CovidSeniorV1, Main, Curation, bibRecord, 000811

D-dimer surge and coagulation disorders in COVID-19 related pneumonia patients with cardiac injury: A case series.

Identifieur interne : 000811 ( Main/Curation ); précédent : 000810; suivant : 000812

D-dimer surge and coagulation disorders in COVID-19 related pneumonia patients with cardiac injury: A case series.

Auteurs : Xingtong Wang ; Beibei Du [République populaire de Chine] ; Jia Li ; Shunan Wang ; Xiuxiu Wang ; Mengyuan Guo ; Bo Yang [République populaire de Chine] ; Daoyuan Si [République populaire de Chine] ; Ou Bai

Source :

Medicine [ 1536-5964 ] ; 2020.

RBID : pubmed:32756189

Descripteurs français

English descriptors

KwdEn :
- Aged (MeSH), Aged, 80 and over (MeSH), Betacoronavirus (MeSH), Blood Coagulation Disorders (virology), Cardiovascular Diseases (virology), Coronavirus Infections (blood), Coronavirus Infections (complications), Coronavirus Infections (virology), Fatal Outcome (MeSH), Fibrin Fibrinogen Degradation Products (metabolism), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (blood), Pneumonia, Viral (complications), Pneumonia, Viral (virology), Retrospective Studies (MeSH).
MESH :
- chemical , metabolism : Fibrin Fibrinogen Degradation Products.
- blood : Coronavirus Infections, Pneumonia, Viral.
- complications : Coronavirus Infections, Pneumonia, Viral.
- virology : Blood Coagulation Disorders, Cardiovascular Diseases, Coronavirus Infections, Pneumonia, Viral.
- Aged, Aged, 80 and over, Betacoronavirus, Fatal Outcome, Humans, Male, Middle Aged, Pandemics, Retrospective Studies.

Abstract

BACKGROUND

Cardiac injury and coagulation disorders have been two increasing concerns in the management of patients with severe coronavirus disease (COVID-19). Coagulation disorders in COVID-19 patients with cardiac injury have not been characterized.

METHODS

We analyzed the data of five COVID-19 patients with cardiac injury who had D-dimer surge (defined as a rapid increase in the D-dimer level in 72 h, from <5-21 μg/mL) during hospitalization, which were extracted from a registered retrospective study (ChiCTR2000031301). Clinical data and data on changes in coagulation parameters were collected, verified, and characterized.

RESULTS

Among these five patients, four had pre-existing cardiovascular or cerebrovascular diseases. D-dimer surge was accompanied with prolonged prothrombin time (PT) and reduced platelet count (PLT) and fibrinogen level. Three patients had an ISTH DIC score of 5 and met the criteria for overt DIC. All five patients needed invasive ventilation support and were incubated 0 to 6 days after the first D-dimer upper reference limit (URL) was reached. All five patients died within 10 days after the first D-dimer URL was reached. All five patients had observed D-dimer URL results 1 to 3 days before death.

CONCLUSION

D-dimer surge in COVID-19 patients with cardiac injury surely leads to worse in-hospital outcome. D-dimer surge and concomitant DIC can be the leading causes of in-hospital death. Pre-existing cardiovascular or cerebrovascular diseases might pose a higher risk for developing these coagulation disorders. These findings can serve as hypothesis generating and need further clinical trials to confirm.

DOI: 10.1097/MD.0000000000021513
PubMed: 32756189
PubMed Central: PMC7402888

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Xingtong Wang

<affiliation><nlm:affiliation>Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline.</nlm:affiliation>
<wicri:noCountry code="subField">National Key Discipline</wicri:noCountry>
</affiliation>

Jia Li

<affiliation><nlm:affiliation>Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline.</nlm:affiliation>
<wicri:noCountry code="subField">National Key Discipline</wicri:noCountry>
</affiliation>

Shunan Wang

<affiliation><nlm:affiliation>Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline.</nlm:affiliation>
<wicri:noCountry code="subField">National Key Discipline</wicri:noCountry>
</affiliation>

Xiuxiu Wang

<affiliation><nlm:affiliation>Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline.</nlm:affiliation>
<wicri:noCountry code="subField">National Key Discipline</wicri:noCountry>
</affiliation>

Mengyuan Guo

<affiliation><nlm:affiliation>Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline.</nlm:affiliation>
<wicri:noCountry code="subField">National Key Discipline</wicri:noCountry>
</affiliation>

Ou Bai

<affiliation><nlm:affiliation>Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline.</nlm:affiliation>
<wicri:noCountry code="subField">National Key Discipline</wicri:noCountry>
</affiliation>

Le document en format XML

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<term>Aged, 80 and over (MeSH)</term>
<term>Betacoronavirus (MeSH)</term>
<term>Blood Coagulation Disorders (virology)</term>
<term>Cardiovascular Diseases (virology)</term>
<term>Coronavirus Infections (blood)</term>
<term>Coronavirus Infections (complications)</term>
<term>Coronavirus Infections (virology)</term>
<term>Fatal Outcome (MeSH)</term>
<term>Fibrin Fibrinogen Degradation Products (metabolism)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (blood)</term>
<term>Pneumonia, Viral (complications)</term>
<term>Pneumonia, Viral (virology)</term>
<term>Retrospective Studies (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term>
<term>Betacoronavirus (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Infections à coronavirus (complications)</term>
<term>Infections à coronavirus (sang)</term>
<term>Infections à coronavirus (virologie)</term>
<term>Issue fatale (MeSH)</term>
<term>Maladies cardiovasculaires (virologie)</term>
<term>Mâle (MeSH)</term>
<term>Pandémies (MeSH)</term>
<term>Pneumopathie virale (complications)</term>
<term>Pneumopathie virale (sang)</term>
<term>Pneumopathie virale (virologie)</term>
<term>Produits de dégradation de la fibrine et du fibrinogène (métabolisme)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Troubles de l'hémostase et de la coagulation (virologie)</term>
<term>Études rétrospectives (MeSH)</term>
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</keywords>
<keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
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<term>Pneumopathie virale</term>
<term>Produits de dégradation de la fibrine et du fibrinogène</term>
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<keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
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<keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Infections à coronavirus</term>
<term>Maladies cardiovasculaires</term>
<term>Pneumopathie virale</term>
<term>Troubles de l'hémostase et de la coagulation</term>
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<keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Blood Coagulation Disorders</term>
<term>Cardiovascular Diseases</term>
<term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
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<term>Aged, 80 and over</term>
<term>Betacoronavirus</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>Cardiac injury and coagulation disorders have been two increasing concerns in the management of patients with severe coronavirus disease (COVID-19). Coagulation disorders in COVID-19 patients with cardiac injury have not been characterized.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>We analyzed the data of five COVID-19 patients with cardiac injury who had D-dimer surge (defined as a rapid increase in the D-dimer level in 72 h, from <5-21 μg/mL) during hospitalization, which were extracted from a registered retrospective study (ChiCTR2000031301). Clinical data and data on changes in coagulation parameters were collected, verified, and characterized.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Among these five patients, four had pre-existing cardiovascular or cerebrovascular diseases. D-dimer surge was accompanied with prolonged prothrombin time (PT) and reduced platelet count (PLT) and fibrinogen level. Three patients had an ISTH DIC score of 5 and met the criteria for overt DIC. All five patients needed invasive ventilation support and were incubated 0 to 6 days after the first D-dimer upper reference limit (URL) was reached. All five patients died within 10 days after the first D-dimer URL was reached. All five patients had observed D-dimer URL results 1 to 3 days before death.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>D-dimer surge in COVID-19 patients with cardiac injury surely leads to worse in-hospital outcome. D-dimer surge and concomitant DIC can be the leading causes of in-hospital death. Pre-existing cardiovascular or cerebrovascular diseases might pose a higher risk for developing these coagulation disorders. These findings can serve as hypothesis generating and need further clinical trials to confirm.</p>
</div>
</front>
</TEI>
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<DateCompleted><Year>2020</Year>
<Month>08</Month>
<Day>24</Day>
</DateCompleted>
<DateRevised><Year>2020</Year>
<Month>08</Month>
<Day>24</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1536-5964</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>99</Volume>
<Issue>31</Issue>
<PubDate><Year>2020</Year>
<Month>Jul</Month>
<Day>31</Day>
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<Title>Medicine</Title>
<ISOAbbreviation>Medicine (Baltimore)</ISOAbbreviation>
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<ArticleTitle>D-dimer surge and coagulation disorders in COVID-19 related pneumonia patients with cardiac injury: A case series.</ArticleTitle>
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<ELocationID EIdType="doi" ValidYN="Y">10.1097/MD.0000000000021513</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Cardiac injury and coagulation disorders have been two increasing concerns in the management of patients with severe coronavirus disease (COVID-19). Coagulation disorders in COVID-19 patients with cardiac injury have not been characterized.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We analyzed the data of five COVID-19 patients with cardiac injury who had D-dimer surge (defined as a rapid increase in the D-dimer level in 72 h, from <5-21 μg/mL) during hospitalization, which were extracted from a registered retrospective study (ChiCTR2000031301). Clinical data and data on changes in coagulation parameters were collected, verified, and characterized.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Among these five patients, four had pre-existing cardiovascular or cerebrovascular diseases. D-dimer surge was accompanied with prolonged prothrombin time (PT) and reduced platelet count (PLT) and fibrinogen level. Three patients had an ISTH DIC score of 5 and met the criteria for overt DIC. All five patients needed invasive ventilation support and were incubated 0 to 6 days after the first D-dimer upper reference limit (URL) was reached. All five patients died within 10 days after the first D-dimer URL was reached. All five patients had observed D-dimer URL results 1 to 3 days before death.</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">D-dimer surge in COVID-19 patients with cardiac injury surely leads to worse in-hospital outcome. D-dimer surge and concomitant DIC can be the leading causes of in-hospital death. Pre-existing cardiovascular or cerebrovascular diseases might pose a higher risk for developing these coagulation disorders. These findings can serve as hypothesis generating and need further clinical trials to confirm.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Wang</LastName>
<ForeName>Xingtong</ForeName>
<Initials>X</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Du</LastName>
<ForeName>Beibei</ForeName>
<Initials>B</Initials>
<AffiliationInfo><Affiliation>Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Cardiovascular Research Institute, Changchun.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Li</LastName>
<ForeName>Jia</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Wang</LastName>
<ForeName>Shunan</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Wang</LastName>
<ForeName>Xiuxiu</ForeName>
<Initials>X</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Guo</LastName>
<ForeName>MengYuan</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Yang</LastName>
<ForeName>Bo</ForeName>
<Initials>B</Initials>
<AffiliationInfo><Affiliation>Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Si</LastName>
<ForeName>Daoyuan</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Cardiovascular Research Institute, Changchun.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bai</LastName>
<ForeName>Ou</ForeName>
<Initials>O</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType>
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D-dimer surge and coagulation disorders in COVID-19 related pneumonia patients with cardiac injury: A case series.

D-dimer surge and coagulation disorders in COVID-19 related pneumonia patients with cardiac injury: A case series.

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