Abstract
Coagulation disturbances are common in severe COVID-19 infection. We examined laboratory markers in COVID-19 patients during the first wave of the pandemic in Finland. We analysed a wide panel of coagulation tests (IL ACL TOP 750/500 ® ) from anonymously collected samples of 78 hospitalized COVID-19 patients in intensive care units (ICUs; n = 34) or medical wards ( n = 44) at Helsinki University Hospital in April-May 2020. These coagulation data were supplemented with the laboratory information system results, including complete blood count and C reactive protein (CRP). Coagulation and inflammatory markers were elevated in most: FVIII in 52%, fibrinogen 77%, D-dimer 74%, CRP 94%, platelet count 37%. Anaemia was common, especially in men (73% vs. 44% in women), and overall weakly correlated with FVIII (women R 2 = 0.48, men R 2 = 0.24). ICU patients had higher fibrinogen and D-dimer levels ( p < .01). Men admitted to the ICU also had higher platelet count, leukocytes and FVIII and lower haemoglobin than the non-ICU patients. None of the patients met the disseminated intravascular coagulation (DIC) criteria, but 31% had a D-dimer level of at least 1.5 mg/L. Presence of both anaemia and high D-dimer together with FVIII is independently associated with ICU admission. Antithrombin was reduced in 47% of the patients but did not distinguish severity. Overall, CRP was associated with coagulation activation. Elevated FVIII, fibrinogen and D-dimer reflected a strong inflammatory response and were characteristic of hospitalized COVID-19 patients. The patients were often anaemic, as is typical in severe inflammation, while anaemia was also associated with coagulation activity.
Keywords: Anaemia; COVID-19; blood coagulation; disseminated intravascular coagulation; inflammation.
【저자키워드】 COVID-19, Inflammation, Blood coagulation, Disseminated intravascular coagulation, Anaemia, 【초록키워드】 Inflammation, pandemic, severity, intensive care unit, CRP, D-dimer, ICU, Laboratory, Coagulation, Haemoglobin, complete blood count, Patient, ICU admission, Platelet, fibrinogen, Inflammatory marker, women, information, characteristic, university, First wave, Antithrombin, Blood, hospitalized COVID-19 patient, marker, D-dimer level, Inflammatory response, COVID-19 patient, criteria, leukocyte, coagulation test, C reactive protein, Severe COVID-19 Infection, Activation, hospitalized COVID-19 patients, non-ICU patients, severe inflammation, Helsinki, FVIII, men, ICU patient, collected, examined, the patient, elevated, analysed, reflected, correlated, was reduced, R 2, anonymously, Presence, 【제목키워드】 Coagulation, Severe COVID-19 Infection,