Hemostatic Abnormalities in COVID-19: An Update

Aggarwal, Mukul; Dass, Jasmita; Mahapatra, Manoranjan

doi:10.1007/s12288-020-01328-2

Cited by 37 publications

(48 citation statements)

References 65 publications

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“…Higher levels of other biomarkers, such as serum D-dimer, ferritin, and procalcitonin are accompanied by poor prognosis (Huang et al 2020c). Increased d-dimer may reflect the progress of DVT and/or pulmonary embolism, and can predict both severity and mortality of disease (Aggarwal et al 2020). More recently, high serum concentrations of cortisol were reported to be attributed to the severity of disease and poor prognosis of treatment in critically ill COVID-19 patients (Tan et al 2020b).…”

Section: Features Of Hematological Abnormalities In Covid-19mentioning

confidence: 99%

COVID-19 and multiorgan failure: A narrative review on potential mechanisms

et al. 2020

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The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) in December 2019 form Wuhan, China leads to coronavirus disease 2019 (COVID-19) pandemic. While the common cold symptoms are observed in mild cases, COVID-19 is accompanied by multiorgan failure in severe patients. The involvement of different organs in severe patients results in lengthening the hospitalization duration and increasing the mortality rate. In this review, we aimed to investigate the involvement of different organs in COVID-19 patients, particularly in severe cases. Also, we tried to define the potential underlying mechanisms of SARS-CoV2 induced multiorgan failure. The multi-organ dysfunction is characterized by acute lung failure, acute liver failure, acute kidney injury, cardiovascular disease, and as well as a wide spectrum of hematological abnormalities and neurological disorders. The most important mechanisms are related to the direct and indirect pathogenic features of SARS-CoV2. Although the presence of angiotensin-converting enzyme 2, a receptor of SARS-CoV2 in the lung, heart, kidney, testis, liver, lymphocytes, and nervous system was confirmed, there are controversial findings to about the observation of SARS-CoV2 RNA in these organs. Moreover, the organ failure may be induced by the cytokine storm, a result of increased levels of inflammatory mediators, endothelial dysfunction, coagulation abnormalities, and infiltration of inflammatory cells into the organs. Therefore, further investigations are needed to detect the exact mechanisms of pathogenesis. Since the involvement of several organs in COVID-19 patients is important for clinicians, increasing their knowledge may help to improve the outcomes and decrease the rate of mortality and morbidity.

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Section: Features Of Hematological Abnormalities In Covid-19mentioning

confidence: 99%

COVID-19 and multiorgan failure: A narrative review on potential mechanisms

et al. 2020

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“…Typical coagulation testing findings in COVID-19 infection include a normal or slightly prolonged prothrombin time (PT) and activated plasma thromboplastin time (aPTT) in mild disease, to marked prolongation of PT and aPTT in severe disease [34]. Platelet counts can be normal to slightly increased in mild illness and markedly reduced in severe disease [35].…”

Section: Laboratory Findings and Prognostic Implicationmentioning

confidence: 99%

Hematologic disorders associated with COVID-19: a review

et al. 2021

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Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2. Primarily an infection of the lower respiratory tract, it is now well known to cause multisystem abnormalities. Hematologic manifestations constitute a significant area of concern. Severe acute respiratory syndrome coronavirus 2 infects monocytes and endothelial cells leading to a complex downstream cascade, cytokine storm, and eventual intravascular thrombosis. Coronavirus disease 2019 causes lymphopenia, neutrophilia, and thrombocytopenia. Prophylactic anticoagulation is vital in patients with coronavirus disease 2019, as its effect on the coagulation system is associated with significant morbidity and mortality. The disease can cause both arterial and venous thromboses, especially pulmonary embolism and pulmonary microthrombi. A high index of suspicion is indispensable in recognizing these complications, and timely institution of therapeutic anticoagulation is vital in treating them. Virus-induced disseminated intravascular coagulation is uncommon but shares some similarities to sepsis-induced disseminated intravascular coagulation. Marked elevations in hematologic biomarkers such as lactate dehydrogenase, D-dimer, ferritin, and C-reactive protein are associated with worse outcomes. Understanding the pathophysiology and recognizing factors associated with poor prognosis are crucial in improving patient outcomes with coronavirus disease 2019.

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“…Nearly 20% of patients, with COVID infection, become critically ill, with high mortality, ranging from 8% to 33%. [1][2][3] Excessive inflammation, platelet activation, endothelial dysfunction, hypercoagulability, and sepsis, along with many others, are held responsible for patho-physiological events in COVID infection. Inturn, these translate into different findings, which predict the course and prognosis of the disease.…”

Section: Introductionmentioning

confidence: 99%

Predictive Efficacy of Haematological Biomarkers in COVID-19 infection

Ikram¹

2023

JRMC

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Introduction: The ongoing Corona Virus Pandemic is linked with high rates of morbidity and mortality globally. Early and effective predictors of clinical outcomes are urgently required to develop effective management protocols.Objective: To investigate the predictive efficacy of haematological biomarkers in Covid -19 infectionMethods: Blood samples were drawn from COVID‐19 infected pneumonia patients. Baseline clinical information was collected and quantification of hemostatic variable was done. Laboratory data both groups expired and recovered were compared using t- test, Mann Whitney- U test, chi squared-test and Kruskal Wallis test. Multivariate regression analysis was performed to determine the independent contribution of haematological variable in Covid19 related mortality. Receiver operating characteristic curve were drawn to find the predictive efficacy of significantly related parameters.Results: Out of 191 patients 68.1% were male. D‐dimer (median 800 ng/mL; IQR 200‐3200) and NLR (median 10.40; IQR 3.20-22.80) were found to be predominantly raised and significantly correlated with Covid mortality in multivariate regression analysis. The optimum cutoff value of D-dimer to predict in-hospital mortality was 450 ng/ml with a sensitivity of 71.6% and a specificity of 95.8%. The optimum cutoff value of NLR to predict in-hospital mortality was 5.450 with a sensitivity of 70.1% and a specificity of 71%.Conclusion: D-dimer and NLR could be used as the signiﬁcant indicators in predicting the mortality of COVID-19.

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Hemostatic Abnormalities in COVID-19: An Update

Cited by 37 publications

References 65 publications

COVID-19 and multiorgan failure: A narrative review on potential mechanisms

COVID-19 and multiorgan failure: A narrative review on potential mechanisms

Hematologic disorders associated with COVID-19: a review

Predictive Efficacy of Haematological Biomarkers in COVID-19 infection

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