传播性血管内凝血与COVID-19患者的预后不佳有关
Satoshi Gando1,2, Takayuki Akiyama3,4
1Department of Acute and Critical Care Medicine, Sapporo Higashi Tokushukai Hospital, N34, E14, Higashi-ku, Sapporo, 065-0033, Japan. gandoicoud@icloud.com.
Scientific reports
|May 30, 2024
概括
到第15天,传播性血管内凝血 (DIC) 影响超过10%的COVID-19患者. 早期和晚期发作的DIC显著增加器官功能障碍和住院死亡的风险,影响患者的预后.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
背景情况:
- 冠状病毒疾病2019 (COVID-19) 与高风险的血栓性并发症有关.
- 传播性血管内凝血 (DIC) 是一种严重的疾病,其特点是广泛的凝血和出血.
研究的目的:
- 为了确定COVID-19患者中DIC的发病率和临床意义.
- 评估DIC与患者结局之间的关联,包括多器官功能障碍综合征 (MODS) 和住院死亡.
主要方法:
- 一项利用大规模COVID-19注册数据的多中心队列研究.
- 患者被分为DIC和非DIC组,根据入院时的诊断和在15日之前的不同时间点进行分类.
- 进行了统计分析,以评估DIC与不良结果的预测性表现和独立关联.
主要成果:
- 在COVID-19患者中,DIC的发病率在入院时为1.1%,到第15天升至10.9%.
- 入院时的DIC诊断中度预测的MODS和住院死亡.
- 晚发性DIC (诊断在第8天或第15天) 与较低的生存概率和增加的住院死亡显著相关.
结论:
- 尽管最初的发病率很低,但DIC是导致COVID-19患者预后不佳的关键因素.
- 早期,尤其是晚期发病的DIC诊断对于识别高风险个体至关重要.
- 了解DIC在COVID-19病变发生中的作用对于改善患者管理和结果至关重要.
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