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Profile of natural anticoagulant, coagulant factor and anti-phospholipid antibody in critically ill COVID-19 patients

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单位: [1]Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Hematol, 1 Shuai Fu Yuan, Beijing 100730, Peoples R China [2]Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Infect Dis, 1 Shuai Fu Yuan, Beijing 100730, Peoples R China [3]Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Med ICU, Beijing 100730, Peoples R China [4]Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Clin Lab, Beijing 100730, Peoples R China [5]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Clin Lab, Wuhan 430030, Hubei, Peoples R China [6]Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Cardiol, Beijing 100730, Peoples R China
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关键词: Critical COVID-19 Coagulopathy Factor VIII Antiphospholipid antibody

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The outbreak of novel coronavirus disease 2019 (COVID-19) has now become a global pandemic. Coagulopathy has been reported widely in critically ill COVID-19 patients and was related to high mortality. However, the comprehensive coagulation profiles have not been examined and the underlying mechanism of the coagulopathy in COVID-19 patients is unclear. To study the coagulation profiles of routine hemostasis tests, natural anticoagulants, coagulant factors and antiphospholipid antibodies in critically ill COVID-19 patients. This single-center and cross-section study included 19 patients with COVID-19, who were admitted to intensive care unit (ICU) at Tongji hospital in Wuhan, China, from Feb 23 to Mar 3, 2020. Demographic data, laboratory parameters, treatments and clinical outcomes of the patients were collected and analyzed. The final date of follow-up was Mar 31, 2020. In this study, 12 thrombotic events occurred in 9 patients, including 4 cerebral infarctions, 7 acro-ischemia and 1 internal jugular vein thrombosis. The common abnormalities of routine coagulation tests included evelated D-Dimer level (100%), prolonged prothrombin time (73.7%) and hyperfibrinogenemia (73.7%). The median activities of natural anticoagulants including protein C, protein S and antithrombin were all below the normal range. Factor VIII activities were significantly above normal range (median value 307%, IQR 198-441) in all patients. Factor V and factor VII activities were significantly lower in near-terminal stage patients. Anti-phospholipid antibodies were present in 10 patients. Strikingly, 4 cerebral infarction events were in patients had anti-phospholipid antibodies of multiple isotypes. Sustained hypercoagulable status and thrombotic events were common in critically ill patients with COVID-19. The low activities of natural anticoagulants, elevated factor VIII level and the presence of antiphospholipid antibodies, together, may contribute to the etiopathology of coagulopathy in COVID-19 patients.

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出版当年[2019]版:
大类 | 3 区 医学
小类 | 4 区 心脏和心血管系统 4 区 血液学 4 区 外周血管病
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 血液学 4 区 心脏和心血管系统 4 区 外周血管病
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出版当年[2018]版:
Q2 PERIPHERAL VASCULAR DISEASE Q2 HEMATOLOGY Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Q2 HEMATOLOGY Q2 PERIPHERAL VASCULAR DISEASE

影响因子: 最新[2023版] 最新五年平均 出版当年[2018版] 出版当年五年平均 出版前一年[2017版] 出版后一年[2019版]

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第一作者单位: [1]Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Hematol, 1 Shuai Fu Yuan, Beijing 100730, Peoples R China
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