Analysis of the association between resolution of disseminated intravascular coagulation (DIC) and treatment outcomes in post-marketing surveillance of thrombomodulin alpha for DIC with infectious disease and with hematological malignancy by organ failure

Kawano, Noriaki; Wada, Hideo; Uchiyama, Toshimasa; Kawasugi, Kazuo; Madoiwa, Seiji; Takezako, Naoki; Suzuki, Kei; Seki, Yoshinobu; Ikezoe, Takayuki; Hattori, Tsuyoshi; Okamoto, Kohji

doi:10.1186/s12959-020-0216-6

Cited by 12 publications

(9 citation statements)

References 35 publications

(46 reference statements)

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“…Infection, trauma, aortic aneurysm and CPA were frequently associated with DIC 17 , 18 ; elevated D-dimer levels were previously reported to be associated with these diseases. 19 , 20 Heart failure is not usually associated with DIC; however, elevated D-dimer levels were observed in patients with heart failure in the present study and in previous studies. 21 The mechanism of D-dimer elevation in patients with heart failure was reported to involve hemostatic abnormality and to predict a poor outcome.…”

Section: Discussioncontrasting

confidence: 50%

Elevated D-Dimer Levels Predict a Poor Outcome in Critically Ill Patients

Ichkawa

Wada

Ezaki

et al. 2020

Clin Appl Thromb Hemost

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D-dimer is a biomarker of thrombosis and recently been considered to predict a poor outcome in patients with infectious diseases. Plasma D-dimer levels were measured in critically ill patients to examine their relationship with the poor outcome. The plasma D-dimer levels were markedly higher in the patients with various underlying disease especially venous thromboembolism in comparison to those without severe underlying diseases. The plasma D-dimer levels in non-survivors were significantly higher than those in survivors. In a receiver operating characteristic analysis, the area under the curve was high for the disseminated intravascular coagulation (DIC) score, the D-dimer value, and the prothrombin time-international normalize ratio (PT-INR). Adequate cut-off values for predicting the outcome were 3 as follows: DIC score, 3 points; D-dimer, 4.2 mg/L; and PT-INR, 1.08. D-dimer, which is a biomarker for thrombosis, is increased in various underlying diseases and predicts a poor outcome.

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Section: Discussioncontrasting

confidence: 50%

Elevated D-Dimer Levels Predict a Poor Outcome in Critically Ill Patients

Ichkawa

Wada

Ezaki

et al. 2020

Clin Appl Thromb Hemost

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“…Coagulation has also an immune function, which can be hence considered another line of defense against severe infections [24]. Therefore, although we find it reasonable that hemostasis is deranged in patients with COVID-19, an excessive consumption of coagulation factors then leads to the risk of developing DIC, which has an obvious negative impact on the prognosis [25,26]. In conclusion, blood coagulation in COVID-19 patients seems to be clearly deranged compared with a healthy control population.…”

Section: Discussionmentioning

confidence: 64%

Prominent changes in blood coagulation of patients with SARS-CoV-2 infection

Han

Yang

et al. 2020

Clinical Chemistry and Laboratory Medicine (CCLM)

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AbstractBackgroundAs the number of patients increases, there is a growing understanding of the form of pneumonia sustained by the 2019 novel coronavirus (SARS-CoV-2), which has caused an outbreak in China. Up to now, clinical features and treatment of patients infected with SARS-CoV-2 have been reported in detail. However, the relationship between SARS-CoV-2 and coagulation has been scarcely addressed. Our aim is to investigate the blood coagulation function of patients with SARS-CoV-2 infection.MethodsIn our study, 94 patients with confirmed SARS-CoV-2 infection were admitted in Renmin Hospital of Wuhan University. We prospectively collect blood coagulation data in these patients and in 40 healthy controls during the same period.ResultsAntithrombin values in patients were lower than that in the control group (p < 0.001). The values of D-dimer, fibrin/fibrinogen degradation products (FDP), and fibrinogen (FIB) in all SARS-CoV-2 cases were substantially higher than those in healthy controls. Moreover, D-dimer and FDP values in patients with severe SARS-CoV-2 infection were higher than those in patients with milder forms. Compared with healthy controls, prothrombin time activity (PT-act) was lower in SARS-CoV-2 patients. Thrombin time in critical SARS-CoV-2 patients was also shorter than that in controls.ConclusionsThe coagulation function in patients with SARS-CoV-2 is significantly deranged compared with healthy people, but monitoring D-dimer and FDP values may be helpful for the early identification of severe cases.

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“…These results imply that severe patients with COVID‐19 possess coagulation dysfunction. This seemingly contradictory result can be explained by that the functions of coagulation, anticoagulation, and fibrinolysis in most of the severe cases with COVID‐19 are simultaneously and negatively affected 6,9,10 . Compared with healthy controls, the dramatically elevated values of FDP and D‐D and significantly reduced values of AT in severe COVID‐19 patients also confirm this conclusion.…”

Section: Discussionmentioning

confidence: 95%

Manifestations of blood coagulation and its relation to clinical outcomes in severe COVID‐19 patients: Retrospective analysis

Zhang

Chen

et al. 2020

Int J Lab Hematology

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Introduction: Characteristics of blood coagulation and its relation to clinical outcomes in COVID-19 patients are still rarely reported. We aimed to investigate the blood coagulation function and its influences on clinical outcomes of patients with syndrome coronavirus 2 (SARS-CoV-2) infection. Methods: A total of 71 severe patients with confirmed SARS-CoV-2 infection who were treated in Wuhan First Hospital from February 12 to March 20, 2020, were enrolled. The blood coagulation data in these patients and in 61 healthy controls were collected. The patients with COVID-19 were divided into two groups: the aggravated group and the nonaggravated group, respectively, basing on whether the patients' conditions turned to critically ill or not after admission. Results: Compared with healthy controls, patients with COVID-19 had significant performances with coagulation dysfunction, including dramatically elevated values of FIB, PT, APTT, INR, FDP, and D-Dimers but markedly reduced AT value (P < .05). Importantly, more noteworthy coagulation disorders similar to the differences between patients and controls were found in the aggravated patients with conditions deterioration after admission than those in the nonaggravated patients without conditions deterioration (P < .05). Moreover, the aggravated patients possessed a longer hospital stay and a higher mortality compared with the nonaggravated patients (P < .001). The coagulation parameters of COVID-19 patients were widely and closely related to the indexes of liver function and inflammation (P < .05), indicating the coagulation dysfunction of these patients may be caused by liver injury and inflammatory storm. Conclusion: Severe patients with SARS-CoV-2 infection often possess coagulation dysfunction on admission. A certain correlation exists in coagulation disorder and adverse clinical outcome among severe COVID-19 patients.

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Analysis of the association between resolution of disseminated intravascular coagulation (DIC) and treatment outcomes in post-marketing surveillance of thrombomodulin alpha for DIC with infectious disease and with hematological malignancy by organ failure

Cited by 12 publications

References 35 publications

Elevated D-Dimer Levels Predict a Poor Outcome in Critically Ill Patients

Elevated D-Dimer Levels Predict a Poor Outcome in Critically Ill Patients

Prominent changes in blood coagulation of patients with SARS-CoV-2 infection

Manifestations of blood coagulation and its relation to clinical outcomes in severe COVID‐19 patients: Retrospective analysis

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