Investigation of the Molecular Mechanism of Coagulopathy in Severe and Critical Patients With COVID-19

Komi, Daniel Elieh Ali; Rahimi, Yaghoub; Asghari, Rahim; Jafari, Reza; Rasouli, Javad; Mohebalizadeh, Mehdi; Abbasi, Ata; Nejadrahim, Rahim; Rezazadeh, Farzin; Shafiei‐Irannejad, Vahid

doi:10.3389/fimmu.2021.762782

Cited by 7 publications

(3 citation statements)

References 52 publications

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“…С первых месяцев пандемии COVID-19 клиницисты столкнулись с особенностями заболевания, которые проявлялись в значительных сдвигах параметров коагуляционной системы с удлинением ПВ, активированного частичного тромбопластинового времени (АЧТВ), повышением уровня D-димера, ассоциированных с неблагоприятным прогнозом заболевания [21]. Однако, если уровни ПВ и АЧТВ все же в ряде случаев сохраняются в пределах нормальных значений, в том числе, у пациентов в палатах интенсивной терапии, то D-димер демонстрирует свойства надежного предиктора тяжести течения COVID-19 [22].…”

Section: Discussionunclassified

Pulmonary Vascular Thrombosis in COVID-19: Clinical and Morphological Parallels

Porembskaya

Kravchuk

Galchenko³

et al. 2022

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. We aimed to study the histological and thrombotic changes in lung vessels in patients who died with COVID-19, to access the correlation between anticoagulation therapy (ACT) and thrombotic events (TE), treatment results, clinical and laboratory patients' characteristics.Material and Methods. We retrospectively analyzed treatment results of patients hospitalized with COVID-19 and lung vessel samples of the deceased patients. Dynamic changes and highest levels of D-dimer and fibrinogen were studied in its correlation with the disease severity according to SOFA score, computer tomographic (CT) results, lung, renal and hepatic dysfunction. The association between different doses of ACT and treatment results, laboratory indicators and thrombotic events was accessed. The histological lung vessels examination was performed using Martius Scarlet Blue (MSB)staining.Results. 313 patients were included in the study (61 patients died). The median age of hospitalized patients was 60 years (IQR 51-66 years). The frequency of the intravitallyconfirmed TE was 4,8%. The strong statistical association was revealed between D-dimer level and 3-4 points SOFA score, patients' mortality, oxygen support requirement, CT3-CT4 pneumonia, glomerular filtration rate and TE. There was no mortality in patients with D-dimer normal references, but in cases with three times elevation reached 13%, 48,5% - in cases with 3-6 times elevation and 64,6% - in cases with more than 6 times elevation. The strong statistical association was registered between fibrinogen and SOFA score, CT 3-4 pneumonia, patients' mortality. D-dimer and fibrinogen levels demonstrated weak correlation. There was no statistical correlation between prophylactic, intermediate and therapeutic ACT and D-dimer and fibrinogen levels, CT results, patients' mortality. MSBstaining was used in 36 deceased patients tissue samples. 1394 lung vessels were analyzed. Lung vessels thrombi persisted in samples of all 36 patients (100%). Vessels with the diameter 3,5-30 mm were thrombosed in 7%, with the diameter 0,034-0,84 mm - in 48%, with the diameter 0,85-3,4 mm - in 45%. The frequency of thrombi persisted 06 hours, 6-12 hours, 12-18hours, 18-24 hours and more than 24 hours was12%, 14%, 62%, 5% and 7% respectively.Conclusion. Thrombi of different ages from fresh to organized were observed in one third of lung vessels in all deceased patients. Lung vessels thrombosis plays an important role in pathogenesis and thanatogenesis of COVID-19. The D-dimer level correlates with lung, renal dysfunction, patients' mortality and doesn't show any correlation with ACT and can be accepted as a criterion of lung vessel thrombotic progression.

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Section: Discussionunclassified

Pulmonary Vascular Thrombosis in COVID-19: Clinical and Morphological Parallels

Porembskaya

Kravchuk

Galchenko³

et al. 2022

Racionalʹnaâ farmakoterapiâ v kardiologii

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“…However, this COVID-19-associated coagulopathy (CAC) have not yet been specifically defined. Available studies suggest that CAC develops at a relatively early stage, and is a mild form of sepsis-like diffuse intravascular coagulopathy (DIC) with increased levels of D-dimer and fibrinogen, relatively normal platelet count or mild thrombocytopenia, and near-normal/slightly prolonged prothrombin time (PT) and activated partial thromboplastin time [4] , [15] , [16] . However, DIC is a consumptive coagulopathy that is characterized by an increased D-dimer levels, decreased fibrinogen levels and platelet counts, and prolonged PT [17] .…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of von Willebrand factor and ADAMTS13 in patients with COVID-19: A systematic review and meta-analysis

Feng

Jia

et al. 2022

Thrombosis Research

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“…Finally, a recent review of the literature using the MeSH term COVID associated coagulopathy reveals that this term was a standard descriptor for the singular observation of these patients to develop early clots that required delicate and closely monitored anti-coagulation [ 8 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ].…”

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confidence: 99%