To reveal if coagulopathies relate to the course of COVID-19, we examined 255 patients with moderate and severe COVID-19, receiving anticoagulants and immunosuppressive drugs. Coagulopathy manifested predominantly as hypercoagulability that correlated directly with systemic inflammation, disease severity, comorbidities, and mortality risk. The prolonged clotting tests in about ¼ of cases were associated with high levels of C-reactive protein and antiphospholipid antibodies, which impeded coagulation in vitro. Contraction of blood clots was hindered in about ½ of patients, especially in severe and fatal cases, and correlated directly with prothrombotic parameters. A decrease in platelet contractility was due to moderate thrombocytopenia in combination with platelet dysfunction. Clots with impaired contraction were porous, had a low content of compressed polyhedral erythrocytes (polyhedrocytes) and an even distribution of fibrin, suggesting that the uncompacted intravital clots are more obstructive but patients could also be prone to bleeding. The absence of consumption coagulopathy suggests the predominance of local and/or regional microthrombosis rather than disseminated intravascular coagulation. The results obtained (i) confirm the importance of hemostatic disorders in COVID-19 and their relation to systemic inflammation; (ii) justify monitoring of hemostasis, including the kinetics of blood clot contraction; (iii) substantiate the active prophylaxis of thrombotic complications in COVID-19.
【저자키워드】 Infection, Prognostic markers, 【초록키워드】 COVID-19, antibodies, severe COVID-19, disease severity, Comorbidities, C-reactive protein, Local, in vitro, immunosuppressive drugs, Coagulation, Coagulopathy, Hemostasis, Prophylaxis, Patient, bleeding, Platelet, systemic inflammation, distribution, moderate, parameters, patients, hypercoagulability, Blood, Disseminated intravascular coagulation, Anticoagulant, Combination, mortality risk, blood clot, dysfunction, contraction, erythrocyte, clot, Obstructive, decrease, prothrombotic, thrombotic complication, Course, examined, receiving, absence, correlated, manifested, consumption coagulopathy, hemostatic disorder, patients with moderate, polyhedral, porous, 【제목키워드】 Platelet, moderate-to-severe COVID-19, coagulation function, Altered,