, such as occlusion in the spinal artery, resulting in spinal cord stroke.

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“… 8 Therefore, it is essential to assess the hemostasis system including the platelets (PLT) parameter in COVID-19 patients for proper disease management. 9 …”

Section: Introductionmentioning

confidence: 99%

Baseline Thrombocytopenia and Disease Severity Among COVID-19 Patients, Tibebe Ghion Specialized Hospital COVID-19 Treatment Center, Northwest Ethiopia

Asrie¹,

Tekle²,

Gelaw³

et al. 2022

JBM

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Background Thrombocytopenia and platelet indices in COVID-19 patients were important for prompt treatment and management of the disease. Therefore, the main objective of this study was to assess the prevalence of thrombocytopenia, platelet indices, and its association with disease severity among COVID-19 patients at the Tibebe Ghion Specialized Hospital, COVID-19 treatment center, Northwest Ethiopia. Methods A cross-sectional study was conducted among 117 conveniently recruited COVID-19 patients from March to June 2021. Socio-demographic and clinical data were collected using a structured questionnaire and checklist, respectively. The platelet parameters were analyzed by the Mindray-BC 5800 automated hematological analyzer. ANOVA and Kruskal–Wallis tests were used to compare the difference between parametric and non-parametric continuous variables, respectively. Binary logistic regression was used to identify the factors associated with thrombocytopenia. A P-value < 0.05 was defined as statistically significant for all statistical tests. Results Among COVID-19 patients, 45, 43 and 29 were mild, moderate and severe, respectively. 65.8% of the patients were males and 34.2% were alcohol drinkers with a mean age of 50.6 ± 15.4. Moreover, 44.4% of the patients had co-morbidity. Thrombocytopenia was presented in 23.9% of the patients. It was 4.57 (95% CI: 1.30–16.07) and 6.10 (95% CI: 1.54–24.08) times more likely in the moderate and severe cases compared to mild cases, respectively. Disease severity was also associated with PDW (P-value = 0.001). Conclusion Even though thrombocytopenia was not presented in most moderate and severe COVID-19 patients, thrombocytopenia and PDW were associated with disease severity.

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Coagulopathy in SARS-CoV-2 Infected Patients: Implication for the Management of COVID-19

Cited by 11 publications

References 83 publications

Implications of COVID-19 on Thrombotic Profile of Severely Affected Patients

Implications of COVID-19 on Thrombotic Profile of Severely Affected Patients

Hypercoagulable State Induced Spinal Cord Stroke After Coronavirus Disease 19 Infection

Baseline Thrombocytopenia and Disease Severity Among COVID-19 Patients, Tibebe Ghion Specialized Hospital COVID-19 Treatment Center, Northwest Ethiopia

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