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Author Spotlight: Deciphering Coagulation Disorders in Traumatic Brain Injury Patients
Published on: August 4, 2023
Changes of coagulation function and risk of stroke in patients with COVID-19
Feng Qiu1, Yue Wu2, Aiqing Zhang3
1Cerebrovascular Disease Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu Province, China.
Insights
COVID-19 patients, especially severe cases, show altered blood coagulation, increasing stroke risk. This highlights the need for monitoring coagulation in these patients to prevent cerebrovascular events.
Area of Science:
- Infectious Diseases
- Hematology
- Neurology
Background:
- COVID-19 pandemic presents a global health challenge.
- A link exists between SARS-CoV-2 infection and biochemical changes, particularly coagulation.
- Infections can induce hypercoagulable states, potentially leading to cerebrovascular diseases.
Purpose of the Study:
- To investigate the impact of COVID-19 on coagulation functions.
- To assess neurological function and stroke risk in COVID-19 patients.
- To identify associations between stroke risk and clinical/laboratory parameters in COVID-19.
Main Methods:
- Study included 193 COVID-19 patients, categorized into non-severe (143) and severe (50) groups.
- Evaluated laboratory tests: routine blood counts, inflammatory markers (CRP, ESR), electrolytes, and coagulation profiles.
- Assessed neurological function using Glasgow scores and stroke risk via Framingham Stroke Risk Profile.
Main Results:
- Severe COVID-19 patients exhibited elevated white blood cells, neutrophils, IL-6, ESR, and CRP compared to non-severe patients.
- Significant increases in coagulation parameters (PT, INR, aPTT, TT, D-dimer, FDPs) were observed in severe cases.
- Severe patients had higher stroke risk scores and lower Glasgow scores, with stroke risk associated with age, blood counts, and coagulation markers.
Conclusions:
- COVID-19 significantly affects blood coagulation, leading to a hypercoagulable state.
- This hypercoagulable state in COVID-19 patients is associated with an increased risk of stroke.
- Close monitoring of coagulation and stroke risk is crucial for severe COVID-19 patients.
Background And Purpose:
COVID-19 is spreading throughout the whole world as a public health issue. There is a link between the new coronavirus and changes in biochemical indicators, such as coagulation functions. Hypercoagulable state of blood caused by infections may lead to cerebrovascular diseases. More attention should be paid to patients with COVID-19, especially critically ill individuals with history of cerebrovascular disease who may have high risk of stroke.
Methods:
193 patients with COVID-19 were enrolled in the study. These patients were categorized into nonsevere (143 patients) and severe (50 patients) groups. This study evaluated laboratory tests, including routine blood tests, C-reactive protein, erythrocyte sedimentation rate, electrolytes, and coagulation functions. Furthermore, neurological function and stroke risks were evaluated in this study.
Results:
Compared to the nonsevere group, there were increases in white blood cells, neutrophil count, interleukin-6, erythrocyte sedimentation rate, and C-reactive protein in the severe group (p < .05). For coagulation functions, parameters like prothrombin time, international normalized ratio, activated partial thromboplastin time, thrombin time, D-dimer, and fibrin degradation products were increased significantly in the severe group (p < .01). Severe patients also demonstrated higher scores on the Framingham stroke risk profile and lower Glasgow scores (p < .05). Furthermore, significant associations were noticed between stroke risk and age, blood cell count, neutrophil count, D-dimmer, and fibrin degradation productions (p < .05).
Conclusions:
Data suggested that coagulation functions were affected in patients with COVID-19. Hypercoagulable state in patients may lead to potential high risk of stroke.
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