An Insight to ncovid-19 associated coagulopathy

2021 ◽  
Vol 13 ◽  
Author(s):  
Sumel Ashique ◽  
Tahamina Khatun
Keyword(s):  
Clinical Presentation ◽  
Degradation Products ◽  
Hospitalized Patients ◽  
Low Molecular Weight ◽  
Hemorrhagic Events ◽  
Coagulation Tests ◽  
Severe Difficulty ◽  
Seriously Ill ◽  
Vessel Thrombosis ◽  
D Dimer

: Several current studies have highlighted the high occurrence of coagulopathy in nCOVID-19 infection. The corona virus often prompts hypercoagulability along with both microangiopathy and local thrombus development, and systemic coagulation limitation which causes large vessel thrombosis and key thromboembolic issues such as pulmonary embolism in seriously ill hospitalized patients. Based on recent reports, the most severely ill patients present with coagulopathy, and disseminated intravascular coagulation (DIC)-like massive intravascular clot formation is frequently seen in this cohort. Therefore, coagulation tests may be considered useful to discriminate severe cases of nCOVID-19. The clinical presentation of nCOVID-19-associated coagulopathy is organ dysfunction primarily, while hemorrhagic events are less frequent. Changes in hemostatic biomarkers represented by increase in D-dimer and fibrin/fibrinogen degradation products indicate the essence of coagulopathy is massive fibrin formation. Overall, the patients have an increase in venous and arterial thrombotic events especially in ICU patients. Routine thromboprophylaxis with low molecular weight heparin is recommended in all hospitalized patients to reduce the incidence of thrombosis. Though, the importance of thromboembolic impediments has not been extensively spotlighted, thus the rationale of this article is to provide recent information about this severe difficulty. In this article the mechanism of coagulopathy, associated problems and possible therapeutics has been reviewed.

scholarly journals Laboratory manifestations of COVID-19 associated with hemostatic abnormalities

2021 ◽  
Vol 4 (3) ◽  
pp. 423-427
Author(s):  
Ahmed Elhadi Elsadig ◽  
May Mohammed Ali ◽  
Alfatih Aboalbasher Yousif
Keyword(s):  
Disease Severity ◽  
Protein C ◽  
Degradation Products ◽  
Disease Outcome ◽  
Icu Patients ◽  
Fibrin Degradation Products ◽  
Laboratory Markers ◽  
Increased Risk ◽  
Coagulation Tests ◽  
D Dimer

Hemostatic abnormalities had been reported in COVID-19 patients, which may include disseminated intravascular coagulation (DIC), hypercoagulability, and alterations in platelets parameters. Articles that investigate the alterations of hemostatic abnormalities during the COVID-19 disease (2020-2021) and their predictive value of disease outcome have been thoroughly reviewed. Among the reviewed articles, thrombocytopenia is observed in 5.0-41.7% of COVID-19 patients, which is related to disease severity. Moreover, other platelets parameters, including Platelets/lymphocytes ratio (PLR), Mean platelets volume (MPV), and aggregation, may also be affected. On the other hand, findings of coagulation tests such as D dimer; fibrinogen, Antithrombin (AT), and Fibrin degradation products (FDP) are significantly elevated in COVID-19 patients, while in a single study, most of the patients had positive Lupus anticoagulants (LA) and normal protein C (PC). In the same perspective, these alterations showed significant correlations with disease severity. Overall, hemostatic laboratory markers are significant predictors of COVID-19 disease outcome as indicated by the increased risk of venous and arterial thrombotic events, especially in ICU patients.  

The laboratory control of anticoagulant thromboprophylaxis during the early postpartum period after cesarean delivery

2018 ◽  
Vol 46 (3) ◽  
pp. 251-260 ◽  
Author(s):  
Ekaterina M. Koltsova ◽  
Anna N. Balandina ◽  
Konstantin I. Grischuk ◽  
Margarita A. Shpilyuk ◽  
Elena A. Seregina ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Postpartum Period ◽  
Low Molecular Weight ◽  
Normal Range ◽  
Coagulation Assays ◽  
Early Postpartum Period ◽  
Early Postpartum ◽  
Coagulation Tests ◽  
Coagulation Assay ◽  
D Dimer

Abstract Introduction: The incidence of venous thromboembolism (VTE) after cesarean section is up to 0.6%, and the widespread use of cesarean section draws attention to this group. The dosage and duration of low-molecular-weight heparin (LMWH) prophylaxis after delivery is estimated by anamnestic risk-scales; however, the predictive potency for an individual patient’s risk can be low. Laboratory hemostasis assays are expected to solve this problem. The aim of this study was to estimate the potency of tests to reflect the coagulation state of patients receiving LMWH in the early postpartum period. Materials and methods: We conducted an observational study on 97 women undergoing cesarean section. Standard coagulation tests (Fg, APTT, prothrombin, D-dimer), an anti-Xa assay, rotation thromboelastometry and thrombodynamics/thrombodynamics-4D were performed. Coagulation assay parameters were compared in groups formed in the presence or absence of LMWH to estimate the laboratory assays’ sensitivity to anticoagulation. Results: Coagulation assays revealed hypercoagulation after delivery and a tendency toward normalization of coagulation during early postpartum. The thromboprophylaxis results revealed a higher percentage of coagulation parameters within the normal range in the LMWH group. Conclusion: This research is potentially beneficial for the application of thrombodynamics and thrombodynamics-4D in monitoring coagulation among patients with high VTE risk who receive thromboprophylaxis with heparin.

Coagulopathy in COVID-19 infection

2020 ◽  
Author(s):  
С.И. Кузнецов ◽  
Е.А. Шестаков ◽  
Е.Б. Жибурт
Keyword(s):  
Degradation Products ◽  
Activated Partial Thromboplastin Time ◽  
Low Molecular Weight ◽  
Time Data ◽  
Low Molecular Weight Heparins ◽  
Passive Immunotherapy ◽  
Fibrin Degradation Products ◽  
Pharmacological Thromboprophylaxis ◽  
D Dimer ◽  
Donor Plasma

Введение. Известно о коагулопатиях при инфекциях коронавирусами SARS и MERS. Цель исследования: изучить накопленную информацию о коагулопатии при инфекции COVID-19. Материалы и методы. В библиотеке PubMed провели поиск по ключевым словам «COVID-19», «coagulopathy». Обнаружили 15 публикаций, содержащих результаты оригинальных исследований. Результаты. При тяжелом течении заболевания наблюдают цитокиновый шторм, более высокие уровни Д-димера и продуктов деградации фибрина (ПДФ), более длительное протромбиновое время и активированное частичное тромбопластиновое время. Данные о частоте развития синдрома диссеминированного внутрисосудистого свертывания противоречивы. Заключение. У пациентов с COVID-19 с острой дыхательной недостаточностью наблюдается выраженная гиперкоагуляция. Всем госпитализированным пациентам с COVID-19 рекомендована фармакологическая тромбопрофилактика низкомолекулярными гепаринами или фондапаринуксом. Донорскую плазму для пассивной иммунотерапии нужно переливать только в рамках клинических исследований. Background. Coagulopathies are known for infections with SARS and MERS coronaviruses. Objectives: the reviewing the early accumulated information on coagulopathy in COVID-19. Patients / Methods. In PubMed Library with the keywords «COVID-19», «coagulopathy» we selected 15 publications containing the results of original studies. Results. In severe cases of the disease, a cytokine storm is observed, higher levels of D-dimer and fibrin degradation products (FDP), longer prothrombin time and activated partial thromboplastin time. Data about incidence of disseminated intravascular coagulation are contradictory. Conclusions. Patients with COVID-19 with acute respiratory failure exhibit severe hypercoagulation. Pharmacological thromboprophylaxis with low molecular weight heparins or fondaparinux is recommended for all hospitalized patients with COVID-19. Donor plasma for passive immunotherapy should be transfused only as part of clinical trials.

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

2021 ◽  
Vol 12 ◽  
Author(s):  
Daniel Elieh Ali Komi ◽  
Yaghoub Rahimi ◽  
Rahim Asghari ◽  
Reza Jafari ◽  
Javad Rasouli ◽  
...  
Keyword(s):  
Molecular Mechanism ◽  
Protein C ◽  
Degradation Products ◽  
Protein S ◽  
Coagulation Factors ◽  
Fibrin Degradation Products ◽  
Significant Difference ◽  
Coagulation Tests ◽  
Critical Patients ◽  
D Dimer

Coagulopathy is a frequently reported finding in the pathology of coronavirus disease 2019 (COVID-19); however, the molecular mechanism, the involved coagulation factors, and the role of regulatory proteins in homeostasis are not fully investigated. We explored the dynamic changes of nine coagulation tests in patients and controls to propose a molecular mechanism for COVID-19-associated coagulopathy. Coagulation tests including prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen (FIB), lupus anticoagulant (LAC), proteins C and S, antithrombin III (ATIII), D-dimer, and fibrin degradation products (FDPs) were performed on plasma collected from 105 individuals (35 critical patients, 35 severe patients, and 35 healthy controls). There was a statically significant difference when the results of the critical (CRT) and/or severe (SVR) group for the following tests were compared to the control (CRL) group: PTCRT (15.014) and PTSVR (13.846) (PTCRL = 13.383, p < 0.001), PTTCRT (42.923) and PTTSVR (37.8) (PTTCRL = 36.494, p < 0.001), LACCRT (49.414) and LACSVR (47.046) (LACCRL = 40.763, p < 0.001), FIBCRT (537.66) and FIBSVR (480.29) (FIBCRL = 283.57, p < 0.001), ProCCRT (85.57%) and ProCSVR (99.34%) (ProCCRL = 94.31%, p = 0.04), ProSCRT (62.91%) and ProSSVR (65.06%) (ProSCRL = 75.03%, p < 0.001), D-dimer (p < 0.0001, χ2 = 34.812), and FDP (p < 0.002, χ2 = 15.205). No significant association was found in the ATIII results in groups (ATIIICRT = 95.71% and ATIIISVR = 99.63%; ATIIICRL = 98.74%, p = 0.321). D-dimer, FIB, PT, PTT, LAC, protein S, FDP, and protein C (ordered according to p-values) have significance in the prognosis of patients. Disruptions in homeostasis in protein C (and S), VIII/VIIIa and V/Va axes, probably play a role in COVID-19-associated coagulopathy.

scholarly journals The Associations Between Fasting Plasma Glucose Levels and Mortality of SFTS in Patients

2021 ◽  
Author(s):  
Yin Zhang ◽  
Yu Zhang ◽  
Yuanhong Xu ◽  
Ying Huang
Keyword(s):  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Degradation Products ◽  
Hospitalized Patients ◽  
P Value ◽  
Glucose Levels ◽  
Fasting Plasma ◽  
Poor Outcomes ◽  
Factor Α ◽  
D Dimer

Abstract Objective To identify the correlation between the level of at-admission fasting plasma glucose (FPG) with poor outcomes in hospitalized patients suffering from severe fever with thrombocytopenia syndrome (SFTS). Methods Between April 1 and December 1, 2020, the list of hospitalized patients affected with SFTS infection was provided by the Infectious Disease Department at First Affiliated Hospital of Anhui Medical University, followed by the collection of information I.e., gender, age, diabetic history and the level of FPG on admission. Results In this study, a total of 77 patients were included and were categorized into three groups (<5.6, 5.6–6.9, and ≥7.0 mmol/l) on the basis of their glucose level in the blood. The obtained results revealed that among three groups considerable variations were observed in leukocytes, FPG, D-Dimer, aspartate aminotransferase (AST), tumor necrosis factor-α (TNF-α), fibrin degradation products (FDP), and interleukin (IL)-10 level. Correlation analysis indicated a linear negative correlation between PLT and FPG (r = −0.28, P = 0.01), however, a linear positive correlation was observed between AST, IL10, D-Dimer, and FDP levels and FPG (P-value < 0.05). Conclusions Elevated level of FPG has been correlated with hypercoagulability, inflammation, and lower PLT in SFTS patients. The measurement of FPG level can help in evaluating the inflammatory process, hypercoagulability, and prognosis of patients suffering from SFTS.

MONITORING OF DEEP VEIN THROMBOSIS BY D DIMER DETERMINATION. INFLUENCE OF HEPARIN REGIMEN

1987 ◽  
Author(s):  
C Soria ◽  
Mc Mirshahi ◽  
J Soria ◽  
M Mirshahi ◽  
R Faivre ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
No Reduction ◽  
Degradation Products ◽  
Low Molecular Weight ◽  
Dramatic Decrease ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Fibrin Degradation Products ◽  
Deep Vein ◽  
D Dimer

In 49 patients the level of plasma fibrin degradation products (FbDP) was measured during the first ten days of deep vein thrombosis (DVT) in order to determine whether FbDP may be used as a non invasive marker to follow the evolution of DVT. Plasma FbDP was measured precisely and reliably by Elisa using a personal anti D neo monoclonal antibody. Thrombus size was determined angiographically on day 0 and day 10 and expressed according to Marder score. Patients were treated by standard or by a very low molecular weight heparin (CY 222 from Choay Laboratory, Paris France).It is shown that before treatment, in 45 cases of DVT the level of FbDP was dramatically increased as compared to control and remained normal or slightly elevated in 4 cases of DVT. The correlation between thrombus size and FbDP level at day 0 was poor (p = 0.3). During the 10 days of treatment, FbDP determination may give some informations about the evolution of DVT. Three groups were defined :1 There was no reduction of thrombus size in patients who presented a normal or only slightly elevated FbDP level, leading to the evidence that thrombolysis was almost inexistant in these patients.2 Thrombolysis was almost complete in 10 days in patients presented both a high FbDP level before treatment and a dramatic decrease of FbDP after 10 days treatment. Taking into account the half life of FbDP, the decrease in FbDP level is related to the reduction in thrombus size.3 A partial or absence of recanalization was evidenced in patients presenting a high FbDP level throughout the 10 days on therapy. In cases without recanalization we have to assume that thrombolysis evidenced by plasma FbDP level was continuously counteract by a clotting process.Similar results were observed in patient treated by standard and CY 222.

scholarly journals The associations between fasting blood glucose levels and mortality of SFTS in patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yin Zhang ◽  
Yu Zhang ◽  
Yuanhong Xu ◽  
Ying Huang
Keyword(s):  
Blood Glucose ◽  
Degradation Products ◽  
Fasting Blood Glucose ◽  
Hospitalized Patients ◽  
Multivariate Statistical ◽  
Survival Group ◽  
Glucose Levels ◽  
Survivor Group ◽  
Significant Difference ◽  
D Dimer

Abstract Objective To identify the correlation between the level of at-admission fasting blood glucose (FBG) with poor outcomes in hospitalized patients suffering from severe fever with thrombocytopenia syndrome (SFTS). Methods Between April 1 and December 1, 2020, the list of hospitalized patients affected with SFTS infection was provided by the Infectious Disease Department at First Affiliated Hospital of Anhui Medical University, followed by the collection of information I.e., gender, age, diabetic history and the level of FBG on admission. Results In this study, a total of 77 patients were included and were categorized into three groups (< 5.6, 5.6–6.9, and ≥ 7.0 mmol/l) on the basis of their glucose level in the blood. The obtained results revealed that among three groups considerable variations were observed in leukocytes, FBG, D-Dimer, aspartate aminotransferase (AST), tumor necrosis factor-α (TNF-α), fibrin degradation products (FDP), and interleukin (IL)-10 level. Correlation analysis indicated a linear negative correlation between PLT and FBG (r = − 0.28, P = 0.01), however, a linear positive correlation was observed between AST, IL10, D-Dimer, and FDP levels and FBG (P-value < 0.05). Multivariate statistical analysis results shown that there was significant difference between group comparison (F = 17.01, P < 0.001) and interaction between group and time (F = 8.48, P < 0.05); but there was no significant difference between time point comparison (F = 0.04, P = 0.96). With the prolongation of time, the changes of FBG were different between survivor group and non-survivor group. The FBG in survival group shown a downward trend; The non-survivor group shown an upward trend. Conclusions Elevated level of FBG has been correlated with hypercoagulability, inflammation, and lower PLT in SFTS patients. The measurement of FBG level can help in evaluating the inflammatory process, hypercoagulability, and prognosis of patients suffering from SFTS. FBG can predict the prognosis of SFTS. It is necessary to pay attention to the role of FBG in the process of treatment in patients with SFTS.

A Novel Method for the Rapid Purification of Human and Rat Fibrin(OGEN) Degradation Products in High Yields

1979 ◽  
Author(s):  
W. Nieuwenhuizen ◽  
I. A. M. van Ruijven-Vermeer ◽  
F. Haverkate ◽  
G. Timan
Keyword(s):  
Degradation Products ◽  
Complete Separation ◽  
Purification Method ◽  
Amino Terminal ◽  
Novel Method ◽  
Rapid Purification ◽  
The One ◽  
High Yields ◽  
Size Heterogeneity ◽  
D Dimer

A novel method will be described for the preparation and purification of fibrin(ogen) degradation products in high yields. The high yields are due to two factors. on the one hand an improved preparation method in which the size heterogeneity of the degradation products D is strongly reduced by plasmin digestion at well-controlled calcium concentrations. At calcium concentrations of 2mM exclusively D fragments, M.W.= 93-000 (Dcate) were formed; in the presence of 1OmM EGTA only fragments M.W.= 80.000 (D EGTA) were formed as described. on the other hand a new purification method, which includes Sephadex G-200 filtration to purify the D:E complexes and separation of the D and E fragments by a 16 hrs. preparative isoelectric focussing. The latter step gives a complete separation of D (fragments) (pH = 6.5) and E fragments (at pH = 4.5) without any overlap, thus allowing a nearly 100% recovery in this step. The overall recoveries are around 75% of the theoretical values. These recoveries are superior to those of existing procedures. Moreover the conditions of this purification procedure are very mild and probably do not affect the native configuration of the products. Amino-terminal amino acids of human Dcate, D EGTA and D-dimer are identical i.e. val, asx and ser. in the ratgly, asx and ser were found. E 1% for rat Dcate=17-8 for rat D EGTA=16.2 and for rat D- dimer=l8.3. for the corresponding human fragments, these values were all 20.0 ± 0.2.

scholarly journals Spontaneous Retroperitoneal Hematoma in COVID-19 Severe Pneumonia–Dual-phase Multidetector Computed Tomography (MDCT) Angiogram and Role of Radiologist

2021 ◽  
Author(s):  
Vikash Kumar Gupta ◽  
Buthaina Mohammad Alkandari ◽  
Wasif Mohammed ◽  
Mohsen Ahmed Abdelmohsen ◽  
Mohammad Gaber Abdullah Mohammad
Keyword(s):  
Significant Risk ◽  
Severe Pneumonia ◽  
Retroperitoneal Hematoma ◽  
Low Molecular Weight ◽  
Rt Pcr ◽  
Prophylactic Dose ◽  
Therapeutic Anticoagulation ◽  
Coagulation Tests ◽  
Polymerase Chain

AbstractStudies available in the literature have shown alterations in blood coagulation tests in severe cases of COVID-19 pneumonia, with a significant risk of venous thromboembolism (VTE). Since microvascular thrombosis is a well-known fact in COVID-19 disease, requiring therapeutic anticoagulation, low-molecular weight heparin (LMWH) in prophylactic dose is a part of the clinical management of hospitalized COVID-19 patients. In this scenario, we describe three cases of abdominal spontaneous retroperitoneal hematoma (SRH) in hospitalized reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 patients.

scholarly journals Clinical and angiographic characteristics of patients with STEMI and confirmed diagnosis of COVID-19: an experience of Tanta University Hospital

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Ahmed Alaarag ◽  
Timoor Hassan ◽  
Sameh Samir ◽  
Mohamed Naseem
Keyword(s):  
Poor Prognosis ◽  
Management Strategy ◽  
Clinical Presentation ◽  
Underlying Mechanism ◽  
Fibrinolytic Therapy ◽  
University Hospital ◽  
Total Occlusion ◽  
St Elevation ◽  
Primary Management ◽  
D Dimer

Abstract Background Patients with established cardiovascular diseases have a poor prognosis when affected by the coronavirus disease 2019 (COVID-19). Also, the cardiovascular system, especially the heart, is affected by COVID-19. So we aimed to evaluate the angiographic and clinical characteristics of COVID-19 patients presented by ST-elevation myocardial infarction (STEMI). Results Our retrospective study showed that STEMI patients with COVID-19 had elevated inflammatory markers with mean of their CRP (89.69 ± 30.42 mg/dl) and increased laboratory parameters of thrombosis with mean D-dimer (660.15 ± 360.11 ng/ml). In 69.2% of patients, STEMI was the first clinical presentation and symptoms suggestive of COVID-19 developed during the hospital stay; about one third of patients had a non-obstructive CAD, while patients with total occlusion had a high thrombus burden. Conclusion STEMI may be the initial presentation of COVID-19. A non-obstructive CAD was found in about one third of patients; on the other hand, in patients who had a total occlusion of their culprit artery, the thrombus burden was high. Identification of the underlying mechanism responsible for the high thrombus burden in these patients is important as it may result in changes in their primary management strategy, either primary PCI, fibrinolytic therapy, or a pharmaco-invasive strategy. Furthermore, adjunctive anticoagulation and antiplatelet therapy may need to be revised.

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