Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia

Abstract

A recently published article by Dr. Tang and colleagues on "Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia" highlighted that disseminated intravascular coagulation is common severe respiratory failure patients with Novel Coronavirus (Covid-19). 1 Covid-19 infection leading to pneumonia and severe acute respiratory distress syndrome (ARDS) was first reported in Wuhan, Hubei Province, China, and has subsequently spread to almost all other countries in the world.On November 3, 2020, the World Health Organization declared the Covid-19 outbreak a global pandemic. Patients with severe illness may develop dyspnea and hypoxemia within 1 week after onset of the disease, which may quickly progress to ARDS or end-organ failure.

High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study

“…The monitoring of anticoagulant treatment should be achieved through anti-Xa measurement, owing to changes of standard hemostasis parameters in this particular pathology. Although Tang et al [3] suggested that anticoagulant therapy mainly with LMWH appears to be associated with better prognosis in severe COVID-19 patients meeting SIC criteria or with markedly elevated D-dimer, higher anticoagulation targets than usual should probably be taken into consideration.…”

“…Platelets, prothrombin time, aPTT and antithrombin remained within normal ranges in 120 (80%), 108 (72%), and 100 patients (66.7%), respectively, which explains the normal JAAM-DIC (< 4 points) in 144 patients (96%) and normal ISTH (< 5 points) scores in all patients. Median scores were 0 [0; 1] and 2 [2,3] points for JAAM-DIC and ISTH scores, respectively. Only 6 patients (2.7%) had a positive JAAM-DIC score, and none had a positive ISTH score.…”

“…Patients with severe acute respiratory syndrome (ARDS) due to SARS-CoV-2 infection, also known as coronavirus disease 2019 (COVID- 19), who are admitted to intensive care units (ICUs) mainly develop respiratory and digestive symptoms [1,2]. However, some patients may also develop coagulopathy, then associated with poor prognosis [3]. In a retrospective series of 183 consecutive patients, Tang et al reported that 71.4% of non-survivors met the criteria of disseminated intravascular coagulation (DIC), while only 0.6% of survivors did.…”

“…Despite increasing evidence of coagulation disorders, based on these retrospective data in a small number of patients, no data are available for the most severe patients, i.e., those admitted to ICU. In addition, none of the published articles describe the clinical or radiological issues related to these coagulation disorders [3][4][5]. The clinical relevance of these results may still be questionable.…”

Comparative therapeutic efficacy of interferon and combination Kaletra plus interferon alpha-2b against SARS-CoV-2

“…Since the rst case with SARS-CoV-2 was published in December 2019, the laboratory-con rmed cases are continuously escalating day to day and spread like wild re to more than 200 countries and territories [5,6]. COVID-19 cases are frequently associated with respiratory and multiorgan dysfunction that result in deaths [7][8][9][10]. Accordingly, the use of antiviral drugs in patients with this disease have triggered questions and whether currently antiviral drugs could be effectively cured this disease prompts a critical consideration.…”