Premium
COVID‐19 coagulopathy: An in‐depth analysis of the coagulation system
Author(s) -
MartínRojas Reyes María,
PérezRus Gloria,
DelgadoPinos Valeria Estefania,
DomingoGonzález Amalia,
RegaladoArtamendi Isabel,
AlbaUrdiales Natalia,
DemeloRodríguez Pablo,
Monsalvo Silvia,
RodríguezMacías Gabriela,
Ballesteros Monica,
OsorioPrendes Santiago,
DíezMartín José Luis,
Pascual Izquierdo Cristina
Publication year - 2020
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13501
Subject(s) - coagulopathy , coagulation , medicine , disseminated intravascular coagulation , covid-19 , thrombosis , gastroenterology , pneumonia , d dimer , coagulation disorder , coagulation testing , coagulation system , disease , infectious disease (medical specialty)
Background Abnormal coagulation parameters have been reported in COVID‐19‐infected patients. Although the underlying mechanism of COVID‐19 coagulopathy remains unknown, it has been suggested to be a form of disseminated intravascular coagulation (DIC). Objectives The aim of our study was to analyze the coagulation parameters of patients with COVID‐19, determine whether coagulation factors consumption occurs and identify potential prognostic biomarkers of the disease. Patients/Methods Blood samples from hospitalized patients with COVID‐19 pneumonia were collected. We performed basic coagulation tests and quantification of coagulation factors and physiological inhibitor proteins. Laboratory data were compared with clinical data and outcomes. Results The study involved 206 patients (63.6% male). D‐dimer was particularly elevated (median 450 ng/mL; IQR 222.5‐957.3). Free protein S levels were below the normal range (median 56.6%; IQR: 43.6‐68.9), and factor VIII showed an increasing trend (median 173.4%; IQR: 144.1‐214.9). However, all coagulation factors were within normal limits. We found no correlation between abnormal coagulation parameters and thrombosis, except for higher D‐dimer (HR 1.99; 95% CI 1.3‐3.1; P = .002). Conclusions COVID‐19 is associated with coagulopathy that correlates with poor prognosis. However, we did not demonstrate a consumption of coagulation factors, as seen in DIC.