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Author Spotlight: Deciphering Coagulation Disorders in Traumatic Brain Injury Patients
Published on: August 4, 2023
Coagulopathy is associated with multiple organ damage and prognosis of COVID-19
Rui Zhang1, Yani Liu1, Bei Zhang2
1Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, PR China.
Insights
Coagulopathy, a blood clotting issue, significantly increases the risk of organ damage and mortality in hospitalized COVID-19 patients. Early detection and anticoagulant therapy may improve survival rates for these critically ill individuals.
Area of Science:
- Internal Medicine
- Hematology
- Infectious Diseases
Background:
- Severe COVID-19 is linked to high mortality rates and multi-organ damage.
- Coagulopathy affects a significant portion of hospitalized COVID-19 patients, contributing to poor outcomes.
Purpose of the Study:
- To investigate the association between coagulopathy and organ dysfunction in COVID-19 patients.
- To identify factors associated with coagulopathy and its impact on mortality.
Main Methods:
- Retrospective analysis of 198 hospitalized COVID-19 patients.
- Multivariable regression to assess the relationship between coagulopathy and organ dysfunction (liver, renal, ARDS).
- Analysis of clinical factors, inflammatory markers (IL-6, CRP), and mortality.
Main Results:
- Coagulopathy was present in 32.8% of patients and strongly associated with acute liver injury, renal dysfunction, and ARDS.
- Mortality was substantially higher in patients with coagulopathy (65%) compared to those without (3.76%).
- Hypertension, leukocytosis, and elevated CRP were linked to increased odds of coagulopathy.
Conclusions:
- Coagulopathy, including overt and non-overt DIC, is associated with multi-organ dysfunction and increased mortality in COVID-19.
- Anticoagulant therapy is suggested as a potential intervention to mitigate organ damage and improve survival in COVID-19 patients with coagulopathy.
Abstract:
Mortality rate is high with COVID-19. Multiple organ damage is a common and lethal complication of the severe COVID-19 patients. Of 198 recruited participants, 65 patients (32.8 %) had coagulopathy. In this retrospective study, we analyzed the association of coagulopathy with organ dysfunction in hospitalized COVID-19 patients. The incidence of coagulopathy was associated with increased odds of acute liver injury, renal dysfunction and acute respiratory distress syndrome (ARDS) by multivariable regression. Overall mortality was 65 % for the patients with coagulopathy and 3.76 % for the patients without coagulopathy. History of hypertension, leukocytosis and elevated CRP concentrations were associated with higher odds of coagulopathy. Patients with coagulopathy had similar levels of hepatic and renal functional enzymes prior to the onset of coagulopathy as the patients without coagulopathy, suggesting that coagulopathy is an association of the progression of multi-organ dysfunction in COVID-19. Plasma IL-6 was higher in patients with coagulopathy than controls, but it's not a risk factor for organ dysfunction by logistic regression. The present study shows that coagulopathy, overt DIC and non-overt DIC, associates with organ dysfunction and higher mortality rate in COVID-19. Thus, anticoagulant therapy may prevent organ dysfunction and increase survival rate in COVID-19.
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