tetano
Editor, Senior Moderator
Int J Hematol
. 2022 Feb 16.
doi: 10.1007/s12185-022-03308-w. Online ahead of print.
The balance of comprehensive coagulation and fibrinolytic potential is disrupted in patients with moderate to severe COVID-19
Tomoko Onishi[SUP] #[/SUP][SUP] 1 [/SUP], Naruto Shimonishi[SUP] #[/SUP][SUP] 1 [/SUP], Masahiro Takeyama[SUP] 2 [/SUP], Shoko Furukawa[SUP] 1 [/SUP], Kenichi Ogiwara[SUP] 1 [/SUP], Yuto Nakajima[SUP] 1 [/SUP], Kei Kasahara[SUP] 3 [/SUP], Kenji Nishio[SUP] 4 [/SUP], Kiyomi Yoshimoto[SUP] 4 [/SUP], Satoki Inoue[SUP] 5 [/SUP], Masahiko Kawaguchi[SUP] 5 [/SUP], Hidetada Fukushima[SUP] 6 [/SUP], Yoshihiko Saito[SUP] 7 [/SUP], Hitoshi Yoshiji[SUP] 8 [/SUP], Shigeo Muro[SUP] 9 [/SUP], Kazuhiko Tsuruya[SUP] 10 [/SUP], Sadanori Okada[SUP] 11 [/SUP], Kazuma Sugie[SUP] 12 [/SUP], Ryuji Kawaguchi[SUP] 13 [/SUP], Toshiya Nishikubo[SUP] 14 [/SUP], Masaharu Yamazaki[SUP] 15 [/SUP], Yukio Oda[SUP] 16 [/SUP], Toshiki Kawabe[SUP] 16 [/SUP], Kengo Onishi[SUP] 16 [/SUP], Tomohisa Nishio[SUP] 16 [/SUP], Keiji Nogami[SUP] 1 [/SUP]
Affiliations
Abstract
Coagulation and fibrinolytic mechanisms are enhanced in patients with coronavirus (COVID-19), but disturbances in the balance of both functions in COVID-19 patients remain unclear. We assessed global coagulation and fibrinolysis in plasma from 167 COVID-19 patients (mild/moderate/severe: 62/88/17, respectively) on admission using clot-fibrinolysis waveform analysis (CFWA). Maximum coagulation velocity (|min1|) and maximum fibrinolysis velocity (|FL-min1|) were expressed as ratios relative to normal plasma. Ten patients (6.0%) developed thrombosis, 5 (3.0%) had bleeding tendency, and 13 (7.8%) died during admission. FDP levels increased with severity of COVID-19 symptoms (mild/moderate/severe; median 2.7/4.9/9.9 μg/mL, respectively). The |min1| ratios were elevated in all categories (1.27/1.61/1.58) in keeping with enhanced coagulation potential, with significant differences between mild cases and moderate to severe cases. The |FL-min1| ratios were also elevated in all groups (1.19/1.39/1.40), reflecting enhanced fibrinolytic potential. These data identified coagulation dominance in moderate to severe cases, but balanced coagulation and fibrinolysis in mild cases. There were significant differences in FDP and TAT, but no significant differences in |min1| or |FL-min1| ratios, between patients with and without thrombosis. CFWA monitoring of coagulation and fibrinolysis dynamics could provide valuable data for understanding hemostatic changes and disease status in COVID-19 patients.
Keywords: COVID-19; Coagulation; Fibrinolysis; Monitoring; Severity.
. 2022 Feb 16.
doi: 10.1007/s12185-022-03308-w. Online ahead of print.
The balance of comprehensive coagulation and fibrinolytic potential is disrupted in patients with moderate to severe COVID-19
Tomoko Onishi[SUP] #[/SUP][SUP] 1 [/SUP], Naruto Shimonishi[SUP] #[/SUP][SUP] 1 [/SUP], Masahiro Takeyama[SUP] 2 [/SUP], Shoko Furukawa[SUP] 1 [/SUP], Kenichi Ogiwara[SUP] 1 [/SUP], Yuto Nakajima[SUP] 1 [/SUP], Kei Kasahara[SUP] 3 [/SUP], Kenji Nishio[SUP] 4 [/SUP], Kiyomi Yoshimoto[SUP] 4 [/SUP], Satoki Inoue[SUP] 5 [/SUP], Masahiko Kawaguchi[SUP] 5 [/SUP], Hidetada Fukushima[SUP] 6 [/SUP], Yoshihiko Saito[SUP] 7 [/SUP], Hitoshi Yoshiji[SUP] 8 [/SUP], Shigeo Muro[SUP] 9 [/SUP], Kazuhiko Tsuruya[SUP] 10 [/SUP], Sadanori Okada[SUP] 11 [/SUP], Kazuma Sugie[SUP] 12 [/SUP], Ryuji Kawaguchi[SUP] 13 [/SUP], Toshiya Nishikubo[SUP] 14 [/SUP], Masaharu Yamazaki[SUP] 15 [/SUP], Yukio Oda[SUP] 16 [/SUP], Toshiki Kawabe[SUP] 16 [/SUP], Kengo Onishi[SUP] 16 [/SUP], Tomohisa Nishio[SUP] 16 [/SUP], Keiji Nogami[SUP] 1 [/SUP]
Affiliations
- PMID: 35171446
- DOI: 10.1007/s12185-022-03308-w
Abstract
Coagulation and fibrinolytic mechanisms are enhanced in patients with coronavirus (COVID-19), but disturbances in the balance of both functions in COVID-19 patients remain unclear. We assessed global coagulation and fibrinolysis in plasma from 167 COVID-19 patients (mild/moderate/severe: 62/88/17, respectively) on admission using clot-fibrinolysis waveform analysis (CFWA). Maximum coagulation velocity (|min1|) and maximum fibrinolysis velocity (|FL-min1|) were expressed as ratios relative to normal plasma. Ten patients (6.0%) developed thrombosis, 5 (3.0%) had bleeding tendency, and 13 (7.8%) died during admission. FDP levels increased with severity of COVID-19 symptoms (mild/moderate/severe; median 2.7/4.9/9.9 μg/mL, respectively). The |min1| ratios were elevated in all categories (1.27/1.61/1.58) in keeping with enhanced coagulation potential, with significant differences between mild cases and moderate to severe cases. The |FL-min1| ratios were also elevated in all groups (1.19/1.39/1.40), reflecting enhanced fibrinolytic potential. These data identified coagulation dominance in moderate to severe cases, but balanced coagulation and fibrinolysis in mild cases. There were significant differences in FDP and TAT, but no significant differences in |min1| or |FL-min1| ratios, between patients with and without thrombosis. CFWA monitoring of coagulation and fibrinolysis dynamics could provide valuable data for understanding hemostatic changes and disease status in COVID-19 patients.
Keywords: COVID-19; Coagulation; Fibrinolysis; Monitoring; Severity.