The clinical and prognostic role of changes in parameters of the hemostasis system and C-reactive protein in the development of thrombotic complications in oxygen-dependent patients with coronavirus disease (COVID-19)
Aim. The purpose of our work was to find out the clinical and prognostic role of changes in hemostasis parameters and C-reactive protein (CRP) in the development of thrombotic complications in oxygen-dependent patients with coronavirus disease (COVID-19). Materials and methods. 211 oxygen-depende...
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Zaporizhzhia State Medical and Pharmaceutical University
2023-04-01
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| Online Access: | http://pat.zsmu.edu.ua/article/view/274921/273006 |
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| author | V. V. Cherkaskyi O. V. Riabokon |
| author_facet | V. V. Cherkaskyi O. V. Riabokon |
| author_sort | V. V. Cherkaskyi |
| collection | DOAJ |
| description | Aim. The purpose of our work was to find out the clinical and prognostic role of changes in hemostasis parameters and C-reactive protein (CRP) in the development of thrombotic complications in oxygen-dependent patients with coronavirus disease (COVID-19).
Materials and methods. 211 oxygen-dependent patients with COVID-19 were examined. To assess the prognostic role of changes in hemostasis parameters and CRP, patients were divided into groups: I group – 94 patients who recovered, II group – 117 patients who died. Subgroups: II-A subgroup – 35 patients with thrombotic complications and II-B subgroup – 82 patients without these complications. All patients were examined and received treatment according to the normative documents in force at the relevant time.
Results. The frequency of thrombotic complications in oxygen-dependent patients with COVID-19 was 16.6 %, among which the most common were pulmonary embolism (6.6 %), myocardial infarction (6.2 %), and ischemic stroke (3.2 %). Lifetime diagnosis of thrombotic complications took place on the 18th [16.0; 24.0] day of illness in 45.9 % of cases. Deathtime diagnosis of thrombotic complications took place on the 24th [20.0; 28.0] day of illness in 54.1 % of cases. Lifetime pulmonary artery thromboembolism was diagnosed less frequently than ischemic stroke (p = 0.002) and myocardial infarction (p = 0.02).
With the development of oxygen dependence and admission to the intensive care unit on the 9th [8.0; 11.0] day of illness, changes in the hemostasis system were characterized as prothrombotic with an increase above the reference values of fibrinogen and D-dimer in patients of all groups. CRP in patients with fatal outcomes of the disease, regardless of the development of thrombotic complications, was higher (p < 0.05) than in patients who subsequently recovered, and was accordingly in patients of the I group – 67.65 [41.20; 139.95] mg/l, in the II-A group – 122.2 [61.2; 178.0] mg/l, and in patients of the II-B group – 109.8 [56.3; 180.0] mg/l.
In the dynamics of complex treatment after 5–7 days, the level of fibrinogen, D-dimer and CRP had a diagnostic value in predicting the further development of thrombotic complications. With an increase in the level of fibrinogen >4.6 g/l (AUC = 0.600, p = 0.042), D-dimer >2.1 μg/ml (AUC = 0.704, p = 0.001) and CRP >89.3 mg/l (AUC = 0.720, p < 0.001) the probability of developing thrombotic complications was significant.
Conclusions. In dynamics of complex treatment of oxygen-dependent patients after 5–7 days, the levels of fibrinogen, D-dimer and C-reactive protein had consistent diagnostic value in predicting further development of thrombotic complications. Increased fibrinogen >4.6 g/l, D-dimer >2.1 μg/ml, and CRP >89.3 mg/l were important for predicting the risk of developing thrombotic complications.
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| format | Article |
| id | doaj-art-e0ec5381d6c64efcb15495a0e4715448 |
| institution | OA Journals |
| issn | 2306-8027 2310-1237 |
| language | English |
| publishDate | 2023-04-01 |
| publisher | Zaporizhzhia State Medical and Pharmaceutical University |
| record_format | Article |
| series | Patologìâ |
| spelling | doaj-art-e0ec5381d6c64efcb15495a0e47154482025-08-20T02:21:29ZengZaporizhzhia State Medical and Pharmaceutical UniversityPatologìâ2306-80272310-12372023-04-01201273510.14739/2310-1237.2023.1.274921The clinical and prognostic role of changes in parameters of the hemostasis system and C-reactive protein in the development of thrombotic complications in oxygen-dependent patients with coronavirus disease (COVID-19)V. V. Cherkaskyi0https://orcid.org/0000-0003-2959-8803O. V. Riabokon1https://orcid.org/0000-0001-7781-991XZaporizhzhia State Medical University, UkraineZaporizhzhia State Medical University, UkraineAim. The purpose of our work was to find out the clinical and prognostic role of changes in hemostasis parameters and C-reactive protein (CRP) in the development of thrombotic complications in oxygen-dependent patients with coronavirus disease (COVID-19). Materials and methods. 211 oxygen-dependent patients with COVID-19 were examined. To assess the prognostic role of changes in hemostasis parameters and CRP, patients were divided into groups: I group – 94 patients who recovered, II group – 117 patients who died. Subgroups: II-A subgroup – 35 patients with thrombotic complications and II-B subgroup – 82 patients without these complications. All patients were examined and received treatment according to the normative documents in force at the relevant time. Results. The frequency of thrombotic complications in oxygen-dependent patients with COVID-19 was 16.6 %, among which the most common were pulmonary embolism (6.6 %), myocardial infarction (6.2 %), and ischemic stroke (3.2 %). Lifetime diagnosis of thrombotic complications took place on the 18th [16.0; 24.0] day of illness in 45.9 % of cases. Deathtime diagnosis of thrombotic complications took place on the 24th [20.0; 28.0] day of illness in 54.1 % of cases. Lifetime pulmonary artery thromboembolism was diagnosed less frequently than ischemic stroke (p = 0.002) and myocardial infarction (p = 0.02). With the development of oxygen dependence and admission to the intensive care unit on the 9th [8.0; 11.0] day of illness, changes in the hemostasis system were characterized as prothrombotic with an increase above the reference values of fibrinogen and D-dimer in patients of all groups. CRP in patients with fatal outcomes of the disease, regardless of the development of thrombotic complications, was higher (p < 0.05) than in patients who subsequently recovered, and was accordingly in patients of the I group – 67.65 [41.20; 139.95] mg/l, in the II-A group – 122.2 [61.2; 178.0] mg/l, and in patients of the II-B group – 109.8 [56.3; 180.0] mg/l. In the dynamics of complex treatment after 5–7 days, the level of fibrinogen, D-dimer and CRP had a diagnostic value in predicting the further development of thrombotic complications. With an increase in the level of fibrinogen >4.6 g/l (AUC = 0.600, p = 0.042), D-dimer >2.1 μg/ml (AUC = 0.704, p = 0.001) and CRP >89.3 mg/l (AUC = 0.720, p < 0.001) the probability of developing thrombotic complications was significant. Conclusions. In dynamics of complex treatment of oxygen-dependent patients after 5–7 days, the levels of fibrinogen, D-dimer and C-reactive protein had consistent diagnostic value in predicting further development of thrombotic complications. Increased fibrinogen >4.6 g/l, D-dimer >2.1 μg/ml, and CRP >89.3 mg/l were important for predicting the risk of developing thrombotic complications. http://pat.zsmu.edu.ua/article/view/274921/273006covid-19viral infectionthrombotic complicationsdiagnosishemostasisc-reactive proteinrisk factorsprognosis |
| spellingShingle | V. V. Cherkaskyi O. V. Riabokon The clinical and prognostic role of changes in parameters of the hemostasis system and C-reactive protein in the development of thrombotic complications in oxygen-dependent patients with coronavirus disease (COVID-19) Patologìâ covid-19 viral infection thrombotic complications diagnosis hemostasis c-reactive protein risk factors prognosis |
| title | The clinical and prognostic role of changes in parameters of the hemostasis system and C-reactive protein in the development of thrombotic complications in oxygen-dependent patients with coronavirus disease (COVID-19) |
| title_full | The clinical and prognostic role of changes in parameters of the hemostasis system and C-reactive protein in the development of thrombotic complications in oxygen-dependent patients with coronavirus disease (COVID-19) |
| title_fullStr | The clinical and prognostic role of changes in parameters of the hemostasis system and C-reactive protein in the development of thrombotic complications in oxygen-dependent patients with coronavirus disease (COVID-19) |
| title_full_unstemmed | The clinical and prognostic role of changes in parameters of the hemostasis system and C-reactive protein in the development of thrombotic complications in oxygen-dependent patients with coronavirus disease (COVID-19) |
| title_short | The clinical and prognostic role of changes in parameters of the hemostasis system and C-reactive protein in the development of thrombotic complications in oxygen-dependent patients with coronavirus disease (COVID-19) |
| title_sort | clinical and prognostic role of changes in parameters of the hemostasis system and c reactive protein in the development of thrombotic complications in oxygen dependent patients with coronavirus disease covid 19 |
| topic | covid-19 viral infection thrombotic complications diagnosis hemostasis c-reactive protein risk factors prognosis |
| url | http://pat.zsmu.edu.ua/article/view/274921/273006 |
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